Life Extension Final Clerance Sale

Life Extension Magazine

Life Extension Magazine March 2013
Report  

Nutritional Strategies to Combat Alzheimer's

By Liam Hawkins

Nutrients with Strong Evidence from Epidemiological Studies

Coffee

Coffee beans forming a background  

Many large epidemiological studies show that moderate coffee consumption (3-5 cups of caffeinated coffee/day) is associated with reduced risk for Alzheimer’s.88-91

People who drank coffee at that level in mid-life had a 65% decrease in Alzheimer’s risk later in life.91,92 And high blood caffeine levels appear to prevent the progression of minimal cognitive impairment to fully-developed Alzheimer’s.93

Studies show that caffeine can reduce brain levels of toxic amyloid beta proteins in animals, while not only slowing but in fact reversing the amyloid beta-associated cognitive impairment.89,94,95 Just 1 to 2 months of caffeine treatment restored memory and lowered brain amyloid beta levels in mice.89

Coffee’s other components, including chlorogenic acid, also have major protective effects on brain cells.90,96-99 It is likely, however, that coffee’s primary benefit to brain health is related largely to its caffeine content.

Magnesium

Magnesium is a mineral that is essential for myriad human biological functions. It is especially important in the brain.

Increasing brain magnesium using a special compound called magnesium-L-threonate restores degraded neuronal connections by increasing synaptic density, a process that underlies learning and memory.100

Lab studies show that magnesium modulates enzymes involved in amyloid beta production; at low levels, magnesium favors amyloid beta buildup, while at higher levels it favors amyloid beta breakdown.101,102 There’s also evidence that magnesium opposes the effects of excitotoxic neurotransmitters; this would have the effect of reducing inflammation and perhaps amyloid beta deposition.103

Magnesium levels are markedly lower in people with Alzheimer’s disease than in healthy controls, and the degree of magnesium deficiency correlates with the severity of the disease.104-106

More Facts About the Alzheimer’s Epidemic
Senior man relaxing at home with a book
  • Roughly 5.4 million Americans suffer from Alzheimer’s disease.
  • Alzheimer’s primarily affects older people, but an estimated 200,000 people under 65 are also afflicted.
  • With the aging of baby boomers, an additional 10 million Americans are expected to develop the disease in the coming decades.
  • By 2050, it’s estimated that a million new cases will arise per year; that will amount to a prevalence of 11 to 16 million in the US alone.
  • The percentage of deaths from heart disease and stroke fell by 13 and 20%, respectively, between 2000 and 2008; the proportion due to Alzheimer’s rose by 66% in the same time period.
  • More than 15 million family members provided an estimated 17.4 billion hours of care to people with Alzheimer’s and other dementias.
  • Payments for health care services for those with Alzheimer’s are estimated at $200 billion per year.
  • Medicare costs for those with Alzheimer’s are 3 times those for people without the disease.
  • One in seven people with Alzheimer’s lives alone, while up to half have no identifiable caregiver.
  • People with Alzheimer’s who live alone are exposed to many other health risks than those who live with others.

Vitamin E

People who have high intakes of vitamin E from food are at lower risk of Alzheimer’s than those who don’t, but studies of typical vitamin E supplements don’t find that effect.107,108 The difference is that most supplements are comprised almost solely of the alpha tocopherol form of vitamin E,107,109 whereas the major form of vitamin E from food is gamma tocopherol. More current studies show that the gamma forms of vitamin E provide needed brain benefits.110,111

Specifically, higher intakes and levels of gamma tocopherol and gamma tocotrienol are associated with lower risks for both Alzheimer’s and its predecessor, mild cognitive impairment.107-109,112

The Underlying Pathological Factors Associated with Alzheimer’s Disease
Radiologist doctor

Numerous abnormalities exist in the brains of people with Alzheimer’s disease, though there is considerable scientific debate about which are causes and which are consequences.179 Prescription medications cannot change any of these abnormalities; rather, they contribute marginally to improving symptoms. By contrast, virtually every one of these anomalies has shown some response to therapy with nutraceuticals in lab studies:1,5,9,15,17,152,179-183

