Sustain Your Brain
Natural therapies can support cognitive function now and into the senior years

By Jill Stansbury, ND

You know you've never met this person before—in fact, you worked in the same building at one time—but her name has fled your mind. At dinner, you tell your visiting son a memory you've just recalled; he rolls his eyes, because he's heard it a dozen times already. And didn't you once memorize your PIN for the ATM?

Losing one's mental faculties is high on the aging population's list of fears. This concern isn't unfounded or irrational, with recent research indicating that Alzheimer's disease and other forms of senile dementia may affect up to 47 percent of all people older than 80. But natural methods abound for coping with, delaying or even avoiding age-related mental decline. Promising research is revealing the role of nutrition, herbs and supplements in treating and preventing cognitive impairment.

Certain types of mental atrophy result from such factors as allergies, stress and low nutrient levels, as well as exposure to toxins and oxidizing agents—all of which appear to contribute to brain inflammation, scarring and loss of mental faculties. The inflammatory process creates chemicals such as free radicals that cause oxygen-induced cell damage, which may hasten senile dementia. Exposure to free radicals can be especially damaging when brain tissues lack adequate levels of antioxidants and other nutrients necessary to defend against chronic inflammation. The aging brain may have low levels of such nutrients for several reasons, including poor diet or inadequate nutrient absorption.

Antioxidants And B Vitamins
To fortify the brain's defenses, antioxidants and B vitamins should top anyone's list of brain foods. Animal studies have shown that antioxidant levels in the brain decline with age; the lowest levels are associated with the greatest brain impairment. Antioxidant nutrients such as beta-carotene, bioflavonoids, essential fatty acids, selenium, vitamins C and E, and zinc all reduce inflammation. Scores of foods, including most fruits and vegetables, boast high levels of antioxidants. Green tea appears particularly promising, exhibiting antioxidant properties that may also help protect the central nervous system from the damage caused by oxidation.

Research indicates that B-vitamin deficiencies can lead to psychosis and cognitive impairment. For example, vitamin B1 (thiamin) deficiency is linked to the personality disorder known as Korsakoff's Syndrome, and low levels of vitamin B3 (niacin) are associated with delirium, dementia and memory deficits. Vitamin B6, which helps transform amino acids into monoamines, an important group of neurotransmitters, may be depleted by hormone replacement therapy and birth control pills. Consequently, scientists believe many hormone-induced mental or emotional disturbances may be improved with B6 supplementation. Abnormally low levels of vitamin B12 are associated with Alzheimer's disease, while folic acid deficiency is linked to forgetfulness, psychosis, dementia and Alzheimer's—further indicators that B vitamins are essential for nervous system and brain health.

More Brain Boosters
In addition to antioxidants and B vitamins, researchers suggest that a host of brain-friendly supplements may help reduce inflammatory damage to the central nervous system as well as prevent and treat impaired brain function.

Acetyl-L-carnitine, an amino acid important to cellular energy production, has become a central focus in neurodegenerative disease research. ALC is one form of carnitine, a vitamin-like compound, and is structurally similar to the neurotransmitter acetylcholine, a critical player in nerve/muscle communication, concentration, memory and learning. In fact, acetylcholine is so central to mental function that the leading pharmaceutical drugs used for senility are aimed at elevating its levels in the brain. ALC supplementation improves general metabolism in many organ systems, including the nervous system, and may improve mental function by enhancing membrane stability, energy production and nerve transmission. In addition, ALC may also have anti-inflammatory effects that reduce the generation of free radicals in the body.

In a double-blind study in Italy, 236 elderly patients with mild senility were treated with either 1,500 mg ALC or placebo. The ALC group showed significant improvements in memory and cognition compared with controls (La Clinica Terapeutica, 1990, vol. 132, no. 6). In several smaller studies, researchers have noted ALC's positive effects on cognitive function in Alzheimer's disease patients. In one double-blind trial, researchers concluded that short-term, intensive (3,000 mg per day) ALC treatment could improve symptoms of senility without significant side effects (International Journal of Clinical Pharmacology, Therapy and Toxicology, 1986, vol. 24, no. 9).

