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Simple Wisdom

Simple Wisdom

by Morten Bryhn, MD, PHD

Mild cognitive impairment & DHA support brain health naturally

Mild cognitive impairment (MCI) is considered to be a very early stage of Alzheimer’s disease, a stage when it may be possible to halt the degenerative process in the brain responsible for Alzheimer’s. Although there are several pharmaceuticals on the market that are used for treating this devastating mental disease, long-term results show that there is only little gain in symptom relief.

Alzheimer’s disease is the end stage of an inflammatory process in the brain that has been going on for a number of years. Just like other chronic degenerative diseases, it is important to spot symptoms as early as possible, when there is still a chance for a successful reversal of the process. Take type 2 diabetes, for example. Scientists have identified metabolic syndrome as an early stage of the disease, and metabolic syndrome responds very well to treatment. MCI may represent the same opportunity to identify people who are at risk for developing Alzheimer’s disease and offer them help before it is too late. Prevention is always better than treatment—treatment is mainly for alleviation of symptoms. Studies show that the polyunsaturated fatty acids in fish, particularly DHA, may play an important role in stopping MCI from progressing to Alzheimer’s disease.

UNDERSTANDING MCI
MCI is an intermediate state of cognitive function that falls between the normal changes associated with aging and those fulfilling the criteria for dementia. Typically, the elderly and their families are aware of the increasing forgetfulness and problems with thinking and language. However, basic mental capacities are relatively preserved, and functional activities are intact. These changes usually aren’t severe enough to interfere with everyday life. The estimated prevalence of MCI ranges from 10 to 20 percent in people older than 65 years of age. Studies have shown that people with MCI are at an increased risk for developing dementia—perhaps as many as 10 percent yearly, compared to 1 to 2 percent of the general population. Some data suggests that there is a fair chance of regaining normal cognition in people with MCI, similar to how people with metabolic syndrome can regain their health before it progresses to type 2 diabetes. But what should people with MCI do to prevent further deterioration of mental capacities?

DIET & THE BRAIN
Controlled trials have clearly shown that the pharmaceutical drugs used to treat Alzheimer’s disease provide little help. Physical and mental training are certainly important to keep the brain sharp. Dietarycomponents are important as well. Large epidemiological studies comparing populations with a regular intake of seafood to those who do not eat fish have clearly demonstrated a reduced risk for developing Alzheimer’s disease in those who eat fish regularly. What is it in fish that could be responsible for this effect?

Seafood contains polyunsaturated fatty acids, namely EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), which are not found in great quantities in other foods.The membranes of brain cells are loaded with DHA, and normal brain function is dependent upon this DHA saturation of neuron cell membranes. But DHA is more than just an important building block within the brain. DHA is the raw material for compounds that prevent the formation of the protein debris in the brain that is found in Alzheimer’s patients, leading to inflammation, brain cell death, and the symptoms associated with the disease. The degree of damage in the brain is correlated to the number of intellectual and psychological symptoms demonstrated by the individual. When the patient has reached a state of multiple mental deficiencies, it is too late to save or even restore brain tissue. This is why it is crucial to diagnose cognition defects at an earlier stage. This beginning stage is called mild cognitive impairment.

THE BENEFITS OF DHA
DHA was used in a placebo-controlled clinical study in Alzheimer’s patients at the Karolinska Hospital in Sweden some years ago. It had no effect on the total group, but when the patients with the lowest number of mental defects were analyzed, those who had been given DHA did significantly better on a number of tests compared to those given placebo capsules. Today, this subgroup of patients in the study would have been diagnosed with MCI. Since then, additional controlled studies with DHA in people with MCI have been published. An average dose of 1.5 grams daily of DHA in a concentrated fish oil product with the MCI people being treated between six months and one year demonstrated statistically significant benefits on a number of diagnostic scores commonly used for diagnosing dementia, including verbal fluency. A large Chinese study in a population of people with MCI also demonstrated positive results with daily omega-3 fatty acid treatment. These results are very promising. They demonstrate how important it is to identify people with very early signs of dementia because this group is at risk for developing overt Alzheimer’s disease. They also reveal that there may be a way of halting memory decline by eating seafood, or more specifically supplementing with DHA.

Large epidemiological studies comparing populations with a regular intake of seafood to those who do not eat fish have clearly demonstrated a reduced risk for developing Alzheimer’s disease in those who eat fish regularly.

“Dietary Supplementation Of Arachidonic Acid (ARA) and Docosahexaenoic Acid (DHA) Improves Cognitive Dysfunction” by S. Kotani et al., Neurosci Res, 10/06 • “Effectiveness of Fish Oil Supplementation on Memory Function and Lipid Profiles in Mild Cognitive Impairment (MCI) . . .” by L. K. Lee et al., Gerontology and Geriatrics Conference, Melbourne, Australia, 10/11 • “Effects of N-3 Fatty Acids, EPA vs. DHA, on Depressive Symptoms, Quality of Life, Memory, and Executive Function in Older Adults with MCI . . .” by N.Sinn et al., Br J Nutr, 9/11 • “Omega-3 Polyunsaturated Fatty Acid Supplements and Cognitive Decline: Singapore Longitudinal Aging Studies” by T. P. Ng et al., J Nutr Health Aging, 2011
 
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