Power Up Your Brain
Power Up Your Brain
by David Perlmutter, MD, FACN, ABIHM &
Albert Villoldo, Ph.D
Raise a Smarter Child by Kindergarten
Raise a Smarter Child by Kindergarten
by David Perlmutter, MD, FACN, ABIHM
The Better Brain Book


by David Perlmutter, MD, FACN, ABIHM
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Drugs cause confusion in elderly

April 3rd, 2009

From USATODAY.com
Commonly used medications could be a culprit in some older peoples’ memory problems, a new report shows.
Elderly patients are often more susceptible to “drug-induced dementia and delirium,” says Public Citizen, a consumer research and advocacy group, in an article posted Wednesday at worstpills.org. The report includes a list of 136 commonly prescribed drugs that are potentially dangerous to seniors’ cognitive health.

Acetyl L-Carnitine – What You Need to Know

January 24th, 2009

By David Perlmutter, MD, FACN, ABIHM

L-Carnitine is truly a mind-body nutrient. Found in all cells of the body and brain, L-carnitine has three main functions. First it transports long chain fatty acids across the inner membrane of the mitochondria. There the fats enter the citric acid cycle to be converted to ATP, the “energy molecule” needed by every cell to carry out its myriad activities. Muscle cells, heart cells and liver cells have very high numbers of mitochondria and correspondingly high amounts of carnitine.(1)

Second, L-carnitine acts as an antioxidant to protect cells from damage by free-radicals in the body and brain. In doing this, L-carnitine reduces the metabolic waste products that damage cells over time. Third, acetyl-L-carnitine donates its acetyl group to a choline molecule in a process that produces the neurotransmitter acetylcholine, which is actively involved in learning and memory.
Here’s a bit about different names for carnitine. Like many molecules in nature, carnitine is found in two stereoisomer forms, literally a “right-handed” shape (D-form) and a “left-handed” shape (L-form). Only the L-form, L-carnitine — also known as levocarnitine — is active. Much current research is done with the activated form, acetyl-L-carnitine, also called ALC or ALCAR.(1) Activated forms of substances in the body are the final molecules needed to carry out any specific activity.

Sources of L-carnitine include biosynthesis in the body, foods, and supplements. Made in the liver and kidney from the amino acids lysine and methionine, the biosynthesis of carnitine requires iron and vitamins C, B-6, and niacin. Acetyl-L-carnitine is made in small amounts naturally in the body, but, as is true of so many substances in the body, its production begins to decline in midlife.(2)

Carnitine is found primarily in animal foods. A 3.5 ounce portion of beef steak, pork, cod, and chicken breast contain 95 mg, 28 mg, 6 mg, and 4 mg respectively. Other sources of L-carnitine include over-the-counter vitamins, energy drinks, and various other products. Interestingly products containing L-carnitine cannot be marketed as “natural health products” in Canada and are not allowed to be imported into Canada.(3)

Because of L-carnitine’s vital roles in energy production and anti-oxidant capabilities, it has beneficial effects on a wide variety of health conditions. Clinical applications of L-carnitine include: diabetes (4); weight loss; enhanced male fertility; enhanced physical performance; and cognitive functioning.

A study done in Italy evaluated the efficacy of L-carnitine on physical and mental fatigue, and on cognitive functions of 66 centenarians. Thirty-two received 2,000 mg levocarnitine daily and 34 received a placebo for 6 months. Changes were monitored in total fat mass, total muscle mass, serum triacylglycerol, total cholesterol, HDL cholesterol, LDL cholesterol, Mini-Mental State Examination (MMSE), Activities of Daily Living, and a 6-min walking corridor test. Researchers concluded that “oral administration of levocarnitine reduces total fat mass, increases total muscular mass, and facilitates an increased capacity for physical and cognitive activity by reducing fatigue and improving cognitive functions.”(5)

