Cognitive Impairment

This page is designed to help you understand why you might be experiencing symptoms or have risk factors relating to cognitive impairment. We look at what cognitive impairment is, possible underlying causes, testing considerations and some things that you might be able to do to help with cognitive impairment issues.

What does the cognitive impairment section relate to?

This section of the Health Score Questionnaire looks at symptoms relating to cognitive impairment. This is quite a broad term covering our state of memory, ability to think clearly, ability to make appropriate judgements, planning or completing complex or general daily tasks.

Cognitive impairment does not mean someone has Alzheimer’s, however in some people it may be an early warning sign for the development of a neurodegenerative condition like Alzheimer’s.

Mild cognitive impairment is actually quite common with around 10-20 of people over the age of 65 having issues in this area. The truth is though, issues in this area can be short term or may be an early sign of something that needs to be managed on a longer-term basis.

The good news is that there is a huge number of things you can do to help improve cognitive function, some of which we are going to touch on here.

What are some of the causes of cognitive impairment?

There are many factors which can contribute to cognitive impairment issues and this is why we must take a holistic approach when considering these symptoms. Below are a few of the possible triggers.

• Cardiometabolic dysfunction – poor glucose and insulin management, blood flow issues, blood pressure issues
• Gastrointestinal health – the balance of microbes, infections, overgrowths and the production of endotoxin/LPS, food sensitivities all may impact cognitive function
• Nutrient insufficiencies and/or nutrient excesses
• Toxicity exposure, heavy metal toxicity, such as mercury, lead etc
• Traumatic brain injury – Is this something that there is a history of?
• Anaemias
• Oxidative stress
• Infections current and past viruses, mould exposure etc
• High levels of stress and stress hormone imbalances
• A loss of life purpose and self-worth
• Depression
• Chronic inflammation

Again, this is a summary of just some of the factors that can contribute to impaired cognitive function. To say it is solely a neurological condition and treated only that way, misinterprets how the human body works and interacts with its environment.

Testing considerations for cognitive impairment

If you scored high in this section, we strongly recommend discussing your symptoms with your Doctor. They may want to run some additional tests such as a neurological exam, specific blood tests, perhaps even some brain imaging assessments.

Also discuss with those close to you. Get their opinion on whether they feel there has been a decline in your ability to function and carry out daily tasks. If so, this should be another reason for further assessment with a specialist in this area.

Beyond just looking at this area. How is the rest of your overall health?

This is the reason I put the Health Score together. We cannot look at an area of dysfunction in the body in isolation. Everything is connected, from the different physiological systems in the body, through to our emotions, past trauma and the environments we find ourselves in on a day-to-day basis. Review the rest of your questionnaire results and also focus on addressing the other areas you scored high in, I have no doubt this will help to improve overall cognitive function.

Dr Dale Bredesen, author of ‘The End of Alzheimer’s,’ highlights some important physiological assessments to determine risk of cognitive decline, these include:

• Assessment of the ApoE gene variant
• Blood tests
• CRP
• Homocysteine
• B vitamin Status
• Omega 6:3 ratio
• Insulin levels, Glucose and HbA1c
• Body Mass index and Body Fat levels
• Cholesterol, triglycerides
• Glutathione
• Vitamin D, C and E
• Red blood cell magnesium levels
• Copper, zinc, potassium, calcium, selenium
• Thyroid function – TSH, Free T3, Free T4
• DHEA
• Testosterone, estrogen, progesterone
• Mercury, arsenic, cadmium, lead
• HLA-DR/DQ
• Microbiome Assessments
• Gastrointestinal and Oral Assessments
• Imaging
• Cognitive performance assessment – CNS Vital Signs, BrainHQ

A lot of the blood tests from this list and the assessment of the gut and oral microbiome are overlooked in the assessment of cognitive impairment/decline.

How can you improve your cognitive health?

Research has shown that correlations, such as the more westernised diet and the less sunshine that we have, are contributing factors towards the development of cognitive issues and neurodegenerative conditions. These two very simple factors highlight the influence of our environment on our risk.

The truth is, we need a multimodal approach to help support and regenerate cognitive function.

For mild cognitive impairment, this is not an area where drugs have been approved, and it is also something that is modifiable through nutrition and lifestyle changes.

Factors that can help to restore cognitive function include:

1. Regular exercise

Exercise can improve neural stem cell function, help to manage stress, improve social engagements, and at the right level, can help to manage inflammation in the body. It’s about finding the right type, intensity and volume of exercise that is right for you. Exercise is strongly correlated with improving cognitive function, particularly movement that involves balance and coordination.

2. Adapting to a diet naturally rich in antioxidants and anti-inflammatory is another good move

Think colourful vegetables and some fruits, oily fish, green tea and normal tea, some leaner proteins, mushrooms etc. In some cases, more therapeutic diets like the ketogenic diet, or lower carb diets can be exceptionally good for cognitive performance, and those with neurodegenerative or neurological conditions have used these diets to considerably improve cognitive function.

3. Optimise your digestive health

Issues in the gut, especially issues with excessive bacterial endotoxin exposure, resulting from the growth of certain bacteria can contribute to cognitive dysfunction. If you have ongoing digestive issues with cognitive decline, addressing the gut will be a priority.

4. Participate in mentally and socially stimulating activities

Social interaction is crucial for cognitive health. Whether in person or just through video calls, maintaining relationships is critical.

5. Optimising sleep health

This is a huge one for cognitive function. Sleep helps to clear specific toxins that build up in the brain throughout the day. Sleep helps to clear Tau proteins, protects against amyloid beta-mediated toxicity, and the sleep hormone melatonin has been shown to slow the progression of cognitive impairment.

6. Management of stress

Stress increases the risk of all neurological conditions such as Alzheimer’s, Parkinson’s etc. Chronic stress has negative impacts on our short-term memory function. Anything you can do to help reduce chronic stress will generally benefit your health. For some, this is reducing overall life demands, others its adding meditation, breathing and heart rate variability training, others it might be managing your diary better, adding more holidays, getting help with childcare etc.