Alpha-lipoic acid (ALA) has been researched since the 1950s as a treatment for Alzheimer's and Parkinson's diseases. Both fat- and water-soluble, ALA travels throughout the body and may protect cells by enhancing other detoxifying agents such as glutathione, which serves as an antioxidant in brain tissues. ALA contributes to numerous metabolic functions including energy production in muscles, glucose metabolism, liver function and nervous system function, all of which affect the brain.

Docosahexaenoic acid (DHA), an omega-3 fatty acid, is a primary building block of the brain. Adequate levels of DHA are necessary for proper neurotransmissions, and deficiencies of this essential fat have been linked to memory loss and depression. In a 1995 study in Europe, 494 elderly people treated for six months with 90 mg per day DHA (contained in 300 mg bovine phosphatidylserine) showed marked improvement in apathy and social withdrawal symptoms (Aging: Clinical and Experimental Research, 1993, vol. 5, no. 2).

Huperzine A (HupA), a purified compound isolated from Chinese club moss (Huperzia serrata), may benefit memory and cognition in several ways. Numerous studies indicate that HupA has a highly selective affinity for acetylcholinesterase (an enzyme that breaks down unused acetylcholine), thus slowing acetylcholine's degeneration. HupA may also be useful in cases of dementia and memory impairment. HupA appears to act quickly and remain active for many hours, and repeated doses do not appear to promote tolerance or unresponsiveness. An added bonus: HupA trials have not shown significant toxicity or side effects.

Phosphatidylserine (PS), a phospholipid present in large amounts in brain tissue and a component of all cell membranes, is thought to be necessary for optimal cognitive function by enhancing communication between cells. In one placebo-controlled study in Italy involving nine healthy men, 800 mg per day of PS counteracted stress-induced cortisol response—a chemical released from the adrenal glands, which, when excessive, is known to promote brain inflammation. Another placebo-controlled test involved 300 mg per day of PS administered to a group of depressed, elderly women; researchers noted that PS improved depression, memory and behavior. Results from other Italian trials have shown PS to improve concentration and awareness in both healthy and senile patients.

As positive as these findings may be, many people have concerns about using PS derived from animal tissues. Because most studies involve animal-brain-derived PS, many clinicians and physicians are waiting until more vegetable-based PS research is conducted before seriously considering this promising treatment. Additionally, the therapeutic dose, which ranges from 50 to 100 mg several times a day, can be cost prohibitive.

Age-old Herbal Wisdom
"Why should anyone die who has sage in their garden" and "rosemary for remembrance" are old sayings that ring true today. Both sage (Salvia officinalis) and rosemary (Rosmarinus officinalis) have been found to promote and enhance acetylcholine, the most versatile and common neurotransmitter. Lemon balm (Melissa officinalis), called the gladdening herb, is also recommended in old herbals for improving mood and cognition.

Ginkgo (Ginkgo biloba) has been well documented to improve cerebral blood flow and to exert antioxidant activity on the nervous and circulatory systems. Ginkgo also may reduce the age-related decline of neurotransmitters and receptors, improving cognitive function and reducing central nervous system degeneration. Ginkgolide-B, an active constituent of ginkgo, has been shown to improve blood viscosity and reduce blood vessel inflammation. The herb's flavonoids, potent free radical scavengers, combined with the ginkgolides, provide a wealth of neuroprotective properties.

Ginseng (Panax ginseng) contains glucosides known as saponins, which, in laboratory studies, have improved learning and memory in rats. One theory suggests that ginseng may improve nitric oxide synthesis in the brain, heart, lungs and kidneys. Because nitric oxide plays a role in vasodilation (widening of the blood vessels), ginseng may enhance the delivery of blood and oxygen to tissues.

Ginseng and ginkgo may also work synergistically. In one double-blind study, 64 subjects with impaired spinal cord function were divided into four groups and given either 80, 160 or 320 mg of the ginseng/ginkgo combination or placebo twice a day and evaluated at one, 30 and 90 days for cognitive and cardiac function. The different doses provided statistically significant improvements in several measures of nervous-system function at various intervals compared with the control group (Psychopharmacology Bulletin, 1997, vol. 33, no. 4).

Results are far from conclusive when it comes to how certain supplements affect brain function and mental acuity. But the nutrients and botanicals mentioned here hold promise and, with what's at stake, deserve the attention of researchers, formulators and anyone who'd like to age gracefully—and memorably.

Jill Stansbury, ND, maintains a private practice in Battleground, Wash., where she specializes in botanical and natural therapies.