Observed Improvement in Cognition During a Personalized Lifestyle Intervention in People with Cognitive Decline
Journal of Alzheimer's Disease, vol. 94, no. 3, pp. 993-1004, 2023 DOI: 10.3233/JAD-230004
Sandison, Heathera; * | Callan, Nini G.L.b | Rao, Rammohan V.c | Phipps, Johnb | Bradley, Ryanb; d
Background:
Alzheimer’s disease (AD) is a chronic condition marked by progressive objective cognitive impairment (OCI). No monotherapy has substantially altered disease progression, suggesting the disease is multifactorial and may require a multimodal therapeutic approach.
Objective:
We sought to determine if cognitive function in a sample with OCI would change in response to a multimodal, individualized care plan based on potential contributors to cognitive decline (e.g., nutritional status, infection, etc.).
Methods:
Participants (n = 34) were recruited from the San Diego, CA area. The multimodal intervention included lifestyle changes (i.e., movement, diet, and stress management), nutraceutical support, and medications. It was delivered pragmatically over four clinical visits, and outcome measures were gathered at four study visits, occurring at baseline, one, three, and six months (primary endpoint). Study participants received weekly phone calls for nutrition support throughout study participation. Outcome measures included the Cambridge Brain Sciences (CBS) battery, and the Montreal Cognitive Assessment (MoCA).
Results:
At 6 months, mean MoCA scores improved from 19.6±3.1 to 21.7±6.2 (p = 0.013). Significant improvement was observed in mean scores of the CBS memory domain [25.2 (SD 23.3) to 35.8 (SD 26.9); p < 0.01] and CBS overall composite cognition score [24.5 (SD 16.1) to 29.7 (SD 20.5); p = 0.02]. All CBS domains improved.
Conclusion:
Multiple measures of cognitive function improved after six months of intervention. Our results support the feasibility and impact of a multimodal, individualized treatment approach to OCI, warranting further research.
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Supplements (table 2)
Supplementary Table 2. Common Interventions and Dosages
| Supplement Name | Ingredients | Amount | Typical dose range | ||
| FOUNDATIONAL (prior to individualization )Nootropic Supplement | per 7 capsuels | 3-7 capsules daily | |||
| Vitamin C (as ascorbic acid) | 100 mg | ||||
| Vitamin D3 (as cholecalciferol) | 25 mcg ( 1,000 IU) | ||||
| Thiamine (as thiamine HCI) | 50 mg | ||||
| Niacin (as niacinamide) | 50 mg | ||||
| Vitamin B6 (as pyridoxal 5' -phosphate) | 20 mg | ||||
| Vitamin B12 (as methylcobalamin) | 1000 mcg | ||||
| Pantothenic Acid (as calcium pantothenate) | 50 mg | ||||
| Acetyl-L-Carnitine HCI | 500 mg | ||||
| Artichoke Leaf Extract (4% cynarin and related flavonoids) | 500 mg | ||||
| Bacopa monnieri Leaf Extract | 300 mg | ||||
| Rhodiola rosea Root Extract (3% rosavins; 1% salidrosides) | 300 mg | ||||
| DL-Phenylalanine | 300 mg | ||||
| Uridine-5' -Monophosphate heptahydrate disodium | 250 mg | ||||
| N-Acetyl-L-Tyrosine | 250 mg | ||||
| Taurine | 200 mg | ||||
| L-Theanine | 200 mg | ||||
| Alpha-Glycerylphosphorylcholine (alpha GPC) | 200 mg | ||||
| Cognizin® | 150 mg | ||||
| Organic Coffeeberry® (90 mg caffeine) Whole Coffee (Coffea arabica) Fruit Extract | 129 mg | ||||
| Velvet Bean (Mucuna pruriens) Seed Extract | 100 mg | ||||
| Phosphatidylserine (from sunflower lecithin) | 100 mg | ||||
| Theobromine | 100 mg | ||||
