With some basic understanding of what underlies Alzheimer’s dementia from my previous article, I’m excited to share important details of the nutrient supplements that slow the progression of dementia.

Nutrient supplements for Alzheimer’s

There are many nutrients that are useful for the treatment of Alzheimer’s dementia. I’ll list them in categories.

Polyphenolic herbs and extracts

These antioxidant and anti-inflammatory extracts have been studied in rodents and found to be safe and effective[1]. They are used in humans but have few clinical trials as of yet. These include extracts from: green tea (EGCG),[2] Ginkgo biloba + ginseng,[3] blueberries (anthocyanins),[4] grape seeds (resveratrol),[5] curcumin,[6] marine algae (fucoxanthin),[7] [8] cat’s claw, bilberry and black currant. Here is further information on these:

• Cat's claw (Uncaria tomentosa) extract contains antioxidant polyphenols and proanthocyanidins; it is a strong antioxidant and anti-inflammatory,[9] a potent enhancer of DNA repair in primary organ cultures of human skin,[10] and has been found to have a high binding affinity to beta amyloid protein.[11]

• Bilberry and black current extracts contain phenolic compounds that were shown to greatly reduce brain beta amyloid protein and improve memory in Alzheimer’s mice.[12]

• Huperzine A (Huperzia serrata, an extract from moss): 200 microgram twice daily inhibits acetylcholine esterase. Two double-blind clinical trials in China showed it to be safe and effective for the long-term treatment of Alzheimer's dementia. It was found to be superior to Aricept, with longer lasting effects and fewer side effects. Reports from an estimated 100,000 people treated suggest low toxicity for this herb. Additionally, it decreases neuronal cell death caused by toxic levels of glutamate, which makes it useful in strokes and epilepsy too.

• Vinpocetine: 20 mg daily. It has been well-proven[13] to have cerebral blood-flow enhancing and neuroprotective effects without adverse events. Several studies indicate it is useful to reduce memory loss and cognitive decline.[14]
   

Amino acids

• Acetyl-l-carnitine: 500-1,000 mg three times daily helps reverse the disease process of Alzheimer’s dementia.[15] For example, memory and cognitive scores in Alzheimer’s patients given 2250-3,000 mg daily of Acetyl-l-carnitine improved 2.8 times better than placebo-treated subjects over 12 weeks[16] in one study.

• L-glutamine and L-tyrosine 3-5 grams daily also help prevent Alzheimer’s disease progression.
   

Phosphatidyl serine and Omega-3 oils

• Phosphatidyl serine (PS): 100 mg three times daily or 300 mg daily has been repeatedly shown in studies[17] [18] [19] [20] to improve memory in aging patients with memory complaints and early cognitive decline, yet there are a few that show no significant improvement by PS supplementation.[21] In a multi-university study, subjects who took PS achieved a 30 percent improvement in cognitive function, including learning, memory, and recalling numbers, names and faces, and another study showed that PS supplementation had a 33 percent improvement in learning and remembering written information compared to the placebo control group.[22] PS also works synergistically with vitamin B12 supplementation.

• Phosphatidyl choline (lecithin): 1-2 Tbsp/day has been shown to improve cognitive function only in early stages of Alzheimer's disease, and there is a "therapeutic window dose" above which the beneficial effects of lecithin treatment are lost.

• Omega-3 oil (Krill oil and/or flaxseed oil): 1-3 Tbsp/day. Omega 3 oils (DHA, EPA) are the building blocks of nerve tissue.
   

Vitamins

• Vitamin B1 (thiamine): Thiamine is important for acetylcholine metabolism and release from the presynaptic neuron. Deficiency of thiamine has been shown to increase β-amyloid plaque accumulation of in many studies. Dosing of 3 to 8 grams daily of oral thiamine had a mildly beneficial effect in Alzheimer's in a 1993 study[23] although a later study in 1996 found similarly good effects with a daily dose of just 100 mg thiamine for 12 weeks.[24]

• Vitamins B6, B12 and folate help reduce homocysteine, a known risk factor for Alzheimer’s dementia. Deficiency of Vitamin B12 can Alzheimer’s symptoms, and one fourth of people aged 60 - 70 and approximately forty percent of those over age 80 are deficient in Vitamin B12, largely from poor absorption. Vitamin B12 works synergistically with phosphatidyl serine supplementation.

