Think Ahead:
Cognitive Wellness Today for Tomorrow
Table of Contents
1. Age-Related Changes in the Brain
2. Oxidative Stress and Brain Health
3. Antioxidant Intake and Cognitive Function
4. Nutrient Solutions for Cognitive Function
5. Pure Encapsulations® Nutrient Solutions for Cognitive Function
6. Summary
7. Resources
Introduction
As we age, supporting brain health and cognitive function increasingly becomes a focal point of our health. Mild memory deficits and slower cognitive processing are a normal part of aging. It has been estimated that 1 in 9
Read on to discover how you can proactively target metabolic processes and related pathways to support your patients’ brain health and cognitive function throughout their lifetime.
Age-Related Changes in the Brain
Changes in brain neurons can begin 20 years or more before cognitive symptoms develop, with the prevalence of these changes doubling every five years after age 65.1
,[1]
Age-related chemical and physical changes in the brain can include:
[2]
- Changes in vascular makeup, reduced blood flow and oxygen
- Decline in production of hormones and neurotransmitters
- Decreased antioxidant defenses
While these underlying brain changes can occur for decades, one factor is emerging as a significant player in the development and occurrence of cognitive changes: oxidative stress.
Oxidative Stress and Brain Health
Oxidative stress occurs when there’s an imbalance between free radicals and antioxidants in the body resulting in greater reactive oxygen species (ROS) production. Free radicals are a natural byproduct of many physiological processes, but they can also be introduced by external sources like diet, toxins and environmental factors.
While free radicals play essential roles in cellular signaling and immune function, an excess can lead to cellular damage, an immune response and mitochondrial dysfunction that can progress to adverse effects on brain function.
[3] Highly metabolic, the brain is a large consumer of oxygen and is rich in polyunsaturated fatty acids. These characteristics combined with its high production of ROS and low levels of antioxidant enzymes make it particularly vulnerable to oxidative damage.
[4],[5]
When ROS production overwhelms the brain’s antioxidant defenses, oxidative stress damages proteins, DNA and cell membranes, disrupts neuronal cell functions and triggers neuronal cell death. Regulation of ROS in the brain is critical for memory consolidation and long-term potentiation.
[6]
Antioxidant Intake and Cognitive Function
Several prospective studies have found that people who consume an antioxidant rich diet of fruits and vegetables can reduce their risk of cognitive changes.
[7],[8],[9]
In a 2023 meta-analysis of cohort studies, researchers sought to investigate the association of antioxidant intake with the risk of cognitive changes.
The meta-analysis included 17 articles with 98,264 participants. Of the total, 7,425 participants had cognitive changes after 2-3 years of follow up, that interfered with their daily living. Studies included participants from Europe, Asia and North America. The studies considered antioxidant intake from diet, supplements or both. The antioxidants studied included vitamin A, vitamin C, vitamin E and flavonoids. Additional subgroup analyses were conducted based on the participants’ kind of nutrition, diet and supplement, geographical region and study quality.
Overall, the researchers determined that a high antioxidant diet or supplement intake significantly decreased the incidence of cognitive changes that interfere with daily living by 16% (RR =.084, 95% CI 077.-091(
pt <0.001).
In subgroup analysis by nutritional type, high dietary and supplement intake of vitamin C or vitamin E alone significantly reduced risk of cognitive changes (RR= 0.81, 95% CI 0.70-0.94, I
2 = 37.9%,
p = 0.097), and (RR=0.77, 95% CI 0.64-0.92, I
2=54%,
p=0.013), respectively.
Both vitamin A and flavonoid intake were also shown to decrease risk of cognitive changes, however results were not statistically significant.
High dietary and supplement antioxidant intake demonstrated a greater risk reduction with statistical significance in North American populations (RR=.083, 95% CI 0.75-0.93, I
2=47.3%,
p=0.003), compared to European populations, where although risk was reduced, results were not statistically significant.
The authors concluded that consuming fruits and vegetables rich in antioxidants or antioxidant supplements can have a protective effect on cognitive function and reduce risk of cognitive changes.
Nutrient Solutions for Cognitive Function
It is important to educate patients about modifiable risk factors associated with mild, age-related cognitive decline like an antioxidant-rich diet, physical activity, managing stress, prioritizing sleep and engaging in social and mental stimulation.
[10] In addition, the practitioner can support the brain’s resilience against oxidative stress with targeted nutrient solutions.
Animal research suggests that magnesium-l-threonate may promote synaptic plasticity and density in the regions of the hippocampus correlated with learning and memory.
[11]‡
Acetyl-L-carnitine supports the availability of acetyl-CoA, an important energy-generating metabolite. In addition, it supports healthy mitochondrial function and cell membrane stability.
