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LE Magazine February 2007

Nutritional Strategies to Preserve Memory and Cognition

By Laurie Barclay, MD

Phosphatidylserine: A Versatile Memory Enhancer

Phosphatidylserine plays an extraordinarily varied role in supporting brain health. It enhances the availability of acetylcholine,33 lowers levels of the stress hormone cortisol, and promotes the release of dopamine, an important neurotransmitter known to improve mood and movement control.

Phosphatidylserine also supports the function of many vital enzymes, acts as an antioxidant to combat free-radical damage, and quells inflammation that can exert deleterious effects in the brain.34 In Europe and Japan, phosphatidylserine is sold as a prescription drug to treat memory and learning dysfunction, but it is available as a nutritional supplement in the United States.

Humans manufacture phosphatidylserine to maintain the structure and function of cell membranes, but its production in the body declines with advancing age. Aged rats with cognitive deficits have demonstrated decreased phosphatidylserine in the hippocampus,35 and subjects with a genetically determined type of cognitive deficit exhibit low phosphatidylserine levels in nerve cell membranes.36

When aged rats were given phosphatidylserine for two months, their performance on an age-related memory impairment test improved significantly, indicating better memory function. Phosphatidylserine supplementation restored the rats’ acetylcholine release and energy metabolism in nerve endings to levels typically seen in young rats.37

Further animal studies suggest that phosphatidylserine acts as an antidepressant agent.38 This finding could have far-ranging implications for elderly humans, in whom depression is often confused clinically with cognitive impairment.

By stimulating acetylcholine production,39 phosphatidylserine has proven useful in clinical trials of patients with cognitive impairment.5 These include an open study in patients with age-related cognitive decline,40 well-controlled, randomized trials in patients with senile dementia,41 and a study in Alzheimer’s patients who exhibited the stiffness and rigidity associated with Parkinson’s disease.42

A review of the available research indicates that while phosphatidylserine may help improve memory in elderly patients,43 its effects may be most pronounced in early cognitive impairment44—an observation that underscores the vital importance of beginning supplementation with brain-nourishing nutrients like phosphatidylserine early in life.

A leading scientist at the Alzheimer’s Prevention Foundation has suggested that phosphatidylserine may be a useful component in a lifestyle and nutrition program aimed at preventing Alzheimer’s disease.45 He concludes that memory loss is not an inevitable consequence of aging, and that Alzheimer’s can be prevented or reversed using an integrated approach that includes phosphatidylserine and other brain-supportive nutrients.

Although phosphatidylserine is generally safe and well tolerated,46,47 it may increase the blood-thinning effect of heparin, and therefore should not be used with medications that thin the blood without consulting a physician.48

Nutritional Strategies to Preserve Memory and Cognition: What You Need to Know

As adults age, they become increasingly vulnerable to impaired memory and cognitive function, which can foreshadow the development of Alzheimer’s disease and other forms of dementia.

Scientists have made great advances in unraveling the physiological changes that precipitate and accompany the declining health of the brain and central nervous system. These findings have led to the development of nutritional strategies to preserve and enhance the structure and function of the nervous system with aging.

Uridine contributes to the structure of essential brain cell components while supporting communication between nerve cells, changes that have been associated with improved memory and mood.

GPC (glycerophosphocholine) supports synthesis of the essential neurotransmitter acetylcholine, while boosting memory function.

Phosphatidylserine boosts acetylcholine levels and contributes to healthy brain cell membranes, with benefits for cognition and mood. Phosphatidylserine may be even more effective when combined with the omega-3 fatty acid DHA.

Vinpocetine enhances metabolism and blood flow in the brain, and may provide support for conditions such as vascular dementia and ischemic stroke.

Like drugs used to treat Alzheimer’s, the herb ashwagandha helps prevent the breakdown of the brain neurotransmitter acetylcholine. Ashwagandha further enhances the growth of neurites, which facilitate communication among neurons.

Blueberries fight the memory impairment associated with free radicals and beta-amyloid plaques in the brain. Similarly, grape seed extract protects brain cells from the toxic effects of oxidative stress and beta amyloid.

The hormone pregnenolone supports nerve cell growth in the brain’s memory center and enhances acetylcholine release.

A proactive approach to preserving and enhancing cognitive function using natural therapies may provide the best protection against mind-robbing dementia and Alzheimer’s disease.

Phosphatidylserine and DHA: Synergistic Support for Brain Cells

Phosphatidylserine may be even more beneficial for brain and nervous system health when coupled with the omega-3 fatty acid DHA.

