Preventing and treating dementia the Functional Medicine way
Preventing and treating dementia the Functional Medicine way
It is estimated that Dementia treatment in Australia is amounts to between 400,000 and 459,000 cases in 2020 with Alzheimer’s disease accounting for up to 70% of diagnosed cases. The number of people with dementia is expected to increase to between 550,000 and 590,000 by 2030. 
The term dementia describes a group of conditions characterised by the gradual impairment of brain function. These conditions can affect memory, speech, cognition, behaviour and mobility. A person with dementia can also experience personality change and the decline of their overall health and functional ability.
The most well-known form of dementia is Alzheimer’s disease, a degenerative brain disorder in which brain cells and the neurons that connect brain cells to one another break down and are destroyed. This damage causes a decline in memory, behaviour and mental capabilities.
It is possible for a person to have multiple types of dementia at the same time.
As our population continues to grow and age, more and more people will require support to slow the progression of dementia. Functional Medicine can offer individuals natural treatment for dementia, with nutritional support and lifestyle changes.
How can we treat dementia naturally?
Uncovering the root cause of disease is a fundamental aim in Functional Medicine. When we discover the nature and cause of Alzheimer’s disease, we can pave the way towards tailoring the most appropriate treatment for the individual.
Neuroinflammation, oxidative stress, and mitochondrial dysfunction all play a role in the progression of dementia.
Amyloid-beta deposition and neurofibrillary tangles cause dysfunction of neural networks and the symptoms of Alzheimer’s disease. Until recently, we have not understood what causes dementia, but leading researcher Dr. Dale Bredesen has identified several types of Alzheimer’s disease, each with unique causes:
- Type 1 (“inflammatory”) is due to an antimicrobial response to pathogens or other inflammatory causes.
- Type 2 (“atrophic”) is associated with reductions in factors that support brain health, like estradiol, progesterone, testosterone, insulin, and vitamin D.
- Type 1.5 (“glycotoxic”) is a composite of types 1 and 2. Inflammation from high blood glucose levels combines with a trophic loss of insulin sensitivity.
- Type 3 (“toxic” or “cortical”) is associated with exposure to toxins such as heavy metals, insecticides/pesticides, antimicrobials, and commercial/industrial toxins.
- Type 4 (“vascular”) is associated with reduced vascular support.
- Type 5 (“traumatic”) is associated with previous head trauma. 
What this means is that amyloid-beta deposition is a protective response to these triggers but the removal of the amyloid-beta, without fixing the underlying cause, can do more harm than good. For most people, there will be a contribution from each of these groups, but one or two often predominate. 
Understanding these root causes are key to the treatment of dementia. There is no cure for dementia, but traditional clinical treatment usually includes targeted medications and other types of therapies. As nutritional deficiencies are associated with, and sometimes predict severity of Alzheimer’s disease and cognitive decline in the elderly, Functional Medicine can support these medications with lifestyle modifications and some other types of therapies including specific foods, natural supplements and diet plans. 
Risk factors for developing dementia
In addition to being age-related, if you have the following, you may be more likely to develop dementia:
- Pre-diabetes or metabolic syndrome
- Gut dysbiosis
- An impaired immune system
- Liver or kidney disfunction
- Low thyroid function
- Deficiencies in B vitamins, especially vitamin B12
- Omega-3 fat deficiencies
- Mercury or other heavy metal toxicity
- Vitamin D deficiency
- Unique genes that predispose you to nutritional or detoxification problems 
Diet plays an important role in the Treatment of Dementia
Many studies suggest that what we eat affects the aging brain’s ability to think and remember. The Mediterranean and Ketogenic diets, with an emphasis on reducing the number of carbohydrates you consume, have been associated with cognitive benefits.
General guidelines include:
Avoid inflammatory foods such as:
Eliminate toxins, including:
- Packaged and highly processed foods
- Coconut or MCT oil
- Green tea
- Proteins including wild-caught fatty fish, grass-fed meats, and organic chicken
- Olive oil
- Vegetables, especially dark, leafy greens 
The gut-brain-axis and Dementia Treatment
The gut’s interaction with and influence on the nervous system, and vice versa, is known as the ‘gut-brain-axis’. Recent evidence suggests that the gut-brain-axis may be implicated in the development of dementia.
One study demonstrated changes in the composition of gut bacteria in patients with Alzheimer’s disease compared to healthy controls. For example, Clostridium and Bifidobacterium species were fewer in patients with Alzheimer’s, whereas Bacterioides and Gemella were more abundant.
