Home Remedies For Alzheimer’s Disease

The conventional medical track record for fighting Alzheimer’s, dementia, or even mild cognitive impairment (MCI) is terrible! Despite the hundreds of millions—if not billions—of dollars spent, there are simply no medications that can slow the progression of this devastating disease. In fact, a new Cleveland Clinic report indicated 244 out of 245 Alzheimer’s clinical trials over the past decade have failed. (However, there are many medications to treat the symptoms associated with it.) 

Since there is nothing available, it’s always a shame when I meet families of MCI or Alzheimer’s patients who have been told by their doctors that there are no supplements worth trying. What is the downside of experimenting with a product that has some evidence and a good safety record? If someone in my family had any form of this disease, I would not hesitate to try one of the supplements recommended in this section. 

In fact, two FDA-approved drugs that are being used to improve cognitive ability in Alzheimer’s patients both came from plants, including galantamine (from the snowdrop or Galanthus woronowii) and rivastigmine (from physostigmine derived from the Calabar bean). If you or your family is dealing with Alzheimer’s or MCI, review this section with your doctors.

What is Alzheimer’s Disease?

Alzheimer’s disease is the number one cause of dementia (70 percent of cases). Cardiovascular events, including reduced bloodflow to and within the brain, are a leading cause, which is known as vascular dementia (17 percent of cases). MCI is kind of a gray, transition area between “normal” and dementia. It’s often defined as having memory or other cognitive problems that are worse than expected for someone’s age but not severe enough to be classified as dementia. 

About 10 to 15 percent of people with MCI will progress to Alzheimer’s. Others will see improvement; it’s a highly unpredictable condition, so staying heart healthy is critical. MCI may actually have the potential to be reversed in my lifetime through drugs, supplements, and lifestyle changes.

Alzheimer’s-related dementia, the primary type of dementia I’ll be referring to in this section, and MCI are abnormal brain conditions that can result in acute memory loss. They’re caused by aging, genetics, poor heart health, and many unknown reasons. Multiple changes can occur with dementia, including:

  1. Cognitive differences (new forgetfulness, difficulty finding words, disorientation, not knowing common facts, like the name of the president)
  2. A reduction in daily functioning (difficulty driving, getting lost, and neglecting self-care or household chores)
  3. Personality changes (social withdrawal, easy frustration, disinterest, and explosive outbursts)
  4. Problem behaviors (nighttime restlessness, obsessive/compulsive behaviors, and wandering)
  5. Mental health issues (depression, paranoia, abnormal beliefs, anxiety, fearfulness, and suspiciousness)

Alzheimer’s is now the sixth leading cause of death in Americans and the fifth leading cause of death in people over 65. And a recently released report from the Centers for Disease Control is suggesting that in one out of every three deaths there is some form of dementia present (it may be undiagnosed). This doesn’t mean it was the cause of death, just that it’s very common. Survival time after a diagnosis of dementia has historically been fewer than 5 years, but with so many clinical trials of new medicines right now, this could be changing soon.

Alzheimer’s risk factors include older age (the biggest risk factor); family history; poor performance on cognitive tests; having the apolipoprotein E, or ApoE, gene (you can ask your doctor about a test for this); abnormal brain MRI findings; thicker carotid or neck artery measurements; slowness in buttoning shirts; and a history of cardiovascular disease. The bottom line for prevention is that heart healthy = brain healthy, even when it comes to Alzheimer’s!

Whatever the potential cause, dementia results in profound memory loss that can be difficult to understand from the outside. Here’s a common example: Many folks forget where they put their car keys; people with dementia often forget what car keys are used for. In many cases, long-term memory stays intact so someone with dementia might remember things from childhood, but that person won’t be able to recall a conversation from 15 minutes ago.

Home Remedies For Alzheimer’s Disease

1. Vitamin E (as dl-alpha-tocopheryl acetate) 1,000 IU twice a day

As I was writing this article, the encouraging results of a new clinical trial were published in the Journal of the American Medical Association. The 5-year study, called the TEAM-AD VA Cooperative Randomized Trial, was conducted at 14 Veterans Affairs medical centers and followed patients with mild to moderate Alzheimer’s disease. More than 600 participants—in what is now one of the largest and longest clinical trials in patients with Alzheimer’s—took 2,000 IU of vitamin E, 20 milligrams of a well-known prescription drug used in some Alzheimer’s patients (memantine), a combination of the two, or a placebo daily. (The patients in this clinical trial were already on an acetylcholinesterase inhibitor, a standard drug treatment for Alzheimer’s.)

