Introduction

Importance of brain health

Brain health is the foundation of overall well-being, essential for not only cognitive functions like memory and attention but also physical ability. When the brain is functioning optimally, it’s better equipped to solve problems, tap into creativity, and maintain emotional resilience. Focusing on key factors like nutrition, stress management, and reducing exposure to environmental toxins can significantly boost cognitive function and protect against cognitive decline. Taking proactive steps to nurture the brain can lead to improved quality of life and sustained mental acuity well into old age.

Root cause perspective on brain health

A comprehensive approach to brain health must address the root causes of cognitive decline, which may include chronic inflammation, insulin resistance, oxidative stress, mitochondrial dysfunction, and nutrient deficiencies.

The gut-brain axis is also critical, as imbalances in gut microbiota can lead to increased intestinal permeability, or “leaky gut,” triggering systemic inflammation that worsens brain health^1,2. The gut microbiomes of individuals with Parkinson’s disease show significant alterations, potentially linked to intestinal inflammation and gastrointestinal symptoms³. These changes involve species like Akkermansia, Faecalibacterium, and Prevotella, with similar patterns also seen in other neurological disorders, such as Alzheimer’s disease⁴.

Environmental toxins like heavy metals and mold can further contribute to neuroinflammation and cognitive decline^5,6. Optimizing diet, enhancing gut health, minimizing toxin exposure, managing stress, getting sufficient sleep, and staying physically active are effective strategies to address the root causes of cognitive decline and support optimal brain function⁷.

Boosting brain health for a longer, healthier life: the key to extending healthspan and longevity

Optimal brain health is intrinsically linked to extended healthspan and increased longevity⁸, playing a critical role in reducing the risk of chronic diseases, such as cardiovascular disease and type 2 diabetes.

Poor brain health is associated with chronic systemic inflammation and insulin resistance⁹. For instance, poor blood sugar regulation can contribute to what is often referred to as “type 3 diabetes,” highlighting the strong connection between insulin resistance and the development of chronic neurodegenerative conditions like Alzheimer’s disease¹⁰.

Adopting a nutrient-dense diet, engaging in regular physical activity, managing stress, and prioritizing proper sleep can bolster mental clarity, focus, and energy levels. This will ultimately lead to better performance, improved mood, and a more vibrant, sustained sense of well-being, thereby extending the period of life spent in good health¹¹.

Cognitive health also plays a pivotal role in both athletic and professional performance^12,13. Maintaining a healthy balance of neurotransmitters, supporting efficient mitochondrial function, and reducing neuroinflammation are essential for stabilizing mood, boosting motivation, and sustaining physical energy. Thus, prioritizing brain health can lead to a happier and more fulfilling life¹⁴.

Understanding Brain Health

Definition and importance

Brain health is about optimizing the brain’s ability to function across all dimensions—cognitive, emotional, psychological, and behavioral. When the brain is healthy, it allows for clear thinking, strong memory, balanced emotions, and resilient stress responses. As the body’s command center, the brain governs everything from basic physical actions to complex thought processes, making its health essential for overall well-being and quality of life¹⁵.

Cognition, which includes attention, memory, problem-solving, and decision-making, is central to brain health. Memory plays a critical role recalling past experiences and in shaping identity, learning, and day-to-day functioning. Preserving cognitive function is integral to personal and professional success and maintaining independence as we age^16,17.

Cognitive decline, dementia, and Alzheimer’s disease

Age-related cognitive decline involves the gradual worsening of cognitive abilities, including memory, attention, decision-making skills, and reasoning, and often signals the early stages of more serious neurodegenerative conditions like Alzheimer’s disease¹⁸. Mild cognitive impairment (MCI) is often a bridge between normal age-related cognitive decline and dementia, where early cognitive changes are noticeable but not yet disruptive to daily life¹⁹. While some level of cognitive decline is expected with aging, it’s important to recognize the difference between normal aging and more serious conditions like Alzheimer’s disease²⁰. Age-related cognitive decline can be slowed and even partially reversed through lifestyle changes. Engaging in regular physical activity, maintaining a healthy diet rich in antioxidants and omega-3 fatty acids, managing stress, getting adequate sleep, and staying mentally active through learning and social engagement are key strategies in the fight against cognitive decline²¹.

Alzheimer’s disease, the most common type of dementia, is a progressive neurodegenerative disorder marked by the buildup of amyloid plaques and tau tangles in the brain, leading to brain cell death²². This process typically begins with memory loss and it symptoms progress to include  confusion, disorientation, language difficulties, and eventually the inability to perform everyday tasks¹⁶.

Dementia is a broad term for conditions that affect memory, cognitive function, and social functioning to the point of interfering with daily life.  Alzheimer’s disease accounts for 60-80% of dementia cases, but other forms include vascular dementia, Lewy body dementia, and frontotemporal dementia²³. These conditions place significant burdens on individuals, families, and healthcare systems. With an aging population, the burden of care is increasing overall^16,17.

Amyotrophic lateral sclerosis (ALS)

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that affects motor neurons, leading to muscle weakness, paralysis, and ultimately, respiratory failure. While the exact cause of ALS remains unclear, it is believed to involve a combination of genetic and environmental factors, oxidative stress, and mitochondrial dysfunction²⁴.

A root-cause approach to addressing ALS involves targeting the underlying triggers and supporting overall neurological health, focusing on reducing inflammation, optimizing mitochondrial function, and protecting the body from environmental toxins that may contribute to neurodegeneration. A diet rich in antioxidants and anti-inflammatory foods, such as leafy greens, berries, nuts, and omega-3 fatty acids from fish and flaxseed, helps combat oxidative stress and reduce inflammation in the nervous system²⁵.

Nutrients like CoQ10, alpha-lipoic acid²⁶, and L-carnitine can enhance energy production and protect neurons from damage. Nutrients like glutathione,  N-acetylcysteine, and those found in cruciferous vegetables can aid in detoxification²⁷. Specific supplements, such as vitamin D, B vitamins, and magnesium, support nerve health and reduce the risk of neurodegeneration. Vitamin D, in particular, has been linked to neuroprotection and may slow the progression of ALS²⁸.

Parkinson's disease (PD)

Parkinson's disease (PD) is a chronic neurodegenerative disorder characterized by the progressive loss of dopaminergic neurons in the brain, leading to symptoms such as tremors, stiffness, slowness of movement, and postural instability²⁹. The underlying causes of PD are multifactorial, involving genetic predispositions, environmental exposures, and disruptions to mitochondrial function and oxidative stress³⁰.

A root-cause approach to Parkinson’s disease seeks to reduce oxidative stress, support mitochondrial function, and enhance detoxification while creating an environment in the body that supports brain health and slows disease progression. A diet rich in phytonutrients, particularly from colorful fruits and vegetables, helps combat oxidative stress and inflammation, which are key contributors to neuronal damage in PD³¹.

