First things first: most people want to know two things.
1. Does the fact that I keep forgetting things mean I am going to get dementia or Alzheimer's?
2. Is there a reliable test I can do to check my memory and cognitive function?
The answer to number one is no, definitely not. The answer to number two is yes, there is.
There was an interesting piece in the BMJ recently (Sep 2013) claiming that many people diagnosed with Alzheimers and dementia probably won’t ever develop issues beyond normal ageing memory loss. Here’s what WDDTY had to say about it:
Around 65 per cent of people aged over 80 will be diagnosed with Alzheimer’s in a new drive in the UK and the US to screen the elderly. But only between five and 15 per cent of people with mild cognitive impairment, such as memory loss, will ever develop Alzheimer’s. The rest will never suffer from the disease, despite the prognosis, and they may even improve, say specialists in the UK and Australia.
A similar picture is emerging for people labelled as having dementia. Around 25 per cent will never see their mild cognitive problems develop into full dementia.
I have noticed that the recent drive for better diagnosis of these conditions has led to many more people being told they are at risk of developing Alzheimers or dementia and this brings a lot of worry that, by the looks of this article, could be totally unwarranted. That seems a shame. The cynic in me would wonder if this is, yet again, a drive to sell more drugs. I hope not.
Of course, it is vitally important to identify those who might be at risk of these horrid conditions but I have been worried about how you do distinguish between simple (if frustrating) memory loss and the more severe conditions. That must be hard.
As the WDDTY article also goes on to suggest, it could even be that the drugs given could cause more cognitive decline themselves.
You can go to the BMJ and sign up to read this article if you like – it is part of the fascinating Too Much Medicine series, which is a fab idea from BMJ and very welcome. If you don’t sign up, reading the rapid responses is enlightening anyway.
Here is a useful article about possible new ways to distinguish between those who may go on to develop more severe problems and those who likely won’t.
Also, foodforthebrain.org has a free cognitive test which takes 20 minutes. It has recently been given five stars in a comparison study published in the International Journal of Geriatric Psychiatry, when the separate aspects of cognitive function tested in the test were compared to the ‘state of the art’ tests used for diagnosis, like those in the article above.
So, what do you do if the test comes up with a possible problem?
One of the experts in this field - and actually one of the organisers of the Food for the Brain organisation is Patrick Holford. He has written a few books on the subject and is behind the Plan B campaign to raise awareness of how nutritional intervention can help in the prevention of cognitive decline.
With that in mind, I thought it might be useful to show you his 1,2,3 steps for Alzheimer's prevention. Check the Food for the Brain website for more info. I've included my comments too for you, of course!
Step 1: Up omega 3s.
While studies have been accumulating to show the benefit of a daily omega 3 fish oil supplement for those with diagnosed memory problems, a recent study has found, for the first time, that taking omega 3 fish oils versus placebos not only improves various aspects of cognition, but also correlates to positive structural changes in the brain indicating healthier, more intact brain tissue in critical areas of the brain.
This study from the Leibniz University in Hannover (sic), Germany, involving 65 healthy people aged 50 to 75, is the first to show that positive memory improvements can actually be seen to have an effect on the brain, which would normally be seen to be shrinking from 60 onwards. They were given daily fish oils of both EPA and DHA, which is what I take two capsules of daily.
In the study they were given four capsules a day providing 1320mg of EPA and 880mg of DHA. I’d suggest supplementing half this if you don’t have memory problems and possibly even less, 500mg of EPA a day if you eat oily fish three times a week. I achieve this by taking two capsules of EPA and DHA (mine has DPA too which can convert to either EPA or DHA as needed).
Ed: I assume he is meaning this product here.
Step 2. Master your blood sugar level.
There have been an ever-increasing number of studies linking blood sugar problems, notably diabetes, with memory loss and increased risk of Alzheimer’s.
The latest and greatest study, published in the New England Journal of Medicine, involving over 35 thousand people, has shown that poor blood sugar control even before diabetes, is strongly linked to declining memory and greatest risk of dementia. The lowest risk occurs at blood glucose levels of 5.2mmol/l (95mg/dl). Diabetics usually have levels above 7mmol/l (125mg/dl), while anything above 6mmol/l (110mg/dl) is considered pre-diabetic.
This means that keeping a tight control on your blood sugar by following my low GL diet makes a big difference. If you struggle with sugar cravings try supplementing the combination of chromium with cinnulin, a cinnamon extract high in MCHP, and/or taking 3 capsules or 3 grams of glucomannan fibre with a large glass of water before meals to even out your blood sugar and make you feel satisfied for longer.
Ed: I have successfully used glucomannan fibre several times to help lower HBA1c diabetes scores. I also have a low GL diet as you know, which is also free from gluten and dairy. If all you need is a quick primer, see the Best and Worst Low GL Foods list, which is included in the book too.
Here is Holford’s Cinnulin and Chromium combined product. The glucomannan I have used comes in either powder or capsules. Here it is on Nutricentre, but ND should get it for you as usual as they stock Nature’s Plus products – just this one is not on their site yet, so ask. I see Holford also has a powder though that I just found here. And here are the caps.
There is an interesting video here with David Perlmutter, the author of the book Grain Brain (see below), where actually he is talking about the need for us to eschew more carbs, especially gluten grains, eat more good fats and control inflammation-raising insulin. So, very much fitting in with Holford's view above. Video is a bit 'popular-TV' if you know what I mean but the principles are sound. Personally, though, I don't advise dairy fats.
The link with gluten is a particularly important one currently since a lot of research is starting to come out about the inflammatory and auto-immune damage caused by gluten to the brain and nervous system. Personally, if I were at risk, I wouldn't eat it. And I don't, actually, as my diet is grain free and good fat high! Here's the book, which I think is worth a read.
Step 3: Check your homocysteine and supplement B vitamins accordingly.
I’ve long been an advocate of the vital importance of checking your homocysteine level, which can be done on a home-test kit and supplementing high dose B12 (500mcg), folic acid (800mcg) and B6 (20mg) accordingly if your level is above 10mmol/l. Many people over 50 have a level above 10.
In the landmark study in May, in the National Academy of Sciences journal, giving these B vitamins to those with memory decline and homocysteine above 10 resulted in almost nine times less brain shrinkage in the areas associated with Alzheimer’s and a virtual cessation of any further memory loss.
One thing I do know is that phosphatidyl serine, a type of phospholipid crucial for the brain, seems to help. You might want to download and read the excellent factsheet below. It's pretty technical and quite astounding!
Nutrigold themselves do a 100mg strength Phos Serine as per the factsheet and so do Biocare. For a complex, I particularly like this Brain Food which contains homocysteine nutrients as well as the phospholipids.
Notice that Prof. Plaskett gives an 'ideal' brain prescription almost there and he includes fatty acids, antioxidants and minerals, especially magnesium and zinc. Those two minerals are especially crucial I have found, especially zinc. I would always make sure you are getting plenty of both and ensure with a multi if in doubt.
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