Evidence has shown that certain supplements can help to improve memory or cognition. Benefits of supplementation include boosting memory in healthy adults and adolescents and improving cognition and memory in people with age-related cognitive decline, Alzheimer's disease and other forms of dementia. Diet and lifestyle changes are also important factors to consider for improving cognition or decreasing the risk of dementia.
Brain fog is not a medical condition but rather a term characterized by confusion, forgetfulness and a lack of focus and mental clarity. This often occurs from lack of sleep, stress and spending too much time on the computer. Treatment for brain fog includes reducing time spent on the computer and mobile phones, stress management, adopting a healthy diet, getting sufficient sleep (7-8 hours a night), incorporating regular exercise into your routine, avoiding alcohol and smoking and limiting caffeine intake in the afternoon.
Studies have shown that diets including high intakes of certain antioxidant compounds have been associated with a decreased risk of Alzheimer's disease and other forms of dementia. Higher intakes of anthocyanins (16 mg/day from foods such as blueberries, strawberries and red wine) and higher intakes of flavonols (14 mg/day from foods such as tea, apples and pears) have also been found to reduce the risk of Alzheimer's and other dementias. The Mediterranean diet entails a greater consumption of eggs, fruits and vegetables, carbohydrates, legumes (beans, lentils, peas, etc.) and was associated with a lower prevalence of dementia.
The MIND diet (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) has also been found to significantly decrease risk of Alzheimer dementia. This diet consists of ten healthy food groups (leafy green vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil, and wine) and five unhealthy food groups (red meats, butter and stick margarine, cheese, pastries and sweets, fried food, and fast food). The quality of the diet is evaluated by how often foods in each group are consumed. The following five healthy factors are considered:
1. Having the highest MIND diet score (upper 40%)
2. Not smoking
3. Engaging in >150 minutes per week of moderate to vigorous-intensity physical activity
4. Light to moderate alcohol consumption (one drink per day for women and two for men)
5. Engagement in late-life cognitive activities (such as reading, writing, playing chess, sudoku or bridge)
Dr Bredesen discovered that Alzheimer’s disease is not just one condition, he believed it is three distinct conditions which are influenced by 36 metabolic factors such as micronutrients, hormone levels and sleep, which can all trigger the onset of this disease.
The three major groups are:
Inflammatory Alzheimer’s (results from a range of inflammatory conditions):
Imbalances in fatty acids
Sugar-damaged proteins
Prolonged exposure to infectious pathogens
Having the ApoE4 allele (Alzheimer’s gene)
Other stressors that cause chronic inflammation
Atrophic Alzheimer’s (results from a loss of trophic or nutritional support):
Hormonal imbalances in the endocrine system
Insulin resistance
A lack of key nutrients
A loss of nerve growth factor
Toxic Alzheimer’s (results from prolonged exposure to toxins):
Heavy metals (mercury or copper)
Biotoxins
Pesticides
Organic pollutants, such as mold
Multiple tests are used to identify any factors that can be contributing to cognitive decline for a specific patient. From these tests, the treatments are very specific to the individual and may include the following:
Specific nutrition regimens and diets, focusing on a plant-based ketogenic diet
Exercise programs, especially aerobic and strength training
Brain training to enhance the brain’s neuroplasticity
Sleep regimens, which includes obtaining seven to eight hours per night and testing for obstructive sleep apnea
Hormones, if necessary
Meditation and other stress-relief programs or treatments
Health coaching to optimize your personalized program and if needed, specific medications
It is important to note that the Bredesen protocol is not one size fits all approach, the treatments are highly specific to the individual.
Dr Dale Bredesen is an expert in neurodegenerative diseases, specifically focusing on Alzheimer's disease. He qualified from Duke University Medical Center and holds faculty positions at various universities. He developed the Bredesen Protocol with the aim of reversing cognitive decline. His book, The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline, is a New York Times bestseller focusing on his research.
Currently there is no cure for dementia, but lifestyle changes and treatment can help prevent or manage disease progression. As dementia involves brain damage, treating symptoms experienced by individuals will not reverse the condition. Evidence has shown that diet can help to slow down the progression of cognitive decline and early stages of dementia. Research has also shown the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet reduces the risk of Alzheimer's and dementia.