In a recent study involving 12 institutionalized patients with moderate-to-late stage Alzheimer’s disease, supplementation with a vitamin/nutriceutical supplement containing folate, vitamin B6, alpha-tocopherol, S-adenosyl methionine [SAMe], N-acetylcysteine, and acetyl-L-carnitine, was found to significantly delay the decline in Dementia Rating Scale and clock-drawing text, as compared to subjects who received a placebo. According to institutional caregivers, those patients who received the nutriceutical supplementation were found to have a 30% improvement in the Neuropsychiatric Inventory and maintenance of performance in the Alzheimer’s Disease Cooperative Study-Activities of Daily Living. The authors conclude, “This formulation holds promise for delaying the decline in cognition, mood, and daily function that accompanies the progression of Alzheimer’s disease, and may be particularly useful as a supplement for pharmacological approaches during later stages of this disorder. A larger trial is warranted.”(6)

References:
1.
2. Gropper S. et.al. Advanced Nutrition and Human Metabolism, 2005, 4th edition, pp.190, 265
3. Carnitine not allowed in Canada
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4. Evans, JD et.al. “Role of acetyl-L-carnitine in the treatment of diabetic peripheral neuropathy”, Annals of Pharmacotherapy, 2008, 42(11):1686-91 < http://www.theannals.com/cgi/content/abstract/42/11/1686 >
5. Malaguarnera, M. et. al. “L-Carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centenarians: a randomized and controlled clinical trial”, American Journal of Clinical Nutrition, December 2007, Vol. 86, pp. 1738-1744.
6. Remington, R. et.al. “Efficacy of a Vitamin/nutriceutical Formulation for Moderate-stage to Later-stage Alzheimer’s Disease: A Placebo-controlled Pilot Study”, American Journal of Alzheimer’s Disease and Other Dementias, Dec. 2008.

Brain Workouts May Tone Memory

October 21st, 2008

From worldhealth.net
It’s common knowledge that a proper exercise regimen can do wonders for the body. Only recently, however, have psychologists and gerontologists aggressively applied the same principle to the mind.

Among people who work with older adults, the concept of “cognitive fitness” has become a buzzword to describe activities that stimulate underutilized areas of the brain and improve memory. Proponents of brain-fitness exercises say such mental conditioning can help prevent or delay memory loss and the onset of other age-related cognitive disorders.

“Most people’s idea of fitness stops at the neck,” said Patti Celori, executive director of the New England Cognitive Center . “But the brain is the CPU of our body, and most people don’t do much to keep it as fit as possible.”

The NECC runs one of a growing number of programs that work with older adults to improve cognitive abilities. Activities include computer programs designed to stimulate specific areas of the brain, replication of geometric designs using boards with pegs and rubber bands, and visual and auditory memory exercises.

Some of the other programs are Maintain Your Brain , initiated a year ago by the Alzheimer’s Association; Mind Alert, run by the American Society on Aging ; and other regional programs such as the Center for Healthy Aging in Kent, Ohio.

For do-it-yourself types, a plethora of books have been published on getting the brain in shape. Paula Hartman-Stein, a geropsychologist at the Center for Healthy Aging, recommends The Better Brain Book , by David Perlmutter and Carol Colman, and The Memory Bible by Gary Small.

One purpose of mental exercises is to reinforce the idea that “in aging, not everything is downhill,” said Elkhonon Goldberg, a Manhattan neuropsychologist and author of The Wisdom Paradox , which examines how some people grow wiser with age.

“There are gains that are subsequent and consequent to a lifelong history of mental activity and mental striving,” Goldberg said. He also believes brain exercises can benefit adults suffering from mild cognitive impairment, and he has developed computer puzzles designed to help them stimulate different areas of their brain.

It’s not clear how much targeted brain exercises can prevent the onset of cognitive disorders in older adults. But some findings indicate that high cognitive ability is tied to a lower risk of Alzheimer’s.

One of the most extensive and widely cited investigations on the subject, the landmark Nun Study , tracked 100 Milwaukee nuns who had written autobiographies in the 1930s. More than 50 years later, scientists gave them cognitive tests and examined the brain tissue of nuns who died. Those who demonstrated lower linguistic ability in the autobiographies were at greater risk for Alzheimer’s disease.

