Definitions PEA (N-palmitoylethanolamide): An endogenous fatty acid amide synthesized and metabolized by cells that binds to cell receptors. It influences a multitude of physiological functions and has potent anti-inflammatory and pain-relieving properties. Endocannabinoid System: A lipid communication network that has critical physiological functions and serves a vital purpose for our health and well-being through signaling processes, homeostasis and hormone regulation. Lipids and the ECS In 1929, scientists George Oswald Burr and his wife, Mildred Burr, discovered that omega 6 fatty acids were essential for health. This kicked off science’s interest into lipids, and by the 1960s a new age of lipid
Natural Health Supplements
In part 1 of this blog series, we explored the foundational dietary and lifestyle factors that may be contributing to declining cognitive function. Here, we discuss key nutritional supplements that show promise for slowing cognitive decline and that should be considered adjunctive measures with dietary and lifestyle improvements. Let’s explore some supplementary options.
Acteyl-L-Carnitine (ALC): This nutrient can enhance acetylcholine production in the brain, a neurotransmitter used for memory. A 2003 meta-analysis examining 21 ALC-versus-placebo trials examining mild cognitive impairment or mild Alzheimer’s Disease (AD) showed quite positive results. In the majority of trials, 1.5-2 grams per day of ALC were studied and improvements were found as early as three months after supplementation began.
Benefits have been found in short-term memory related tasks, long-term memory performance and reaction time. ALC has also been shown useful in treating depression in the elderly. Note: In order for L-carnitine to get into the brain, it must be in the acetylated form!
Phosphatidylserine (PS): This phospholipid is responsible for triggering cell-to-cell communication between brain cells and animal research has shown that PS supports the growth of the brain. In humans, a double-blinded, placebo-controlled trial utilizing 300 mg/day of PS also showed significant enhancements in memory tests with age associated memory impairment after only three weeks of treatment. Specifically, improvements were seen in the treatment subjects’ abilities to remember names and faces, recall telephone numbers and remember the placement location of keys and glasses. After three months, PS improved memory by 30 percent compared to placebo!
PS has also proven to also be beneficial for cognitive measures in cases of depression, ADHD and chronic stress.
Citicoline: This nutrient improves the structure and function of brain cells, especially in cases of stroke victims. For example, 1000mg/day was shown to improve cognitive function at six and 12 months post-stroke (specifically in areas of attention, executive function and temporal orientation). Citicoline has also shown application as a memory aid without vascular causes. A 2005 Cochrane Review looking at all of the data from published, double-blind, randomized human trials on citicoline and cognitive impairment at the time concluded that there was clear evidence of benefit for citicoline on memory function and behavior.
Vitamin D3: Although we classically think of Vitamin D3 as an agent for bone health and immune function, new research is uncovering its role for cognitive health as well. Perhaps the most telling piece of evidence that confirms its role in cognition is the discovery that vitamin D receptors are found widespread within the brain, including within the hippocampus (the area of the brain responsible for memory). Low levels of vitamin D have been correlated with cognitive impairment, although long-term interventional trials are needed. Nevertheless, all of this information is particularly important when we consider that there is a extensive deficiency of vitamin D in the general population and the elderly.
Fish Oil: Generally speaking, fish oil supplements contain two types of beneficial omega 3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). DHA is more regarded as the omega-3 that is most useful for brain health, and with good reason. DHA has been studied versus placebo and shown to improve short-term memory in elderly individuals with mild cognitive impairment. Additionally, cohort studies have shown that fish oil supplements are associated with less shrinkage of the brain with age.
In summary, all of these nutrients may have benefit for preserving cognitive function and memory in older adults. However, this does not necessarily mean that all of them are right for you. Speak with your integrative healthcare practitioner to determine which, if any, may be best suited for your circumstances.
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Michael E Hasselmo. The role of acetylcholine in learning and memory. Curr Opin Neurobiol. 2006 December; 16(6): 710–715.
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Crook TH, Tinklenberg J, Yesavage J, et al. Effects of phosphatidylserine in age-associated memory impairment. Neurology 1991;41:644-649
Baumeister, J.; Barthel, T.; Geiss, K.R.; Weiss, M. Influence of phosphatidylserine on cognitiveperformance and cortical activity after induced stress. Nutritional Neuroscience. 2008; 11(3):103-110
Alvarez-Sabín J et al. Long-term treatment with citicoline may improve poststroke vascular cognitive impairment. Cerebrovasc Dis. 2013;35(2):146-54.
Fioravanti M and Yanagi M. Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. Cochrane Database Syst Rev. 2005; 18;(2):CD000269