Frequently Asked Questions About Cognitive Decline and Brain Health
Is it normal to have "senior moments" and memory problems as I get older?
It's almost a joke among middle-aged people that we have "senior moments" and that our brain doesn't work the way it used to. We've all experienced walking into a room and forgetting why we went there. Most people take it for granted that this is just a normal part of aging.
However, in functional medicine, we don't accept declining cognitive function as normal or inevitable—especially when we know that half of 85-year-olds end up diagnosed with Alzheimer's disease, a severe condition that's heartbreaking for families and requires enormous resources to manage.
What causes cognitive decline?
Similar to what we see with fatigue (which is often the result of brain inflammation), cognitive function requires all of your body's systems to be healthy. Memory, concentration, attention, and the ability to organize and sequence thoughts all depend on your overall health.
The same systems we address for gut health, fatigue, or metabolic health are also crucial for brain function.
What specific factors affect my brain health?
Several key factors impact cognitive function:
I've heard about the ketogenic diet for brain health. Does that really work?
This is one area where brain health is unique. A brain that no longer works well on its normal fuel (glucose from the bloodstream) will often work quite a bit better on a different fuel: ketones, which are breakdown products from fat in the diet.
A ketogenic diet is usually recommended for people who have significant cognitive decline. Interestingly, some patients with severe mood issues, such as bipolar illness or depression, have also had unexpectedly good results with a ketogenic diet.
How does functional medicine approach cognitive decline differently?
We've learned a lot from the work of Dr. Dale Bredesen and his team. While a single system breaking down—such as lack of a certain vitamin or low levels of a certain hormone—rarely causes an impairment in memory or attention, there may be a critical point at which enough systems have broken down that cognition begins to fail.
At that point, it's not enough to fix just one thing. We need to address them all. We need to be systematic.
What else is involved in treating cognitive decline?
We also harness the power of exercise, which raises the levels of hormones that support the brain. Additionally, we use "brain games" and cognitive exercises that help establish new neural connections.
How much work is involved in reversing cognitive decline?
I won't sugarcoat it—stabilizing or reversing cognitive decline can be a lot of work. Depending on the level of cognitive decline, it may require the involvement of a close family member to help implement and maintain the program.
Is it worth the effort, even if we can't completely reverse the decline?
Absolutely but it depends on age and severity. We believe that even slowing down decline and preventing a few years of placement in a memory care facility would be enormously beneficial for families—both emotionally and financially. Every month or year of maintained independence and quality of life is precious.
When should I start addressing cognitive concerns?
The earlier, the better. Don't wait until problems are severe. If you're noticing changes in your memory, concentration, or mental sharpness, that's the time to take action—it will be a lot easier than when things have progressed to a more serious stage.
Is it normal to have "senior moments" and memory problems as I get older?
It's almost a joke among middle-aged people that we have "senior moments" and that our brain doesn't work the way it used to. We've all experienced walking into a room and forgetting why we went there. Most people take it for granted that this is just a normal part of aging.
However, in functional medicine, we don't accept declining cognitive function as normal or inevitable—especially when we know that half of 85-year-olds end up diagnosed with Alzheimer's disease, a severe condition that's heartbreaking for families and requires enormous resources to manage.
What causes cognitive decline?
Similar to what we see with fatigue (which is often the result of brain inflammation), cognitive function requires all of your body's systems to be healthy. Memory, concentration, attention, and the ability to organize and sequence thoughts all depend on your overall health.
The same systems we address for gut health, fatigue, or metabolic health are also crucial for brain function.
What specific factors affect my brain health?
Several key factors impact cognitive function:
- Nutritional deficiencies - We need all the essential nutrients (and hormones) to be present at optimal levels, not just "normal" levels.
- Neurotoxins - These are very common in our environment and can damage brain cells over time.
- Sleep problems - Lack of sleep and sleep apnea play a huge role in cognitive decline.
- Stress - Anxiety and high cortisol levels can cause a reduction in function throughout the brain.
- Chronic infections - These are thought to play a significant role in cognitive decline and are always worth addressing to prevent things from getting worse over time.
I've heard about the ketogenic diet for brain health. Does that really work?
This is one area where brain health is unique. A brain that no longer works well on its normal fuel (glucose from the bloodstream) will often work quite a bit better on a different fuel: ketones, which are breakdown products from fat in the diet.
A ketogenic diet is usually recommended for people who have significant cognitive decline. Interestingly, some patients with severe mood issues, such as bipolar illness or depression, have also had unexpectedly good results with a ketogenic diet.
How does functional medicine approach cognitive decline differently?
We've learned a lot from the work of Dr. Dale Bredesen and his team. While a single system breaking down—such as lack of a certain vitamin or low levels of a certain hormone—rarely causes an impairment in memory or attention, there may be a critical point at which enough systems have broken down that cognition begins to fail.
At that point, it's not enough to fix just one thing. We need to address them all. We need to be systematic.
What else is involved in treating cognitive decline?
We also harness the power of exercise, which raises the levels of hormones that support the brain. Additionally, we use "brain games" and cognitive exercises that help establish new neural connections.
How much work is involved in reversing cognitive decline?
I won't sugarcoat it—stabilizing or reversing cognitive decline can be a lot of work. Depending on the level of cognitive decline, it may require the involvement of a close family member to help implement and maintain the program.
Is it worth the effort, even if we can't completely reverse the decline?
Absolutely but it depends on age and severity. We believe that even slowing down decline and preventing a few years of placement in a memory care facility would be enormously beneficial for families—both emotionally and financially. Every month or year of maintained independence and quality of life is precious.
When should I start addressing cognitive concerns?
The earlier, the better. Don't wait until problems are severe. If you're noticing changes in your memory, concentration, or mental sharpness, that's the time to take action—it will be a lot easier than when things have progressed to a more serious stage.
