10 Best Supplements to Lower Your Alzheimer's and Dementia Risk (2024)
The most common type of dementia is Alzheimer’s Disease (AD). In March 2023, the Alzheimer’s Association of the United States released its latest data indicating that there are about 6.7 million Americans aged 65 and above suffering from Alzheimer’s disease. Without many breakthroughs in prevention, mitigation, or treatment, it is projected that this number could reach 13.8 million by 2060.
Dementia is the name for a group of symptoms associated with an ongoing decline of brain functioning. It can affect memory, thinking skills and other mental abilities.
Currently, there are no cures or effective medications to prevent or treat AD, which translates into USD 321 billion in healthcare costs in the US and over USD 1 trillion in the world [R] that places a significant financial and psychological burden on both patients as well as their family members or caregivers.The exact cause of Alzheimer's disease is not yet fully understood, although a number of things are thought to increase your risk of developing the condition.
These include:
There are currently no drugs available to prevent, treat, or reverse the course of Alzheimer’s disease. The five FDA-approved medications available for Alzheimer’s are designed to relieve symptoms such as memory loss, for a limited time — Aricept®, Exelon®, Namenda®, Namzaric® and Razadyne®.
- increasing age
- a family history of the condition
- untreated depression, although depression can also be one of the symptoms of Alzheimer's disease
- lifestyle factors and conditions associated with cardiovascular disease
Do Vitamins and Supplements Help With Alzheimer's?
The antioxidant connection is a hot area in Alzheimer’s research, but everyone agrees that more still needs to be done. Researchers aren’t sure if some antioxidants are better than others, and it’s possible that it might be better to get your antioxidants from food instead of from supplements.
In this context, a multivariate preventative intervention, targeting several disease-causing mechanisms simultaneously, would probably be more beneficial.
In a December 2023 large-scale study published in JAMA Neurology, researchers identified 15 lifestyle and health risk factors associated with early-onset dementia. The study analyzed information from over 356,000 people younger than 65 whose data were in the UK Biobank, a large-scale biomedical database and research initiative in the United Kingdom, between 2006 and 2010.
The results from the randomized controlled FINGER trial showed that multidomain lifestyle interventions could improve cognition among old people who are at high risk of developing dementia, encouraging further investigation (Kivipelto 2018).
We have compiled a list of the best natural supplements that are currently under research below together with their reference links.
Methodology: The selection or short-listing of the list below is based on the available scientific evidence retrieved from scientific database such as PubMed and scientific search engine such as Google Scholar. Note that this list is not exhaustive.
- B Vitamins
- Vitamin D
- Omega-3 fatty acids and Lutein
- Magnesium
- Ginseng
- Melatonin
- Ginko Biloba
- Coconut Oil (MCT)
- Citicoline
- Mushroom (Ergothioneine)
1. B Vitamins
Vitamins B3, B6, B9 (folate) and B12 may be particularly important for supporting cognitive function as you age, and have been shown to play a major role in the development of dementia, including Alzheimer's disease, which is the most serious (and lethal).
A 2016 randomized controlled trial suggests that B vitamin supplementation slows cognitive decline in select groups, including people with mild cognitive impairment and high baseline homocysteine levels.
A 2013 study took this research a step further, showing that not only do B vitamins slow brain shrinkage, but they specifically slow shrinkage in brain regions known to be most severely impacted by Alzheimer's disease. Moreover, in those specific areas the shrinkage is decreased by as much as 700% which is rather remarkable.
As in the previous study, participants taking high doses of folic acid and vitamins B6 and B12 lowered their blood levels of homocysteine, decreasing brain shrinkage by as much as 90%. Earlier research (2001) has also pointed out that even subclinical deficiencies in B vitamins may have "a subtle influence on aspects of cognitive performance."
A 2014 large meta-analysis of 11 trials did show that while B vitamins lowered homocysteine levels, they did not affect cognitive function.
