Maintaining Memory for Life: The Science Behind Cognitive Support Formulas
Cognitive challenges can be devastating. Changes in brain health can affect focus, memory, mood, sleep, and even personality. Many people live in fear of memory loss as they get older. Others find themselves supporting loved ones who have lost their ability to function in everyday life because of cognitive impairments.
As with most health situations, it’s easier to support the healthy structure and function of the brain than it is to reverse damage once it’s begun. Ideally, supporting brain health and memory starts during childhood and continues through all stages of life. That’s why cognitive support should be a part of everyday practice for all integrative clinicians.
The good news is that a holistic approach to whole-body health inherently supports the brain as well. The brain relies on healthy blood-sugar levels, lipid and homocysteine metabolism, along with healthy cellular energy production. That means most integrative clinicians are indirectly supporting brain health for their patients whether they intend to or not.
For example, sleep, exercise, and diet are all foundational to brain health. A balanced diet provides nutrients such as B vitamins and zinc that are essential for brain function. Exercise promotes the expression of brain-derived neurotrophic factor (BDNF), which is a protein that supports the growth and connection of new nerve cells. And sleep gives the brain essential time to consolidate memories.
Targeted nutritional support can build upon this healthy lifestyle foundation to support brain health and memory. Cognitive-support formulas are designed to do just that.*
Some of these formulas contain one or more of the many ingredients with sound science to support their role in cognition and memory. The two most-well researched ingredients include citicoline and huperzine A.* You can read about them in detail in the Ingredient Spotlight on page 34 and in the Research Review on page 40.
In this article, we review five more top nutrients you’ll likely find in cognitive support formulas.
Phosphatidylserine is an integral component of all cell membranes. It is present in every cell of the human body, but concentrated in the nerve cells of the brain. Phosphatidylserine can be synthesized in the human body from phosphatidylcholine. It can also be consumed directly from foods and supplements.
Phosphatidylserine is included in cognitive-support formulas mainly because of its ability to support the structure of nerve-cell membranes and the function of receptors and neurotransmitter release at nerve synapses. Phosphatidylcholine and citicoline also work similarly to support the structure of nerve-cell membranes.*
Numerous studies show that phosphatidylserine supports brain health in adults, teens, and even children.*
A 2014 study found that supplementation with 200 mg per day for two months supported healthy attention and memory in children. And a double-blind, -placebo-controlled trial published in 2010 found that supplementation with 300 mg per day of phosphatidylserine for six months supported healthy memory in older Japanese adults.*
The suggested use for phosphatidylserine is 100 to 600 mg per day.
Acetyl-l-carnitine is a naturally occurring substance in the body. It forms when an acetyl group (CH3CO) binds to l-carnitine, which is a modified version of the amino acid lysine. Inside the cells of the human body, acetyl-l-carnitine and l-carnitine readily convert from one to the other.
But acetyl-l-carnitine has some advantages over l-carnitine as a dietary supplement. Acetyl-l-carnitine more efficiently absorbs from the gut and more readily crosses the blood-brain barrier. Also, the acetyl group can be used in the brain to support the production of the neurotransmitter acetylcholine.*
Acetyl-l-carnitine is included in cognitive-support formulas mainly because of its central role in mitochondrial function and cellular-energy production. L-carnitine facilitates the transport of fatty acids into the mitochondria so they can be converted into energy. This mechanism makes l-carnitine synergistic with coenzyme Q10, which also supports mitochondrial energy production.*
Multiple studies conducted in the 1990s found that acetyl-l-carnitine supplementation supports memory and cognition in older adults.*
Also, the authors of a 2003 meta-analysis of 21 double-blind, placebo-controlled trials wrote that supplementation with 1.5 to 3 grams of acetyl-l-carnitine per day for three to 12 months resulted in a “significant advantage” over placebo for supporting cognition in elderly patients.*
The suggested use of acetyl-l-carnitine is 1,500 to 2,000 mg per day.
