Mild Cognitive Impairment

How can we Preserve Healthy Cognition, Prevent its Decline and be more Proactive in Preventing MCI, Dementia or Alzheimer’s? 

There is no effective medication for mild cognitive impairment. What does work is lifestyle modifications like exercise, diet, cognitive training and reducing cardiovascular risk factors (Reynolds GO, 2021).

To maintain cognitive function and optimal health, first get the basics right:

• Increase exercise, movement and physical activity. All types of physical activity improve cognitive ability and quality of life. But moderate-intensity physical activities have been found to support cognitive function more than walking exercise and high-intensity physical activity (Alsubaie SF, 2020).
• Eat an anti-inflammatory diet like the gluten-free Mediterranean diet. Focus on a healthy, whole foods diet with a wide variety of fruits and vegetables.
• Don’t drink large amounts of alcohol. Alcohol is toxic to the liver and brain.
• Be social with friends and family. Do not isolate as loneliness is a risk factor. Stay socially active. 
• Exercise the mind. Read. Have stimulating conversations. Do puzzles or play challenging games like chess and memory training.
• Minimize risk of head injury. A brain injury damages cognitive function and memory abilities.
• Don’t smoke.
• Manage any health conditions such as diabetes, high blood pressure, high cholesterol, obesity or depression.

Extra steps to take that protect cognitive function:

Diet

Certain foods speed up cognitive decline (Grant WB, 2023). These include ultra processed foods, refined carbohydrates, sugar-sweetened beverages and fruit juice (Grant WB, 2023). All of these are inflammatory for the brain, which damages cognitive health. These foods increase inflammation, insulin resistance, oxidative stress and homocysteine (Grant WB, 2023). 

Foods that support cognitive health are brightly colored veggies, legumes, nuts, garlic, leafy greens and coffee (Grant WB, 2023).

• Polyphenols, a category of molecules found in foods, are good for the brain. They protect against neuroinflammation. They maintain synaptic plasticity of neuronal networks in the brain. Polyphenols help cerebral blood flow and prevent mitochondrial dysfunction. This helps learning and good cognition. 
• Interestingly, the anti-inflammatory effect of polyphenols happens through the regulation of the gut microbiome (Godos J, 2023). 
• Anthocyanins and flavones are the two flavonoids most important for brain health (Godos J, 2023).
• Anthocyanins are associated with a 27% lower risk of cognitive issues. They are in red to purplish blue-colored plants such as berries, currents, grapes, some tropical fruits, radishes, red potatoes, red cabbage, purple sweet potatoes, black carrots and black beans. Their anti-neuroinflammatory activity involves several mechanisms, including a decrease in inflammatory markers (Godos J, 2023).
• Flavones show a 23% lower risk of cognitive decline (Godos J, 2023). Flavonols fight oxidative stress and neuroinflammation and inhibit beta amyloid plaque accumulation. They are in tea, celery, parsley, red peppers, chamomile, mint, tomatoes, apples, artichokes and kumquats.
• Other polyphenols like lignans and phenolic acids also protect cognition. Phenolic acids are in nuts, apple, coffee and tea. In fact, walnuts, coffee and tea are associated with lower odds of cognitive decline (Godos J, 2023).
• Phenolic acids can pass through the blood-brain barrier and act directly on the brain. They have antioxidant and anti-inflammatory properties. They can inhibit pro-inflammatory cytokines production and inhibit the accumulation of beta amyloid plaque seen in dementia and Alzheimer’s disease (Godos J, 2023).

To get more flavonoids and polyphenols in the diet, eat fruits, vegetables, herbs, spices, seeds, nuts, legumes and whole grains. Drink moderate amounts of coffee and tea. Variety is important. Eat a wide range of natural whole plant foods to get a mix of as many polyphenols (and other nutrients) as possible.

Improve Gut Health

MCI and Alzheimer’s are associated with abnormal inflammation in the brain and the gut. Negative changes in gut bacteria can shift the gut towards a pro-inflammatory stance (Daisukea A, 2022). 

• Probiotics can counteract gut inflammation and dysbiosis. Probiotics can improve cognitive and gut issues in patients with Alzheimer’s and MCI through reducing inflammation (Daisukea A, 2022). 
• Certain strains of probiotics can help reduce inflammation and prevent, if not outright improve, cognition.
• The probiotic strain Bifidobacterium breve MCC1274 reduces beta amyloid-induced inflammation in mice. In humans, it can improve memory and prevent brain shrinkage linked to inflammation (Daisukea A, 2022).
• Supplementing Bifidobacterium breve MCC1274 can prevent memory impairment, decrease beta amyloid levels, lessen microglial activation (which is inflammatory) and decrease pro-inflammatory cytokines in the brain (Daisukea A, 2022). 