  • Senileplaques: these are collections of abnormal proteins called amyloid beta, composed of a precursor called amyloid precursor protein; these extracellular plaques impose oxidant stress and trigger inflammatory changes and ultimately death of brain cells.
  • Neurofibrillary tangles: these are intracellular structures also composed of abnormal proteins called tau; like amyloid beta they trigger cell destruction and ultimately death.
  • Imbalanced neurotransmitters: levels of the neurotransmitter acetylcholine are inadequate for proper signaling in Alzheimer’s disease; modern drug therapy is almost exclusively directed at boosting acetylcholine levels in brain cells, though this neither slows nor stops the disease progression.
  • Oxidative stress: most researchers believe that oxidative stress is one of the true “fundamental” causes of Alzheimer’s, although the precise mechanisms are unclear; oxidant stress is both a cause and a consequence of abnormal protein accumulations such as amyloid beta.
  • Inflammation: like oxidant stress, inflammation is now recognized as a root cause of Alzheimer’s; inflammation is triggered by oxidant stress and also causes it, and release of inflammatory cytokines and invasion of brain tissue by inflammatory cells appear to exacerbate the condition.
  • Inefficient mitochondria: disturbances of energy flow through mitochondria, the “reactors” that power cellular processes, releases huge amounts of oxidative molecules that damage surrounding cell structures as well as mitochondria themselves.
  • Elevated homocysteine: homocysteine is an amino acid that is elevated in many chronic conditions; elevated levels can increase activation of tau and amyloid precursor proteins, leading to deposits of amyloid beta and neurofibrillary tangles.
  • Excitotoxicity: like any machine run at high levels for a long period, the brain suffers from too much excitatory signaling, typically caused by the neurotransmitter glutamate; excitotoxicity can result not only from normal wear and tear, but also from most of the other abnormalities described above.

Nutrients with Strong Laboratory and Theoretical Evidence

Ashwagandha

The Ayurvedic plant, Ashwagandha, has widely-demonstrated beneficial effects, many of which are attributed to several of its antioxidant components, which are more powerful than most commercial antioxidants.113

Extracts from Ashwagandha’s fruit and root protect brain cells in culture from the oxidant effects of amyloid beta; in one study they negated the cell death caused by amyloid beta.113

Laboratory findings reveal that ashwagandha extract inhibits acetylcholinesterase, an enzyme responsible for breaking down acetylcholine, one of the brain’s key chemical messengers.114 Drugs such as Aricept®, which is currently used in the treatment of Alzheimer’s disease, act in this very manner to slow the progression of this mind-robbing disease as well as improve cognition and behavior.115

The Role of Anti-inflammatory Drugs and Metformin
pills

Given the impact of inflammation in the Alzheimer’s disease brain, it is natural that scientists would look with hope to the group of drugs known as non-steroidal antiinflammatory drugs (NSAIDs). The NSAIDs include common, over-the-counter drugs like ibuprofen and naproxen, certain prescription drugs, such as celecoxib, and aspirin, the oldest NSAID in existence.

All of the NSAIDs work by inhibiting activities of enzymes, cyclooxegenases (or simply COX), which are involved in production of inflammatory signaling molecules called prostaglandins. By inhibiting COX activity, the hope is that one might reduce inflammatory changes in brain tissues of people with Alzheimer’s disease.

Epidemiological studies are encouraging, consistently showing lower incidence of Alzheimer’s disease among people who use NSAIDs regularly, with greater protection among those who use them over long time periods.184-186 The rate of protection varies somewhat, but in general NSAID users develop Alzheimer’s at rates in the range of 40 to 65% of those in people not using NSAIDs.184,185

Animal studies also show improvement both in physical changes in the brain on NSAIDs and also in behavior, memory, and cognition. Unfortunately, human studies have been less convincing, until quite recently. Earlier studies showed little improvement in Alzheimer’s patients taking NSAIDs, but more recent, and more carefully-designed studies now suggest that certain NSAIDs (naproxen and ibuprofen) may slow disease progression in patients with very early, mild disease.187-190 And at least one study showed that a regimen of both ibuprofen 400 mg/day and aspirin 500 mg/day for one year resulted in modest increases in performance on cognitive testing in middle-aged women with normal cognition.191

