A proactive approach to reducing the risk of dementia
In Part 2 of this two-part series, we investigate some botanicals and additional supplements which complement nutritional and lifestyle factors for the prevention of cognitive decline. Also, you may want to listen to Dr. Decker’s live interview with Natural Medicine Journal on the topic of cognitive health titled “A Proactive Approach to Reducing Dementia Risk: Maintaining a Healthy Brain Today, Tomorrow, and Years to Come.”
Choline and brain health
The brain is comprised of fatty tissue and especially rich in phosphatidylcholine (PC). The body can synthesize PC from a substance called citicoline, also known as CDP-choline. Citicoline and phosphatidylcholine both support the integrity and functionality of the brain. Choline, which can be derived from either of these substances, enhances synthesis of acetylcholine, a neurotransmitter that plays a significant role in memory and learning.
Citicoline has been studied in populations having memory-related issues ranging from mild cognitive impairment to vascular dementia and Alzheimer’s disease. A comprehensive review of 14 double-blind, randomized, placebo-controlled trials found that citicoline has positive effects on memory and behavior in the short to medium term, and recommended that studies of longer duration be conducted. Citicoline has even been shown to significantly improve cognitive performance and other parameters associated with brain health in individuals with a significant genetic-associated risk of developing dementia.
Botanicals that support the brain
Because inflammation plays a role in the development of Alzheimer’s disease, supplements that help reduce inflammation and oxidative stress can be helpful. This is one mechanism via which things like essential fatty acids may support cognitive health as well.
Curcumin has been shown to reduce oxidative stress and accumulation of the beta amyloid plaques associated with Alzheimer’s disease. Curcumin has been shown to improve working memory, attention, and reduce cognitive decline in healthy elderly patients, and studies have also shown it helps to reduce depression as well. Of course, making sure the curcumin is bioavailable is important: research suggests that the best bioavailability can be obtained with a molecular dispersion process that enhances the water dispersion of fat-soluble ingredients. This technique yields six times higher absorption than the commonly used curcumin phytosome found in many supplements.
Curcumin has been shown to reduce oxidative stress and accumulation of the beta amyloid plaques associated with Alzheimer’s disease.
Huperzine A, an extract from the club moss Huperzia serrata, acts as an acetylcholinesterase inhibitor, which also happens to be one mechanism of medications which address dementia. Huperzine A also may help prevent dementia by decreasing production of the beta amyloid plaques, and has been shown to protect the cells in the brain from oxidative stress and dysfunction by other mechanisms as well. Huperzine A has been shown to significantly improve cognitive function in people with vascular dementia, as well as cognition, mood, and performance of day-to-day activities in those with mild to moderate Alzheimer’s disease.,
Ginkgo biloba also has been studied in many clinical trials in the setting of dementia. As a botanical, we think of it being a go-to herb for supporting the microcirculation, which also is important for cognitive function. Ginkgo is protective in part due to its antioxidant effects, and supports circulation in the small vessels by reducing platelet activation and aggregation as well as stimulating the release of endothelium-derived relaxation factor. Ginkgo has been shown to improve cognitive function, memory, and even balance, which is also something that can be an issue with Alzheimer’s disease.
Ginkgo has been shown to improve cognitive function, memory, and even balance, which is also something that can be an issue with Alzheimer’s disease.
Lion’s mane mushroom (Hericium erinaceus) has a long history of traditional use for supporting the health of the nerves (including those in the brain). We now know it induces the secretion of nerve growth factor, a substance in the body that signals for the nerves to grow. Lion’s mane has been shown to significantly increase cognitive function scores, as well as reduce depression and anxiety. It can also be of benefit in alleviating peripheral neuropathy (weakness, numbness, or pain in the hands and feet) which often can occur with age due to diabetes, vitamin B12 deficiency, or unknown causes. Like many of the medicinal mushrooms, it may also protect against certain forms of cancer.,
French maritime pine bark extract has been the topic of over 400 PubMed indexed studies. This extract from the French maritime pine has been shown to improve cognitive function, attention, mental performance, and working memory.,, It also positively impacts blood pressure, cholesterol balance, and blood sugar, all of which may mitigate the risk of Alzheimer’s disease.,
For many, a combination of nutritional supplements, diet and lifestyle choices, and directed botanical support can support healthy function of the brain today, tomorrow, and for years to come.
Click here to see References
 D’Orlando KJ, Sandage BW Jr. Citicoline (CDP-choline): mechanisms of action and effects in ischemic brain injury. Neurol Res. 1995 Aug;17(4):281-4.
 Fioravanti M, et al. Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD000269.
 Alvarez XA, et al. Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer’s disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion. Methods Find Exp Clin Pharmacol. 1999 Nov;21(9):633-44.
 Wall R, et al. Fatty acids from fish: the anti-inflammatory potential of long-chain omega-3 fatty acids. Nutr Rev. 2010 May;68(5):280-9.
 Mishra S, Palanivelu K. The effect of curcumin (turmeric) on Alzheimer’s disease: An overview. Ann Indian Acad Neurol. 2008 Jan;11(1):13-9.
 Cox KH, et al. Investigation of the effects of solid lipid curcumin on cognition and mood in a healthy older population. J Psychopharmacol. 2015 May;29(5):642-51.