A similar study published in the Journal of the American Medical Association surveyed 801 older Catholic nuns, priests and brothers . The results linked reading newspapers and participating in other brain-stimulating activities with a reduced risk of Alzheimer’s.

A 2000 National Research Council report commissioned by the National Institute on Aging found some brain exercises were worthy of government funding.

But skeptics question whether beginning an active regimen of brain teasers late in life will do much to prevent brain disorders.

Research to date provides scant evidence that mental exercise can stave off dementia, wrote Margaret Gatz, a psychology professor at the University of Southern California, in an article published by the Public Library of Science.

Gatz wrote in an e-mail that she would be more convinced if researchers randomly assigned cognitive training, then followed study subjects over several decades.

She also said she was concerned that too much emphasis on the benefits of mental fitness could stigmatize Alzheimer’s patients.

“If mental exercise is widely believed to prevent (Alzheimer’s disease), then individuals who do become demented may be blamed for their disease on the grounds of not having exercised their brains enough,” she said.

Still, supporters of cognitive-fitness programs are pushing for greater recognition from the federal government. During December information-gathering sessions leading up to the White House Conference on Aging , conference representatives said several speakers have made a case that brain health ought to be promoted in much the same way that physical fitness is today.

Few people see much downside in pursuing brain-stimulating activities, said Nancy Ceridwyn, special-projects director at the American Society on Aging. Puzzles, spelling practice, memory exercises or book discussions don’t pose much harm.

That said, Ceridwyn isn’t convinced that all the brain exercises being offered today are practical. She wonders whether workbooks that ask adults to do pages of math problems to get their brains in gear might be unnecessarily torturing people in their twilight years.

“How many people are going to get up and say, ‘I’m excited about doing my multiplication tables today’?” she said. “Not many.”

Woman With Perfect Memory Baffles Scientists

June 8th, 2008

nt Remembers Every Day and Almost Every Detail of Her Life 

From ABC NEWS.com

James McGaugh is one of the world’s leading experts on how the human memory system works. But these days, he admits he’s stumped.

 

McGaugh’s journey through an intellectual purgatory began six years ago when a woman now known only as AJ wrote him a letter detailing her astonishing ability to remember with remarkable clarity even trivial events that happened decades ago.

 

Give her any date, she said, and she could recall the day of the week, usually what the weather was like on that day, personal details of her life at that time, and major news events that occurred on that date.

 

Like any good scientist, McGaugh was initially skeptical. But not anymore.

 

“This is real,” he says.

 

Soon after AJ took over his life, McGaugh teamed with two fellow researchers at the University of California at Irvine. Elizabeth Parker, a clinical professor of psychiatry and neurology (and lead author of a report on the research in the current issue of the journal Neurocase), and Larry Cahill, an associate professor of neurobiology and behavior, have joined McGaugh in putting AJ through an exhaustive series of interviews and psychological tests. But they aren’t a lot closer today to understanding her amazing ability than they were when they started.

 

“We are trying to find out, but we haven’t hit ‘bingo’ yet,” says McGaugh.

 

His initial hypothesis, like several others, has turned out to be wrong — or at least incomplete.

 

McGaugh has spent decades studying how such things as stress hormones and emotions affect memory, and at first he thought AJ’s memories were of such emotional power that she couldn’t forget them.

 

But that hypothesis fell short of the mark when it became obvious that “the woman who can’t forget” remembers trivial details as clearly as major events. Asked what happened on Aug 16, 1977, she knew that Elvis Presley had died, but she also knew that a California tax initiative passed on June 6 of the following year, and a plane crashed in Chicago on May 25 of the next year, and so forth. Some may have had a personal meaning for her, but some did not.

 

“Here’s a woman who has very strong memories, but she has very strong memories of things for which I have no memory at all,” McGaugh says.

 

That became particularly clear one day when he asked her out of the blue if she knew who Bing Crosby was.

 

“I wasn’t sure she would know, because she’s 40 and wasn’t of the Bing Crosby era,” he says.

 

But she did.

 

“Do you know where he died?” McGaugh asked.