But these beneficial results seem to occur only in patients with very early Alzheimer’s, or in those who as yet show no symptoms. In fact, there’s some evidence that taking NSAIDs in more advanced Alzheimer’s disease can worsen certain aspects of the disease.189,190

Some studies focus specifically on aspirin, the prototypical NSAID derived originally from willow bark. In addition to its ability to block the inflammation-inducing COX enzymes, aspirin has additional benefits of importance in Alzheimer’s disease. For example, it reduces the number of activated platelets; people with Alzheimer’s often have excessive amounts of activated platelets, which may contribute to poor blood flow in the disease.192 An exciting synergistic effect has been suggested between aspirin and the omega-3 fatty acid DHA: aspirin appears to promote conversion of DHA into anti-inflammatory molecules that may help to blunt the effects of inflammation on development of Alzheimer’s disease.193,194

Metformin, like aspirin, is a well-established modern-day drug with natural origins (it’s derived from a French lilac bush).195-197 Most applications for metformin today have to do with diabetes and insulin resistance, which are increasingly relevant topics for Alzheimer’s researchers. In fact, the brain impact of diabetes and insulin resistance is so great that some scientists term Alzheimer’s “Type III diabetes.”198 Studies show that metformin helps the body break down and deactivate proteins that contribute to the neurofibrillary tangles characteristic of neurons affected by Alzheimer’s disease;199 obese mice with experimental Alzheimer’s show fewer biochemical brain changes when treated with metformin.200

B-Vitamins

The B vitamins folate (B9), pyridoxine (B6), and cobalamin (B12) are essential for recycling of the molecules that make up DNA; without sufficient B vitamins there is a buildup of the amino acid homocysteine, which is toxic to many tissues. Elevated homocysteine levels are a known risk factor for Alzheimer’s disease, though it is still unclear if homocysteine is actually a cause of the condition.116-118

Laboratory and human studies show that B vitamin supplements lower homocysteine, slow buildup of abnormal proteins amyloid beta and tau, and reverse the cognitive and memory deficits induced by artificially elevated homocysteine levels.119,120

Blueberries

Blueberries  

Blueberries are extremely rich in the beneficial plant molecules called polyphenols, which are powerful antioxidants.121 Polyphenols can also affect the way genes are expressed, switching on those that offer protection against neuronal damage, and switching off those that signal increased inflammation or other deleterious effects.122

Blueberry extracts’ antioxidant actions help protect neurons against the damage done by amyloid beta proteins.121,123 They have also been shown to protect neurons and improve animal behavior even when amyloid beta levels are unchanged, meaning that they provide protection “downstream” from amyloid beta’s oxidant and inflammatory effects.124-126

CoQ10 and PQQ

Coenzyme Q10 (CoQ10) and pyrroloquinoline quinone (PQQ) are essential nutrients that help keep mitochondria healthy by improving their efficiency at burning foods to produce energy.127-130

Laboratory studies show that CoQ10 supplementation reduces the amount of amyloid beta plaque formation in brain cells, resulting in improved behavior.131,132 PQQ acts after amyloid beta has already accumulated, helping cells recover from amyloid beta-induced oxidant stress, preventing neuronal cell death, and decreasing further production of reactive oxygen species.133

Balancing Hormones, Especially DHEA, in Alzheimer’s

Although its effects are not fully understood, it’s clear that stress of all kinds takes a toll on the brain. Eventually, mainly under the influence of excessive levels of the stress-response hormone cortisol, structural and functional changes occur, especially in the hippocampus, the brain’s most concentrated region of memory-processing neurons.201

Normally, the effects of cortisol are balanced by high brain concentrations of the neurosteroid dehydroepiandrosterone (DHEA).202 DHEA, and its “sulfate” form, DHEAS, are the most abundant hormones produced by the adrenal glands, the body’s stress-controlling organs.203 These hormones serve to protect hippocampus and other brain cells from oxidative stress and the deleterious immune system disruptions induced by cortisol, which left unchecked can drive inflammatory processes that further damage memory and cognition.204,205

