Novel Approaches to Cognitive Decline: Protecting Your Brain for the Long Term

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Gingko Tree help with cognitive decline and long term mental health

Cognitive decline is one of the greatest health concerns facing aging populations today. While many people associate dementia and Alzheimer’s disease with inevitability, research shows that brain health is deeply influenced by lifestyle, nutrition, and modifiable risk factors.

In August, our Mind Body Soul team attended a professional education seminar hosted by Cyto-Matrix and presented by Dr. Romi Fung, ND, MSc (PhD cand.), titled “A Novel Approach to Treating Cognitive Decline.”  This presentation explored the biological mechanisms behind memory loss, dementia, and Alzheimer’s disease, while offering practical strategies for prevention and support.

Let’s dive into some key insights and how these can be applied to everyday life to protect long-term brain function.

Understanding Dementia

The World Health Organization defines dementia as a chronic or progressive syndrome marked by deterioration in cognitive function beyond what is expected from normal aging .1 It affects memory, thinking, comprehension, judgment, language, and learning capacity, but it does not alter consciousness. Dementia is not inevitable. In fact, a 2011 study found that nearly 20% of dementia cases may be reversible if identified early and properly addressed. 2 Factors such as thyroid imbalance, anemia, sleep apnea, and cardiovascular issues can contribute to symptoms that mimic dementia and may improve with targeted treatment.

The Biology Behind Cognitive Decline

There are two critical pathways highlighted in the development of Alzheimer’s Disease as follows:

1. BACE-1 (Beta-Site Amyloid Precursor Protein Cleaving Enzyme 1)

This enzyme plays a role in producing amyloid-beta proteins. Excess accumulation of these proteins leads to plaques in the brain—a hallmark of Alzheimer’s disease. BACE-1 is made worse by health conditions that create low oxygen levels in the body such as anemia, sleep apnea, hypertension, and more. 3-8

2. GSK3β (Glycogen Synthase Kinase 3 Beta)

This enzyme influences insulin signaling, tau phosphorylation (which contributes to tangles in the brain), and amyloid production. Overactivation of GSK3β is linked to impaired learning, memory loss, and neuronal death. Both pathways are influenced by lifestyle factors such as oxygenation, blood sugar regulation, and inflammation—making them actionable targets for prevention.

Key Modifiable Risk Factors

Research has identified over 100 modifiable risk factors for dementia. Above all, 10 of these factors that have a Level A (strongest) evidence8 for prevention and include:

  • Education & lifelong learning
  • Cognitive activity
  • High BMI in late life
  • High homocysteine (as part of cholesterol lab marker)
  • Depression
  • Chronic stress
  • Diabetes
  • Head trauma
  • Hypertension
  • Orthostatic hypotension

Each of these represents an opportunity for early intervention and naturopathic medicine is your best shot when it comes to prevention of chronic disease. 

What the Brain Needs to Function

Oxygen – Low oxygen (hypoxia) is strongly linked to increased BACE-1 activity and amyloid buildup. Conditions like anemia and sleep apnea deprive the brain of oxygen and significantly increase dementia risk. Conditions such as Anemia with either low or high hemoglobin levels are associated with dementia. Ensuring optimal iron, B12, and folate status is key. Sleep Apnea is another condition which causes repeated drops in oxygen overnight, driving inflammation, oxidative stress, and higher Alzheimer’s risk. Simple screening tools like STOP-BANG can help identify your risk. Botanical interventions for improved blood flow to the brain may include Ginkgo Biloba, Lions Mane, Bacopa monnieri and nutrients such as Omega 3 fish oils, phospatidylserine or phosphatidylcholine.

Fluid (& Cardiovascular Health) – Poor circulation, hypertension, and low blood pressure reduce cerebral blood flow, starving the brain of nutrients and oxygen. Studies show treating hypertension in mid-to-late life lowers dementia risk.

Fuel (Blood Sugar Balance) – The brain relies on steady glucose for energy. Insulin resistance—often preceding diabetes by 10–15 years—is strongly tied to cognitive decline. Some researchers even call Alzheimer’s “Type 3 Diabetes.” Screening for elevated insulin and blood sugar levels as important as these promote amyloid plaque formation. Interventions include balanced diet, exercise, stress management, and may include supplements like berberine, chromium, resveratrol, and inositol.