Just like in ALS, supporting mitochondrial function is essential in PD³². CoQ10, NAD+, and acetyl-L-carnitine are potent mitochondrial enhancers that can improve energy production and protect brain cells from degeneration. Probiotics, prebiotics, and a fiber-rich diet can contribute to a healthy gut microbiome, which in turn supports brain health and may reduce the progression of PD³³. Reducing the body’s toxic burden by supporting liver detoxification with sulfur-rich foods like garlic, onions, and cruciferous vegetables, as well as with supplements like glutathione, plays a vital role in reducing oxidative stress. Nutrients and supplements like vitamin D, omega-3 fatty acids, and curcumin have neuroprotective properties and may also help slow the progression of PD³⁴. These supplements support brain function, reduce inflammation, and enhance overall neurological health.

The role of genetics: family history and genotyping

Genetics plays a crucial role in brain health, impacting both the risk of cognitive decline and the likelihood of developing neurodegenerative diseases like Alzheimer’s disease. While lifestyle factors such as diet, exercise, and mental stimulation are vital for maintaining brain health, genetic predispositions can significantly elevate an individual’s risk for these conditions³⁵.

A strong family history of Alzheimer’s or dementia, particularly in close relatives like parents or siblings, is a clear indicator of genetic risk. This increased risk is often linked to specific gene variants, with the APOE ε4 allele being one of the most recognized³⁶. Carrying one copy of the APOE ε4 gene raises the risk of Alzheimer’s disease, and having two copies amplifies it further. However, having this allele doesn’t guarantee the disease; it simply increases the risk of developing it³⁷.

Genotyping, the process of identifying an individual’s genetic variants, can be a powerful tool in assessing one’s risk. Knowing whether you carry high-risk alleles like APOE ε4 allows for personalized prevention strategies. These approaches may include more rigorous lifestyle interventions, regular cognitive screening, and even participation in clinical trials for preventive therapies³⁸. However, it’s important to approach genetic information with caution. Genetics are just one factor in the complex equation of brain health; environmental influences and lifestyle choices also play significant roles³⁹.

By understanding both genetic and non-genetic factors, individuals can take a proactive approach to brain health. This involves combining lifestyle changes, regular monitoring, and medical interventions when necessary, with the goal of not only delaying or preventing neurodegenerative diseases but also promoting a lifetime of optimal cognitive function and well-being¹⁴.

Root Cause Approach to Brain Health

Root causes of cognitive decline

Cognitive decline is a complex, multifactorial process driven by various root causes. Chronic inflammation and oxidative stress are central players, damaging neurons by producing inflammatory cytokines and reactive oxygen species (ROS), which disrupt cellular structures, impair synaptic function, and ultimately lead to neuronal death⁴⁰. Additionally, the brain’s need for support from factors like brain-derived neurotrophic factor (BDNF) can be compromised by stress, aging, and other conditions, resulting in synaptic loss and cognitive impairment⁴¹.

Environmental toxins like heavy metals, pesticides, and mycotoxins (mold toxins) can worsen cognitive decline by impairing mitochondrial function and increasing oxidative stress⁴². Additionally, glucose dysregulation, especially insulin resistance, impairs the brain’s ability to utilize sugar, leading to energy deficits and cognitive impairment⁴³.

Nutrient deficiencies, particularly in omega-3 fatty acids, B vitamins, and antioxidants, reduce the brain’s ability to synthesize neurotransmitters, weaken defenses against oxidative stress, and promote neurodegeneration⁴⁴. Hormonal imbalances, including those involving sex hormones like estrogen and testosterone⁴⁵, insulin⁴⁶, and thyroid hormones⁴⁷, can disrupt neuronal communication, increase inflammation, and contribute to cognitive decline.

Vascular damage, such as hypertension and atherosclerosis, significantly impacts cognitive health by restricting blood flow to the brain, depriving it of essential oxygen and nutrients. This may lead to neuronal injury and cognitive impairment^48,49. Moreover, a history of head trauma, including repeated concussions or traumatic brain injuries, can disrupt neural networks, leading to chronic neuroinflammation and increased risk of neurodegenerative diseases⁵⁰.

Trauma-induced cognitive decline resulting from injuries like traumatic brain injuries (TBIs), concussions, and chronic traumatic encephalopathy (CTE) is especially common in athletes, car crash survivors, and veterans. These injuries can lead to memory loss, mood changes, and long-term cognitive impairment, profoundly affecting quality of life⁵¹. Repeated head injuries, particularly in contact sports or combat, increase the risk of developing CTE, a progressive brain disease with severe cognitive and emotional consequences.

Inflammation and oxidative stress

Inflammation and oxidative stress are closely linked to cognitive decline. Chronic activation of the brain’s immune cells leads to neuroinflammation, which can cause ongoing damage to neurons⁵². At the same time, oxidative stress occurs when the brain’s natural antioxidant defenses are overwhelmed by the production of reactive oxygen species (ROS), resulting in mitochondrial dysfunction and cell death⁵³.

These processes can be triggered by infections, toxin exposure, and metabolic imbalances, and are often worsened by poor lifestyle choices like diets high in ultra-processed foods and sugar⁵⁴. To preserve cognitive function, it’s essential to address the root causes of inflammation and oxidative stress through diet, lifestyle changes, and targeted therapies⁵⁵.

Nutrient deficiencies

Nutrient deficiencies are a critical yet often overlooked factor in cognitive decline⁵⁶. The brain depends on a consistent supply of key nutrients like B vitamins, omega-3 fatty acids, vitamin D, and magnesium to function at its best⁵³. When these nutrients are lacking, essential processes like neurotransmitter production, synaptic plasticity, and DNA repair can become compromised⁵⁵.

For instance, B vitamins are essential for methylation, a process that helps maintain cognitive function and prevents the buildup of homocysteine, a known risk factor for neurodegeneration^57,58. Omega-3 fatty acids, especially DHA, are vital for keeping neuronal membranes healthy and supporting anti-inflammatory pathways⁵⁹. To protect the brain and prevent cognitive decline, it’s important to address nutrient deficiencies through a balanced diet and targeted supplementation⁵⁵.

Hormonal imbalances

Hormonal imbalances impact cognitive health, especially as we age. Hormones like estrogen, testosterone⁶⁰, insulin, and thyroid hormones⁴⁷ play critical roles in regulating brain function.

For instance, a decline in estrogen is linked to a higher risk of neurodegenerative diseases because of its role in protecting neurons and supporting synaptic plasticity⁶¹. Insulin resistance, which is common in type 2 diabetes, disrupts the brain’s ability to use glucose efficiently, leading to energy deficits and cognitive impairment⁶². Additionally, imbalances in cortisol⁶³ and thyroid hormones⁶⁴ can interfere with neuronal communication and exacerbate inflammation, further contributing to cognitive issues. Maintaining balanced hormone levels through lifestyle changes, proper nutrition, and targeted therapies is crucial for preserving brain health as we age.

Environmental toxins

Exposure to environmental toxins like heavy metals, pesticides, mycotoxins, and industrial chemicals is all too common in today’s world and plays a significant role in cognitive decline by disrupting cellular processes and promoting neuroinflammation⁵⁴. These toxins can cross the blood-brain barrier, where they accumulate and directly damage neurons, setting the stage for cognitive dysfunction⁵².

