The population is living longer, and patients are turning to preventative measures to maintain cognitive health into their later years.
One of the greatest achievements of the 20th century was the dramatic increase in the lifespan of the human race, said Shaheen Majeed, marketing director of New Jersey-based Sabinsa, Santura, (America’s Finest, Inc.’s [AFI] parent company). “While babies born in the early 1900s often didn’t live past the age of 50, today the life expectancy in developed countries is in the range of 81 to 84. But as the Baby Boomers come of age, they realize that living longer means more years coping with age related challenges.”
As we age, both mind and body still experience declines. Because of this, Baby Boomers have shifted their focus to maintaining physical and cognitive abilities as they continue to age, and outlive the generations before them.
“We all want to stay mentally sharp and as we age, our memory begins to fail us. Aging causes our brains to change both vascularly and in volume,” said Kathy Birkner, CRNA, PhD, president and CEO of Pain & Stress Center Products (PSC) in Texas.
According to the American Psychological Association (APA), as people age, their memory changes. The brain reaches its maximum size in a person’s early twenties. It slowly declines in volume and overtime blood flow also decreases.
Semantic memory, the ability to recall concepts and general facts that are not related to specific experiences, continue to improve for many adults, APA said. Procedural memory, which is the memory of how to do things (ex. tell time), stays the same as most people age. However, there are some types of memory declines that are common in the aging population, including information processing, learning something new, multitasking, and episodic memory, which is the collection of past personal experiences that occurred at a particular time and place (dissimilar to the semantic memory).
“For people nearing or over age 65, such memory lapses [losing keys, misplacing an item, forgetting someone’s name] can be frightening. They wonder if they have Alzheimer’s disease or another type of dementia,” APA said. “The good news is that Alzheimer’s disease is not a normal part of aging.”
Mental status testing works to evaluate memory, problem solving and other thinking/critical thinking skills. Tests can give the practitioner an overall sense of whether a person is aware of symptoms, knows the date/time/where they are, can remember short lists of words, do simple calculations and follow instructions. According to the Alzheimer’s Association, mini-mental state exam, used to test a range of everyday mental skills, and the mini-cog test, where they are asked to remember and later repeat names of three common objects and draw a face on a clock (with all 12 numbers in the correct places) and a specified time, are the most commonly utilized.
Mood assessments can also be good tools in diagnosis. The doctor can evaluate a patient’s “sense of well-being to detect depression or other mood disorders that can cause memory problems, loss of interest in life, and other symptoms that can overlap with dementia,” APA said.
Fewer than one in five people age 65-plus and less than half of people aged 85-plus have the disease [Alzheimer’s], APA continued.
“In adults over 60 years of age, the prevalence is approximately 6 percent, with about half of these being diagnosed with Alzheimer’s,” said Dr. Jacob Teitelbaum, creator of the free iPhone app, Cures A-Z, and a member of Natural Practitioner’s editorial advisory board.
“Unfortunately, most physicians are not aware of the research showing that 30 to 50 percent of people diagnosed with Alzheimer’s turn out on autopsy to never had Alzheimer’s disease. This means they had other causes of their illness, which despite quite likely having been treatable, were often, simply missed,” Dr. Teitelbaum explained.
When Should Cognitive Health Be a Health Focus?
“Studies show that a gradual reduction of memory and processing power starts in our mid-20s,” said Kathy McIntee, vice president of New York-based Patient One. “Denise Park, PhD, director of research for the Center of Vital Longevity, Distinguished University Chair in Behavioral and Brain Sciences, Regents’ Research Scholar at UT (University of Texas) Dallas, explains that even though their cognitive abilities are decreasing at the same rate of those in their 60s and 70s, because they have more capital than they need, younger adults in their 20s and 30s simply do not notice their loss.”
According to Birkner, people should start thinking about supplementation for cognitive health in their 40s. “Supplementing helps keep the brain supplied with the nutrients it needs to stay healthy. Drugs are not the answers, as we were not born with drugs in our bodies. Amino acids, vitamins and minerals are what constitute our biochemistry,” she continued. She believes that amino acids and omega-3s are the way to go.
On the other hand, Mark J. Kaylor, founder of Radiant Health Project, consulting with New Jersey-based Mushroom Wisdom, believes there is no time like the present. “Alzheimer’s and dementia usually develop over a period of decades. It is not a condition that you ‘catch’ or come down with quickly in the vast majority of cases.”
Since cognitive decline primarily develops over such long periods of time, the focus is best placed on what patients are doing now. “Alzheimer’s disease is definitely a condition where the cure lies in prevention,” Kaylor continued.
Over the last few years, there has been a dramatic increase in the number of people under 50 that have a rapidly growing interest in cognitive health, noted Dr. Chris Leatherman, chief sales officer for Texas-based Onnit Labs, LLC.