Brain Inflammation & Screening Tests

Chronic Inflammation involves Pro-inflammatory cytokines (IL-1β, TNF-α, IL-6) which activate GSK3β, promoting amyloid production and tau tangles. Managing inflammation through nutrition, sleep, stress reduction, and omega-3 intake is protective.

Traumatic Brain Injury (TBI) and repeat concussions are major risk factors for dementia, accelerating tau buildup and oxidative stress. More recent research is suggesting that a protein in the blood called Neurofilament lightchain (NfL) are expressed in increased levels in TBI individuals, which indicated that NfL could be a potential biomarker in the diagnosis of TBI and other neurodegenerative diseases.9 Preventing falls, using helmets, and careful post-injury monitoring are vital.

We have some exciting news coming to labs in British Columbia. As part of monitoring for brain inflammation, inflammatory blood markers will soon be available as screening tools from our local labs, and they include the following:

  • Neurofilament lightchain (NfL) as mentioned above
  • Glial Fibrillary Acidic Protein (GFAP) is a protein that serves as a key biomarker for astrocyte activation, a process known as astrogliosis, which occurs in response to injury or stress in the central nervous system (CNS).
  • pTau217 is a phosphorylated tau protein at the 217 position and represents a significant blood biomarker for Alzheimer’s Disease (AD) pathology that can help in its diagnosis and monitoring. It measures the presence of a specific, modified form of the tau protein that is a key indicator of AD and has shown high accuracy in identifying the presence of amyloid and tau pathology in the brain.

While these tests are not yet available – they should be arriving soon. Currently, we do run comprehensive genetic screening for the APOE4 gene as there are numerous studies which suggest carriers have increased GSK3B activity, leading to excessive tau hyperphosphorylation and neurodegeneration. APOE4 gene may affect GSK3B through mechanisms involving insulin resistance, neuroinflammation, and oxidative stress, which can further exacerbate tau pathology.10 Our Canadian genetic screening lab goes beyond the APOE4 gene to include multiple methylation pathways and 96 gene markers (127 gene variants in total).

3. Critical Lifestyle Preventions Factors

  1. Cognitive Stimulation with lifelong learning and mental challenges (puzzles, new languages, new skillset, etc.) help maintain neural pathways.
  2. Physical activity improves blood flow, increases brain-derived neurotrophic factor (BDNF)11, and preserves brain volume. In particular, some studies have suggested that coordination-focused activities have the most protective effects as they combine mental focus with physical exertion – such as non-contact boxing, dancing, table tennis, tennis, Tai Chi.12
  3. Sleep – Optimizing deep sleep is when the brain’s glymphatic system clears waste, including amyloid plaques. Chronic sleep deprivation or untreated sleep disorders raise dementia risk.
  4. Autophagy & Fasting – Fasting practices can trigger autophagy—a cellular recycling process that clears damaged proteins and supports brain health. Research suggests autophagy begins after ~16–24 hours of fasting, though even overnight fasting (12 hours) may have benefits. We always recommend consulting a healthcare provided for further guidance when starting a fasting regimen.
  5. Dietary Approaches 
  • The Ketogenic diet has been around a very long time and has been used traditionally to reduce seizures in epilepsy as well as to reduce systemic inflammation. As such, it may improve cognition in dementia13. While not for everyone, it highlights the potential of nutrition to modulate brain pathways.
  • The Mediterranean-style diet which is rich in fish, olives and olive oil, vegetables, and legumes combined with a Low-glycemic load to reduce insulin resistance and adequate protein and hydration are often recommend as a naturopathic dietary approach for healthy brain function 

Practical Steps for Optimal Brain Health & take away tips 

  • Get screened for sleep apnea and anemia. 
  • Maintain healthy blood pressure and blood sugar.
  • Stay physically and mentally active.
  • Prioritize restorative sleep.
  • Consider targeted supplements for glucose control, hypertension, inflammation, and mitochondrial support.
  • Explore time-restricted eating or intermittent fasting under professional guidance.

Conclusion

Cognitive decline is not an inevitable part of aging. By addressing modifiable risk factors and supporting the body’s natural repair systems, we can protect brain function for the long term. At our clinic, we integrate the latest research including genetic screening markers with our Canadian-based Labs & use naturopathic principles to help patients take proactive steps in maintaining cognitive health. If you are concerned about memory changes—or want to take preventive action—reach out to our team for personalized support.