Heavy metals like mercury and lead bind to proteins and disrupt their normal function, leading to neuronal damage⁶⁵. Pesticides and industrial chemicals further aggravate this damage by interfering with neurotransmitter function and inducing oxidative stress, both of which are key drivers of cognitive decline⁶⁶.

Mycotoxins, which are toxic compounds produced by certain molds, pose a particularly insidious threat. They can enter the body through inhalation, ingestion, or skin contact, triggering chronic inflammation and oxidative stress⁶. These toxins can impair mitochondrial function, disrupt hormone signaling, and even damage DNA⁶⁷. Prolonged exposure to mycotoxins is associated with neurological symptoms like memory loss, brain fog, and cognitive impairment⁶⁸.

To protect brain health, detoxification is essential. This includes supporting liver function with nutrients like glutathione and N-acetylcysteine, boosting elimination with a diet rich in fiber and antioxidants, and minimizing exposure to known sources of toxins, such as mold-contaminated environments⁶⁹.

Acute infections

Acute encephalitis can be triggered by various viruses, parasites like Taenia solium (causing neurocysticercosis), and bacteria like Streptococcus pneumoniae. These infections can lead to severe brain inflammation, resulting in cognitive decline, seizures, and long-term neurological damage⁷⁰. Strengthening the immune system using a nutrient-dense diet and targeted supplements is important for prevention and potential reversal if diagnosed early.

Chronic infections

Chronic infections, such as those caused by herpes simplex virus (HSV), Epstein-Barr virus (EBV), cytomegalovirus (CMV)⁷¹, and Chlamydia pneumoniae, are increasingly linked to the development of Alzheimer’s disease⁷². These pathogens can linger in the body, driving chronic inflammation and activating the brain’s immune system, which leads to neuroinflammation and damage to neurons. HSV-1, in particular, has been found in the brains of individuals with Alzheimer’s disease, where it may interact with genetic factors like the APOE ε4 allele, worsening amyloid plaque buildup and tau pathology⁷³.

Similarly, infections like EBV and CMV are associated with systemic inflammation that can disrupt the blood-brain barrier, allowing harmful molecules and pathogens to enter the brain and contribute to neurodegeneration⁷⁴. The ongoing presence of these infections may create a pro-inflammatory environment in the brain, increasing the risk and progression of Alzheimer’s disease.

Vascular damage (hypertension, atherosclerosis/arteriosclerosis)

Vascular damage is a key driver of cognitive decline, especially in conditions like hypertension and atherosclerosis. High blood pressure can damage the brain’s delicate blood vessels, leading to microvascular damage and impaired blood flow¹⁹. This restricts oxygen and nutrient delivery to brain cells, which can cause neuronal injury and contribute to vascular dementia⁷⁵.

Atherosclerosis, with its plaque buildup and arterial hardening, further restricts blood flow to the brain, increasing the risk of strokes and other ischemic events that directly damage brain tissue⁷⁶. The chronic reduction in cerebral blood flow caused by these vascular conditions leads to a gradual but significant decline in cognitive function⁷⁷.

To protect brain health, it’s crucial to maintain healthy blood pressure, manage cholesterol, and follow a heart-healthy diet to reduce the risk of vascular-related cognitive decline.

History of head trauma

A history of head trauma, especially repeated concussions or traumatic brain injuries (TBIs), is a well-established risk factor for cognitive decline. These injuries can disrupt the brain’s neural networks, leading to chronic neuroinflammation and increased susceptibility to neurodegenerative diseases like Alzheimer's and chronic traumatic encephalopathy (CTE)⁷⁸.

The damage from head trauma is complex. It can cause immediate damage, such as axonal shearing and brain hemorrhaging, and can also trigger long-term inflammatory responses that worsen neurodegeneration⁷⁹. TBIs can also hinder the brain’s ability to clear toxic proteins like beta-amyloid and tau, which accumulate and drive cognitive decline⁵⁰. TBIs can trigger psychological and psychiatric issues, such as depression, anxiety, and mood swings, as the injury alters brain chemistry and disrupts emotional regulation⁸⁰. For more information, visit Mental Health and Stress Management 101.

TBIs are more severe in women due to differences in brain structure, hormonal fluctuations, and a higher likelihood of post-concussive symptoms like migraines and depression⁸¹. The developing brain is particularly vulnerable; in adolescents and children, TBIs can disrupt crucial stages of brain development, leading to long-term cognitive, behavioral, and emotional challenges and impacting their academic performance and social interactions⁸².

To manage the long-term effects of head trauma, a comprehensive approach is essential. This includes regularly monitoring cognitive function, addressing hormonal imbalances that may arise from pituitary gland injury, and incorporating neuroprotective strategies to support overall brain health.

Lifestyle factors (diet, exercise, sleep, stress)

Lifestyle factors are the cornerstone of brain health, profoundly influencing whether we maintain cognitive function or experience decline. Choose a nutrient-rich, anti-inflammatory diet that’s abundant in whole foods and healthy fats as well as low in sugar. This type of diet provides essential nutrients and reduces oxidative stress, both of which are crucial for optimal brain function.

Regular physical activity is just as vital. Exercise promotes neurogenesis (the creation of new neurons), enhances brain plasticity, and increases the production of growth factors like BDNF that are key to cognitive health⁸³.

Sleep, too, is non-negotiable. It’s during sleep that the brain consolidates memories and clears metabolic waste, including beta-amyloid, the protein associated with Alzheimer’s disease⁸⁴.

Managing stress is yet another critical element. Chronic stress raises cortisol levels, which can damage the hippocampus, the brain’s memory center. Incorporating practices like meditation, deep breathing, and yoga, as well as working to foster a sense of community, can mitigate stress and protect brain health⁸⁵.

By addressing these root causes through tailored dietary interventions, lifestyle modifications, detoxification strategies, and improving vascular health and neuroprotection—especially in those with a history of head trauma—we can not only prevent cognitive decline, but also promote brain resilience and longevity³⁵.

Assessing Brain Health

Blood tests

Phosphorylated tau (p-tau)

Phosphorylated tau (p-tau) is a critical biomarker linked to neurofibrillary tangles, one of the key features of Alzheimer’s disease. Elevated p-tau levels in the blood can indicate tau pathology in the brain, making this biomarker especially useful in detecting the disease during the early stages when cognitive decline begins. Measuring p-tau has the potential to identify Alzheimer’s disease even before symptoms appear, offering a diagnostic tool for early detection and even prevention⁸⁶.

Amyloid beta (Aβ)

Amyloid beta is a protein that forms plaques in the brain, a hallmark of Alzheimer’s disease. The ratio of Aβ42 to Aβ40 in the blood is a vital biomarker for detecting amyloid pathology, especially in the early stages before cognitive symptoms appear. These tests are most effective in the preclinical and early symptomatic phases, making them a valuable tool for early detection and potentially even prevention in those at high risk⁸⁷.

Amyloid probability score 2 (APS2)

The amyloid probability score 2 (APS2) has high diagnostic accuracy for Alzheimer’s disease, particularly in individuals with mild cognitive impairment or dementia treated in primary care settings. When combined with the percentage of p-tau217, the APS2 significantly enhances diagnostic accuracy. Therefore, when interpreted in the context of mild cognitive symptoms, blood testing to measure APS2 as well as the percentage of p-tau217 ensures timely diagnosis and early intervention. Both are critical to preventing neurodegeneration⁸⁸.  