Homocysteine levels are commonly high in people over 65 and are linked to strokes, coronary artery disease, and dementia. (2010 paper)
The good news is your body can eliminate homocysteine naturally, provided you're getting enough B9 (folate), B6 and B12. One study confirming this was published in 2010. Participants received either a placebo or 800 micrograms (mcg) of folic acid (the synthetic form of B9), 500 mcg of B12 and 20 mg of B6.
The good news is your body can eliminate homocysteine naturally, provided you're getting enough B9 (folate), B6 and B12. One study confirming this was published in 2010. Participants received either a placebo or 800 micrograms (mcg) of folic acid (the synthetic form of B9), 500 mcg of B12 and 20 mg of B6.
The study was based on the presumption that by controlling homocysteine levels you might be able to reduce brain atrophy, thereby slowing the onset of Alzheimer's. Indeed, after two years those who received the vitamin-B regimen had significantly less brain shrinkage compared to the placebo group. Those who had the highest levels of homocysteine at the start of the trial experienced brain shrinkage at half the rate of those taking a placebo.
Vitamin B3 and NAD
Since age is the greatest risk factor for Alzheimer's disease and dementia, supplements that slow aging-related processes may also slow progression of these diseases. An observational study found that older adults have lower levels of the coenzyme NAD+ in their brains than younger adults (Pubmed 2015).
Related: Best NMN Supplement
2. Vitamin D
In a March 2023 study, Vitamin D supplementation was associated with 40% lower dementia incidence versus no exposure.
People with low levels or low dietary intake of vitamin D appear to be more likely to develop mild cognitive impairment (MCI) or dementia (Littlejohns 2014], but no clinical research has yet tested whether treatment with vitamin D can protect from this risk.
Participants (~65 years of age) from a Brazilian cross-sectional study that were diagnosed with dementia showed lower serum vitamin D levels. Interestingly, a rise in each unit of serum vitamin D led to a fall in dementia prevalence by 8%, suggesting that vitamin D may be a meaningful disease-modifiable factor (Santos 2020).
A study by Zhao and colleagues (Zhao 2020) examined if the consumption of vitamin D is associated with the risk of dementia. A multi-ethnic cohort from the Washington Heights-Inwood Columbia Aging Project (WHICAP) comprised more than 1750 individuals over 65 years old without dementia at baseline. At a 5.8-year follow-up, 329 subjects were diagnosed with dementia and those with the lowest vitamin D intake had the highest risk of developing dementia, supporting the concept that higher vitamin D consumption, and its enhanced action thereof, may be beneficial for healthy cognitive functions.
Related: Best Vitamin D3 Supplements
3. DHA (Omega-3) and Lutein
Docosahexaenoic acid (DHA) is a long-chain omega-3 polyunsaturated fatty acid found in some fish and over-the-counter supplements. It is a building block of the brain involved with numerous cellular pathways.Published in 2022, the Cognitive impAiRmEnt Study (CARES Trial 2), was designed to examine the potential synergistic effects of a combination of omega-3 fatty acids (namely DHA and eicosapentaenoic acid [EPA]), xanthophyll carotenoids (specifically lutein, zeaxanthin and meso-zeaxanthin) and vitamin E (d-α-tocopherol) on the cognitive performance of cognitively healthy older adults. This study provides Class II evidence that 24-month supplementation with 430 mg DHA, 90 mg EPA, 10 mg lutein, 2 mg zeaxanthin, 10 mg meso-zeaxanthin and 15 mg vitamin E (d-α-tocopherol) is effective in improving cognitive performance, namely working memory, in cognitively healthy older adults.
In conclusion, the CARES research has shown improvements in working memory following 24-month supplementation with omega-3 fatty acids, xanthophyll carotenoids (lutein and zeaxanthin) and vitamin E in cognitively healthy older adults. These results support a biologically plausible rationale whereby these nutrients work synergistically, and in a dose-dependent manner, to improve cognitive performance. These findings illustrate the importance of nutritional enrichment in improving cognition and enabling older adults to continue to function independently, and highlight how a combination of omega-3 fatty acids and xanthophyll carotenoids may prove beneficial in reducing cognitive decline and/or delaying Alzheimer's disease onset in later life. (Power 2022).