[12]‡
Phosphatidylserine supports cognitive function, emotional well-being and behavioral performance. It has also been shown to support healthy memory.
[13],[14] ‡
Resveratrol promotes cardiometabolic, neuronal and cellular health through a variety of effects on cell signaling, mitochondrial function and endogenous antioxidant defenses.
[15],[16],[17],[18], ‡
Omega 3 Fatty Acids encourage cardiovascular health by supporting lipid metabolism and healthy blood flow.
[19],[20],[21], In addition, studies indicate these oils help maintain healthy endothelial function.
[22]‡
Curcumin supports neuronal stability and function, in part, by promoting healthy cytokine balance and antioxidant defenses.
[23]‡
Bacopa monnieri has been utilized traditionally for centuries in Ayurvedic medicine to support the nervous system, cognitive capacity and memory. A three-month trial conducted by Australian scientists suggests that bacopa may support learning, moderate stress and support memory.
[24]‡
Luteolin promotes neuronal health through antioxidant, immunomodulating and mast cell stabilizing actions, helping to moderate the release of immune mediators.
‡
Ginkgo biloba helps sustain the strength and elasticity of blood vessels and capillaries. It may also promote the flow of oxygen and blood to the brain.
‡
With oxidative stress and related metabolic shifts occurring early in the development of changes in cognitive function, identifying and addressing these processes can be crucial for healthy function.
Pure Encapsulations® Nutrient Solutions for Cognitive Function
As the most trusted brand and leader in the professional supplement space, Pure Encapsulations® is committed to helping healthcare professionals understand and apply personalized, evidence-based nutrition to achieve optimal patient outcomes.
The following supplements can support neuronal health, vascular integrity, memory, mental sharpness and overall cognitive function.
‡
Memory Pro promotes neural health, cognitive function and memory. Also supports vascular integrity and promotes relaxation.
‡
Suggested use: As a dietary supplement, take 3 capsules daily, with or between meals.
BenfoMax is a fat-soluble vitamin B1 (thiamine) derivative that maintains healthy advanced glycation end (AGE) product activity to support vascular, nerve, retinal and kidney cellular health. It also promotes healthy glucose metabolism.
‡
Suggested use: As a dietary supplement, take 1 capsule, 1-3 times daily, with meals.
O.N.E. Omega contains triglyceride form EPA and DHA from fish oil produced through a unique solvent free, supercritical, CO2-based extraction method. Encourages cardiovascular health by supporting lipid metabolism and healthy blood flow. Also helps maintain healthy endothelial function.
‡
Suggested use: As a dietary supplement, take 1 capsule daily, with a meal.
CurcumaSorb Mind contains Meriva® bioavailable curcumin phytosome; support for mood, memory and mental sharpness.
‡
Suggested use: As a dietary supplement, take 2 capsules, 1-2 times daily, with meals
CogniMag promotes cognitive function, learning ability and working memory. Also supports optimal brain magnesium levels.
‡
Suggested use: As a dietary supplement, take 2 capsules, twice daily, with a meal and at bedtime.
Brain Reset promotes concentration, mental clarity and memory with a multi-faceted blend of nutrients and herbal extracts. Promotes neuroimmune health by supporting cellular function, neuroprotection and immune mediator balance.
‡
Suggested use: As a dietary supplement, take 2 capsules daily, between meals.
AntiOxidant Formula supports the body’s natural defense mechanism against free radicals.
‡ Offers a synergistic, broad spectrum of antioxidants, including essential vitamins and minerals like vitamin A, E and B complex vitamins.
Suggested use: As a dietary supplement, take 1 capsule, 1-2 times daily, with meals.
Ester-C® & Flavonoids offers a blend of Ester-C ® and flavonoid compounds to provide vitamin C support for healthy immune and cellular function as well as blood vessel integrity.
‡
Suggested use: As a dietary supplement, take 1 capsule, 1-2 times daily, with or between meals.
Summary
In the quest to maintain optimal brain health, understanding and addressing the role of oxidative stress is key to safeguarding your patient’s cognitive function
Resources
Mild Age-Related Cognitive Decline Protocol‡: Developed in collaboration with our scientific and medical advisors to support cognitive health in older adults
‡
Drug-Nutrient Interactions Checker: provides valuable information on potential interactions between your patients’ prescriptions, over-the-counter medications and nutritional supplements.
PureInsight™: Our streamlined platform easily collects patient data and provides valuable recommendations to help achieve their health goals.
Virtual Dispensary: our Pure Patient Direct program provides account holders FREE access to our virtual dispensary to help simplify patient sales and reduce in-office inventory.