Neurofilament light chain (NfL)

Neurofilament light chain (NfL) is a key protein found in nerve cells. It is an important marker for brain health. When nerve cells are damaged, NfL is released into the bloodstream or cerebrospinal fluid, making it a valuable means of detecting and monitoring neurological diseases like Alzheimer’s disease, Parkinson’s disease, ALS, frontotemporal dementia, and even acute conditions like traumatic brain injury⁸⁹. Elevated levels of NfL in the blood or cerebrospinal fluid can indicate ongoing nerve cell damage, even before symptoms appear. This makes NfL a promising biomarker for early diagnosis and for tracking the progression of neurodegenerative diseases⁹⁰.

Genetic testing

APOE genotype

The APOE gene has different alleles, with APOE ε4 being closely linked to a higher risk of developing Alzheimer’s disease. Genetic testing for the APOE genotype can be a valuable tool for identifying individuals at greater risk, allowing them to take proactive steps in their health management before symptoms emerge. While this test is useful for prevention, it is not typically used to diagnose symptomatic individuals, as it indicates the risk rather than the presence of the disease⁹¹.

Point of care tests

Point of care tests allow for rapid, on-site evaluation of traumatic brain injury (TBI) severity, offering immediate insights into whether an individual has sustained significant brain damage⁹². This is crucial for timely intervention, especially in sports, military, and emergency settings. Measuring specific biomarkers in the blood, such as neurofilament light chain (NfL)⁸⁹ or glial fibrillary acidic protein (GFAP)⁹³, can help guide treatment decisions, monitor recovery, and potentially prevent long-term cognitive decline.

Other tests

Inflammatory markers (e.g., C-reactive protein, IL-6)

Inflammatory markers like C-reactive protein (CRP) and interleukin-6 (IL-6) are indicators of systemic inflammation, which is linked to cognitive decline and neurodegenerative diseases⁹⁴. These tests are useful for both prevention and monitoring because chronic inflammation is a significant risk factor for cognitive impairment. Addressing inflammation early can delay or even prevent the onset of cognitive symptoms.

Nutrients (e.g., Vitamin D, B vitamins, omega-3 fatty acids)

Assessing nutrient levels, especially levels of vitamin D, B vitamins, and omega-3 fatty acids, is essential for identifying deficiencies that may contribute to cognitive decline⁹⁵. By addressing these deficiencies early, it helps to support cognitive function and significantly lower the risk of neurodegenerative diseases. Regular testing and monitoring are key strategies in maintaining optimal brain health and preventing cognitive issues.

Metabolic function (e.g., glucose, insulin, HbA1c)

Metabolic markers such as fasting glucose, insulin, and HbA1c (a marker of long-term blood sugar control), are essential for evaluating insulin resistance and diabetes, both of which are key risk factors for cognitive decline and Alzheimer’s disease. Monitoring these markers is critical in both the prevention and early symptomatic stages of cognitive decline, as maintaining healthy blood sugar levels can significantly reduce the risk of cognitive impairment and help slow the progression of the disease⁹⁶.

Heavy metals (e.g., lead, mercury)

Heavy metals like lead and mercury can build up in the body, leading to neurotoxicity and cognitive decline⁶⁵. Mercury is particularly harmful because it can cross the blood-brain barrier; once it is in the brain, it damages neurons and disrupts brain function⁹⁷. This buildup is linked to memory problems, difficulty concentrating, and an increased risk of neurodegenerative diseases like Alzheimer’s disease.

Detoxifying the body through dietary changes, supplements, and reducing exposure to heavy metals is crucial for protecting brain health. By testing blood or urine for these toxins, we can identify overall exposure levels. This is particularly relevant for prevention, as minimizing exposure and supporting the body’s detoxification processes can protect against cognitive issues.

Infections

When it comes to infections that can cause significant cognitive damage, certain viruses, parasites, and bacteria are particularly concerning.

• Viruses: Viruses like herpes simplex virus (HSV), West Nile virus, and Japanese encephalitis virus are known to cause encephalitis (inflammation of the brain) that can lead to severe neurological symptoms, including memory loss, confusion, and cognitive decline⁹⁸.
• Parasites: Cysticercosis, caused by the Taenia solium tapeworm, is one of the leading parasitic infections impacting the brain. When the larvae invade the central nervous system, it can result in neurocysticercosis, causing seizures, headaches, and cognitive impairments⁹⁹.
• Bacteria: Bacterial infections like meningitis caused by Streptococcus pneumoniae or Haemophilus influenzae can also result in cognitive damage¹⁰⁰. These bacteria can cause inflammation of the brain, resulting in long-term cognitive deficits like memory problems and difficulty concentrating.

Understanding the underlying causes makes it possible to implement strategies to boost the immune system, support detoxification, and ensure the body can effectively combat these infections.

Mycotoxins

Mycotoxins, which are toxic substances produced by molds, can cause significant neurological harm, contributing to cognitive decline¹⁰¹. Identifying exposure early, typically through urine analysis, is key to prevention. Once detected, targeted detoxification strategies can help reduce their impact and protect brain health.

Autoimmune markers (e.g., ANA, rheumatoid factor)

Autoimmune markers like antinuclear antibodies (ANA) and rheumatoid factor (RF) can indicate the presence of autoimmune diseases, which are often linked to cognitive decline through systemic inflammation^102,103. Identifying these biomarkers early is valuable in both the prevention and symptomatic stages, as it allows for timely intervention to manage autoimmune activity. By addressing the underlying inflammation, we can protect brain health and potentially slow cognitive decline in those affected.

Function tests

• Beta-amyloid 42/40 ratio: Assesses risk of Alzheimer’s disease pathology in adults with mild cognitive impairment (MCI) or dementia.
• Phosphorylated tau (p-tau): Assesses Alzheimer’s disease-associated tau pathology in adults with mild cognitive impairment (MCI) or dementia.
• Apolipoprotein E (ApoE) genotype: ApoE is a predictive genetic biomarker that can determine the risk of developing AD before symptom onset.
• High-sensitivity C-reactive protein (hs-CRP): Assesses systemic inflammation that can influence brain health¹⁰⁴.
• Advanced lipid biomarker assessment: Helps in assessing the risk of cardiovascular diseases more accurately than a standard lipid panel, and includes total cholesterol/HDL ratio, HDL large, LDL cholesterol, LDL particle number, LDL peak size, Lipoprotein (a), total cholesterol, Apolipoprotein B (ApoB), HDL cholesterol, LDL medium, LDL pattern, LDL small, Non-HDL cholesterol, triglycerides.
• Metabolic : Helps identify metabolic derangements such as insulin resistance and diabetes, which are risk factors for cognitive decline and AD, and includes adiponectin, glucose, hemoglobin A1c (HbA1c), insulin, leptin, and uric acid in serum.
• Nutrients: Essential for brain health and cognitive function.‍
  • Vitamin D, 25-hydroxy: Important for brain health and neuroprotection¹⁰⁵.‍
  • Omega-6/Omega-3 ratio: Essential fatty acids that play a role in reducing inflammation and supporting neuronal function.‍
  • Homocysteine: Elevated levels can be a risk factor for cognitive decline⁹⁵.