A posthoc analysis study of the OmegAD trial, published in 2019, concluded that the effect of omega-3 supplementation on MMSE and CDR (measures of cognitive dysfunction) appears to be influenced by baseline tHcy (total homocysteine level), suggesting that adequate B vitamin status is required to obtain beneficial effects of omega-3-fatty acid on cognition.
Studies (Pubmed 2016, Pubmed 2018) have linked a low omega-3 index (below approximately 5 percent) with an increased risk of cognitive decline in older adults, linking a low omega index to brain shrinkage and cognitive impairment.
Some observational research studies found that people who eat fish every week (i.e., a major source of dietary DHA) or have higher DHA levels also had a lower risk of dementia or a slower rate of brain aging (Pubmed 2016).
Increased beneficial effects of macular carotenoids (lutein and zeaxanthin) were also observed upon their intake together with fish oil and omega-3 fatty acids, suggesting a dietary synergism (Nolan 2018).
Many governments recommend eating omega-3 containing fatty fish, two times per week. But that is often not enough. Ideally, people would need to eat fatty fish four times per week, while also supplementing with omega-3 fatty acids, at least 1,000 mg of pure omega-3 (DHA and EPA) per day.
Make sure you buy high-quality omega-3 fatty acid supplements, meaning that the omega-3 fatty acids are pure and have not oxidized much (having low “TOTOX” value).
Make sure you buy high-quality omega-3 fatty acid supplements, meaning that the omega-3 fatty acids are pure and have not oxidized much (having low “TOTOX” value).
4. Magnesium
Magnesium (Mg) is an essential mineral for the body and brain, which is needed for the proper functioning of many enzymes that carry out biochemical reactions. Sufficient levels of magnesium are usually obtained through a healthy diet.
A meta-analysis conducted in 2022 concluded that a significant Mg deficiency exists in subjects diagnosed with MCI or AD [Du 2022]. These findings suggest that Mg deficiency may be either the result of low dietary intake of Mg or the consequence of disease progression.
Reduced Mg amount in the AD brain may be attributed to lower circulating Mg levels caused by its reduced dietary intake, or defective Mg transport mechanism. The findings of higher dietary Mg intake are associated with a lower risk of MCI indicating a potential neuroprotective effect of Mg intake or supplementation (Glick 2016).
Specifically, one study followed more than 1,400 healthy older adults for 8 years and reported that higher dietary magnesium intake was associated with an 86 percent reduced risk of developing mild cognitive impairment for men but not women [Cherbuin 2014].
Another 17-year study that followed more than 1,000 Japanese adults over the age of 60 found that those who consumed more than 200 mg of magnesium per day were 37 percent less likely to develop any type of dementia and 74 percent less likely to develop vascular dementia [Ozawa 2012].
One 2016 pilot randomized controlled trial of 44 patients reported that magnesium L-threonate improved overall cognitive ability for elderly patients with memory complaints (Liu 2016).
5. Ginseng
Panax ginseng is a plant used in traditional Chinese medicine (also known as Korean or Asian ginseng). Its root contains compounds called ginsenosides, which have anti-oxidative and anti-inflammatory effects. Panax ginseng is purported to enhance longevity, promote cognitive functions, and alleviate fatigue.A 2020 double-blind randomized controlled trial of 52 healthy individuals reported that Panax ginseng treatment (1 g/day) for eight weeks significantly increased the volume of a brain region important for memory and improved scores on executive function, attention, and memory, effects that were not seen in the placebo group.
In a 2011 study, the longest placebo-controlled clinical trial included 61 Alzheimer’s patients and lasted two years (Ref). In the low-dose Panax ginseng group (4.5 g/day), cognitive scores (as measured by the Mini-Mental State Examination) improved after 48 weeks, then slightly decreased at 96 weeks. In the high-dose group (9.0 g/day), cognitive scores showed slight improvement at 48 and 96 weeks. In this study, maximum cognitive improvement was observed around 24 weeks, then sustained for two years.
