Memory Builders Essay, Research Paper

When someone says “Can I pick your brain for a minute,” does it bother you that that may be as long as it takes?

Losing one’s memory is a common subject of humor as we age. I’m just now realizing, however, that it’s more serious and scary than we may like to admit (or, if I realized it earlier, I forgot about it). My dad, at 85 and one of the sharpest minds I know, has said in moments of not-totally-tongue-in-cheek, “If I ever lose my mind, shoot me.” I like to obey my parents, but fortunately I can’t remember where the gun is.

Senility, dementia, Alzheimer’s disease, “forgetfulness”- unfortunately, by whatever name you give it, memory loss is no joke if you or a loved one is really worried about it and you’re convinced it’s more than just misplacing the keys. The conventional medical profession, great for treating acute problems, has a poor track record, in my opinion, for chronic situations. The progressive loss of memory certainly qualifies as one of the latter, because there’s tons you can do, and a lot of both history and research to back it up.

Lange’s Current Diagnosis & Treatment (1997) defines dementia as “an acquired persistent and progressive impairment of intellectual function with compromise in at least two of the following spheres of mental activity: language, memory, visuospatial skills, emotional behavior or personality, and cognition (calculation, abstraction, judgment, etc.)”

(Gee, since I have no idea what a visuospatial skill is and my athletes tell me I have a deadbeat personality, I may be in trouble.)

Anyway, forgetfulness usually comes first, and the fact that you are a bit forgetful doesn’t necessarily mean you have Alzheimer’s, as progression to true dementia is not an absolute. Also bear in mind that though full-blown dementia in the elderly is often of the Alzheimer type (60-70 percent), there are other causes of forgetfulness and confusion, problems that conventional medicine can be very helpful with. Vascular problems from blood clots, aneurysms (causing blood to leak out of blood vessels), arteriosclerosis (causing blocked blood vessels), some forms of anemia, and various combinations can all be involved. Depression can play a big factor, as can just plain inattention. Medication can cause memory problems, sometimes severe. Metabolic, biological and/or endocrine dysfunction, such as thyroid or liver disease, electrolyte imbalance, infection, tumors, and nutritional disorders, including malabsorption, can all be involved. (Oh, I forgot to add trauma.) Also, chemical exposures may be involved, such as aluminum, mercury, alcohol, lead, etc.

So, there’s a lot to consider before just writing someone off to senile dementia, and that’s a big reason why your doc should definitely be involved.

Unfortunately, however, medical therapy for Alzheimer’s type of memory impairment (senile dementia) just a few years ago was limited to what’s called the ergot alkaloids, specifically hydergine. This is a pretty innocuous drug that much of the medical profession thought (and thinks) to be basically useless (though I’m not at all convinced for some individuals). More recently the FDA has approved the reversible cholinesterase and acetylcholinesterase inhibitors (Aricept/Donepezil, Cognex/Tacrine, others). These are not as innocuous, the costs are high, liver monitoring is needed, only about one-third of patients respond, and even then the degree of response is admittedly poor (but remember the term “acetylcholinesterase inhibitor” because we’ll come back to it).

Other than the above, managing depression and reassuring both patient and family are the mainstays of treatment, and that’s pretty much what the hallowed halls of modern medicine have to offer for this type of memory loss.

But don’t dare think for a second that nothing else can be done. Modern medicine has been wrong before (like, uh, need I start a list?!). They seem to at least be getting started on the nutrition bandwagon, as a recent study in the New England Journal of Medicine (April 24, 1997, 336 (17) 1216-22) found that either a drug (selegiline) or Vitamin E (alpha-tocopherol) slowed progression of Alzheimer’s. So which would you choose? At least the nutrients have a history of being the safest route.

Anyway, what else is out there for progressive, age-related memory loss?

First of all, for those who care to have an actual screening test for Alzheimer’s disease there’s actually a new urine test available. It’s called AD7C urinalysis and checks for a special protein called neural thread protein (NTP), which has been found in large amounts in the brains of Alzheimer’s victims. Interested parties can contact NYMOX (800-936-9669, or [email protected]) for more information.

There really is a long list of nutrients to consider if one chooses to really attack senility or even just mild forgetfulness. A concerted effort to find legitimate candidates can drown you in possibilities, with studies to match. We can’t cover them all, but we’ll discuss a few of my favorites.