• Vitamin D3: a recent meta-analysis[25] reveals that low vitamin D levels predict poor memory and other cognitive dysfunction and vitamin D repletion in these subjects improved brain executive functions while it showed no different with control groups. A study[26] reported in 2013 tells us that vitamin D restores suppressed synaptic transmission when given to Alzheimer's rats.

• Vitamin E (d-alpha-tocopherol with mixed tocopherols): 800 IU twice daily for up to 2 years is safe and has been reported to slow the progression of Alzheimer's disease, probably because it is synergistic[27] with CoEnzyme Q10, an endogenous compound that decreases with age.

Coenzyme Q10: 200 mg daily. This is shown to boost brain mitochondrial activity and provide a protective effect in rodent nerve tissue, especially when taken together with vitamin E.[28] In 2011 a study in the Journal of Alzheimer’s Disease reported that coenzyme Q10 decreased amyloid-beta pathology and improved behavioral and cognitive performance in Alzheimer’s mice (transgenic mouse model).[29]

Nicotinamide adenine dinucleotide (NADH): 10 mg/day, 30 minutes before breakfast. A small double-blind study[30] found no evidence of progressive cognitive deterioration and significantly higher cognitive performance scores among Alzheimer’s patients who took 10 mg daily for 6 months compared with those treated with placebo.

Medical foods:

• Caprylic acid (clinically tested as Ketasyn [AC-1202] is marketed as a “medical food” called Axona®) and coconut oil[31]

• Tramiprosate (clinically tested as Alzhemed, marketed as a "medical food" called ViviMind™)
   

Best foods for Alzheimer’s

The best foods are those with the highest complete protein, anti-oxidant activity, mineral content and that have an anti-inflammatory effect. To give you some ideas, consider these:

• Wild salmon (omega-3 oil)

• Cacao powder or dark chocolate (not chocolate bars with high sugar content)

• Matcha (Gyokuru green tea powder): EGCG (Epigallocatechin Gallate) content as high as 10 times other green teas

• Acai berries or blueberries (strongest antioxidants)

• Coffee beans: regular coffee consumption has been shown in several studies to reduce dementia (from fresh ground beans, without artificial creams/sweeteners)

• Grape juice, pomegranate juice (antioxidant resveratrol)

• Apples (the antioxidant flavonoid, quercetin)

• Leafy green vegetables such as spinach and collard greens (phytonutrients)

• Avocados, unsalted nuts and seeds (vitamin E, healthy oil)

• Goji berries (a.k.a. wolfberries) have strong antioxidant properties

• Allum foods: garlic, onions, chives, leeks, shallots and scallions. These contain flavonoid antioxidants thought to reduce the Alzheimer's disease process.

• More great foods: bananas, brewer's yeast, broccoli, brown rice, Brussels sprouts, cantaloupe, feta cheese, chicken, collard greens, eggs, flaxseed oil, legumes, oatmeal, oranges, peanut butter, peas, potatoes (not in excess), romaine lettuce, soybeans, spinach, tuna, turkey, wheat germ, and plain yogurt.

Remember to eliminate the following foods as much as possible: alcohol; artificial food colorings; artificial sweeteners; colas, sodas and high-sugar drinks; corn syrup and high fructose corn syrup; frostings; hydrogenated fats; junk sugars; white bread; and nicotine.

Exercise your mind

One parting thought: the importance of mental exercises[32] in Alzheimer’s patients[33] [34] have been proven to slow the cognitive decline. Here’s what you can do:

• start a new hobby

• travel

• get a part time job

• attend adult community seminars and events

• volunteer

• learn a foreign language or develop a new skill

• buy interesting mind games at http://www.lumosity.com/ or www.brainready.com.
   

To think clearly and feel good for health, Michael Cutler, M.D.

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[2] Mandel S, Weinreb O, Amit T, Youdim MB. Cell signaling pathways in the neuroprotective actions of the green tea polyphenol (-)-epigallocatechin-3-gallate: implications for neurodegenerative diseases. J Neurochem. 2004 Mar;88(6):1555-69.