• Tick (Lyme) antibodies: Checks for antibodies related to the tick-borne disease.
• Viral antibodies: These include cytomegalovirus antibodies (IgG, IgM), Epstein-Barr virus antibody (IgG, IgM), Epstein-Barr virus early antigen D antibody (IgG), hepatitis panel, and herpesvirus 6 (HHV-6) antibodies.
• Thyroid (thyroglobulin antibodies, thyroid peroxidase antibodies, TSH, free T4, free T3): Ensures thyroid hormones are balanced, as imbalances can affect cognitive health¹⁰⁶.
• Cortisol: Checks for stress and adrenal function, which can impact overall health and brain function¹⁰⁷.
• Liver (ALP, ALT, AST, GGT, total bilirubin, total protein): Assesses liver health, as liver function can impact overall metabolism and brain health.
• Kidney (BUN, BUN/creatinine ratio, blood creatinine, urine creatinine, eGFR, microalbumin, sodium): Checks kidney health, which is essential for maintaining metabolic balance.

Nutrition and Supplements for Brain Health

Nutrition plays a key role in overall health. Nutrition 101 is a science-based review of foundational nutritional principles and eating practices that promote health and well-being.

The MIND (Mediterranean-DASH diet Intervention for Neurodegenerative Delay) diet

The MIND diet emphasizes whole foods, healthy fats, and plant-based nutrients and while limiting the intake of animal products and high saturated-fat foods¹⁰⁸. Key components include:

• Green leafy vegetables: 6+ servings/week
• Vegetables: 1+ servings/day
• Berries: 2+ servings/week
• Nuts: 5+ servings/week
• Whole grains: 3+ servings/day
• Beans: 3+ meals/week
• Fish: 1+ meals/week
• Poultry: 2+ meals/week
• Olive oil

The MIND diet includes foods rich in folate, vitamin E, carotenoids, and flavonoids, the antioxidant and anti-inflammatory properties of which protect the brain by reducing oxidative stress and neuroinflammation¹⁰⁹.

Mediterranean ketogenic diet

The Mediterranean ketogenic diet (MKD) combines the principles of the Mediterranean and ketogenic diets, offering a powerful dietary approach rich in healthy fats from fish, nuts, seeds, and olive oil¹¹⁰. This diet emphasizes a higher intake of polyunsaturated and monounsaturated fats known for their anti-inflammatory and neuroprotective properties¹¹¹. Unlike the standard ketogenic diet, which often emphasizes saturated fats from sources like red meat and dairy, the MKD focuses on omega-3 fatty acids from fish and alpha-linolenic acid from plants. These fats are essential for protecting brain health, reducing oxidative stress, and lowering inflammation—key factors in preventing and managing Alzheimer’s disease¹¹².

The MKD’s emphasis on anti-inflammatory and antioxidant-rich foods, like those found in the Mediterranean diet, offers significant advantages for cognitive health¹¹³. While the standard ketogenic diet effectively promotes ketosis and reduces carbs, it can also lead to increased intake of saturated fats, potentially increasing inflammation if not carefully balanced with other nutrients¹¹⁴. In contrast, the MKD’s focus on healthy fats and plant-based nutrients like polyphenols supports brain function, reduces neuroinflammation, and may provide superior protection against Alzheimer’s disease^115,116.

Anti-inflammatory diet

Chronic inflammation is linked to increased accumulation of beta-amyloid plaques and tau tangles in the brain. An anti-inflammatory diet helps reduce inflammation and supports brain health. Adopting a diet rich in anti-inflammatory foods can mitigate Alzheimer’s brain pathology. These foods include:

• Fruits and vegetables: Rich in antioxidants, vitamins, and minerals. Berries, leafy greens (e.g., collard greens, kale, spinach, Swiss chard), and cruciferous vegetables are particularly beneficial¹¹⁷.
• Healthy fats: Omega-3 fatty acids found in fatty fish (such as salmon, mackerel, and sardines), ground flaxseed, chia seeds, and walnuts can reduce inflammation and support neuronal health¹¹⁸.
• Whole grains: Foods like quinoa, brown rice, and oats provide essential nutrients and fiber, supporting overall health and reducing inflammation¹¹⁹.
• Nuts and seeds: Almonds, chia seeds, and sunflower seeds provide healthy fats and antioxidants that can protect brain cells¹²⁰.
• Olive oil: A primary fat source in the Mediterranean diet, olive oil is rich in monounsaturated fats and antioxidants^121,122
• Curcumin: The active ingredient in turmeric, curcumin has powerful anti-inflammatory and antioxidant properties¹²³.

Antioxidant-rich foods

Antioxidants neutralize free radicals that can damage brain cells and contribute to the accumulation of beta-amyloid plaques and tau tangles in the brain.

• Berries: Blueberries, strawberries, and blackberries are high in antioxidants and may improve cognitive function^124,125.
• Green tea: Has neuroprotective effects¹²⁶.
• Dark chocolate: Contains flavonoids that can enhance brain function and reduce oxidative stress^127,128.

The gut-friendly diet: foods that promote microbiome wellness

A healthy gut microbiome supports brain health¹²⁹. To feed the microbiome, incorporate:

• Fermented food: Yogurt and kefir (if dairy is tolerated), sauerkraut, and kimchi.
• High-fiber foods: Cruciferous vegetables, whole grains, beans, and legumes.

Key supplements for brain health

Omega-3 fatty acids (EPA and DHA)

Omega-3 fatty acids, especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are essential for maintaining the structure and function of brain cells. DHA is a critical component of effective communication between neurons¹³⁰. EPA, on the other hand, is vital for reducing inflammation, which protects the brain from chronic conditions that can lead to cognitive decline¹³¹. Together, EPA and DHA enhance cognitive function, support synaptic plasticity, and may lower the risk of neurodegenerative diseases like Alzheimer’s¹³².

• Benefits: Improves cognitive function and reduces inflammation¹³³
• Dose: 1-3 g.
• Frequency: Once daily.
• Mechanism of action: Reduce inflammation by inhibiting the production of pro-inflammatory cytokines and modulating membrane fluidity in neurons.

B vitamins (B6, B12, folate)

B vitamins—specifically B6, B12, and folate—are vital for brain health because they play a key role in managing homocysteine levels. Elevated homocysteine is linked to a higher risk of cognitive decline and Alzheimer’s disease⁵⁸. B vitamins help convert homocysteine into methionine, effectively lowering its levels and supporting brain function. They are also involved in neurotransmitter synthesis, DNA repair, and myelin formation, all critical processes for preserving cognitive function and protecting against neurodegeneration. B vitamin supplementation reduces oxidative stress and may lower the risk of neurodegenerative diseases over time¹³⁴.