| DHA (as Docosahexaenoic Acid from Algae) | 80 mg | ||||
| Celastrus paniculatus Seed Extract | 60 mg | ||||
| Ginkgo biloba Leaf Extract (24% glycosides) | 50 mg | ||||
| Coleus forskohlii Root Extract (20% forskolin) | 20 mg | ||||
| Pyrroloquinoline Quinone disodium | 10 mg | ||||
| Huperzia serrata Leaf Extract (7% Huperzine A) | 5 mg | ||||
| Omega 3's | per 1 capsule | 2-6 capsules daily | |||
| EPA (eicosapentaenoic acid) | 860 mg | ||||
| DHA (docosahexaenoic acid) | 600 mg | ||||
| Vitamin D | per 1 capsule | 1 capsule daily | |||
| Vitamin D3 (cholecalciferol) | 5,000 IU | ||||
| Vitamin K2 (menaquinone-7) | 90 mcg | ||||
| Probiotic | per 1 capsule | 1 capsule daily | |||
| Proprietary Blend | 409 mg (50 Billion CFU) | ||||
| Lactobacillus acidophilus La-14 | |||||
| Bifidobacterium longum Bl-05 | |||||
| Lactobacillus plantarum Lp-115 | |||||
| Bifidobacterium lactis HN019 | 167 mg (50 Billion CFU) | ||||
| Cognitive Support | per 1 capsule | 1 capsule daily | |||
| Apoaequorin | 40 mg | ||||
| Vitamin D3 | 2,000 IU | ||||
| ENVIRONMENTAL EXPOSURE Detox Support Formula | per 2 capsules | 2-4 capsules daily | |||
| Vitamin A (as 69% beta carotene and retinyl palmitate) | 2,167 mcg | ||||
| Vitamin C (ascorbic acid) | 167 mg | ||||
| Vitamin E (as d-alpha tocopheryl succinate) | 56 mg | ||||
| Thiamin (as thiamin HCl and thiamin pyrophosphate) | 8.7 mg | ||||
| Riboflavin (as riboflavin-5'-phosphate) | 8.3 mg | ||||
| Niacin | 10 mg | ||||
| Vitamin B6 (as pyridoxal-5'-phosphate) | 10 mg | ||||
| Folate (209 mcg Quatrefolic® brand (6S)-5-methyltetrahydrofolate glucosamine salt) | 200 mcg DFE | ||||
| Vitamin B12 (as methylcobalamin) | 42 mg | ||||
| Biotin | 66 mg | ||||
| Pantothenic Acid (as calcium D-pantothenate) | 33 mg | ||||
| Choline (as choline bitartrate) | 66 mg | ||||
| "Magnesium (as magnesium oxide | citrate | malate)" | 88 mg | ||
| Zinc (as Zinc Picolinate) | 10 mg | ||||
| Selenium (as L-Selenomethionine) | 66 mcg | ||||
| Copper (as copper citrate) | 0.334 mg | ||||
| Manganese (as manganese bisglycinate) | 2 mg | ||||
| Molybdenum (as molybdenum citrate) | 50 mcg | ||||
| Calcium D-Glucarate | 66 mg | ||||
| Glycine | 66 mg | ||||
| L-Glutamic Acid HCl | 66 mg | ||||
| L-Glutamine | 66 mg | ||||
| L-Methionine | 66 mg | ||||
| NAC (N-acetyl L-cysteine) | 66 mg | ||||
| Quercetin Dihydrate | 66 mg | ||||
| Taurine | 66 mg | ||||
| "Broccoli (Brassica oleracea L. var. italica) Seed | Sprout | Floret) (contains 0.4% sulforaphane)" | 33 mg | ||
| Inositol | 33 mg | ||||
| L-Ornithine HCl | 33 mg | ||||
| L-Carnitine (as L-carnitine tartrate) | 16 mg | ||||
| "L-Glutathione | (reduced)" | 16 mg | |||
| L-Histidine | 16 mg | ||||
| L-Serine | 16 mg | ||||
| Milk Thistle (Silybum marianum) Seed Extract | 16 mg | ||||
| Turmeric (Curcuma longa) Rhizome Extract (standardized to contain 95% curcuminoids) | 16 mg | ||||
| Coenzyme Q10 (CoQ10) (ubiquinone-10) | 8.4 mg | ||||
| Green Tea (Camellia sinensis) Leaf Extract (standardized to contain 90% polyphenols and 80% catechin) | 8.3 mg | ||||
| "Grape (Vitis vinifera) Seed Extract (standardized to contain 95% polyphenols | including procyanidolic oligomers)" | 3.4 mg | |||
| Catalase | 16 mcg | ||||
| Liposomal Glutathione | 425 mg per teaspoon | 1-3 tsp daily | |||
| Detox Binder | Proprietary Blend | 1-3 capsules daily | |||
| Zeolite clay | |||||
| Activated charcoal | |||||
| Silica | |||||