“There seem to be a couple of major reasons behind this shift in the demographics. One reason seems to be the increasing competitive natures of ‘life.’ Competition in the workplace to be the most productive, profitable, and positioning for promotions seems to have become an epidemic of sorts,” Dr. Leatherman said. “Second, is due to the attention more and more people have put on achieving and maintain the best health possible. Our society’s awareness has expanded to realize that health is about more than just physical health. It is now common practice to focus on mental and spiritual health, knowing that there must be a balance in the ‘health triad’ to be truly healthy.”
Students, at younger and younger ages, are also looking for new options for improving memory and recall with the goal of improving grades and test scores, Kaylor noted. “Unfortunately, you see an increasing use of pharmaceuticals within this category as well,” he added. “In the last handful of years we have seen numerous products introduced into the sports category designed to improve focus and intensity.”
Dr. Leatherman revealed that Onnit Labs’, LLC, research and clinical trials have shown that cognitive enhancement/improvement can occur in healthy young adults, not just the aging population. To achieve and maintain optimum mental health, he believes that it’s never too early to start thinking and acting on keeping your brain health. “We know even toddlers benefit from essential fatty acids when it comes to cognitive development. I think a real focus should begin in middle school or high school at the latest in terms of addressing cognitive function,” Dr. Leatherman said.
In addition, children whose diets do not supply sufficient essential fatty acids may also benefit from supplementation. “Increasing evidence indicated that fatty acid deficiencies or imbalances contribute to childhood neurodevelopment disorders,” McIntee said.
Today’s diet commonly lacks sufficient omega-3s, many children are deficient in EPA and DHA, the two most studied essential fatty acids in fish oil. “These vital nutrients are important building blocks of child development and play key roles in every aspect of health, including brain and eye function. Omega-3s, particularly high in EPA and DHA ratios, have been studied for their role in healthy neuro and emotional development, behavioral improvement, cardiovascular function, respiration and joint flexibility,” McIntee explained.
In addition, women who are trying to conceive or who are pregnant, seeking support for fetal neural development, are also patients who may be seeking cognitive health support products.
The role of omega-3s in developing and maintaining cognitive health is a lifelong pursuit, said Ahmed Daak, MD, MSc, PhD, clinical research director and medical director, Florida-based Ocean Blue Professional. “From before birth DHA supplementation plays a vital role in the development of brain health for the baby. Fats make up about 60 percent of the human brain with DHA being the primary structural component of brain tissue.”
The EFSA Scientific Panel recommends that pregnant and nursing women should consume 200 mg of DHA in addition to their healthy diet of omega-3 consumption to ensure the healthy development of the baby’s brain and eyes. Ocean Blue offers Ocean Blue Optimal Health Prenatal DHA, which contains 250 mg of purified DHA, for this purpose.
All Ocean Blue products contain pharmaceutical grade fish oil that maintains the highest standards of purity (88 percent) and concentration. According to Dr. Daak, most oils only contain 30 percent pure omega-3 per capsule, the rest being fish fats and fillers. Additionally, each product contains a proprietary concentration and ratio of EPA:DHA. “Unique to Ocean Blue products is the addition of pharmaceutical grade d-limonene, a naturally occurring orange oil that neutralizes the fish taste and odor, and eliminates fish burps that lead to discontinuation,” Dr. Daak said.
Ocean Blue offers four different products for cognitive health. Ocean Blue Professional Omega-2 2100 (OPB2100), is an all natural product containing 1050 mg of omega-3 in each 1,200 mg soft gel. With the ratio of 2.25:1 EPA:DHA, each soft gel takes the place of three to five of the standard fish oil doses, Dr. Daak revealed.
Ocean Blue Minicaps Omega-3 is formulated similarly to the OPB2100, in 1/3 size and volume. With 350 mg of omega-3 per capsule and natural vanilla flavor, this minicap is ideal for older and younger patients who cannot tolerate swallowing larger capsules.
Utilizing the same formulation as the Ocean Blue Minicaps, Ocean Blue also makes Ocean Blue Minicaps Omega-3 +D3. “Low vitamin D blood levels are associated with a higher risk of cognitive impairment—with multiple studies showing lower test scores, poor decision making and cognitive impairment when vitamin D levels are low,” Dr. Daak revealed.
Patient One’s NeuroOne is a supplement targeted toward aging adults experiencing memory problems, forgetfulness and mental fogginess, as well as younger adults who want to support healthy cognition and students who are seeking support for focus, concentration and recall, McIntee said.
The company also has Patient One SHARPkids Omegas, which will launch April 2016. This particular product supplies highly purified and concentrated omega-3 fatty acids as triglycerides and in an easy-to-take liquid form. According to McIntee, it is formulated with an evidence-backed four-to-one ratio of EPA to DHA. Higher doses of EPA within essential fatty acid supplements were significantly associated with increased efficacy in treating ADHD (attention deficit hyper activity disorder) symptoms.1 And Patient One Q-Folate, which supports accepted scientific recommended nutrient requirements during pregnancy.