When supplementing with B vitamins, it’s important to choose the correct methylated forms, such as pyridoxal‑5‑phosphate instead of B6, methylcobalamin instead of hydroxocobalamin, and 5 methyl-folate instead of folate, as they are more bioavailable and can be better utilized by the body, especially for those with genetic variations affecting methylation¹³⁵.

Vitamin B6 (pyridoxal‑5‑phosphate)

• Benefits: Supports neurotransmitter synthesis essential for cognitive function¹³⁶.
• Dose: 2-10 mg.
• Frequency: Daily as part of a multivitamin.
• Mechanism of action: B6 acts as a cofactor for enzymes involved in amino acid metabolism, neurotransmitter synthesis, and conversion of homocysteine, supporting neurological health.

Vitamin B12 (methylcobalamin)

• Benefits: Essential for myelin formation, protecting nerve fibers and supporting cognitive function⁹⁵.
• Dose: 2.4 mcg.
• Frequency: Daily as part of a multivitamin.
• Mechanism of action: B12 is vital in the methylation cycle, converting homocysteine to methionine, and is critical for DNA synthesis.

Folate (5 methyl- folate)

• Benefits: Converts homocysteine to methionine, supports neurotransmitter synthesis and DNA repair¹³⁷
• Dose: 400-800 mcg.
• Frequency: Daily as part of a multivitamin.
• Mechanism of action: Folate is crucial for DNA and RNA synthesis and for the conversion of homocysteine to methionine.

Vitamin D

Vitamin D plays a vital role in brain health through its neuroprotective, anti-inflammatory, and antioxidant properties. It also plays a key role in regulating the immune system and reducing neuroinflammation, both of which are linked to cognitive decline and dementia¹³⁸.

Vitamin D receptors are present throughout the brain, suggesting that adequate levels of this vitamin are crucial for maintaining cognitive function¹³⁹. A deficiency in vitamin D has been associated with a higher risk of cognitive impairment and Alzheimer’s disease, highlighting the need for supplementation, especially in older adults¹⁴⁰.

• Benefits: Supports overall brain health and reduces risk of cognitive decline¹⁰⁵.
• Dose: 1,000-2,000 IU.
• Frequency: Once daily.
• Mechanism of action: Regulates neurotrophic factors and reduces neuroinflammation.

Magnesium

Magnesium is crucial for many brain functions, including neurotransmitter release, synaptic plasticity, and protecting neurons. It also helps regulate NMDA receptors, which are key to learning and memory. Low magnesium levels have been linked to increased oxidative stress, inflammation, and a higher risk of neurodegeneration¹⁴¹. Maintaining adequate magnesium levels supports cognitive function, helps reduce anxiety, and may protect against age-related cognitive decline¹⁴².

• Benefits: Magnesium helps protect against neurodegeneration by reducing oxidative stress and inflammation¹⁴¹.
• Dose: 200-400 mg/day.
• Frequency: Once daily.
• Mechanism of action: Reduces oxidative stress, which protects neurons from damage and slows the progression of neurodegenerative diseases.

Curcumin

Curcumin, the active compound in turmeric, has strong anti-inflammatory and antioxidant effects that are beneficial for brain health¹⁴³. It can cross the blood-brain barrier, reducing neuroinflammation and oxidative stress—both major factors in cognitive decline and neurodegenerative diseases like Alzheimer’s disease¹⁴⁴. Curcumin has also been shown to lower amyloid plaque buildup and tau protein aggregation in the brain, making it a promising nutraceutical for supporting cognitive function and potentially preventing Alzheimer’s disease¹⁴⁵.

• Benefits: Potent anti-inflammatory and antioxidant properties^123,145.
• Dose: 500-1,000 mg.
• Frequency: Once daily.
• Mechanism of action: By inhibiting the activity of inflammatory enzymes and reducing oxidative stress, curcumin reduces amyloid and tau accumulation in the brain, both of which are associated with Alzheimer’s disease and other forms of dementia.

Phosphatidylserine

Phosphatidylserine is a vital phospholipid found in brain cell membranes, playing a crucial role in maintaining cellular health, aiding neurotransmitter release, and supporting synaptic plasticity¹⁴⁶. Supplementing with phosphatidylserine has been shown to enhance memory, cognitive function, and mood, especially in older adults. It may also help slow cognitive decline by preserving brain cell membrane integrity and improving communication between neurons¹⁴⁷.

• Benefits: Supports cognitive function and memory¹⁴⁸.
• Dose: 100-300 mg.
• Frequency: Once daily.
• Mechanism of action: Modulates neurotransmitter release and synaptic function.

Ginkgo biloba

Ginkgo biloba is a powerful herbal supplement that’s been trusted for centuries to boost brain health. It works by improving blood flow to the brain, ensuring that brain cells receive the oxygen and nutrients they need to thrive. Ginkgo is also rich in antioxidants, which help protect your brain cells from oxidative damage and reduce inflammation¹⁴⁹. Ginkgo biloba is also associated with improved memory, attention, and overall cognitive function, especially in those with mild cognitive impairment or early-stage Alzheimer’s disease¹⁵⁰.

• Benefits: Enhances cognitive function and improves blood flow to the brain¹⁵¹.
• Dose: 120-240 mg.
• Frequency: Once daily.
• Mechanism of action: Ginkgo biloba increases cerebral blood flow and has neuroprotective antioxidant properties.

Coenzyme Q10 (CoQ10)

Coenzyme Q10 (CoQ10) is a powerful antioxidant that plays a crucial role in mitochondrial energy production, which is essential for brain health. It helps protect neurons from oxidative damage and supports overall cognitive function, making it particularly valuable in conditions like Parkinson’s disease and Alzheimer’s disease, in which mitochondrial dysfunction is a key factor¹⁵².

• Benefits: CoQ10 is an antioxidant that supports mitochondrial function and reduces oxidative stress¹⁵³.
• Dose: 100-300 mg.
• Frequency: Once daily.
• Mechanism of action: Improves mitochondrial function and reduces oxidative stress, which can help in lowering tau phosphorylation.

Alpha-lipoic acid (ALA)

Alpha-lipoic acid (ALA) is a potent antioxidant that supports brain health by protecting neurons from oxidative stress and inflammation, both of which are key factors in neurodegenerative diseases. It also enhances mitochondrial function, promoting energy production in brain cells and potentially slowing cognitive decline¹⁵⁴.

• Benefits: Antioxidant properties improve mitochondrial function¹⁵⁵.
• Dose: 600 mg.
• Frequency: Once daily.
• Mechanism of action: Reduces oxidative stress and inflammation.

Acetyl-L-carnitine

Acetyl-L-carnitine (ALC) is a naturally occurring compound that plays a crucial role in energy production by transporting fatty acids into the mitochondria, where they are burned for fuel. In the brain, ALC supports cognitive function and neuroprotection by enhancing mitochondrial function, reducing oxidative stress, and promoting the synthesis of the neurotransmitter acetylcholine, which is vital for memory and learning¹⁵⁶.

• Benefits: Enhances cognitive function and energy production¹⁵⁶.
• Dose: 500-2,000 mg.
• Frequency: Once daily.
• Mechanism of action: Facilitates mitochondrial energy production and has neuroprotective effects.