 Rainey-Smith SR, et al. Curcumin and cognition: a randomised, placebo-controlled, double-blind study of community-dwelling older adults. Br J Nutr. 2016 Jun;115(12):2106-13.
 Lopresti AL, et al. Curcumin for the treatment of major depression: a randomised, double-blind, placebo controlled study. J Affect Disord. 2014;167:368-75.
 Jäger R, et al. Comparative absorption of curcumin formulations. Nutr J. 2014 Jan 24;13:11.
 Zhang HY, et al. Potential therapeutic targets of huperzine A for Alzheimer’s disease and vascular dementia. Chem Biol Interact. 2008 Sep 25;175(1-3):396-402.
 Wang R, Tang XC. Neuroprotective effects of huperzine A. A natural cholinesterase inhibitor for the treatment of Alzheimer’s disease. Neurosignals. 2005;14(1-2):71-82.
 Xu ZQ, et al. Treatment with Huperzine A improves cognition in vascular dementia patients. Cell Biochem Biophys. 2012 Jan;62(1):55-8.
 Zhang Z, et al. [Clinical efficacy and safety of huperzine Alpha in treatment of mild to moderate Alzheimer disease, a placebo-controlled, double-blind, randomized trial]. Zhonghua Yi Xue Za Zhi. 2002 Jul 25;82(14):941-4.
 Yang G, et al. Huperzine A for Alzheimer’s disease: a systematic review and meta-analysis of randomized clinical trials. PLoS One. 2013 Sep 23;8(9):e74916.
 Shen JG, Zhou DY. Efficiency of Ginkgo biloba extract (EGb 761) in antioxidant protection against myocardial ischemia and reperfusion injury. Biochem Mol Biol Int. 1995 Jan;35(1):125-34.
 Smith JV, Luo Y. Studies on molecular mechanisms of Ginkgo biloba extract. Appl Microbiol Biotechnol. 2004 May;64(4):465-72.
 Dong ZH, et al. [Effects of ginkgo biloba tablet in treating mild cognitive impairment]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 Sep;32(9):1208-11.
 Zhao MX, et al. [Effects of Ginkgo biloba extract in improving episodic memory of patients with mild cognitive impairment: a randomized controlled trial]. Zhong Xi Yi Jie He Xue Bao. 2012 Jun;10(6):628-34.
 Bahureksa L, et al. The Impact of Mild Cognitive Impairment on Gait and Balance: A Systematic Review and Meta-Analysis of Studies Using Instrumented Assessment. Gerontology. 2017;63(1):67-83.
 Mori K, et al. Nerve growth factor-inducing activity of Hericium erinaceus in 1321N1 human astrocytoma cells. Biol Pharm Bull. 2008 Sep;31(9):1727-32.
 Mori K, et al. Improving effects of the mushroom Yamabushitake (Hericium erinaceus) on mild cognitive impairment: a double-blind placebo-controlled clinical trial. Phytother Res. 2009 Mar;23(3):367-72.
 Nagano M, et al. Reduction of depression and anxiety by 4 weeks Hericium erinaceus intake. Biomed Res. 2010 Aug;31(4):231-7.
 Yi Z, et al. Protective Effect of Ethanol Extracts of Hericium erinaceus on Alloxan-Induced Diabetic Neuropathic Pain in Rats. Evid Based Complement Alternat Med. 2015;2015:595480.
 Li G, et al. Anticancer potential of Hericium erinaceus extracts against human gastrointestinal cancers. J Ethnopharmacol. 2014 Apr 28;153(2):521-30.
 Kim SP, et al. Hericium erinaceus (Lion’s Mane) mushroom extracts inhibit metastasis of cancer cells to the lung in CT-26 colon cancer-tansplanted mice. J Agric Food Chem. 2013 May 22;61(20):4898-904.
 Trebatická J, et al. Treatment of ADHD with French maritime pine bark extract, Pycnogenol. Eur Child Adolesc Psychiatry. 2006 Sep;15(6):329-35.
 Dvoráková M, et al. Urinary catecholamines in children with attention deficit hyperactivity disorder (ADHD): modulation by a polyphenolic extract from pine bark (pycnogenol). Nutr Neurosci. 2007 Jun-Aug;10(3-4):151-7.
 Dvoráková M, et al. The effect of polyphenolic extract from pine bark, Pycnogenol on the level of glutathione in children suffering from attention deficit hyperactivity disorder (ADHD). Redox Rep. 2006;11(4):163-72.
 Hosseini S, et al. A randomized, double-blind, placebo-controlled, prospective, 16 week crossover study to determine the role of Pycnogenol in modifying blood pressure in mildly hypertensive patients. Nutr Res. 2001 Sep 1;21(9):1251-60.
 Koch R. Comparative study of Venostasin and Pycnogenol in chronic venous insufficiency. Phytother Res. 2002 Mar;16 Suppl 1:S1-5.
 Liu X, et al. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Life Sci. 2004 Oct 8;75(21):2505-13.
 Singh VP, et al. Advanced glycation end products and diabetic complications. Korean J Physiol Pharmacol. 2014 Feb;18(1):1-14.