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B Vitamins Slow Brain Aging, Preserve Cognitive Function in Older Patients

By James P. Meschino, DC, MS

The Oxford Project to Investigate Memory and Ageing (OPTIMA) published the results of a key aspect of their study in the online journal Public Library of Science ONE in 2010.¹ In this arm of the study, they investigated the effect of B-vitamin supplementation on various parameters of brain aging and associated cognitive function.

The study group consisted of 168 individuals over the age of 70 with mild cognitive impairment.

The treatment group was given daily supplementation of the following B vitamins: folic acid (800 mcg), vitamin B₁₂ (500 mcg) and vitamin B₆ (20 mg). The main outcome measured was change in rate of whole brain atrophy on MRI investigation after 24 months of supplementation compared to the placebo group.

Study results showed that the group taking the B-vitamin cocktail experienced a 30-percent slower rate of brain atrophy, on average, and in some cases patients experienced reductions as high as 53 percent. Greater rates of atrophy were associated with lower cognitive test scores.

How Do B Vitamins Slow Brain Atrophy and Preserve Brain Function?

There are two mechanisms that most likely explain the value of B-vitamin supplementation in slowing brain atrophy and preserving cognitive function. Folic acid, vitamin B₆ and vitamin B₁₂ are required to prevent a rise in homocysteine, which is known to damage brain cells and brain blood vessels. Higher blood homocysteine levels have been linked to accelerated brain atrophy in a number of studies.

In addition, certain B vitamins are also required for brain cells to synthesize important neurotransmitters, which are required for normal cognition, attention, memory, focus and other aspects of healthy brain function. For example, B vitamins are required for the synthesis of dopamine, epinephrine, norepinephrine, serotonin and acetylcholine. Based on the study findings, optimal B-vitamin status achieved via supplementation appears to be required to slow age-related brain atrophy and preserve cognitive function with respect to these two known mechanisms of action.

The Aging Brain

We have known for many years that in the elderly, the brain shows progressive atrophy. Atrophy occurs even in cognitively healthy subjects, but is much more accelerated in patients suffering from Alzheimer's disease. Studies show the following:¹

• An intermediate rate of atrophy is found in people with mild cognitive impairment (MCI).
• People over 60 years of age without MCI normally have brain shrinkage of approximately 0.5 percent per year.
• Individuals showing MCI normally show a brain atrophy rate that is twice as fast: approximately 1 percent per year.
• Alzheimer's patients can lose 2.5 percent of brain volume per year.

Recommendations for Lifelong Healthy Brain Function

1. Take a High-Potency Multiple Vitamin and Mineral that is enriched with antioxidants and a B-50 Complex. A formula of this type not only provides B vitamins at meaningful doses, but also should provide 400 IU of vitamin E, which is known to protect the brain from free-radical damage. Free-radical damage is a consistent feature in Alzheimer's disease, Parkinson's disease and other neurodegenerative diseases. Vitamin E supplementation has been used to successfully slow the progression of Alzheimer's disease and Parkinson's disease in various clinical trials.²

2. Take an Essential Fatty Acid Supplement that contains 400 mg each of fish, flaxseed and borage oil. A number of studies have shown a correlation between higher intake levels, blood levels, and/or brain levels of omega-3 fats and a reduction in risk of Alzheimer's disease in various populations.³

After age 55, take a supplement that will help preserve acetylcholine levels (memory chemical) in the brain, consisting of CDP-choline, phosphatidylserine, huperzine A and Bacopa monnieri.⁴

Other Lifestyle Strategies of Importance to Maintaining Cognitive Function

• Limit alcohol consumption, as it kills nerve cells.
• Avoid all recreational drugs and abstain from smoking.
• Avoid high-animal-fat foods (fish is the exception), as they clog brain blood vessels with cholesterol deposits.
• Exercise regularly to increase brain blood flow.
• Get adequate sleep.

In addition, help patients reduce their reliance on many prescription drugs whenever possible (e.g., chiropractic care can reduce or eliminate need for analgesics, muscle relaxants and anti-inflammatories. Improved lifestyle management in some cases may reduce the need for cholesterol-lowering drugs, diabetic drugs, triglyceride-lowering drugs, anti-hypertensive drugs, anti-depressant and anti-anxiety drugs).

Other Anti-Aging Brain Strategies

As individuals get older, it is important to keep the brain forming new neural circuits or degeneration will likely occur. There are a number of suggested ways to form these new neural circuits and keep the old ones alive. Some valuable ideas taken from the book, Change Your Brain, Change Your Life, by D. Amen, MD, involve activities such as the following:5 dance lessons, ping pong, learning a musical instrument, learning a foreign language, and learning things that are outside your normal realm of knowledge. I highly recommend this book for additional information on the topic.

The finding from the OPTIMA study that B-vitamin supplementation can slow brain atrophy in older subjects and help to preserve cognitive function is a major discovery and breakthrough. It is important to point out that thus far, no drug has shown an ability to slow brain atrophy, which, in my view, makes this research important to holistic health providers. Also intriguing is that fact that the dosages of B vitamins required to achieve these brain anti-aging effects exceed that which can be provided by food alone. Hence, the argument in favor of targeted, evidence-based, nutritional supplementation continues to unfold.

References

1. Smith AD, et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One, Sept. 8, 2010;5(9):e12244.
2. Meschino J. "Vitamin E Improves Outcomes in Patients With Alzheimer's Disease." Dynamic Chiropractic, Oct. 7, 2010.  
3. Meschino J. "Omega-3 Fats May Reduce Risk of Age-Related Cognitive Decline, Dementia and Alzheimer's Disease." Dynamic Chiropractic, July 16, 2007.
4. Meschino J. "Helping Your Patients Prevent Mental Decline and Alzheimer's." Dynamic Chiropractic, Aug. 12, 2008.
5. Amen D. Change Your Brain, Change Your Life. Three Rivers Press, 1998.

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