Practice Mindfulness & Cognitive Training

Mindfulness is staying in the present moment. It can positively affect mood, quality of life and cognition among adults. 

• Mindfulness and cognitive training can delay cognitive decline, especially in the early disease stages (Reynolds GO, 2021). 
• Regular and frequent mindfulness practice can change the quantity and type of gut bacteria, through the gut-brain axis (Khine WT, 2020).

Cognitive training is brain training to strengthen cognitive skills. 

• It improves neuroplasticity. Neuroplasticity refers to the neural connections in the brain. 
• It is the brain’s ability to learn and adapt. Building new neural pathways improve the brain’s ability to process information. 
• With strong neuroplasticity, the brain can form and reorganize connections. 
• The neural networks in the brain can change through growth and reorganization.

It is possible to change and improve the structure of the brain. Brain training can target weak cognitive areas and strengthen them. Neural pathways can grow and change throughout adulthood if supported properly. 

To Improve Cognition:

• Manage stress. The brain needs time off. End your work day and don’t let the work stress go on. 
• Learn new vocabulary words. Learning one new word every day can exercise the neural pathways.
• Use the ‘wrong’ hand. Non-dominant hand exercises form new neural pathways and strengthen connectivity between existing neurons. If you’re right-handed, brush your teeth with your left hand. Try it while balancing on one leg for a double neuroplasticity bonus. 
• Learn to juggle. Juggling improves neuroplasticity. 

Improve Sleep 

Get sleep problems under control. Sleep is an early indicator of memory and cognition problems later in life. Practice good sleep hygiene and manage any sleep problems. Test for sleep apnea if you have problems sleeping. Turn off screens in the evening. Try melatonin, calming herbs, aromatherapy and good sleep hygiene. Avoid stimulants like tea or coffee, or alcohol, before bed. 

Try New Things

Start a new hobby, learn a new language. It’s even better if it’s social and involves movement as well. For example, dance therapy can stimulate neuroplasticity (Huang CS, 2023). In research, dance therapy significantly improves cognitive function, memory, attention, language and mental health in people over 55 years old with MCI (Huang CS, 2023). Dance therapy stimulates learning and remembering complex motor movements, following instructions, executing complex movement patterns, integrating visual and rhythmic movements (Huang CS, 2023). 

This is all done in a social setting that reduces social isolation, loneliness and depressed mood and involves physical activity (Huang CS, 2023). 

SUMMARY

• MCI is memory or cognitive/ thinking problems that start as a person ages. A person with MCI has more issues with cognition and memory than their peers of the same age do. 
• Mild cognitive impairment is actually an early symptom of dementia. It lies somewhere between normal age-related changes in cognition and dementia. 
• A first sign of cognitive decline is difficulty with planning or solving problems. A person with MCI may have difficulty concentrating and take much longer to do things than they did before. 
• Symptoms of MCI may be stable for years. It can improve over time. Or it may progress to dementia or Alzheimer’s disease. 
• Catching MCI early is best to avoid it developing into worsening cognition. 
• There is currently no pharmaceutical medication for cognitive decline. The medications that exist can only slow the process of cognitive decline but cannot reverse it. 
• In this case, lifestyle factors are important. The possible triggers of MCI include poor sleep, gut problems, chronic or systemic inflammation and a sedentary lifestyle.
• Non-pharmaceutical therapies and Functional Medicine can help prevent and even reverse cognitive decline (Khine WT, 2020).
• Get the health basics in place first. Then concentrate on getting enough sleep, improve gut health, reduce inflammation, exercise. Eat loads of fruit & vegetables for the polyphenols, favonols and other brain-supportive nutrients. Practice mindfulness & cognitive training. Learn new skills like a new language or to play chess. Take up new hobbies like dancing. The best is things that incorporate learning with physical activity and a social setting. 

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As always, please get in touch with us. If you or someone you know is struggling with cognitive issues, contact our clinic today. We can work on any issue(s) and improve your health. Book a free health evaluation call with us today, to see how we can help you with your concerns. We can answer your questions and help you book an initial consult with one of the functional medicine doctors in our clinic.