Promoting good bacteria over bad bacteria in the gut is important in maintaining good digestive, immune and neurological health. Plant-based foods, probiotics in yoghurt, as well as prebiotics in the diet, naturally promote a good balance of microbiota in the gut. Incorporate plenty of fruits, vegetables, onions, garlic, nuts, lentils, high fibre foods and polyphenols into your diet on a daily basis to keep your gut healthy and balanced.
Key nutrients to help prevent cognitive decline
Folate (vitamin B9)
Folate (folinic acid or methylfolate) is essential for the health of blood cells and nerve cells. It is found in green vegetables such as spinach and broccoli.
High levels of folate decrease the levels of homocysteine in the blood. High levels of homocysteine are associated with an increased risk of coronary artery disease and stroke.
High levels of homocysteine and/or low levels of folic acid are also associated with a higher rate of developing Alzheimer’s disease.
Folic acid is the synthetic form or folate and is required to be converted into methylfolate before the body can use it. Best forms to supplement are either folinic acid or methylfolate, particularly with those individuals with MTHFR gene variants.
Vitamin B12 deficiency also increases homocysteine levels and has also been associated with an increased risk of Alzheimer’s disease. Vitamin B12 may even have a cognitive-enhancing effect in persons with normal cognition.
Vitamin E can protect the body’s cells against the effects of ageing. One study suggested that taking Vitamin E decreased the rate at which people with more severe Alzheimer’s disease deteriorated. 
Ginkgo biloba is extracted from the leaf of the Maidenhair tree. Studies have found that ginkgo biloba provides neurocognitive benefits via its three main active agents: ginkgolides, bilobalide and flavonoids.
Together, these agents promote blood flow, inhibit inflammatory mediators, inhibit platelet-activating factor receptors, reduce the effects of glutamate and work as antioxidants. People most likely to benefit from ginkgo biloba include those who already have dementia.
Omega-3 fatty acids
Nutritional sources of omega-3 fatty acids are primarily fish, nuts, algae and krill.
The two main forms of omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are important in neuronal development and provide a neuroprotective role through antioxidant, anti-inflammatory and antiamyloid effects.
Older adults who are looking to prevent cognitive decline can benefit from a diet rich in omega-3 fatty acids, including fish whilst older adults who already have mild cognitive impairment can benefit from omega-3 fatty acid supplementation to improve attention and memory.
Omega-3 fatty acid supplements also provide an antidepressant effect so using them as supplements for cognitive impairment can have a positive impact on mood and relieve depression that is common in people with dementia. 
Studies have shown that ginseng may have cognitive-enhancing effects. Numerous preclinical studies have confirmed that ginseng and its active components such as ginsenosides, gintonin, and compound K are effective for the treatment of cognitive decline. These active ingredients are anti-neuroinflammatory and help fight against oxidative stress These roles may be involved in enhancing cognition and attenuating impairment. 
Studies suggest that Vitamin D has a role to play in preventing cognitive impairment. It regulates neurotransmitters and neurotrophins and has anti-inflammatory, antioxidant and neuroprotective properties. Emerging evidence suggests its role in the reduction of Alzheimer’s disease hallmarks such as amyloid-beta and phosphorylated tau.
Resveratrol and curcumin
A growing body of in vitro and in vivo evidences shows a possible role of polyphenols in counteracting neurodegeneration.
“It works by reducing inflammation in the brain, regulating the brain’s immune system, and boosting brain levels of the antioxidant glutathione. It’s important your curcumin supplement contain black pepper, which helps with bioavailability.
Another anti-inflammatory powerhouse is resveratrol, the compound found in the skins of grapes and also found in Japanese knotweed. In addition to combating inflammation and acting as a potent antioxidant, resveratrol has also been shown to increase blood flow to the brain, stimulate brain growth and synaptic connections, inhibit plaque formation in the brain, and reduce the damage caused by strokes, inflammation, and seizures. Animal studies show it protects against mild cognitive impairment and Alzheimer’s disease.” 
How you can help prevent and slow the rate of cognitive decline
- Regularly challenge your brain with mentally stimulating activities
- Participate in social activities and stay connected with your community, family and friends
- Drink less alcohol which can damage your brain and lead to an increased risk of developing dementia
- Keep fit with regular physical exercise
- Get plenty of sleep
These factors, combined with targeted nutritional advice for a clean, healthy diet and with effective supplements, can help protect against, and slow the development of dementia as you age.
A functional Medicine assessment can uncover a variety of imbalances in the body that can be corrected to improve health and quality of life. Underlying gut imbalances, nutrient deficiencies, viral and bacterial loads and hormone dysregulation all play a major role in an individual’s health.
Correcting these things and balancing the patient’s biochemistry can correct imbalances and allow the body to restore health, improving or removing any age related symptoms that may be apparent.
To find out more, please get in touch.