A meta-analysis of five double-blind randomized controlled trials in healthy subjects reported that Panax ginseng treatment for 8-12 weeks showed improvement in some aspects of cognitive function, behavior, and quality of life, though the evidence was not convincing or consistent across studies (Cochrane 2010).
6. Melatonin
Melatonin is neuro-protective. The brain consumes 20% of the body’s oxygen. All that oxygen passing through the brain makes a toxic byproduct called reactive oxygen species, which can damage nerves and blood vessels.
Is Melatonin Good For Alzheimer's?
Melatonin improves sleep, which could theoretically lead to long-term protection against Alzheimer's. A review and meta-analysis on melatonin treatment in Alzheimer's published in Neuroscience & Biobehavioral Reviews (Aug 2021) showed individuals with Alzheimer's improved with more than 12 weeks of treatment.
Your brain uses many different antioxidants, including melatonin, to neutralize the reactive oxygen species before they can cause harm. Therefore, it is not surprising that studies (2018) show melatonin seems to provide some protective effect against diseases like Alzheimer’s.
7. Gingko Biloba
Given that the ginkgo biloba tree is among the oldest trees in the world, ginkgo seeds have been used in traditional Chinese medicine and other types of treatment for thousands of years. The sole survivor of trees from 270 million years ago, it releases all its leaves in a golden explosion in just one day (Twitter).
 |
| Photo by Han Fei |
In a 2016 study published in Nutrition, ginkgo biloba was shown to protect the brain from toxicity associated with aluminum chloride. Exposure to aluminum chloride has been linked to Alzheimer's and other cognitive impairments.
A 2012 study published in International Psychogeriatrics suggests ginkgo biloba may slow the aging process within mitochondria of your cells, which can affect the progression of Alzheimer’s.
There are two meta-analyses in dementia patients. In one analysis (2015), seven studies showed that patients using ginkgo had improved scores on certain cognitive performance tests. Two studies in the same analysis using different assessments, however, did not show a statistically significant difference (Ref). Another meta-analysis (2016) of patients with mild cognitive impairment and Alzheimer's disease showed that after 24 weeks of ginkgo, in combination with conventional medicine, they improved cognitive performance scores (Ref).
According to Cleveland Clinic (2002), an adult dose of 120 to 600 milligrams (mg) of ginkgo biloba per day seems to be effective for addressing memory problems. Some have suggested even better results may be achieved by taking ginkgo in combination with panax ginseng or codonopsis.
Risks and Cautions Related to Ginkgo Intake
According to the U.S. National Center for Complementary and Integrative Health, intake of ginkgo biloba is thought to be safe for healthy adults when taken by mouth in moderate amounts. Potential side effects of ginkgo may include allergic skin reactions, dizziness, headache and stomach upset. An increased risk of bleeding is possible with ginkgo if you are older, pregnant or have a known bleeding risk. Ginkgo has been shown to interact with blood thinners (anticoagulants), so do not take it if you are currently on a blood-thinner medication. For similar reasons, you should not take ginkgo before undergoing surgery or dental procedures. Also, do not eat raw or roasted ginkgo seeds, because they can cause serious side effects and may be poisonous.
You Need B Vitamins if You Take Ginkgo Biloba
A word of caution related to ginkgo biloba: Its seeds contain ginkgotoxin (4'-Omethylpyridoxine), an “antivitamin” that may lead to neurological problems in certain people, particularly those who are deficient in certain B vitamins. B vitamins are important not only when you consume ginkgo, but they are also useful in helping to reduce brain shrinkage and prevent degenerative brain diseases (J Epilepsy Res. 2015).
8. Coconut Oil (Medium-Chain Triglycerides)
Coconut oil has been quite the buzzword over the past several years. It has been touted as a health food and as a cure-all to everything from acne, dry skin, diaper rash and now to Alzheimer’s.
Coconut oil, as we all have been hearing, is a good fat; it contains medium-chain triglycerides (MCTs), which our bodies can use as an alternate energy source by converting them into ketones. Our body’s first source of energy is glucose, and when we run low on glucose, we will break down fat and ketones are the byproduct — the alternate energy source.
