Addressing the Fear of Cognitive Decline & How to Be Proactive

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Addressing the Fear of Cognitive Decline & How to Be Proactive

Alzheimer’s disease, the most common form of dementia, is the sixth leading cause of death in the U.S. For most people, the subject of Alzheimer’s brings fear and trepidation. Why? Because the thought of deteriorating brain function and memory loss is frightening. Unfortunately, current medical treatments are inadequate, dealing only with its end result.

Alzheimer’s is characterized by the destruction of synapses in the neurons, the nerve cells in the brain, by amyloid plaques. In addition, “tangles” form in the cells leading to loss of brain function. This leads to progressive loss of memory and behavioral problems like aggression, hallucinations, and delusions, as well as deterioration of activities of daily living. This is heartbreaking for patients and their families.

Despite years of ongoing research, there are still many unanswered questions about what causes Alzheimer’s disease. Let’s explore some of the known risks associated with dementia and learn how to lower those risks.

You may not have heard the term “type 3 diabetes” as another name for Alzheimer’s Dementia. Type 2 diabetes and prediabetes, also called insulin resistance, are both strongly linked to the development of Alzheimer’s dementia. This could actually be good news because it means this is a preventable risk factor.

Why has the term Type 3 diabetes been coined?  Let’s start by discussing sugar, which in large quantities is a poison. The body is not designed to handle more than 15-20 grams per day yet a soda has at least 40 grams and the average American consumes 82 grams per day.

Excess sugar causes an outpouring of insulin from the pancreas and over time causes the cells in the body – including the brain – to become resistant to insulin. This leads to chronically elevated blood sugar which causes Advanced  Glycation Endproducts or AGES to be produced. These AGES then attack the eyes, kidney, peripheral nerves, and the brain!

Other causes of dementia include recurrent traumatic brain injury (concussions), infections like Lyme disease and syphilis, excess alcohol and drugs, prolonged general anesthesia, and sleep apnea. Heavy metals such as lead in pollution and mercury in dental amalgams, and large fish, like tuna, swordfish and shark increase the risk of dementia. In the 1800’s the term “mad as a hatter” came about because hat makers were using a form of mercury to make fur hats and it destroyed brain cells. Studies also show that living near major highways is a risk factor for Alzheimer’s, as well as living or working in a water-damaged building leads to growth of toxic mold, which poisons the nervous system.

There are several genes that predispose to Alzheimer’s such as the ApoE4. However, just because we have a gene does not mean it will be expressed. Every time we eat, exercise, sleep, meditate, communicate, create something, play, learn and love, we are turning genes on and off.

The good news is the brain can actually grow and change in a positive way, even as we get older.

Lifestyle strategies can promote neurogenesis (new brain cells) and neuroplasticity (changes in the brain and its pathways). These strategies involve a substance called BDNF or brain-derived neurotrophic factor, which promotes brain cell growth and connectivity as demonstrated on MRI scans. In fact, the hippocampus, which is involved in emotional memory, gets larger the more BDNF is available. A large part of the lifestyle strategy involves modifying the diet to lower unhealthful carbs and increase healthful fats thus lowering the risk of diabetes.

Strategies include:

  1. Reducing (non-vegetable) carbohydrate consumption, including sugars and artificial sweeteners, and grains, which can cause inflammation of the lining of the digestive track, or “leaky gut”. An inflamed gut causes an inflamed brain and reduces the size of the hippocampus.Functional testing looking at stool, urine and breath can determine if your gut is leaky. Replace nutrients lost from a leaky gut or poor diet like B12, folate, B6, magnesium and iron.
  2. Increase healthy fat consumption by increasing omega-3 fat intake and reduce consumption of damaged omega-6 fats (like processed vegetable oils) in order to balance your omega-3 to omega-6 ratio. Omega-3 from fish sources shows lower risk of cognitive impairment.
  3. Add prebiotic fiber which nurtures gut bacteria and hippocampus. Probiotic supplementation which enhances the healthy bacteria in the gut, decreases the inflammatory marker, C-reactive protein, increases the antioxidant  glutathione , and improves mental status as measured by the Mini Mental Status Exam
  4. Exercise! Physical activity produces biochemical changes, increasing BDNF, that strengthen and renew not only your body but also your brain – particularly the hippocampus, the area associated with memory and learning. This is especially important for carriers of the ApoE4 gene. A good exercise regimen includes aerobic and resistance training at least 3-4 times per week for 30-45 minutes.
  5. A ketogenic diet is linked to an increase in BNDF, which causes the hippocampus to get bigger (better memory).This involves cutting down on carbohydrates which reduces insulin resistance (diabetes), and increasing good fats like avocado, olive oil, MCT (medium chain triglycerides found in coconut oil) and intermittent fasting 12-14 hours between dinner and breakfast so that the body breaks down fats and produces ketones.
  6. Consider getting tested for heavy metal and toxic mold exposure and work with your doctor to eliminate them.
  7. Balance hormones such as thyroid, cortisol, sex hormones and Vitamin D (which is actually a hormone).
  8. Work on getting at least 7-8 hours of solid sleep. If sleep is poor rule out sleep apnea. Low oxygen in the brain can lead to stroke and heart attacks, which are risk factors for dementia.
  9. Find out whether you are insulin resistant by getting a HgA1C test and fasting insulin.  Eliminating the risk of Type 2 diabetes (insulin resistance), can lower the risk of Alzheimer’s dementia (Type-3 Diabetes).
  10. Remember to take time to slow down, be mindful (meditation and yoga) spend time with loved ones, and take time to laugh and have fun. This is medicine for our minds.

Lisa Lilienfield, MD



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About the Author:

Lisa Lilienfield, MD
Lisa Lilienfield, M.D. is board-certified in family medicine and is a member of the American Academy of Medical Acupuncture. Dr. Lilienfield practices Acupuncture and Osteopathic Manipulative Medicine and has developed an expertise in both Women’s Health and Sports Medicine. Dr. Lilienfield also serves as a Clinical Assistant Professor at Georgetown University School of Medicine’s Department of Community and Family Medicine. To read Dr. Lilienfield’s complete bio, click here