Certain dietary factors have been associated with an increased risk of developing dementia, these include:
Higher intake of saturated and trans-unsaturated fats (butter, lard, meat, full-fat dairy products, coconut oil, palm oil, chocolate, fast food, snack foods, fried foods and commercially baked goods like cakes and biscuits)
Lower intake of monounsaturated (olive, canola, peanut, sunflower and safflower oils and in avocados, peanut butter and most nuts) and polyunsaturated fats (sunflower, corn, soybean and cottonseed oils)
Lower intake of omega-3 fats (mackerel, salmon, untinned tuna, walnuts, chia seeds, flaxseeds and canola oil)
Lower intake of some antioxidants and vitamins (B vitamins and magnesium)
Lower intake of vegetables and fruits
High consumption of alcohol
Memory is regarded as a higher brain function and in order to have good memory, your brain needs to be in a healthy condition. Proven ways to protect memory include following a healthy diet (MIND, Mediterranean and DASH diet), exercising regularly, not smoking and keeping blood pressure, cholesterol, and blood sugar in check. Incorporating meditation into your routine is important too, as it has been shown that people with a greater mental wellbeing tend to have better memory and cognitive thinking skills than those with poorer mental health. Brain games such as problem solving, memory, recall, crossword puzzles, Sudoku, jigsaws, memory games, and card games are also effective as muscles grow stronger with use and mental exercise helps keep mental skills and memory in tune.
Brain training apps or brain games claim to improve your memory and attention skills, ability to make good decisions and even vision and hearing. They involve standard tasks including memory span tasks, vision tasks and executive function tasks. Many of these products originate from scientific research that has shown positive effects in some individuals, but the effectiveness of these apps are highly controversial and more research needs to be done.
Working memory is the part of short-term memory that allows our brain to hold onto information for a brief period of time while doing something else. New information in working memory is temporary. Problems with working memory are more common in children with learning and attention issues such as Attention Deficit Hyperactivity Disorder (ADHD) and Dyslexia. Individuals with traumatic brain injury, deafness, oral language deficits or genetic disorders such as Down Syndrome are also more likely to have weak working memory.
It is often very common for people over the age of 50 to forget names, specific information, misplace their keys and needing to pause and remember direction, however this type of slight memory loss shouldn't interfere with daily tasks like paying bills, brushing teeth, and getting dressed. Studies have found that almost 40% of people experience some form of memory loss after turning 65 years old.
Memory loss that disrupts your life is one of the first signs of dementia. Dementia is an umbrella term used to describe a group of symptoms, including impairment in memory, reasoning, judgment, language and other thinking skills.
Other early signs of memory loss include:
Asking the same questions repeatedly
Forgetting common words when speaking
Mixing words up e.g. saying "bed" instead of "table"
Taking longer to complete familiar tasks
Misplacing items in inappropriate places
Getting lost while walking or driving in a familiar area
Mood or behavior changes for no reason
Anything that affects thinking, learning or remembering can impact memory. Here are some of the most common causes of memory loss:
Medications (prescription drugs like benzodiazepines and anticonvulsants), head injury (concussion or head trauma), thyroid issues, alcohol, lack of sleep, nutritional deficiencies, cancer treatment, stroke, mental health issues, epilepsy, dementia and infections of the brain and its lining.
Bacopa (Bacopa monnieri), also known as hyssop, is a herb used in traditional Ayurveda. It is taken for improving cognitive function, stress relief and general enhancement of vitality. Many small studies suggest it may have very small benefits in healthy adults without memory or cognitive deficits.
Choline is an essential nutrient that is present in some foods (eggs, beef, chicken, milk, fish, mushrooms and certain beans) and is available as a dietary supplement. Choline plays an important role in preservation of plant and animal cell structural integrity. The nutrient is also needed to produce acetylcholine, an important neurotransmitter for memory, mood, muscle control and other brain and nervous system functions. Choline supplements may help improve short-term memory and attention in healthy older adults, but this benefit has only been found with certain forms of choline (e.g cytidine 5’-diphosphocholine) and not others.
Cocoa flavanols are compounds found in raw cocoa. It contains specific compounds called epicatechin and catechin, as well as chains of flavanols, called procyanidins. Cocoa flavanols may have short-term cognitive benefits in healthy adults, such as improving attention, increasing processing speed and reducing mental fatigue.