The results: The vitamin E group experienced a significant delay (more than 6 months) in the progression of the disease compared to the other groups. Caregiver time also decreased by 2 hours each day in the vitamin E group (and that’s huge if you’re a caregiver)! There was no difference among the treatment groups in safety or mortality; in fact, the patients taking vitamin E had the lowest risk of mortality. This is critical because for more than a decade high-dose vitamin E has been hampered by the suggestion from many experts that it increases the risk of death.

Although a previous clinical trial with moderately severe Alzheimer’s patients found that 2,000 IU of vitamin E daily resulted in a delay in clinical progression of approximately 7 months, more testing is still needed. Regardless, these results are worth discussing with your doctor immediately, especially in mild to moderate Alzheimer’s cases.

This is another classic example of how vitamin E and other supplements should not be painted with such a broad brush; the decision to use a supplement should be based on the individual disease and situation. Vitamin E could delay the loss of independence that occurs with these patients (such as dressing or bathing themselves) by 6 months or more, which would not only improve quality of life but save large amounts of health care dollars— and all this with a supplement that costs pennies a day.

Note: This recommendation is only for Alzheimer’s patients. It did not work for people with MCI.

2. Huperzine A (Huperzia serrata) 400 micrograms twice a day for 16 weeks

Derived from club moss (a well known Chinese herb), huperzine A is used to treat Alzheimer’s disease in China and other countries. More studies are still needed, but there have been at least 20 randomized clinical trials with this herb, so it’s worth looking at. Researchers believe it works in a variety of ways, including increasing acetylcholine levels in the brain, which is also how some of the Alzheimer’s prescription drugs work (that’s also why it’s been called a natural cholinesterase inhibitor). Preliminary results in Alzheimer’s clinical studies from China suggest that at dosages of up to 400 micrograms per day, huperzine A does improve mental health, including memory, and maybe even the ability to carry out activities of daily living.

The Alzheimer’s Disease Cooperative Study (comprising a diverse group of experts from around the United States) did one of the best studies of this compound. In the large, 16-week Phase 2 clinical trial, huperzine A (200 or 400 micrograms twice a day, or 400 to 800 micrograms total) was compared with a placebo in 177 patients with Alzheimer’s. The primary measure the researchers used was the well-known Alzheimer’s Disease Assessment Scale (ADAS), but they also looked at many other secondary parameters to determine if the herb would have any impact.

At 200 micrograms twice daily, huperzine A did not work better than placebo; in the group that took 400 micrograms twice daily, there was significant improvement on the ADAS as well as some improvement on a mental health questionnaire called the MMSE (Mini Mental State Exam). Therefore, these results suggest there’s a short-term benefit in symptoms or cognitive improvement.

Many of the study subjects had stopped taking their conventional cholinesterase inhibitor drugs, and the responses to huperzine A were no different between those who had used or never used these drugs. Still, about 11 percent of the people taking huperzine A could not tolerate it, primarily due to nausea.

Since a large, rigorous study (in addition to the Chinese studies) has shown a preliminary benefit, I had to rank this number two for now. It’s certainly worth sharing with your doctor. It’s possible that this herbal product works no better or worse than what is available today by prescription, but the research is exciting. One word of caution: This herb should not be combined with FDA-approved cholinesterase inhibitors (donepezil, galantamine, rivastigmine) because the side effects in combination could be serious.

3. (tie) Panax ginseng or Korean red ginseng 4,500 to 9,000 milligrams a day in divided doses

The primary active ingredients in ginseng are ginsenosides, and there are seven main ones found in many dietary supplements: Rb1, Rb2, Rc, Rd, Re, Rf, and Rg1. Some of them have shown an ability in the laboratory to reduce levels of a compound called amyloid beta peptide, which is found in the brains of Alzheimer’s patients. Ginsenosides can also cut the production of some inflammatory compounds and improve bloodflow.

One trial using 4,500 milligrams per day of Panax ginseng (ginsenoside content of about 8 to 8.5 percent) showed cognitive improvements in Alzheimer’s patients within 12 weeks that were significantly better than a placebo. A smaller trial with Korean red ginseng, a special form of Panax ginseng, found that 9,000 milligrams per day over 12 weeks improved cognition better than 4,500 milligrams per day. Since Panax ginseng has a good safety record overall, the trials are promising. (American ginseng, which is somewhat similar in structure, has been shown to improve energy levels in patients with severe fatigue.)