Vinpocetine is a compound derived from vincamine, which is an alkaloid in the seeds of the periwinkle plant (Vinca minor). Vinpocetine is approved by prescription in some countries, and is available as a dietary supplement in the U.S.
Vinpocetine is included in cognitive–support formulas because of its ability to support healthy blood flow in the brain. Positron emission tomography (PET) scans of the brain show that vinpocetine readily crosses the blood-brain barrier. It’s then taken up by brain areas where it supports cellular metabolism and blood flow.*
Vinpocetine is not the only compound that supports healthy blood flow to the brain. Ginkgo biloba has long been used in the same way.
A combination product containing ginkgo biloba and vinpocetine was evaluated in a double-blind study conducted at the Scripps Research Institute in California in 2001. The results of the study showed that 14 days of supplementation supported working memory in healthy adults.*
The suggested use of vinpocetine is 10 to 30 mg per day. The FDA has warned that consumption of vinpocetine may be associated with adverse reproductive effects and should not be used by women who are pregnant or could become pregnant.
Curcumin is a compound extracted from turmeric root (Curcuma longa). Curcumin has been shown to support numerous physiological pathways, including healthy responses to inflammation and oxidative stress.*
Curcumin is included in cognitive-support formulas primarily because of its ability to support antioxidant defenses against reactive oxygen species. Brain cells are very susceptible to oxidative damage and require ongoing support for cellular antioxidant protection. N-acetylcysteine (NAC) and alpha-lipoic acid (ALA) are often included in cognitive-support formulas for the same reason.
A double-blind, placebo-controlled trial published in 2015 found that a solid lipid curcumin formulation (400 mg as Longvida curcumin) supported memory and mood in healthy older adults.* Longvida’s formulation was originally developed by UCLA neuroscientists investigating the action of curcumin on biomarkers of brain health. The bioavailability challenges of curcumin are well known, but Longvida’s patented lipophilic matrix protects and delivers curcumin into circulation and is proven to stay in circulation for a significant amount of time, long enough to cross the blood brain barrier and exert effect.
In 2018, researchers at the University of California Los Angeles published an 18-month clinical trial of curcumin (Theracumin) in older adults. Their results showed that 180 mg of curcumin per day supported memory and mood, and correlated with positive changes on PET scans of the brain.*
The suggested use of curcumin is 200 to 1,000 mg per day.
Coffee fruit is the bright red flesh that surrounds coffee beans. Extract of whole coffee fruit contains chlorogenic acid and other antioxidant compounds.
Coffee fruit extract is included in cognitive-support formulas because of its ability to support the production of BDNF—a protein that helps grow and repair nerve cells. Based on results from the Framingham Study, published in the Journal of the American Medical Association in 2014, researchers concluded that higher serum BDNF levels protect healthy memory and cognition in aging adults.*
Another study found that 100 mg of whole coffee fruit extract boosted BDNF levels in healthy adults by 143 percent in less than two hours.
Although other supplement ingredients, particularly fish oil and curcumin, might also support BDNF, coffee fruit extract is the only ingredient that has been shown to do so in human studies.
The suggested use for coffee fruit extract is 100 to 200 mg per day.
CHOOSING A COGNITIVE-SUPPORT FORMULA
The brain relies on ALL systems working correctly. It needs cellular energy, adequate blood flow, antioxidant defenses, and all of the nutrient building blocks to support its structural integrity. Consequently, when choosing a cognitive-support formula for a patient, it’s important to look for a combination of ingredients that address multiple mechanisms of action.
When beginning a cognitive-support formula with a patient, remember that not everyone will respond the same way. Many people feel better if they take these supplements in the morning or early afternoon because of the stimulating effect of some ingredients. Always check for potential interactions with other dietary supplements or medications.
Many people now expect to live into their 80s and 90s and maintaining cognitive function is of primary concern. It’s never too soon to consider cognitive support as part of any patient’s holistic wellness, but needs naturally increase with age. Practitioners prepared to support patient’s cognitive health in all stages of their life-cycle, are providing pro-active support for long term quality of life. n
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