According to Cognitive Vitality, a program of Alzheimer’s Drug Discovery Foundation, with Alzheimer's "the ability of the brain to use glucose is impaired. Ketones are an alternative energy source for the brain and might be able to compensate for this impairment."
The Research
Currently, there have been several small trials testing the theory that the MCTs found in coconut oil are beneficial for Alzheimer’s:
Coconut oil, as we all have been hearing, is a good fat; it contains medium-chain triglycerides (MCTs), which our bodies can use as an alternate energy source by converting them into ketones. Our body’s first source of energy is glucose, and when we run low on glucose, we will break down fat and ketones are the byproduct — the alternate energy source.
According to Cognitive Vitality, a program of Alzheimer’s Drug Discovery Foundation, with Alzheimer's "the ability of the brain to use glucose is impaired. Ketones are an alternative energy source for the brain and might be able to compensate for this impairment."
The Research
Currently, there have been several small trials testing the theory that the MCTs found in coconut oil are beneficial for Alzheimer’s:
- One trial performed on elderly individuals with age-related cognitive decline reported no benefit with the use of an MCT supplement.
- Another trial performed on patients with diabetes showed that MCT supplements preserved cognitive functioning related to hypoglycemia, which can cause a decrease in brain cells, especially if it occurs repeatedly.
- For patients who were carriers of the APOE4 genotype (a genotype that causes atherosclerosis, which in turn increases the risk for certain conditions such as heart attacks, strokes and brain conditions related to cognitive impairment), MCTs were not effective. For patients who were not carriers of this genotype, MCT supplements improved mild cognitive decline.
- There is currently a major trial being performed in the U.S. This study seeks to find whether coconut oil is safe to use in the Alzheimer’s population and whether it is effective in improving memory and cognition.
- Another study (Avgerinos 2019) surrounded men and women with Alzheimer's disease or mild cognitive impairment. The participants were given either MCTs or a placebo. The researchers found that those who were given MCTs had increased memory improvements. This type of research led Emilie Reas, a postdoctoral fellow at UC San Diego who studies brain changes with aging and disease, to conclude that ketones (such as those from coconut oil) may be a "miracle treatment."
9. Citicoline
In a 2023 review and meta-analysis, six studies (including more than 1,300 patients with mild cognitive impairment, Alzheimer's Disease and post-stroke dementia) were selected for the meta-analysis. Overall, citicoline improved cognitive function. However, the overall quality of the studies was poor with significant risk of bias in favor of the intervention.
In a 2021 randomized controlled trial (not included in the review above), 100 patients with AAMI (Age Associated Memory Impairment) were randomized.
10. Mushroom (Ergothioneine)
Evidence has suggested that mushrooms, which are a rich source of the potent antioxidants ergothioneine and glutathione as well as vitamin D, may have neuro-protective properties. A 2022 study analysed data from older adults aged ≥ 60 years from the 2011-2014 National Health and Nutrition Examination Survey. Mushroom intake was measured using up to two 24-h dietary recalls and was categorised into three groups (lowest, middle and highest). The study included 2840 participants. Greater mushroom intake was associated with certain cognitive performance tests, suggesting regular mushroom consumption may reduce the risk of cognitive decline.
Metabolic Health and Alzheimer's Disease
Reputable researchers argue that Alzheimer’s is a metabolic disease. The consumption of added sugar fuels this disease. Interestingly, cancer, kidney disease, heart disease, strokes, and obesity are all tied to metabolic dysregulation.
Don’t expect the mainstream media to report this, though. For years, we have been fed lies by prominent, mainstream media outlets. Take the pernicious idea that the consumption of chocolate on a regular basis can help you lose weight, for example. Let’s be clear: An occasional piece of chocolate, be it milk chocolate or dark chocolate, isn’t going to ruin your health. However, the idea that regular chocolate consumption is compatible with a healthy lifestyle is simply false. The same goes for red wine, an alcoholic beverage that is still being marketed as some sort of miracle supplement, an elixir capable of transforming your life for the better.