Lifestyle Factors

Importance of sleep

Maintaining good sleep quality is essential for overall health and particularly important for brain health. For more information, visit Sleep 101.

Especially in midlife, poor sleep is associated with an increased risk of developing dementia later in life. Restorative sleep reduces the production of proinflammatory cytokines and regulates inflammation, reduces stress, and improves blood flow to the brain. During sleep, the heart rate and blood pressure naturally decrease, allowing the brain to rest and recover from daily activities. Over time, this reduces risk of cognitive decline.

Slow-wave sleep (SWS), the deepest stage of non-REM sleep, is particularly important for memory consolidation and the clearance of metabolic waste products from the brain¹⁵⁷. The accumulation of amyloid-beta plaques and tau tangles in the brain are central features of neurodegeneration and cognitive decline in Alzheimer’s disease and other forms of dementia²².

The glymphatic system, a network in the brain responsible for clearing waste products like amyloid-beta and tau proteins, is most active during sleep, particularly deep sleep. Disrupted or insufficient SWS contributes to the accumulation of amyloid-beta and tau proteins by impairing the brain’s ability to clear these proteins, accelerating the progression of neurodegenerative conditions¹⁵⁸.

Improving sleep quality—specifically, increasing the amount of SWS—is a key strategy in delaying or preventing the onset of neurodegenerative diseases. Interventions aimed at increasing SWS, such as acoustic stimulation during sleep, lifestyle modifications, and potential pharmacological approaches, are protective against cognitive decline and dementia¹⁵⁷.

Additionally, elevated cortisol levels, often associated with chronic stress and sleep disturbances, may contribute to an increased risk of beta-amyloid accumulation in the brain over time. This accumulation is a hallmark of Alzheimer’s disease and managing cortisol levels is critical for preventing or slowing the progression of Alzheimer's disease¹⁵⁹

Notably, sleep disorders such as obstructive sleep apnea (OSA) may increase the risk for Alzheimer’s disease by interfering with blood flow to the brain and disrupting brain patterns that promote cognitive health¹⁶⁰.

Exercise

Regular exercise benefits overall health by improving cardiovascular health, aiding in weight management, lowering blood pressure, and reducing the risk of conditions such as hypertension. For more detailed information on exercise, including how to adapt exercise for disability, visit Exercise 101.

Regular aerobic exercise is a powerful tool in slowing the progression of Alzheimer’s disease¹⁶¹. It not only supports brain health by improving blood flow, reducing inflammation, promoting upregulation of neurotrophic factors such as BDNF^162,163, and increasing neurogenesis (the growth of new neurons), but it also aids in managing weight, lowering blood pressure, and reducing the risk of chronic metabolic conditions like obesity, diabetes, and cardiovascular disease—key risk factors for Alzheimer’s disease¹⁶⁴.

Exercise has neuroprotective effects for diabetes-related neurodegenerative conditions because it improves insulin sensitivity and blood sugar control, and reduces inflammation^165,166. Moderate- to high-intensity aerobic exercise has been shown to enhance learning and memory, making it a crucial component of any strategy to maintain cognitive health as we age^167,168.

In neurodegenerative conditions like Parkinson’s disease, exercise lowers elevated hs-CRP levels, improves mitochondrial function^169,170 and has positive effects on the gut microbiome, leading to improvements in cognitive function and mood as well as reduced disease risk^3,171. Additionally, mind-body exercises like Tai Chi, yoga, and meditation improve cognitive function, sleep quality, disease symptoms, and quality of life in individuals with Parkinson’s disease¹⁷².

The role of social connection in cognitive health

Social connection is a vital component of cognitive health, especially as we age. Engaging in meaningful social interactions helps stimulate cognitive function, reducing the risk of cognitive decline and neurodegenerative diseases like Alzheimer’s disease¹⁶¹. Social connection promotes the release of neurotransmitters like dopamine and serotonin, which are essential for mood regulation and brain health¹⁷³. Additionally, social engagement provides mental stimulation, emotional support, and a sense of purpose—all of which contribute to maintaining cognitive function. Individuals who maintain strong social ties are more likely to experience slower cognitive decline and have a lower risk of dementia.

Strategies to help maintain social engagement to support cognitive health^174,175:

• Involvement in group activities: Encourage participation in group activities like art classes, music therapy, or gardening, which can provide both mental stimulation and a sense of community.
• Regular family visits: Arrange frequent, structured visits from family members to provide familiarity and emotional support.
• Utilize technology: Use video calls to connect with distant friends and family, helping to maintain relationships even when physical visits aren’t possible¹⁷⁶.
• Engage in community programs: Involvement in community programs tailored to those with Alzheimer’s, such as memory cafes or senior centers, can foster a supportive social environment.
• Volunteer opportunities: Provide opportunities for volunteering in safe and supervised settings, allowing individuals to contribute to their community while staying engaged.
• Pet therapy: Interaction with pets can provide comfort, reduce stress, and create opportunities for socialization, particularly in group settings where multiple individuals can interact with the animals.
• Encourage reminiscence therapy: Sharing personal stories and memories in a group setting can enhance social bonds and provide cognitive stimulation through discussion.

Navigating Alzheimer’s disease: the social and family impact of cognitive decline and caregiver stress

Mental health and stress reduction are paramount for overall well-being, including brain health. Visit Mental Health and Stress Management 101 for more information on optimizing mental health and managing stress.

Alzheimer’s disease affects more than just the individual who has the condition; it has far-reaching consequences for families and caregivers¹⁷⁷. The emotional, physical, and financial tolls of caregiving can lead to chronic stress, burnout, and health challenges for those providing care. By focusing on modifiable risk factors for cognitive decline, we can improve outcomes for those at risk and reduce the heavy burden on caregivers and families. Access to community support, education, and resources is crucial in managing the widespread impact of cognitive disorders¹⁷⁸.

A root-cause approach to prevention

A root cause approach is aimed at preventing and reversing cognitive decline and dementia associated with Alzheimer’s disease, mild cognitive impairment (MCI), and other neurodegenerative conditions¹⁷⁹.

This typically involves a multifaceted approach that includes a series of tests and protocols to identify and address the underlying causes of cognitive impairment:

Testing

Comprehensive blood tests: These tests provide a broad view of an individual’s health and help identify any underlying conditions contributing to cognitive decline.