[3] Wesnes KA, Ward T, McGinty A, Petrini O.The memory enhancing effects of a Ginkgo biloba/Panax ginseng combination in healthy middle-aged volunteers. Psychopharmacology (Berl). 2000 Nov;152(4):353-61.

[4] Brewer GJ, Torricelli JR, Lindsey AL, Kunz EZ, Neuman A, Fisher DR, Joseph JA. Age-related toxicity of amyloid-beta associated with increased pERK and pCREB in primary hippocampal neurons: reversal by blueberry extract. J Nutr Biochem. 2010 Oct;21(10):991-8.

[5] Wang J, Tang C, Ferruzzi MG, et al. Role of standardized grape polyphenol preparation as a novel treatment to improve synaptic plasticity through attenuation of features of metabolic syndrome in a mouse model. Mol Nutr Food Res. 2013 Aug 21.

[6] Ramassamy C. Emerging role of polyphenolic compounds in the treatment of neurodegenerative diseases: a review of their intracellular targets. Eur J Pharmacol. 2006 Sep 1;545(1):51-64.

[7] Peng J, Yuan JP, Wu CF, Wang JH. Fucoxanthin, a marine carotenoid present in brown seaweeds and diatoms: metabolism and bioactivities relevant to human health. Mar Drugs. 2011;9(10):1806-28.

[8] Pangestuti R, Vo TS, Ngo DH, Kim SK. Fucoxanthin Ameliorates Inflammation and Oxidative Reponses in Microglia. J Agric Food Chem. 2013 Apr 12. This study found that fucoxanthin ameliorates oxidative stress and inflammation in amyloid-β42 (Aβ42)-induced BV2 microglia cells and thereby may protect neuronal cells from neurotoxic mediators.

[9] Sandoval M, Okuhama NN, Zhang XJ, Condezo LA, Lao J, Angeles' FM, Musah RA, Bobrowski P, Miller MJ.

Anti-inflammatory and antioxidant activities of cat's claw (Uncaria tomentosa and Uncaria guianensis) are independent of their alkaloid content. Phytomedicine. 2002 May;9(4):325-37.

[10] Mammone T, Akesson C, Gan D, Giampapa V, Pero RW. A water soluble extract from Uncaria tomentosa (Cat's Claw) is a potent enhancer of DNA repair in primary organ cultures of human skin. Phytother Res. 2006 Mar;20(3):178-83.

[11] Frackowiak T, Baczek T, Roman K, Zbikowska B, Gleńsk M, Fecka I, Cisowski W. Binding of an oxindole alkaloid from Uncaria tomentosa to amyloid protein (Abeta1-40). Z Naturforsch C. 2006 Nov-Dec;61(11-12):821-6.

[12] Vepsäläinen S, Koivisto H, Pekkarinen E, et al. Anthocyanin-enriched bilberry and blackcurrant extracts modulate amyloid precursor protein processing and alleviate behavioral abnormalities in the APP/PS1 mouse model of Alzheimer's disease. J Nutr Biochem. 2013 Jan;24(1):360-70.

[13] Patyar S, Prakash A, Modi M, Medhi B. Role of vinpocetine in cerebrovascular diseases. Pharmacol Rep. 2011;63(3):618-28.

[14] Valikovics A, Csányi A, Németh L. [Study of the effects of vinpocetin on cognitive functions]. [Article in Hungarian]. Ideggyogy Sz. 2012 Mar 30;65(3-4):115-20.

[15] Mancuso C, Bates TE, Butterfield DA, Calafato S, Cornelius C, De Lorenzo A, Dinkova Kostova AT, Calabrese V. Natural antioxidants in Alzheimer's disease. Expert Opin Investig Drugs. 2007 Dec;16(12):1921-31.

[16] Gavrilova SI, Kalyn IaB, Kolykhalov IV, Roshchina IF, Selezneva ND. [Acetyl-L-carnitine (carnicetine) in the treatment of early stages of Alzheimer's disease and vascular dementia]. [Article in Russian] Zh Nevrol Psikhiatr Im S S Korsakova. 2011;111(9):16-22.