Alpha BRAIN by Onnit Labs, LLC, and Alpha BRAIN Instant are compromised of 12 well-researched, earth-grown nutrients, amino acids and vitamin B6, and contain no stimulants or caffeine, Dr. Leatherman revealed. “The success lies in the skillful combination of earth-grown ingredients that support functional areas of cognitive health in a balanced, yet potent combination.”
Focused primarily on support acetylcholine synthesis, Alpha BRAIN has multiple ingredients targeting many facets of overall cognitive health and performance. These ingredients include, ac-11—Cat’s Claw Extract, Alpha GPC (L-Alpha glycerylphosphorylcholine), Huperzia Serrata and Bacopa Monniera.
“Alpha GPC is a phospholipid derivative found concentrated in important brain cell membranes. Unlike less expensive forms of choline bitrartate, Alpha GPC has been shown to be well absorbed, easily crossing the blood-brain barrier,” Dr. Leatherman said.
Huperzia Serrata is the second part of Alpha BRAIN’s two-pronged strategy to help increase resources of the vital neurotransmitters. An extract from a plant in the clubmoss family (Huperzia serrata), Huperzine A is a naturally derived acetylcholinesterase (AchE) inhibitor. AchE is responsible for the breakdown of acetylcholine.
“By effectively inhibiting AchE, more acetylcholine is made available,” Dr. Leatherman explained. “In an independent study, efficacy has been shown in a range of 200-400 mcg daily, and safety has been demonstrated in trials up to five weeks and 600 mcg daily. On a subjective note, it continues to be reported by customers who take Alpha BRAIN and Alpha BRAIN Instant, that some people notice a ‘difference’ in as soon as one dose.”
Alpha BRAIN comes in capsule form, while Alpha BRAIN Instant comes in a powder/zip stick form that can easily be added to water.
Key ingredients in PSC Products, Brain Link Formula are the amino acids that create neurotransmitters, in addition to the vitamins that help activate the amino acids. Brain Link is a powder, that can be dissolved in juice which helps provide maximum uptake and absorption of the aminos and other vitamins.
“Amino acids such as glutamine support focus and concentration; GABA calms so you feel less nervous,” Birkner said. “Tyrosine provides the dopamine pathway—dopa and norepinephrine. 5-HTP is the precursor to serotonin, the calming, uplifting feeling in control neurotransmitter.”
Additionally, all of the 22 amino acids are present in Brain Link to support the brain and body. This product is for all ages and is one of the most neuro-nutrient complex available, Birkner said.
PSC also makes Super Balanced Complex (SBNC), which is a super complex of amino acids in capsule form. It contains 13 amino acids to facilitate absorption to aid in proper brain function. Mushrooms
Mushroom Wisdom recently developed a product for cognitive support, particularly the aging brain. It is derived from Lion’s Mane, called Amyloban 3399.
Amyloban is a concentrated extract of the Lion’s Mane mushroom standardizing two constituents, hericenones and amyloban, Kaylor said. “A growing body of research, in vitro as well as in vivo, supports both of these ingredients. The hericenones have been shown to stimulate Nerve Growth Factor, a naturally occurring compound that has exhibited promise in supporting the health of an aging brain. Amyloban is a fatty acid constituent that research shows provides a synergistic action with the hericenones by protecting the brain against damage.”
What makes Amyloban 3399 stand out amongst other products is that it standardizes and concentrates the compounds backed by clinical research, Kaylor explained. “The majority of Lion’s Mane mushroom products in the marketplace are either simply ground-up mushroom or mycelium, which have bioavailability issues, or they are hot water extracts, which will not pull out these active compounds.”
On a final note, Mushroom Wisdom has done a number of studies with this exact same product, with precisely the same ingredients and is committed to ongoing research efforts to explore its intriguing and promising actions and applications.
According to Kaylor there is also promising research in the use of other medicinal mushrooms to support brain health; the Maitake D-Fraction, best known for its immune related actions, has been shown in research to be an effective neuro-protective compound.
One of the most important mechanisms of curcumin, which has been cited for anti-depressive activity, is anti-inflammatory activity. Further curcumin has also been known to inhibit the monoamine oxidase and improve levels of serotonin and dopamine in brain tissue, Majeed shared from Phytotherapy Research 2014.
For prevention of Alzheimer’s (for example, those with positive history) the most critical supplements would be a special, highly absorbed form of curcumin 750 mg, called CuraPro by EuroMedica, said Dr. Teitelbaum. “For this, it is critical to use this brand as most others are very poorly absorbed. For example, it would take as many as 300-500 turmeric pills, or seven to 10 pills of pure curcumin, to get the same effect as one pill of the CuraPro.”