Research is ongoing, so it’s always best to copy exactly what worked in clinical trials. If you find a product with a higher concentration (17 percent, for example) then you want to take a lower dose because the potency is higher. You should also divide your daily dose and take it with food to reduce gastrointestinal problems. Also, start low with 1,000 to 2,000 milligrams a day and build up (and always talk to your doctor).

Keep in mind: This supplement seems to have a slight stimulant effect (that’s why it increases energy), so taking it late in the afternoon or in the evening could cause sleep problems. (See the section on Memory Loss for a ginseng product that can help improve memory.)

3. (tie) Bacopa monnieri (Brahmi or bacopa) 150–450 milligrams a day

This is an alternative Ayurvedic medicine that in preliminary clinical trials has reduced stress and anxiety better than a placebo. That’s one reason I like it for Alzheimer’s, but the other is its potential for memory enhancement.

Many of the components of bacopa were isolated years ago and include alkaloids, saponins, sterols, bacopa saponins, and bacosides. The latter appear to be involved in nerve cell repair, production, and signaling, and they also appear to have some antioxidant benefit in different areas of the brain, including the hippocampus, frontal cortex, and striatum. The compounds garnering attention and research for their effects on the brain are bacosides A and B.

In one 12-week trial, a 300-milligram daily dose (55 percent combined bacosides, meaning a combo of A and B) resulted in a significant improvement in memory, learning, and speed of information processing. The results were observed in the final weeks of the study, suggesting you need to take it long term to potentially see a benefit; no real benefits have been seen in studies lasting fewer than 12 weeks. In the Journal of Alternative and Complementary Medicine, Australian researchers reviewed six clinical studies and found that bacopa extract at 300 to 450 milligrams per day (40 to 55 percent bacoside content) appeared to improve memory, but not other areas of cognition. (Always look for a product that has been standardized to a minimum of 25 percent bacoside A or ideally 50 percent bacosides.) The most common side effect, especially at higher doses, is mild gastrointestinal upset, such as abdominal cramps, increased stool frequency, and nausea, so I recommend taking bacopa with a meal.

The only real problem with this supplement is that all of the impressive clinical research has been in people who don’t have dementia. There is a desperate need to test this product in individuals with MCI and Alzheimer’s. So why did I include it, you ask? The preliminary results with memory in older adults are encouraging, and they make this a supplement to keep on the radar and discuss with your doctor.

Laboratory studies of dementia suggest bacopa can improve bloodflow in the brain and perhaps even raise brain levels of neurotransmitters that are believed to be involved in enhancing the memory process. In fact, at the time of this article’s publication, I learned of a small study in Alzheimer’s patients using 300 milligrams of bacopa twice daily for 6 months. The researchers reported improved cognitive performance in regard to time, places, and people as well as an improved quality of life because of less irritability and better sleep. Stay tuned!

4. Omega-3 supplements

Omega-3 supplements may improve appetite and weight gain in people with Alzheimer’s (1.7 grams of DHA and 600 milligrams of EPA for 6 to 12 months). They do not appear to help with memory overall, but the research hints that they might help reduce depression symptoms.

5. Saffron (Crocus sativus) extract

Saffron (Crocus sativus) extract (15 milligrams twice a day) may have some antidepressant benefits, and preliminary studies are showing it might be able to enhance cognition in mild to moderate Alzheimer’s patients. Larger studies are needed, and if they show the same thing, this will definitely be worth trying.

What Supplements Are Useless For Alzheimer’s Disease?

Ginkgo biloba

I know what you’re thinking: How can I reject the number one supplement used around the world for memory, MCI, and dementia? (That was what you were thinking, right?) In my “salad days,” I wanted to believe that ginkgo or an extract from ginkgo could help people with Alzheimer’s, but now I’m incredibly skeptical—for three reasons. First, researchers have learned just how difficult it is to really make any kind of serious impact on this disease. Second, there are serious quality control issues. And third, as the clinical trials have become more rigorous, the results with ginkgo have become less impressive.

