MCI and Dementia
Mild cognitive impairment (MCI) is an early form of neurodegenerative disease which often progresses to dementia over time.
It can affect people as early as in their 40’s or 50’s and usually starts with forgetting simple things such as names of people, where you parked your car, items to get at the grocery store or driving directions to or from places you used to be able to get to without help.
As it progresses, it can lead to mood changes, loss of control of thoughts and judgment, difficulty with speech or recalling vocabulary and even inability to recognize friends or family.
MCI is a condition that steals one’s mind and cognitive function from oneself and one’s loved ones and leads to a tremendous burden on family members who are left to witness the progression of this disease.
While Alzheimer’s disease is the most common type of dementia by far, there are other types of dementia that ultimately lead to the same outcome.
Conventional Treatment of Dementia
Too often mild cognitive impairment (MCI) is not treated until it progresses into a more progressed form of dementia. Medical drug treatment may involve cholinesterase inhibitors, memantine, antidepressants or anti-anxiety medications.
Functional Medicine Management of Dementia
A comprehensive approach to the management of MCI and dementia must take into consideration many aspects of health, including gut barrier integrity and imbalances of gut flora, liver detoxification capacity and toxic burden, hormone imbalances, energy production capacity, nutrient status and immune imbalances which promote inflammatory states. More generally, Functional Medicine approaches MCI and dementia by supporting normal physiology of the body which can impact brain function and may contribute to the development and progression of neurodegenerative disease.
There are several areas of management of depression in the Functional Medicine approach which are detailed in Dr. Dale Breseden’s book The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline:
- Restoring normal gut barrier integrity, digestion and gut microbial balance
- Supporting liver detoxification processes and decreasing toxic load
- Identifying and supporting insulin sensitivity and glucose metabolism
- Supporting restoration of physiologic hormone levels, including testosterone in men and estrogen and progesterone levels throughout the monthly menstrual cycle in women
- Supporting restoration of brain neurotransmitters and neurotransmitter function responsible for cognitive function
- Restoring normal blood-brain barrier function
- Restoring healthy levels of nutrients in cases of nutritional deficiencies (especially vitamins B1, B2, B3, B6, B12, folate, essential fatty acids, vitamin D, minerals such as Mg, Zn, Fe and other key nutrients for the brain)
- Identifying and removing food sensitivities which can trigger neuroinflammation and neurodegeneration
Identifying and managing signs of chronic inflammation
The Dale Bredesen RECODE Protocol
SJFM follows the Bredesen RECODE protocol described in The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline. In this protocol, we identify the type of imbalance that is promoting the neurodegenerative state through various laboratory testing and focus on correcting that particular imbalance through dietary, nutritional and lifestyle change. These 3 types of imbalance are the following:
- Inflammatory type (specific markers indicating excessive inflammation)
- Nutrient deficiency type (specific markers indicating key nutrient deficiencies)
- Toxic type (specific markers and history consistent with toxic exposures)¹
¹ Bredesen, D. E. (2017). The End of Alzheimer’s: The first program to prevent and reverse cognitive decline. New York: Avery, an imprint of Penguin Random House.