With advancing age comes a drop in DHEA production, however, while cortisol production is relatively unchanged (in fact, some studies suggest that cortisol increases with age).201-204 The sharp decline in DHEA levels is often referred to as “adrenopause,” and is thought to contribute to age-related increases in atherosclerosis, cancer, and dementia.203

The resulting imbalance in the DHEA/cortisol ratio is a direct measure of risk for Alzheimer’s disease: people (especially women) with Alzheimer’s have much lower DHEA/cortisol ratios than do healthy age-matched controls, who in turn have lower ratios than younger adults.201,206

Laboratory and animal studies demonstrate that DHEA supplementation has substantial anti-inflammatory effects in the brain, including inhibition of nitric acid production, an early inflammatory signaling molecule.204,207,208 DHEA also stimulates production of new neurons in tissue-culture experiments.209 DHEA produces a restoration of youthful cognition and memory when older animals, or those with Alzheimer’s disease, are supplemented with the neurohormone.210,211

Curcumin

Indian Turmeric Abstract  

Curcumin is a yellow biomolecule derived from the spice turmeric.134 Like other antioxidants, curcumin protects brain cells and their mitochondria against amyloid beta-induced toxicity and inhibits formation of abnormal proteins.134-136

But curcumin also possesses some unique features with regard to Alzheimer’s disease. Sophisticated molecular studies reveal that curcumin can prevent amyloid beta molecules from assembling, and can also destabilize amyloid beta plaques after they have formed.137,138 This permits the body’s natural cleanup cells, macrophages, to rapidly clear amyloid beta fragments before they can re-form and damage brain cells. And curcumin stimulates macrophages to make that cleanup process still more rapid and efficient.

Another beneficial mechanism of curcumin is to enhance the health of mitochondria, the tiny cellular power plants that provide energy to all of our cells. Aging mitochondria are thought to be responsible for much of the brain cell death and dysfunction that occurs in Alzheimer’s disease.139 Curcumin, through its antioxidant actions, scavenges dangerous oxygen free radicals produced by ailing mitochondria, preventing their death and enhancing their action.140

Finally, curcumin has favorable effects on brain insulin receptors. The balance between glucose levels and insulin in the brain is capturing scientists attention, with some even referring to Alzheimer’s disease as “type III diabetes.”141 Studies of diabetic animals reveal that curcumin enhances actions of insulin receptors in brain tissue.142,143

Studies in animal models of Alzheimer’s disease demonstrate the value of these multiple mechanisms on learning and memory. Curcumin supplements given even after the onset of Alzheimer’s-like symptoms result in fewer mistakes on memory-dependent tasks, and improved performance on mazes that test both reasoning and memory.144-147 When the animals’ brains are examined at the end of such experiments, they demonstrate significantly less brain cell death in memory-processing brain areas.145

In one of the most dramatic experiments to date, curcumin supplements were found to protect against brain aging in general among mice treated with an age-accelerating compound.148 These remarkable findings were accompanied by improved performance on cognitive tasks and enhanced locomotion; in these animals’ brains improved oxidant defenses and restored mitochondrial enzyme activities were observed as well.

This kind of reversal of Alzheimer’s damage is something no existing drug can do.

Grape Seed Extract

Close-up of grapes seeds, medicine ingredient  

Grapes, and particularly their seeds, contain very high levels of proanthocyanidins, clusters of polyphenols that have multiple health benefits including anti-inflammatory and antioxidant effects. But they also have remarkable gene modulating activities, directing protein expression away from that seen in Alzheimer’s and towards a more normal state.149 And they readily cross the blood-brain barrier to be deposited in brain tissue.150

These effects result in reduction of Amyloid beta formation by several different mechanisms, as well as enhanced amyloid beta clearance.151-153 Grape seed extracts also reduce inflammation in animal models of Alzheimer’s disease.154

Green Tea

Close-up of grapes seeds, medicine ingredient  
Green tea is rich in a variety of polyphenols, especially one called EGCG, that has multiple beneficial attributes. EGCG interferes with the Alzheimer’s disease process in several important ways.155

 