The largest US study on this supplement, called the Ginkgo Evaluation of Memory (GEM) trial, which was very well done, found no impact despite using one of the finest ginkgo products available in terms of quality control and research. Subjects with either normal cognition or MCI took 120 milligrams of ginkgo biloba extract (EGb 761, from Schwabe Pharmaceuticals) or a placebo twice daily.

The researchers were trying to determine if the supplement could reduce the risk of being diagnosed with dementia or Alzheimer’s disease. The median follow-up was just over 6 years, and out of 1,500 subjects, 277 developed dementia in the ginkgo group and 246 in the placebo group. The overall dementia rate was 3.3 per 100 person-years in participants taking ginkgo and 2.9 in the placebo group.

Plus, there were twice the number of hemorrhagic strokes (16 versus 8) in the ginkgo group. Even though this was not statistically significant, it emphasizes a point about this supplement that definitely worries me: It has extreme blood-thinning potential. Researchers saw similar results (including the increased incidence of strokes) in the second-largest ginkgo and memory study, known as GuidAge, which was conducted with patients reporting memory problems; it also failed to show a reduced risk of progression to Alzheimer’s disease with this herb.

High doses of B vitamins

These actually made depression worse in patients with Alzheimer’s in the large Alzheimer’s Disease Cooperative Study, which was published in the Journal of the American Medical Association. Researchers tested 5 milligrams of folic acid, 25 milligrams of vitamin B6, and 1 milligram of vitamin B12 over 18 months and found that the combination reduced a blood

marker called homocysteine, which has been associated with cognitive decline (when it’s at high levels). However, this is a case where improving the blood test results doesn’t necessarily translate to improving the actual symptoms (i.e., your number may go down, but it doesn’t mean your symptoms will change). It was also concerning that almost 28 percent of patients in the B-vitamin group experienced depression, compared to 18 percent who took a placebo.

Curcumin. This compound in the spice turmeric is being studied for its antiinflammatory properties. It has not shown any benefit in long, rigorous studies, but I believe that curcumin may have better potential in the prevention of Alzheimer’s, if it works at all.

Resveratrol

It’s still in the superhyped stage and entering clinical trials now.

I want to believe it can do something for dementia, but I’m not betting on it. (I hope I’m wrong.)

Melatonin

 In the vast majority of well-done clinical trials, melatonin (at both low and high doses) didn’t work much better than a placebo to improve sleep in Alzheimer’s patients. In my experience, low doses have provided some small benefit as reported by caregivers, so it may still be an option to consider. And there is some hint that melatonin might not only improve sleep but also reduce the risk of MCI progressing to Alzheimer’s if used early enough, so stay tuned.

Phosphatidylserine

Lots of the “experts” recommend this dietary supplement for improving memory, but based on my experience and the lack of really good research, I say save your money.

What Lifestyle Changes Can Help With Alzheimer’s Disease?

Heart healthy = brain healthy

Experts believe that anything that has been found to reduce the risk of cardiovascular disease (exercising and maintaining a healthy weight and normal cholesterol, blood sugar, and blood pressure levels) can also help lower the risk of Alzheimer’s disease and dementia. We know that a leading cause of dementia is reduced bloodflow to the brain, so lowering your risk of stroke (a cardiovascular problem) is hugely important.

Find the right protein, fat, and carb balance

New studies are suggesting that a diet high in lean protein and healthy fats may protect against mild cognitive impairment, while a high-carbohydrate diet may promote MCI. I think what’s really going on is that people who have problems controlling their blood sugar, those with pre-diabetes and diabetes, may have a greater risk of Alzheimer’s. There is a theory that the brain may experience its own diabetes- like condition, where its ability to absorb sugar (your noggin’s number one fuel source) is compromised. This may increase the risk of Alzheimer’s disease. (New research is looking at giving inhaled insulin to MCI patients to see if it works, so stay tuned!)

Flex your mental muscles

Cognitively demanding exercises—such as crossword puzzles, Sudoku, playing cards, and reading—appear to reduce the risk of MCI and Alzheimer’s in some people. Activities that challenge the mind help strengthen and protect the mind. In fact, that “use it or lose it” saying was initially coined in this area of research.

Take time to de-stress

Chronic stress can increase the amount of stress steroids produced in the body, which can block brain activity and may increase the risk of Alzheimer’s disease, based on recent laboratory research from Umeå University in Sweden. Whether this turns out to be true is not so much the issue because it is already known that chronic stress is damaging to the human body in general, so you should minimize it as much as possible.

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