A review of 18 studies on therapeutic ketosis as a potential therapy for neurodegenerative disorders–in particular, mild cognitive impairment (MCI), Alzheimer's disease (AD), and Parkinson's disease (PD) concluded, "Collectively, the strongest evidence to date exists for cognitive improvement in individuals with mild cognitive impairment and in individuals with mild-to-moderate Alzheimer's disease negative for the apolipoprotein ε4 allele. Larger-scale, pivotal trials are justified in these populations." (Bohnen 2023)
Exercise and Dementia
The University of Oxford and other research institutions in the United Kingdom published a paper in the Journal of Neurology, Neurosurgery & Psychiatry (2023) in which the researchers conducted five surveys involving 1,417 participants aged between 36 and 69. The results showed that exercising to improve brain function is beneficial at any age and it is important to maintain exercise throughout life.
It has also been evidenced recently that one of the best strategies for healthy brain aging is regular aerobic exercise. It is suggested that exercise likely remains the most effective intervention for healthy brain aging because it stimulates strategic energy-sensing pathways that modulate multiple hallmarks of aging. (Exerc Sport Sci Rev 2021)
Instead, it focused on cardiovascular fitness, as measured by a stepwise-increased maximal ergometer cycling test. Cardiovascular fitness can be a measure of how well blood is circulating to your heart and brain. Study author and physiotherapist Helena Horder told Time, "If the small blood vessels and circulation in the heart are OK, then the brain is also affected in a positive way by good small vessel circulation."
Additional Dementia's Prevention Strategies
In addition to the supplement recommendations mentioned above, the following additional prevention strategies will help you avoid Dementia and Alzheimer's.
- Eat real food, ideally organic
- Replace refined carbohydrates with healthy fats
- Avoid gluten and casein
- Get sufficient quality sleep
- Intermittent fasting
Alzheimer’s Disease Linked to Exposure to Aluminum
A study published in the Journal of Alzheimer’s Disease (JAD) on January 13, 2020, supports a growing body of research that links human exposure to aluminum with Alzheimer’s disease (AD). Researchers found significant amounts of aluminum content in brain tissue from donors with familial AD. The study also found a high degree of co-location with the amyloid-beta protein, which leads to early onset of the disease.
“This is the second study confirming significantly high brain accumulation in familial Alzheimer’s disease, but it is the first to demonstrate an unequivocal association between the location of aluminum and amyloid-beta in the disease. It shows that aluminum and amyloid-beta are intimately woven in the neuropathology,” explained lead investigator Christopher Exley, PhD, Birchall Center, Lennard-Jones Laboratories, Keele University, Staffordshire, UK.
“This is the second study confirming significantly high brain accumulation in familial Alzheimer’s disease, but it is the first to demonstrate an unequivocal association between the location of aluminum and amyloid-beta in the disease. It shows that aluminum and amyloid-beta are intimately woven in the neuropathology,” explained lead investigator Christopher Exley, PhD, Birchall Center, Lennard-Jones Laboratories, Keele University, Staffordshire, UK.
According to Dr Exley:
Editor's Note: Clearly, Alzheimer's is not caused by a single factor. Your diet and lifestyle play significant roles, as do other toxic exposures. To learn more about the factors that raise your risk for Alzheimer's, see "How Iron Overload Affects Your Risk of Alzheimer's Disease" and "How Vegetable Oil Wrecks Your Health".
Concern and Caution
It has been reported that antioxidants can act as pro-oxidants when accumulated in excessive amounts (Varesi 2022), underlying the importance of patient-to-patient evaluation. This holds particularly true when considering the fact that older people make use of several chronic medications, which may end up interfering with the expected activity of the recommended supplementation.If antioxidant combinations are then considered, careful assessment of synergism and antagonism among various compounds should be conducted, as the simultaneous administration of several antioxidants does not always represent the best option (Sharman 2019).
Related:
Comments
Post a Comment