EGCG physically blocks the assembly of amyloid beta proteins, preventing them from clumping together to form plaques.156 The compound also generates a unique set of stable proteins from the amyloid beta precursor molecule; these proteins can’t bind together at all, further reducing the burden of plaque.157

Intriguingly, EGCG, given before exposure, prevents mitochondrial dysfunction induced by amyloid beta in brain cells, while also normalizing cells’ responses to the excitatory neurotransmitter NMDA.158,159

Resveratrol

Resveratrol is a multi-functional polyphenol that plants use as an antifungal compound; it is found abundantly in red grapes.8,160-162 Resveratrol has antioxidant characteristics, but scientists are especially excited about its ability to change how genes are expressed.163 This so-called epigenetic capability allows resveratrol to affect multiple points in the complex series of events that ultimately produces Alzheimer’s symptoms.164

Studies show that these properties of resveratrol act both before and after amyloid beta protein is deposited in brain tissue. Resveratrol promotes enzyme actions that slow amyloid beta production, and speed its clearance, while it also promotes expression of enzymes that limit the nitric oxide and inflammatory cytokine production that amyloid beta triggers.160,165-168

Glucose utilization is impaired in the brains of Alzheimer’s patients, leading to further deterioration of their cells; this is one of the many ways that Alzheimer’s and type II diabetes overlap. Breaking research reports that resveratrol can promote glucose utilization in brain cells, potentially mitigating the destructive effect of elevated sugar.169

Vinpocetine

Vinpocetine is an alkaloid derived from the periwinkle (Vinca) plant.170 It increases brain blood flow and decreases platelet aggregation through its inhibition of the enzyme PDE1.170,171 Vinpocetine also produces higher brain levels of the neurotransmitter acetylcholine that is deficient in Alzheimer’s disease.171

By separate mechanisms, vinpocetine provides antioxidant protection to brain cells, and markedly reduces mitochondrial dysfunction.170-172 These combined mechanisms, and perhaps others, contribute to vinpocetine’s ability to prevent neuronal damage and improve impaired learning and memory in animal models of Alzheimer’s.171

Nutrient Combinations

The multifactorial nature of Alzheimer’s disease makes it a natural condition for combinations of nutrients that, together, can target many, if not most, of the underlying molecular damage.173

Studies of a mouse model of Alzheimer’s reveal so much improvement in learning in supplemented mice that their performance could not be distinguished from that of healthy mice. The supplement contained curcumin, piperine, epigallocatechin gallate, alpha-lipoic acid, n-acetylcysteine, B vitamins, vitamin C, and folate.174

Several human studies have been done with a supplement containing curcumin, piperine, EGCG, alpha-lipoic acid, N-acetylcysteine, B vitamins, vitamin C, and folate in those with mild to moderate Alzheimer’s disease. Patients’ performance on standard neuropsychiatric measures were equivalent to those on donepezil, and exceeded those of galantamine, drugs in current use for Alzheimer’s.175 Even in institutionalized patients with later-stage disease, this formulation produced an improvement of about 30% on the standard neuropsychiatric inventory.176 This formulation has also been shown to improve cognitive performance in people without dementia, demonstrating the power of combined supplementation.177

One proprietary nutritional product (containing Ashwagandha, blueberry, grape seed extract, ginger, vinpocetine, and phosphatidylserine plus alpha-glyceryl phosphoryl choline and other ingredients) has also now been shown to improve cognition in adults with memory and cognition problems and improve working memory, executive function, and inspection time (a measure of decision-making), in an open clinical trial.178

Summary

Alzheimer’s is a complex, multifactorial, and progressive disease that steals mind and memory. To date, mainstream medicine remains baffled by the condition, with just 5 drugs on the market, none of which can modify or slow disease progression.

Nutritional supplements, on the other hand, have multiple mechanisms, offering a broader front on which to attack Alzhiemer’s. Many different supplements show great promise by acting on several or many different targets in the disease’s progression. Combining many nutrients together is proven to offer even greater impact.

Using a combination of multitargeted supplements may be the only way to stop or slow Alzheimer’s disease, and prevent it from taking away your personality.

If you have any questions on the scientific content of this article, please call a Life Extension® Health Advisor at 1-866-864-3027.