Curcumin is found in Indian food, such as curries. The prevalence of Alzheimer’s is 70 percent lower in India, and this has been traced back to being associated with the curcumin/turmeric in the food. In addition, it is important to get a high potency multivitamin that includes 1,000 units of vitamin D and 400 µg of folic acid (including 5MTHF form for those who have methylation issues).
“I use the Daily Energy Enfusion by Integrative Therapeutics,” Dr. Teitelbaum shared. “I use these in anyone with a family history of Alzheimer’s, or in anyone showing signs of dementia. The CuraPro has the added benefit of treating hidden depression, being more effective than antidepressants in head-on studies.”
Curcumin C3 Complex, by AFI (Santura) is a standardized extract from turmeric root curcuma longa) with a unique composition of curcuminoids (curcumin, demethoxycurcumin and bisdemethoxycurcumin). It has been scientifically shown to be a powerful antioxidant preventing formation of free radicals and neutralizing already-formed free radicals.
“Curcumin C3 Complex is known as a bio-protectant due to its dual activity of prevention and intervention of free radicals, which play an important role in cognitive decline,” Majeed said. Other actives in this product include bacopin, a standardized triterpene glycosides (bacosides) extract, BioPerine a natural extract from black pepper fruit which improves the absorption and bioavailability of nutrients, and L-DOPA (Levodopa), which is extracted from Mucuna pruriens or velvet bean seeds. DOPA is the precursor of the neurotransmitter dopamine which itself is the precursor of neurotransmitters nor-epinephrine and epinephrine. DOPA is consumed to generate dopamine, supporting healthy mood and mental alertness.
A preliminary clinical trial using C3 Complex was conducted at UCLA (University of California, Los Angeles) as a randomized, double-blind placebo controlled clinical trial for 24 weeks with an open labeled trial extension for 24 weeks, Majeed shared. The average age of subjects was 73.5. The results, though preliminary at this stage, showed that curcumin was generally well tolerated and was found to be safe (Ringman et al Alzheimer’s Research and Therapy 2012).
Two key treatements that have existed in the mainstream include Aricept and Namenda. “Unfortunately, the main benefits of these treatments are that they are very profitable. Sadly, they are not effective at increasing cognitive function, but simply have a minimal effect of slowing progression,” Dr. Teitelbaum said.
A natural approach practitioners can focus on to maintain or improve cognitive health is called the MIND Protocol. Dr. Teitelbaum shared this model, MIND working as an anagram for the steps necessary in it.
1. Metabolism: Optimize hormonal function
2. Infections: Clear all infections including candida
3. Nutritional support
4. Drugs: Get people off any unneeded medications.
By optimizing the treatments discussed above practitioners can better serve their patients. “Also, by being aware that many if not most people diagnosed with Alzheimer’s don’t actually have it, and may have treatable underlying conditions that can be effectively addressed with the MIND Protocol,” Dr. Teitelbaum said.
Practitioners are focused on the health and well-being of their patients, doing extensive research into products they recommend and keeping their eyes out for new ones. Busy practitioners looking for studies and research related information on products they offer their patients can find some companies to be helpful in providing easy access to documents of interest online. Patient One has an educational library available to all practitioners who have a Patient One account. It includes research studies related to the ingredients used in their formulas.
Onnit Labs, LLC, also makes their studies available to practitioners on their website, as well as paper copies that are available to practitioners upon request.
In addition to their website, Sabinsa also shares the science with consumers on social media platforms and via education programs the company hosts, such as Sabinsa on Wheels.
Aging adults, students, children and even women who are trying to conceive, or who are pregnant, seek cognitive supplementation to support growing and aging brains. “Our society tends to eat fat foods and do not obtain the proper balance of nutrients they need to stay healthy. Eventually, the negligence of health catches up to a person,” Birkner said. “People need to be more aware of their health including supplementing to meet [the] body’s needs since our food lacks many nutrients or has pesticide contamination.”
“The body has a ‘use it or lose it’ approach to efficiency. So if you don’t use your mind, you may lose it,” Dr. Teitelbaum concluded.
1 www.ncbi.nlm.nih.gov/pmc/articles/pmc3625948/ & effects of an open-label pilot study with high-dose epa/dha concetrates on plasma phospholipids and behavior in children with attention deficit hyperactivity disorder. Paul H. Scorgi, Edward M. Hallowell, Heather L. Hutchins and Barry Sears.
For More Information:
America’s Finest, Inc. (Santura), www.afisupplements.com
Mushroom Wisdom, Inc., www.mushroomwisdom.com
Ocean Blue Professionals, www.oceanblueprofessional.com
Onnit Labs, LLC, www.onnit.com
Pain & Stress Center Products (PSC), www.painstresscenter.com
Patient One, www.patientoneformulas.com