Courtesy of Dr. Emina Jasarevic, ND

Following References extracted from presentation provided by Dr. Romi Fung, ND, MSc (PhD cand.):

  1. (WHO, September 2022)
  2. Bello, V. M. E., & Schultz, R. R. (2011). Prevalence of treatable and reversible dementias: A study in a dementia outpatient clinic. Dementia & neuropsychologia, 5(1), 44–47. https:// doi.org/10.1590/S1980-57642011DN05010008
  3. Sun, X., He, G., Qing, H., Zhou, W., Dobie, F., Cai, F., Staufenbiel, M., Huang, L. E., & Song, W. (2006). Hypoxia facilitates Alzheimer’s disease pathogenesis by up-regulating BACE1 gene expression. Proceedings of the National Academy of Sciences of the United States of America, 103(49), 18727–18732. https://doi.org/10.1073/pnas.0606298103
  4. Kung, WM. Et al. (2021). Anemia and the Risk of Cognitive Impairment: An Updated Systematic Review and Meta-Analysis. Brain Sci. 11(6), 777. https://doi.org/10.3390/brainsci11060777
  5. Salminen, A., Kauppinen, A., & Kaarniranta, K. (2017). Hypoxia/ischemia activate processing of Amyloid Precursor Protein: impact of vascular dysfunction in the pathogenesis of Alzheimer’s disease. Journal of neurochemistry, 140(4), 536–549. https://doi.org/10.1111/jnc.13932
  6. Gabryelska, A., Szmyd, B., Szemraj, J., Stawski, R., Sochal, M., & Białasiewicz, P. (2020). Patients with obstructive sleep apnea present with chronic upregulation of serum HIF-1α protein. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 16(10), 1761–1768. https://doi.org/10.5664/jcsm.8682
  7. Blood pressure lowering and prevention of dementia: an individual patient data meta-analysis. Ruth Peters,  Ying Xu,  Oisin Fitzgerald,  Htein Linn Aung,  Nigel Beckett, Christopher Bulpitt,  John Chalmers,  Francoise Forette,  Jessica Gong,  Katie Harris, et al. European Heart Journal, Volume 43, Issue 48, 21 December 2022, Pages 4980–4990, https://doi.org/10.1093/eurheartj/ehac584
  8. Jin-Tai Yu, Ewi Xu, Chen-Chen Tan, et al. Evidence-based prevention of Alzheimer’s disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomised controlled trials. J Neurol Neurosurg Psychiatry 2020 Nov;91(11):1201-1209. doi: 10.1136/jnnp-2019-321913. Epub 2020 Jul 20. PMCID: PMC7569385
  9. Neurofilament light chain level in traumatic brain injury A system review and meta-analysis Gao, Wenyan MDa; Zhang, Zhongshan PhDc,d; Lv, Xiaoling MDb; Wu, Qing MDb; Yan, Jing PhDb; Mao, Genxiang PhDb; Xing, Wenmin MDb,∗Medicine 99(38):p e22363, September 18, 2020. | DOI: 10.1097/MD.0000000000022363
  10. Norwitz, N. G., Saif, N., Ariza, I. E., & Isaacson, R. S. (2021). Precision Nutrition for Alzheimer’s Prevention in ApoE4 Carriers. Nutrients, 13(4), 1362. https://doi.org/10.3390/nu13041362
  11. Pro-Brain-Derived Neurotrophic Factor (BDNF), but Not Mature BDNF, Is Expressed in Human Skeletal Muscle: Implications for Exercise-Induced Neuroplasticity Sebastian Edman, Osca Horwath, Thibaux Van der Stede, et al. Function (Oxf). 2024 Jan 27;5(3): zqae005.doi: 10.1093/function/zqae005
  12. Effectiveness of coordination exercise in improving cognitive function in older adults: a prospective study. Timothy CY Kwok, KC Lam, WW Chau, et al. Clin Interv Aging. 2011 Sep 29; 6:261–267. doi: 10.2147/CIA.S19883
  13. Davis, J. J., Fournakis, N., & Ellison, J. (2021). Ketogenic Diet for the Treatment and Prevention of Dementia: A Review. Journal of geriatric psychiatry and neurology, 34(1), 3–10. https://doi.org/10.1177/08919887209015
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