For thousands of years Ginkgo biloba has had (and maintained) a reputation for enhancing cognitive function. There are hundreds of studies available concerning its benefits in increasing blood flow to the brain, and improving memory. Now it’s been found to have beneficial effects in a multitude of situations, including vertigo, asthma, tinnitus (ringing in the ears), and others. For best effect it should be used as a standardized extract of 24 percent flavoglycosides (or ginkgoheterosides). Doses mentioned in most studies seem to settle on about 40 milligrams three times a day. Six months of use should show something. Otherwise, it’s probably not going to help. Though considered nontoxic (which technically nothing is totally), it’s not known what effects it has for pregnant or nursing women, and rare side effects may be headache or stomach ache. The Journal of the American Medical Association (JAMA, Oct 22/29, 1997-vol 278, no. 16) even found that, “in a substantial number of cases”, this remarkable agent was useful in “…improving the cognitive performance and the social functioning of demented patients for six months to one year.”

Number two on my list (and it’s hard to choose) is phosphatidylserine (PS). This is a naturally occurring phospholipid in all cells of the body that’s found in high concentrations in the normal human brain. It’s involved in nerve cell formation and seems to be even more useful when combined with Ginkgo biloba. Both European and American studies over the past 20 years have used from 200-800 milligrams/day with an excellent safety record.

PS is derived from soy lecithin, an excellent source of phosphatidylcholine. This is another nutrient that’s had a long history of use in helping with mental functioning. The Life Extension Foundation has found that lecithin, choline, and the inexpensive DMAE (dimethylaminoethanol) are common nutrients for enhancing memory, and I like them all. These agents increase brain levels of acetylcholine, a well-known neurotransmitter for nerve cell communication, and they tend to do it with remarkably low levels of toxicity, since they’re all natural to the body, not molecules the body was never “designed” to handle. Remember (!) the term “acetylcholinesterase inhibitor,” earlier in the article? The idea is to increase levels of acetylcholine, either by supplying it directly, or by blocking the enzyme that breaks it down (i.e., acetylcholinesterase). That’s the connection, but don’t throw away the term just yet; we’re still not quite done with it.

Acetyl-l-carnitine (ALC) has been shown to generate significant improvement in cognitive function and is used in Europe in the treatment of some forms of senile dementia. Studies found that it improved cerebral blood flow, enhanced short-term memory, and even helped with depression. These studies all used ALC, which is a patented conversion of one of my favorite nutrients, l-carnitine. I’ll bet l-carnitine is just as effective, but the funds for studying this somewhat cheaper nutrient in side-by-side testing are not available, so there’s no proof. ALC has more advertising behind it, but I’m not yet convinced it has advantages over l-carnitine.

We’re almost done, I promise (though you may have been done long ago). It’s worth touching on just a few last agents. The first is actually a hormone, called pregnenolone, which has been studied pretty extensively, along with another hormone called DHEA, concerning the ability of these two agents to modulate chemical reactions involved in the storage and retrieval of memory. I tend to walk softly on hormones, as they can be powerful agents and can have a multitude of chores to do within the body. When I use them I like to use the ones that are farthest up the line of the hormone system, so the body has more chances to decide how to use the downstream products. For that reason I tend to prefer pregnenolone, if I had to choose, and I’d stay with low doses, like 3 milligrams every day to every other day, and only in those over 50. You should talk with your doc on this subject, as hormones can be wonderful agents, but they should be monitored.

Vinpocetine is a natural extract from the periwinkle plant. There are many research papers, mostly from Europe, on both animals and humans concerning this product’s ability to enhance memory function by affecting both microcirculation and production of ATP, the molecule that provides increased energy to cells. Most studies showed levels of up to 40 milligrams twice daily gave subjects the most improvement in both storing and recalling lists, well above placebo results, and with a high degree of safety (but of course ask your doc).

Remember (!) that “acetylcholinesterase inhibitor” term? The last agent (I promise!) is a new one that’s received a fair amount of press, especially in multi-level businesses, called Huperzine A. The recommended dose of this agent seems to have a lot of data behind it, from chess champions on down, showing beneficial effect in short-term memory by increasing those levels of acetylcholine. My research indicates that this product should only be used occasionally, like before finals or a chess tournament, etc., not continuously. Acetylcholine, which as we said is a neurotransmitter, can be useful for proper memory function, and Alzheimer’s patients tend to have high levels of acetylcholinesterase which breaks that transmitter down.

However, normal subjects should not take it continuously (in my opinion), since acetylcholine overload is an unknown in humans. That’s why I prefer the precursors to acetylcholine, like lecithin, choline, phosphatidylcholine, etc., since the cholinesterase enzyme is there to break down any excess the body doesn’t want. I’m not sure I’d want to go the other way and block that enzyme, other than occasionally, or of course in a person known to have too much of it, like in an Alzheimer’s victim.

I’m a shotgunner, myself, as long as I’m convinced that what I’m using is as nontoxic as possible (drugs rarely qualify, in my opinion, but that’s just me). Usually, nutrients work better as a team, and I like the best team members I can get. What you decide to do depends on your own research plus consultation with your own healthcare practitioner.