| Apple pectin | |||||
| Humic powder | |||||
| Aloe vera | |||||
| Chlorella Pyrenoidosa | 250 mg per tablet | 2-15 tablets daily | |||
| Cholesteramine Resin Powder (Rx) | 1/16th - 1/2 tsp daily | ||||
| Calcium EDTA | 1500 - 3000 mg by IV | ||||
| Thiol-functionalized silica | 100 mg per 1/8th tsp (scoop provided) | 1/8 th tsp daily | |||
| NUTRIENTSDigestive Enzymes | per 1 capsule | 1-6 capsules with each meal | |||
| amylase | 12,000 DU | ||||
| protease | 3,000 HUT | ||||
| protease 6.0 | 10,000 HUT | ||||
| glucoamlyase | 15 AGU | ||||
| lactase | 800 ALU | ||||
| lipase | 1500 FIP | ||||
| beta-glucanase | 10 BGU | ||||
| invertase | 450 SU | ||||
| cellulase | 400 CU | ||||
| alpha-galactosidase | 60 GalU | ||||
| protease 3.0 | 10 SAPU | ||||
| phytase | 5 FTU | ||||
| hemicellulase | 100 HCU | ||||
| Betaine HCl | 250 mg | ||||
| Theracurmin | 300 mg per 1 capsule | 2-6 capsules daily | |||
| Proresolvins | 500 mg per 1 capsule | 2-14 capsules daily | |||
| Colostrum | per 1 tablespoon | 1-3 tablespoons daily | |||
| Colostral whey peptides (bovine-derived immunoglobulin concentrate) | 5 gm | ||||
| Immunoglobulin G (IgG) | 1 gm | ||||
| Vitamin A | variable capsules or liquid drops | 5,000 - 15,0000 IU daily | |||
| GlutAloeMine | per 5.8 gm scoop (scoop provided) | 1 scoop daily | |||
| L-Glutamine | 3 gm | ||||
| Arabinogalactan (from Larix laricina)(heartwood) | 2 gm | ||||
| Deglycyrrhizinated Licorice 10:1 Aqueous Extract (Glycyrrhiza glabra)(root) | 500 mg | ||||
| Aloe vera 200:1 Aqueous Extract (Aloe barbadensis)(leaf gel) | 100 mg | ||||
| Nitazoxanide (Rx) | 500 mg | 1 tablet twice daily for 14-30 days | |||
| Oregano Oil | 50 mg per 1 tablet | 1-6 tablets daily | |||
| B-Complex Plus | per 1 capsule | 1-2 capsules daily | |||
| Vitamin B1 (thiamin HCl) | 100 mg | ||||
| Vitamin B 2 (riboflavin) | 12.7 mg | ||||
| Niacinamide and Inositol hexaniacinate | 108 mg | ||||
| Vitamin B5 (calcium pantothenate) | 100 mg | ||||
| Vitamin B6 (pyridoxal HCl) | 16.7 mg | ||||
| Vitamin B12 (methylcobalamin) | 400 mcg | ||||
| Folate (Metafolin®) | 667 mcg | ||||
| Folate (L-5-MTHF) | 400 mcg | ||||
| Biotin | 400 mcg | ||||
| Vitamin C (ascorbyl palmitate | |||||
| Vitamin C | as ascorbic acid | 400 mg per 1 tablet | 1-4 capsules daily | ||
| Alpha-lipoic acid | oral capsule | 300 mg per capsule | 1-3 capsules daily | ||
| SLEEPProgesterone (Rx) | oral capsule | 50 - 300 mg nightly | |||
| Melatonin | 0.5 - 5 mg nightly | ||||
| Sleep Support Formula | per 3 gm (scoop provided) | 1-4 scoops daily | |||
| Magnesium (as di-magnesium malate) | 75 mg | ||||
| myo-Inositol | 2 g | ||||
| Taurine | 500 mg | ||||
| GABA (gamma-aminobutyric acid) | 100 mg | ||||
| L-Theanine | 50 mg | ||||
| Magnesium | per 2.5 gm scoop (scoop provided) | 1-4 scoops daily | |||
| Magnesium L-threonate | 1 gm | ||||
| "di-magnesium malate | magnesium L-threonate | and magnesium lysinate glycinate chelate" | 200 mg | ||
| TBIPhosphytidyl Choline | Phospholipid complex | 650 mg mg per softgel | 4 caps daily | ||
| Phosphytidyl Serine | 100 mg per softgel | 4 caps daily | |||
| MethylB12 | sublingual tablet | 10,000 mcg daily | |||
| NAD+ | IV | 1 gm - 3 gm over 3 days | |||
| HORMONESProgesterone | topical cream or oral | 100 - 300 mg per day | |||
| Topical Estriol (women) | topical cream | 2 - 7.5 mg daily | |||
| Topical Estridiol (women) | topical cream | 0.5 - 2.5 mg daily | |||