[17] Vakhapova V, Cohen T, Richter Y, Herzog Y, Korczyn AD. Phosphatidylserine containing omega-3 fatty acids may improve memory abilities in non-demented elderly with memory complaints: a double-blind placebo-controlled trial. Dement Geriatr Cogn Disord. 2010;29(5):467-74.

[18] Crook TH, Tinklenberg J, Yesavage J, Petrie W, Nunzi MG, Massari DC. Effects of phosphatidylserine in age-associated memory impairment. Neurology. 1991 May;41(5):644-9.

[19] Cenacchi T, Bertoldin T, Farina C, Fiori MG, Crepaldi G. Cognitive decline in the elderly: a double-blind, placebo-controlled multicenter study on efficacy of phosphatidylserine administration. Aging (Milano). 1993 Apr;5(2):123-33.

[20] Crook T, Petrie W, Wells C, Massari DC. Effects of phosphatidylserine in Alzheimer's disease. Psychopharmacol Bull. 1992;28(1):61-6.

[21] Jorissen BL, Brouns F, Van Boxtel MP, Ponds RW, Verhey FR, Jolles J, Riedel WJ. The influence of soy-derived phosphatidylserine on cognition in age-associated memory impairment. Nutr Neurosci. 2001;4(2):121-34.

[22] No reference available

[23] Meador K, Loring D, Nichols M, Zamrini E, Rivner M, Posas H, Thompson E, Moore E. Preliminary findings of high-dose thiamine in dementia of Alzheimer's type. J Geriatr Psychiatry Neurol. 1993 Oct-Dec;6(4):222-9.

[24] Mimori Y, Katsuoka H, Nakamura S. Thiamine therapy in Alzheimer's disease. Metab Brain Dis. 1996 Mar;11(1):89-94.

[25] Annweiler C, Montero-Odasso M, Llewellyn DJ, Richard-Devantoy S, Duque G, Beauchet O. Meta-Analysis of Memory and Executive Dysfunctions in Relation to Vitamin D. J Alzheimers Dis. 2013 Jan 1;37(1):147-171.

[26] Taghizadeh M, Talaei SA, Djazayeri A, Salami M.Vitamin D supplementation restores suppressed synaptic plasticity in Alzheimer's disease. Nutr Neurosci. 2013 Jul 23.

[27] McDonald SR, Sohal RS, Forster MJ. Concurrent administration of coenzyme Q10 and alpha-tocopherol improves learning in aged mice. Free Radic Biol Med. 2005 Mar 15;38(6):729-36.

[28] McDonald SR, Sohal RS, Forster MJ. Concurrent administration of coenzyme Q10 and alpha-tocopherol improves learning in aged mice. Free Radic Biol Med. 2005 Mar 15;38(6):729-36.

[29] Dumont M, Kipiani K, Yu F, Wille E, Katz M, Calingasan NY, Gouras GK, Lin MT, Beal MF. Coenzyme Q10 decreases amyloid pathology and improves behavior in a transgenic mouse model of Alzheimer's disease. J Alzheimers Dis. 2011;27(1):211-23.

[30] Demarin V, Podobnik SS, Storga-Tomic D, Kay G. Treatment of Alzheimer's disease with stabilized oral nicotinamide adenine dinucleotide: a randomized, double-blind study. Drugs Exp Clin Res. 2004;30(1):27-33.

[31] http://www.alz.org/alzheimers_disease_alternative_treatments.asp

[32] Verghese J, Lipton RB, Katz MJ, Hall CB, Derby CA, Kuslansky G, Ambrose AF, Sliwinski M, Buschke H. Leisure activities and the risk of dementia in the elderly. N Engl J Med. 2003 Jun 19;348(25):2508-16.

[33] Hall CB, Lipton RB, Sliwinski M, Katz MJ, Derby CA, Verghese J. Cognitive activities delay onset of memory decline in persons who develop dementia. Neurology. 2009 Aug 4;73(5):356-61.

[34] Wilson RS, Mendes De Leon CF, Barnes LL, Schneider JA, Bienias JL, Evans DA, Bennett DA.

Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA. 2002 Feb 13;287(6):742-8.