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Brain Health and Cognitive Decline


Cognitive Decline:

Most people experience decline in mental or cognitive abilities over time, commonly referred to as a part of getting old. This can be avoided with healthy lifestyle, identification and removal of triggers for such decline and nutritional, metabolic and hormonal support.

What is Dementia?

Dementia is the medical term used to describe cognitive decline. There are many types of Dementia. These include

1. Alzheimer disease (the most common type)

2. Vascular dementia

3. Parkinson disease dementia

4. Lewy body disease

5. Frontotemporal dementia

6. Wernicke korsakoff (alcohol induced)

7. Normal pressure hydrocephalus

8. Huntington disease

9. Others

The most common type of Dementia (Alzheimer disease) is discussed here. 

What is Alzheimer Disease?

Alzheimer disease (AD)is complex condition of the brain caused by multiple underlying pathologies. People who suffer from AD often have a genetic predisposition which makes them susceptible to developing AD. Several triggers cause these genes to express themselves at some point in life and the disease begins. 

Causes of Alzheimer Disease:

  1. Genetic - Multiple genes, specifically APOE 4/4 allele place one at risk for developing typical AD. Additional genes are implicated as well. 

  2. Metabolic insults on the body - Sustained metabolic dysregulation such as high blood sugars, oxidized cholesterol and inflammatory conditions can cause neuronal damage and expedite development of AD. 

  3. Hormone imbalance and deficiency - Decline in vital hormones such as pregnenolone, estrogens, testosterone, DHEA etc. can result in cognitive decline and development of AD. 

  4. Environmental Triggers - Certain chemicals, toxins and harmful substances can trigger expression of genes. 

Types of Alzheimer Disease:

  1. Type 1 - Inflammatory or Hot type AD  results from metabolic and inflammatory causes.

  2. Type 2 - Atrophic or Cold type AD results from hormone and endocrine imbalances

  3. Type 3 - Toxic or Vile type AD results from environmental toxins such as metals, mycotoxins, air pollutants, infections.


A Tsunami awaits ...

By 2050, more than 16 million Americans will be living with Dementia 

Early Evaluation and Intervention is the Key:

Changes related to Alzheimer disease starts to occur several decades before obvious clinical or symptom manifestation of the disease. Therefore, it is important to test early and prevent the process based upon principles of personalized medicine. 

Alzheimer Disease is like a ceiling with 36 holes:

Many factors lead to the development of Alzheimer disease. Therefore it is important to evaluate and address all of these. Treating one or a few causes will not result in reversal of cognitive decline. This is why, medicines alone do not work for this illness. 


1. CNS vitals or Cognitive assessment

This tests measures cognitive function at baseline. Comprehensive cognitive assessment provides information about cognitive performance in 10 domains. 

2. Genetic Tests:

Commonly tested genes are APO E status, MTHFR, HLA DR, HLA DQ, Presenilin, VDR. 

3. Metabolic Tests:

Markers of inflammation and metabolic profile cosnsists of CRP, Lipids, HgbA1C, Adiponectin, Leptin, Fasting insulin.

4. Nutritional Tests:

Nutrition evaluation consistent of Vitamin D, Calcium, Magnesium, Selenium, Zinc, Copper, Ceruloplasmin, Iron, Ferritin.

5. Hormone Evaluation:

Estradiol, Estrone, Estriol, Testosterone, SHBG, Pregnenolone, DHEA, TSH, Free T4, Reverse T3, 

6. Toxin Evaluation:

Toxins which can adversely affect cognitive function are tested such as Heavy metals, Mold, C4A, TGFB, VEGF, MMP-9, ADH, MSH,VIP, MARCONs.

7. Infections:

Chronic infections panel includes several agents as EBV status, HSV, chronic Lyme status, Parvovirus. 

8. Imaging Studies:

Imaging studies such as MRI, Neuroquant imaging etc.  

Do's and Don't s of Brain Health 


  1. Move naturally

  2. Exercise 30-40 minutes daily

  3. Meditate a few minutes a day

  4. Get 7-9 hours of restful sleep

  5. Learn new skills

  6. Make social connections

  7. Eat Healthy

  8. Supplement if needed

  9. Manage chronic diseases

  10. Know and manage your risk


  1. Smoke

  2. Eat inflammatory foods

  3. Drink alcohol excessively

  4. Live a sedentary lifestyle

  5. Be in toxic relationships

  6. Live without real connections 

  7. Be sleep deprived

  8. Ignore warning signs

  9. Be exposed to toxins

  10. Avoid hormone support if needed and not contraindicated  

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