• Nutrient deficiencies: Assess levels of vitamin D, B12, folate, magnesium, and omega-3 fatty acids. These nutrients are crucial for brain health and cognitive function. Deficiencies can lead to neurological symptoms and impaired cognitive performance¹⁴⁰.
• Inflammation: High-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and homocysteine are markers of inflammation. Chronic inflammation is linked to neurodegenerative diseases, and these markers help assess the body’s inflammatory status¹⁸⁰.‍
• Infectious pathogens: Viruses and other common pathogens may trigger chronic inflammation and immune system disturbances affecting brain health¹⁸¹. Commonly tested pathogens include herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), Borrelia burgdorferi (associated with Lyme disease), Bartonella species (associated with cat scratch disease and other conditions), Mycoplasma pneumoniae, Chlamydia pneumoniae, and Helicobacter pylori.‍
• Metabolic: Fasting glucose, insulin, HbA1c, lipid profile (including advanced lipid testing) paint a picture of metabolic health. Metabolic health impacts brain function, and markers like glucose and insulin resistance are associated with cognitive decline⁶².‍
• Thyroid: These include TSH, free T3, free T4, reverse T3, and thyroid antibodies. Thyroid hormones are essential for brain development and function; imbalances can contribute to cognitive issues⁶⁴.‍
• Hormones: These include estradiol, progesterone, testosterone, DHEA-S, and sex hormone-binding globulin (SHBG). These hormones influence brain function, mood, and cognition, and imbalances can affect cognitive health¹⁸².‍
• Stress and againg: This is measured through testing for cortisol (via saliva or urine) and DHEA. Adrenal hormones regulate stress response, and chronic stress can negatively impact cognitive function¹⁸³.

Genetic testing: Identifies genetic predispositions that can influence cognitive decline and the effectiveness of various interventions.

• ApoE genotyping: To determine genetic risk for Alzheimer’s disease (AD). The APOE E4 allele is a significant genetic risk factor for late-onset AD¹⁸⁴.
• Other relevant genes: MTHFR (Methylenetetrahydrofolate reductase) and other genes involved in detoxification and methylation pathways. These genes affect neurochemical processes and detoxification, impacting cognitive health¹⁸⁵.

Toxin exposure testing: Identifies environmental toxins that can contribute to cognitive decline.

• Heavy metals: Mercury, lead, arsenic, and aluminum levels via blood or urine. Heavy metal toxicity is linked to neurological damage and cognitive impairment¹⁸⁶.

Gut health assessment: The gut-brain axis is a dynamic communication network that links the gut and brain, playing a pivotal role in maintaining overall brain health. An imbalance in gut bacteria can lead to inflammation and disruptions in neurotransmitter production, contributing to conditions like anxiety, depression, and even neurodegenerative diseases¹⁸⁹.

• Comprehensive stool analysis: Evaluates gut microbiota, digestion, absorption, inflammation, and presence of pathogens. Gut health significantly impacts brain function through the microbiota-gut-brain axis¹⁹⁰.
• Leaky gut markers: Levels of zonulin and lipopolysaccharides (LPS) may indicate increased intestinal permeability, which can lead to systemic inflammation and affect brain health¹⁹¹.

Advanced neurocognitive testing: Provides detailed information on cognitive function and brain structure.

• Neuropsychological tests: Assess cognitive function, memory, executive function, and other cognitive domains. These tests help determine the extent of cognitive impairment.

• Brain imaging: MRI or PET scans to evaluate structural and functional brain changes can reveal brain atrophy, amyloid plaques, and other signs of cognitive decline¹⁹³.

Other root cause tests: Identifies underlying biochemical and physiological factors contributing to cognitive decline.

• Oxidative stress markers: These include 8-OHdG, F2-isoprostanes. Oxidative stress is a major factor in neurodegenerative diseases and cognitive decline¹⁹⁴.
• Mitochondrial function: These include levels of lactate, pyruvate, and CoQ10. Mitochondrial dysfunction can lead to decreased energy production and increased oxidative stress, affecting brain function¹⁹⁵.
• Inflammatory cytokines: IL-6, TNF-alpha, and other pro-inflammatory cytokines can assess inflammation levels. Chronic inflammation is linked to cognitive decline and neurodegeneration¹⁸⁰.

Protocols

Personalized nutrition plan: Tailored to the individual’s specific health needs, this plan emphasizes dietary changes to support brain health and overall wellness.

• Anti-inflammatory diet: Focus on whole, nutrient-dense foods rich in antioxidants and healthy fats, such as those found in the Mediterranean diet. This diet is known to reduce inflammation and oxidative stress, which are key factors in cognitive decline²⁵.
• Ketogenic or MIND diet: Depending on individual needs, these diets support brain health and reduce neuroinflammation. The ketogenic diet provides ketones as an alternative energy source for the brain, while the MIND diet combines elements of the Mediterranean and DASH diets to lower the risk of Alzheimer’s disease¹⁰⁸.
• Elimination diet: Identifying and removing food sensitivities and allergens can reduce systemic inflammation and improve cognitive function. Common culprits include gluten, dairy, and soy, among others.

Targeted supplementation: Supplements are chosen based on specific deficiencies and health goals to optimize cognitive function.

• Nutrient repletion: Vitamins D, B12, B-complex, magnesium, omega-3 fatty acids, and other essential nutrients are supplemented to address deficiencies and support brain health¹⁹⁶.
• Antioxidants: CoQ10, alpha-lipoic acid, N-acetyl cysteine (NAC), and glutathione are used to combat oxidative stress and protect neuronal integrity.
• Brain-specific nutrients: Phosphatidylserine, acetyl-L-carnitine, curcumin, resveratrol, and Bacopa monnieri can enhance neuroprotection, improve memory, and reduce neuroinflammation^148,156,197.

Hormonal balance: Optimal levels of hormones are critical for cognitive health and overall well-being.

• Bioidentical hormone replacement therapy (BHRT): Used to optimize sex hormone levels (estrogen, progesterone, testosterone) as well as thyroid and adrenal function, which can influence cognitive function and mood¹⁹⁸.
• Stress reduction techniques: Mindfulness, meditation, yoga, and other stress management practices can lower cortisol levels and improve mental clarity¹⁹⁹.

Detoxification protocols: Designed to eliminate toxins that may contribute to cognitive decline and other health issues.

• Detox support: Supplements like glutathione and NAC, along with binders such as activated charcoal or bentonite clay and sauna therapy to enhance the body’s detoxification processes²⁰⁰.
• Gut health restoration: Using probiotics, prebiotics, digestive enzymes, and gut-healing nutrients like L-glutamine and zinc carnosine to restore gut integrity and balance the microbiome¹⁹⁰.

Lifestyle interventions: Essential changes in daily habits that support cognitive health and overall wellness.

• Exercise: Regular aerobic and strength-training exercises improve cardiovascular health, stimulate neurogenesis, and enhance brain plasticity²⁰¹.
• Sleep optimization: Improving sleep hygiene and addressing sleep disorders to ensure restorative sleep, which is vital for cognitive function and overall health²⁰².
• Cognitive training: Engaging in activities that challenge the brain, such as puzzles, learning new skills, and social engagement, to enhance cognitive reserve and delay cognitive decline²⁰³.

Ongoing monitoring and adjustments: Continuous evaluation and support to ensure the effectiveness of the treatment plan.

• Regular follow-up visits: Monitoring progress and making necessary adjustments to the treatment plan based on individual response and changing needs.
• Continuous education and support: Empowering individuals with knowledge and resources to take an active role in their health journey and maintain long-term cognitive health.

This is a comprehensive and individualized approach, addressing the unique needs of each individual to slow or reverse cognitive decline and dementia through comprehensive diagnostics and tailored interventions. A root cause approach aims to improve and potentially reverse the symptoms of cognitive impairment by integrating a suite of science-based strategies that include dietary changes, lifestyle modifications, targeted supplements, and environmental detoxification.