DHA is a major structural and functional component of the central nervous system, accounting for 30-50% of the total fatty acid content of the human brain. In infants and children, DHA is essential for the brain’s growth and functional development. It also helps support normal brain function in adults, including learning and memory. Low levels of DHA, by contrast, are associated with an increased risk for Alzheimer’s.49

In the brain, DHA combines enzymatically with phosphatidylserine to form nerve cell membrane components that support healthy nerve function. Substantial laboratory research suggests that phosphatidylserine’s ability to improve cognitive skills is greatly increased in the presence of DHA.50

Furthermore, the combination of DHA and phosphatidylserine powerfully supports energy production in brain cells. Scientists from the National Institutes of Health believe that phosphatidylserine with attached DHA is among the most critically important molecules for healthy brain function, and that phosphatidylserine works optimally in the presence of abundant levels of DHA.51

Researchers have developed an innovative phosphatidylserine-DHA (PS-DHA) compound designed to optimally support brain cell structure and function. To evaluate its effects on memory, they examined middle-aged rats with accelerated brain aging. While DHA alone showed minimal effects, PS-DHA substantially protected against the memory-robbing effects of brain aging.52

This unique combination of PS-DHA was also examined in a randomized, double-blind, placebo-controlled study of people with attention deficit hyperactivity disorder (ADHD). At the end of three months, those receiving the PS-DHA compound had a total response to treatment of 47%, compared to just 19% in the placebo group. These findings suggest that the phosphatidylserine-DHA combination may improve behavioral and learning disabilities in ADHD patients.52

Vinpocetine: Enhancing Cerebral Blood Flow

The brain health benefits of vinpocetine, derived from the periwinkle flower, are widely recognized in Europe, where it is available only by prescription to treat symptoms of age-related memory impairment.

By improving sluggish cerebral blood flow, vinpocetine enhances the brain’s use of oxygen and glucose.53 Vinpocetine also increases electrical conductivity between nerve cells and supports the activity of nerve pathways related to mental alertness.54 When combined with the popular herb ginkgo biloba, vinpocetine speeds the processing of short-term working memory in normal adults.55

Ginkgo Biloba

By enhancing vasodilation (relaxation of blood vessels), vinpocetine offers targeted benefits for cognitive dysfunction related to vascular disease involving vessels that supply the brain with blood.5 In three studies of older adults with memory impairment related to poor brain circulation or dementia, vinpocetine produced significantly more improvement than placebo in tests of attention, concentration, and memory.43

In a well-controlled trial of 203 patients with mild-to-moderate dementia, 30 or 60 mg of vinpocetine taken daily for four months was deemed safe and was associated with substantial improvements relative to placebo in ratings of overall status, cognitive performance, and severity of illness.56

By interfering with blood clotting at several points during the chain reaction that ultimately causes ischemic stroke, vinpocetine may even protect high-risk individuals from this devastating disease.57 Vinpocetine appears to work by blocking the activation of voltage-sensitive channels for calcium and sodium,58 and by preventing release of potentially toxic glutamate and free radicals.59,60

Because vinpocetine may inhibit blood clotting, it should not be used with Coumadin® or other blood thinners, except under a doctor’s recommendation.

Pregnenolone Supports Nerve Health

One of the most powerful strategies for supporting nervous system health with aging is to ensure optimal levels of the hormone pregnenolone. Synthesized from cholesterol in the mitochondria of all cells, pregnenolone serves as a precursor for numerous essential hormones in the body, including dehydroepiandrosterone (DHEA), estrogens, progesterone, and testosterone.83

As individuals grow older, they experience a dramatic decline in pregnenolone production, as well as in the hormones for which pregnenolone is a precursor.84-86 Declining levels of these essential hormones have been linked with many disorders that commonly accompany aging.

Scientists have noted that levels of pregnenolone are intimately connected with cognitive performance. In fact, pregnenolone directly influences release of the crucial neurotransmitter acetylcholine in several key brain areas involved in memory, learning, cognition, and sleep-wake cycles. Furthermore, administration of pregnenolone reverses the decline in new nerve growth (neurogenesis) that commonly occurs in disorders like Alzheimer’s disease. In particular, pregnenolone dramatically enhances nerve cell growth in the hippocampus, the brain region responsible for memory, which undergoes marked deterioration in Alzheimer’s patients.87,88

Supplemental pregnenolone helps promote a youthful mind and body by contributing to optimal hormone levels, supporting acetylcholine activity, and promoting nerve cell growth in the brain’s memory center.

Since pregnenolone may affect hormone levels, those with hormonally related cancers such as prostate or breast cancer should avoid using pregnenolone.

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