Curcumin is an active component in turmeric and is a very strong antioxidant. This nutrient may modestly improve some aspects of memory and cognition in healthy adults, but the benefit appears to be limited to several hours after use. Curcumin has a low bioavailability due to its water insolubility, therefore it is important to consume a good quality supplement in the form that is better absorbed.
Ginkgo Biloba is produced from the Ginkgo Biloba tree native to China. This nutrient has antioxidant properties and benefits the CNS and vascular conditions by improving circulation. Ginkgo biloba may have some slight, short-term cognitive benefit in healthy adults, but not all studies have found a benefit.
Fish oil is a dietary source of omega 3 fatty acids which your body needs for many functions from muscle activity to cell growth. Some studies have found that fish oil and omega-3 fatty acid supplements may slightly improve certain measures of memory and cognition in healthy adults who do not regularly consume fish and have very low blood levels of DHA. DHA has been shown to accumulate in areas of the brain involved in memory and attention (cerebral cortex and hippocampus). Studies have found that DHA, alone or combined with EPA, contributes to improved memory function in older adults with mild memory complaints.
Iron is a mineral that is an essential component of hemoglobin (red blood cell) that transfers oxygen from the lungs to the tissues. This mineral is naturally present in many foods and available as a dietary supplement. Dietary iron has two main forms, heme and nonheme. Plants and iron-fortified foods contain nonheme iron only, whereas meat, seafood and poultry contain both heme and nonheme iron. Iron deficiency is not uncommon, especially among young children, women of reproductive age and pregnant women. Because iron deficiency is associated with poor diet, malabsorptive disorders and blood loss, people with iron deficiency usually have other nutrient deficiencies. Studies have shown that iron supplementation to correct iron deficiency has been shown to improve verbal learning and memory in adolescent girls.
Ketones are molecules produced in the liver from fatty acids and can be used in the body and in the brain for energy when glucose (sugar) is not available. A small study found that a ketone-containing drink slightly increased cerebral blood flow and improved scores on one test of motor speed and visual attention in obese adults, but larger studies are needed to confirm this benefit.
Lutein is an antioxidant which belongs to the carotenoid group. Food sources such as leafy green vegetables as well as orange and yellow vegetables are rich in lutein. Zeaxanthin is a fat soluble carotenoid found in the cells of the human eye. It is also a powerful antioxidant. These nutrients are often included in vision health supplements, but there is preliminary evidence that these antioxidants may also improve brain functions such as visual processing, speed of processing, attention and memory, as well as reduce computer and screen-related headaches and eye strain.
Magnesium is an essential mineral found in the body. It is present in many foods (wholegrains, dark, leafy vegetables, legumes and nuts) and also as a dietary supplement. Magnesium serves as a cofactor in more than 300 enzymatic reactions. Sufficient amounts of magnesium has been associated with a decreased risk of developing mild cognitive impairment or dementia.
B vitamins play a significant role in maintaining good health and well-being. This nutrient serves as the building blocks of a healthy body and has a direct impact on your energy levels, brain function and cell metabolism. B vitamins including B6 (pyridoxine) and B12 (cobalamin) and B9 (folic acid), taken separately and/or in combination, long-term, may help slow declines in memory and cognition in older adults with mild cognitive impairment.
Fish oil is a dietary source of omega 3 fatty acids which your body needs for many functions from muscle activity to cell growth. These supplements may modestly improve some measures of cognition in adults with age-related cognitive decline, but this evidence may depend on the level of cognitive function prior to treatment, age, diabetes status and whether or not fish is already consumed in the diet. DHA has been shown to accumulate in areas of the brain involved in memory and attention (cerebral cortex and hippocampus). Studies have found that DHA, alone or combined with EPA, contributes to improved memory function in older adults with mild memory complaints.
Spermidine is a polyamine (it has two or more primary amino groups) and is a naturally occurring compound produced in our bodies and found in a variety of foods. It plays an important role in cell maintenance and the clearance of damaged or abnormal cells. This nutrient may also have anti-inflammatory effects. Higher dietary intakes of spermidine have been associated with lower incidence of cognitive impairment in people but more studies need to be done to confirm this.
