How to prevent cognitive decline

An estimated 6.5 million Americans aged 65 and older are living with Alzheimer’s disease today.  This is nearly 11% of seniors in the US.  The cost of caring for patients with Alzheimer’s is approaching $300 billion annually, which is greater than the economy of Finland.  All cancer  care costs in the US last year approached $25 billion, by comparison.


Your Medicare part B premium increased recently to cover the cost of a controversial and expensive new drug (Aduhelm).  The drug doesn’t work very well, in part because it attacks amyloid plaques in the brain, which are formed in RESPONSE to brain irritation, and are not the cause of dementia.  There is no cure for Alzheimer’s, so the very best bet is prevention.

No amount of alcohol is good for your brain (or other vital organs). If you are a woman and drink more than 4 ounces of wine or 2 ounces of harder alcohol a day, cut back.  If you are a man you can supposedly get away with double this amount, though there is no good medical reason to recommend alcohol, especially not on a regular basis.  Binge drinking is the worst for your health.  As soon as ethanol gets into your mouth, the brain goes into overdrive preparing the rest of your body (especially the liver) to detoxify the stuff.  Avoid alcohol if you want your brain to keep working well.

When it comes to promoting good health, preserving your brain health isn’t much different from any other part of your body.  Drink plenty of water.  Get enough sleep.  Eat a sensible diet.  Two meals a day is plenty for seniors.  Eating less has many benefits including mitigating against some of the most problematic “lifestyle” factors which constitute the deadly comorbidities: obesity, diabetes and cardiovascular disease.  If COVID has taught us anything, it’s that the main risk factor for more severe illness of any ilk is having these mitigatable comorbidities.

Your body is brilliant at self-healing.  This is why we can recover from illness and injury and are generally living longer.  But the point is to live longer with good health!  One of my favorite nutrients to help maintain a healthy brain is fish oil; fresh Alaskan salmon is the very best.  On days not enjoying this delicious and nutritious food, take a 2-3 caps of wild-Alaska salmon fish oil, sold at Costco and many health food stores.  Also consider supplementing with Co-Q10 which allows our cells to maintain optimal levels of oxygen.  The more oxygen you can produce in your cells, the less hard your heart has to work to pump oxygenated blood around the body, including to the brain.  Co-Q10 is rather expensive; 200 mg daily is sufficient.

Ginkgo biloba, a widely studied herbal medicine, works well for improving short-term memory.  It is a peripheral oxygenator (opens small blood vessels) and absolutely helps most people sharpen their cognitive abilities.  Start with 120-180 mg daily of a product that contains 24% GBE (ginkgo heterosides, the active ingredient).  If no cognitive improvement after a 10-day trial, increase to 240-300 mg range daily.  Once you find a dose that makes you realize you are not losing your keys and have renewed access to vocabulary, you can taper down to a minimal effective maintenance level.  Other useful herbal medicines to support cognitive function include Ashwagandha, Bacopa moniera, and Gotu kola.

B vitamins are well known nerve nutrients; ideally taken in the methylated form, which allows for optimal absorption through cell membranes where they can be used as co-factors in tissue repair and energy production.  Take a high-quality multi-B especially if you don’t eat red meat (a natural source of these vitamins).

Oral health is key for protecting your brain.  A low-level tooth abscess or even gingivitis keeps pockets of unhealthy bacteria close to your brain.  Many of these bad bugs are stymied by the natural sugar Xylitol.  Several studies have shown that seniors chewing Xylitol sweetened gum or consuming beverages with this zero-calorie sweetener can help promote oral health, reducing dental and ear infections, and preserving cognitive function.  Make sure to visit your dentist twice a year!

Finally, brains are mostly made of fat (specifically cholesterol) which is why statin drugs accelerate early cognitive decline.  But so does the toxic burden in our food, air and water.  Our bodies are designed to protect vital organs against toxins (soft plastics, pesticides, fertilizers, heavy metals, pharmaceuticals) by walling them off inside fat cells.  Unfortunately, many of these noxious substances can cross the blood-brain barrier and lodge in the fatty brain tissue.  Avoid brain irritants.  Don’t eat food or drink liquids that have been stored or cooked in plastic.  Choose organic or locally grown food whenever possible.  As we age, natural substances which promote brain health (such as bio-identical testosterone, estrogen, and DHEA — all of which derive from cholesterol) decline.  Talk to your doctor about partnering with you to implement strategies to preserve your brain.