| Testosterone (women) | topical cream | 0.5 - 2.5 mg daily | |||
| Testosterone (men) | topical cream | 50 - 150 mg daily | |||
| DHEA | capsule | 10 - 25 mg daily | |||
| Pregnenalone | capsule | 50 mg daily | |||
| USP Thryoid | tablet | 15 - 120 mg daily | |||
| INFECTIONSLysine | 500 mg - 3 gm daily | ||||
| Valacylovir | 500 mg - 2000 mg daily | ||||
| Acyclovir | 800 - 1200 mg daily | ||||
| Immune Tincture | Proprietary Herbal Blend | 5 - 30 drops daily | |||
| Bilberry fruit extract | |||||
| Grape seed extract | |||||
| Shiitake mushroom extract | |||||
| Golden Seal root | |||||
| Noni fruit extract | |||||
| Garlic bulb | |||||
| White Willow bark | |||||
| Milk Thistle seed | |||||
| Raspberry fruit | |||||
| Echinacea Purpurea plant extract | |||||
| Echinacea Angustifolia root | |||||
| Black Walnut hull | |||||
| Black Walnut leaf | |||||
| Lavender oil | |||||
| Oregano oil | |||||
| Galbanum oil | |||||
| Tea Tree oil | |||||
| Fumitory aerial parts extract | |||||
| Gentian Lutea root | |||||
VitaminDWiki – Overview Alzheimer's-Cognition and Vitamin D contains
- FACT: Cognitive decline is 19X more likely if low vitamin D
- FACT: Dementia is associated with low vitamin D levels.
- FACT: Alzheimer’s Dementia 2.3X more likely in elderly if low vitamin D – Dec 2022
- FACT: Dementia is associated with low vitamin D - many studies
- FACT: Alzheimer's Disease is 4X less likely if high vitamin D
- FACT: Every single risk factor listed for Alzheimer's Disease is also a risk factor for low vitamin D levels
- FACT: Elderly cognition gets worse as the elderly vitamin D levels get even lower (while in senior homes)
- OBSERVATION: Reports of increased vitamin D levels result in improved cognition
- OBSERVATION: Alzheimer’s patients 3X more likely to have a malfunctioning vitamin D receptor gene – 2012
- OBSERVATION: Alzheimer's Disease has been seen to halt when vitamin D was added.
- OBSERVATION: Alzheimer’s is associated with all 7 of the genes which restrict vitamin D
- OBSERVATION: 39 vitamin D and Alz. or Cognition intervention trials as of Sept 2018
- OBSERVATION: 2 Meta-analysis in 2012 agreed that Alzheimer's Disease. associated with low vitamin D
- OBSERVATION: 50X increase in Alzheimer's while decrease in vitamin D
- OBSERVATION: Vitamin D reduces Alzheimer’s disease in 11 ways
- OBSERVATION: Alzheimer’s cognition improved by 4,000 IU of vitamin D
- OBSERVATION: Plaque removed in mice by equiv. of 14,000 IU daily
- OBSERVATION: DDT (which decreases Vit D) increases risk of Alzheimer's by up to 3.8X
- OBSERVATION: 2% of people have 2 copies of the poor gene reference: Alz Org
- OBSERVATION: Genes do not change rapidly enough to account for the huge increase in incidence
- OBSERVATION: End of Alzheimer's videos, transcripts and many studies protocol has been very successful
- It adjusts Vitamin D, B-12, Iron, Omega-3, food, etc, and can now be done at home. $75/month.
- FACT: Vitamin D is extremely low cost and has very very few side effects
- CONCLUSION: Everyone concerned about cognitive decline or Alzheimer's Disease should take vitamin D
- PREDICTION MET: By 2024 Omega-3 and high dose Vitamin D will be found to reverse Alzheimer's in humans
There are 13+ Alzheimer’s meta-analyses in VitaminDWiki
There are 97+ Alzheimer’s studies in VitaminDWiki
Dementia is associated with low vitamin D - many studies 50+ studies
16+ studies in both categories Cognitive and Omega-3