 

“Oh yes, he died on a golf course in Spain,” she answered, and provided the day of the week and the date when the crooner died.

 

When the researchers asked her to list the dates when they had interviewed her, she “just reeled them off, bang, bang, bang.”

 

She also told McGaugh that on the day after a particular interview, which took place several years ago, he flew to Germany.

 

“I said what? I went to Germany? I couldn’t even remember what year I had gone to Germany,” he says.

 

That level of recall suggests another hypothesis. Some people are able to recall past events by categorizing them. Certain events, or facts, are associated with others, and filed away together so that they may be easier to access. That’s a trick that is often used by entertainers who use feats of memory to wow their audience.

 

AJ does have “some sort of compulsive tendencies. She wants order in her life,” McGaugh says. “As a child, she would get upset if her mother changed anything in her room because she had a place for everything and wanted everything in its place.

 

“So she does categorize events by the date, but that doesn’t explain why she remembers it.”

 

Also, her degree of recall is so much greater than any other person’s in the scientific literature that it seems unlikely to be the complete answer, McGaugh adds.

 

She is also quite different from savants who have surfaced from time to time with extraordinary abilities in music, art or memory.

 

“Some of them can remember every single detail about the particular hobby that they have, such as baseball or calendars or art, but they are very narrow,” he says. McGaugh described one person who could memorize a piece of music instantly, and not forget it, but who “couldn’t make change or couldn’t take a bus because he didn’t know where he was.”

 

By contrast, AJ is a ” fully functioning person,” McGaugh says.

 

The researchers are preparing to take their work in a new direction in hopes of understanding what is going on here. It’s possible AJ’s brain is wired differently, and that may show up through magnetic resonance imaging. Testing is expected to begin within six months.

 

“We will be looking at her brain, using brain scanning techniques, to see if there’s anything that is dramatically different that we can point to,” McGaugh says.

 

Those of us with normal, very fallible memories function somewhat like a computer in that different areas of our brains are interconnected and thus better-suited for general memories. We know where we live and how to get to work, but we may not know what the weather was like on this date four years ago.

 

It’s possible that AJ’s brain has some “disconnections” that help her recall past events from her memory bank without interference from the parts of her brain that act as general processors. But the problem is that even if they find some interesting wiring through brain scans, the researchers will be limited in their conclusions by the fact that AJ seems to be unique.

 

So unique, in fact, that the Irvine team has given her condition a new name. They call it hyperthymestic syndrome, based on the Greek word thymesis for “remembering” and hyper, meaning “more than normal.”

 

Some day, the researchers say, they hope to know what’s different about AJ’s brain, but they are still a ways off.

 

“In order to explain a phenomenon you have to first understand the phenomenon,” McGaugh says. “We’re at the beginning.”

Link between statins and dementia complex

December 5th, 2007

From News – Revolution Health

Previous studies of a link between statins, a cholesterol lowering medication, and cognitive decline have produced mixed results. New research suggests that the relationship between statin use and cognitive decline appears even more complex than originally thought.

The study involved 1,146 African Americans aged 70 and older living in Indianapolis whose cognitive status was assessed in 2001 and again in 2004.

The Indianapolis-based researchers found that cognitive decline in people who took statins was less than in those who did not take statins.

However, those who continued to take statins from 2001 to 2004 had greater cognitive decline than those who were taking statins in 2001 but were no longer taking them in 2004. If statin use were directly associated with a reduction in cognitive decline, continuously taking statins would presumably produce the greatest effect.

“The relationship between statin use and cognitive decline is complex and subjected to unknown confounders,” Dr. Stanley Szwast, of Indiana University School of Medicine, and colleagues note in a report in the journal Neurology. “This effect may not be associated with the cholesterol lowering or anti-inflammatory action of statins.”

“We know that taking statin medication can protect against cardiovascular events such as heart attacks by lowering blood cholesterol. The question at hand is what effects do these medications have on brain function. Our study along with others shows promising results but larger controlled studies are needed,” Szwast noted in a statement.

SOURCE: Neurology, November 6, 2007