Acetyl-L-carnitine is a form of L-carnitine which is an amino acid that is found in nearly all cells of the body. L-carnitine plays an important role in the production of energy from long-chain fatty acids. This nutrient also increases the activity of certain nerve cells in the central nervous system. Acetyl-L-carnitine supplementation may have some benefit in people with mild cognitive impairment.
B vitamins play a significant role in maintaining good health and well-being. This nutrient serves as the building blocks of a healthy body and has a direct impact on your energy levels, brain function and cell metabolism. B vitamins including B6 (pyridoxine) and B12 (cobalamin) and B9 (folic acid), taken separately and/or in combination, long-term, may help slow declines in memory and cognition in older adults with mild cognitive impairment.
Fish oil is a dietary source of omega 3 fatty acids which your body needs for many functions from muscle activity to cell growth. Fish oil supplements high in DHA (docosahexaenoic acid) may help reduce further cognitive decline among people with MCI, but possibly only among those with low blood levels of omega-3 fatty acids prior to treatment but not those with higher IQ prior to treatment. Evidence suggests that having adequate B vitamin status may be needed to benefit from fish oil supplementation. DHA has been shown to accumulate in areas of the brain involved in memory and attention (cerebral cortex and hippocampus). Studies have found that DHA, alone or combined with EPA, contributes to improved memory function in older adults with mild memory complaints.
L-arginine is an amino acid made by the body that assists with building of protein. L-arginine is also found in most protein-rich foods, including fish, red meat, poultry, soy, whole grains, beans and dairy products. L-arginine supplementation may improve cognitive function among some elderly individuals with mild cognitive impairment to a slight degree. Arginine can increase blood levels of nitric oxide, a compound that helps relax blood vessels and increase blood flow to various parts of the body. It may also help improve the function of mitochondria, the component of cells involved in energy production. Mitochondrial dysfunction has been linked with frailty and cognitive decline.
Medium chain triglycerides (MTC), are produced from coconut and palm oil and can be converted by the liver into ketones which can be used by the brain as an alternative source of energy when glucose levels are low. A study including older adults with mild cognitive impairment found that a drink containing MCT oil significantly increased ketone uptake in the brain, but participants had only slight improvements in episodic memory and executive function and not in other measures of cognitive function.
Probiotics are live microorganisms that have beneficial effects on an individual’s health and body. Probiotics may restore the composition of the gut microbiome and promote beneficial effects leading to prevention of gut inflammation and other intestinal diseases. It has been found that probiotics may modestly improve cognition in older adults with cognitive impairment.
A therapeutic protocol was developed by Dr Bredesen, referred to as Therapeutic System 1.0. In this system, multiple nutrients need to be tested and supplemented to ensure maintenance of targeted levels for best results. These blood tests can be requested by a qualified healthcare practitioner in this field. The rationale behind the approaches in this system are based on the known role of inappropriate inflammation in Alzheimer's disease and therefore to reduce inflammation accordingly.
Acetyl-L-carnitine is a form of L-carnitine which is an amino acid that is found in nearly all cells of the body. L-carnitine plays an important role in the production of energy from long-chain fatty acids. Acetyl-L-carnitine supplementation may have benefits in the early (mild) stages of Alzheimer’s disease.
Choline is a nutrient that supports various bodily functions, including cellular growth and metabolism. The body makes some choline, but the majority comes from dietary sources. Dietary sources of choline include protein (eggs in particular), vegetables such as broccoli, potatoes and mushrooms, whole grains and nuts and seeds. Choline supplementation may improve cognition in people with mild to moderate Alzheimer's disease, but this benefit has only been found with certain forms of choline.
Fish oil is a dietary source of omega 3 fatty acids which your body needs for many functions from muscle activity to cell growth. Fish oil supplementation may modestly improve cognitive performance in people with mild to moderate Alzheimer’s disease, but there may only be benefit in people with adequate B vitamin status. DHA has been shown to accumulate in areas of the brain involved in memory and attention (cerebral cortex and hippocampus). Studies have found that DHA, alone or combined with EPA, contributes to improved memory function in older adults with mild memory complaints.
Nootropics are a new classification of molecules that acts selectively towards the brain's high-level integrative activity. Individuals use nootropics to improve memory, increase mental alertness, concentration and boost energy. Caffeine and creatine are considered nootropics as they enhance brain performance and focus.
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