You can also explore
Pure Encapsulations® to find
On-Demand Learning,
Clinical Protocols, and other resources developed with our medical and scientific advisors.
References
[1] ALZ.org. Facts and Figures 2024. Accessed May 14, 2024.
[2] CDC.gov. Accessed May 14, 2024.
[3] NCOA. Accessed May 12, 2024.
[4] Song T et al.
Ageing Res Rev. 2021;72:101503. doi:10.1016/j.arr.2021.101503
[5] Bai R et al.
Ageing Res Rev. 2022;77:101619. doi:10.1016/j.arr.2022.101619.
[6] Qin P, Sun Y, Li L.
Int J Mol Med. 2024;53(5):47. doi:10.3892/ijmm.2024.5371.
[7] Serrano, F., & Klann, E.
Ageing Research Reviews, 2004. 3(4): 431–43. doi:10.1016/j.arr.2004.05.002.
[8] Dai Q, Borenstein AR, Wu Y, Jackson JC, Larson EB. Fruit and vegetable juices and Alzheimer's disease: the Kame Project.
Am J Med. 2006;119(9):751-759. doi:10.1016/j.amjmed.2006.03.045
[9] Barberger-Gateau P et al.
Neurology. 2007. 69(20):1921-30. doi:10.1212/01.wnl.0000278116.37320.52.
[10] Hughes TF et al.
Am J Geriatr Psychiatry. 2010.18(5):413-20. doi:10.1097/JGP.0b013e3181c65250.
[11] Zhao R et al.
J Alzheimers Dis. 2024. 99(s1):S35-S50. doi:10.3233/JAD-220909.
[12] Livingston G et al.
Lancet. 2020. 396(10248):413-46. doi:10.1016/S0140-6736(20)30367-6.
[13] Slutsky I, et al. Neuron. 2010 Jan 28;65(2):165- 77.
[14] Kerner J, et al. Mech Ageing Dev. 2015 Jan;145:39-50.
[15] Maggioni M, et al. Acta Psychiatr Scand. 1990 Mar;81(3):265-70.
[16] Hirayama S, et al. J Hum Nutr Diet. 2013 Apr;27 Suppl 2:284-91.
[17] Xia N, et al. Br J Pharmacol. 2017 Jun;174(12):1633-1646
[18] Brito PM, et al. Atherosclerosis. 2009 Jul;205(1):126-34.
[19] Pyo IS, et al. Molecules. 2020 Oct 12;25(20):4649.
[20] Ghanim H, et al. J Clin Endocrinol Metab. 2010 Sep;95(9):E1-8.
[21] Ottestad I, Hassani S, Borge GI, et al. PLoS One. 2012;7(8):e42550
[22] Ebrahimi M, Ghayour-Mobarhan M, Rezaiean S, et al. Acta Cardiol. 2009 Jun;64(3):321-7.
[23] Geleijnse JM, Giltay EJ, Grobbee DE, et al. J Hypertens. 2002 Aug;20(8):1493-9.
[24] Khan F, Elherik K, Bolton-Smith C, et al. Cardiovasc Res. 2003 Oct 1;59(4):955-62.
[25] Braidy N, et al. FEBS J. 2010 Jan;277(2):368-82.
[26] Stough C, et al. Psychopharmacology (Berl). 2001 Aug;156(4):481-4.
Image adapted from Paro R, Grossniklaus U, Santoro R, et al. Introduction to Epigenetics [Internet]. Cham (CH): Springer; 2021. Chapter 9, Epigenetics and Metabolism. 2021 Mar 24. Available from: https://www.ncbi.nlm.nih.gov/books/NBK585707/doi: 10.1007/978-3-030-68670-3_9. Creative Commons license.
KEY: Nicotinic acid phosphoribosyltransferase (NAPRT), Nicotinic acid mononucleotide (NAMN), Nicotinic acid adenine dinucleotide (NAAD), Nicotinamide mononucleotide adenylyltransferase (NMNAT1-3), 2-amino-3-carboxymuconate semialdehyde (ACMS), Nicotinamide phosphoribosyltransferase (NAMPT), Nicotinamide mononucleotide (NMN)
These pathways collectively regulate the intracellular levels of NAD+, which are essential for maintaining cellular functions and metabolic balance. Understanding the intricacies of NAD+ synthesis and consumption pathways is essential for exploring strategies aimed at modulating cellular metabolism and promoting health.
The decline in NAD+ levels associated with aging underscores its importance in healthy aging. By understanding and potentially influencing NAD+ levels, healthcare practitioners can explore new avenues in promoting cellular health and longevity.‡
