The Importance of Routine and Familiarity

Picture this common hospital scene...

You are 75 years old, and have been on a water fast for a week, being woken every 2â€"4 hours (vital sign checks and the person shrieking all night in the bed next to you), you get upset and want to leave or just get up to pee. You have an IV in, so the nurse won't let you up, so you complain—perhaps loudly. Next thing you know, you get strapped down to the bed in a posey jacket and four point restraints. You can't get up now, so they stick a catheter up your bladder and rectum, while you are left half naked. This leaves you upset, so the staff drugs you with sedatives and antipsychotics. The catheter triggers bladder infections which disorient you further. Meanwhile, being drugged out leaves you paranoid and panicked, leading to, you guessed it, more drugs. You are in unfamiliar environs, and nothing identifies you as human. Instead, you are the 'Dementia in room 7.' No one knows you from before the hospitalization to know that this is not who you usually are. By now, you are near psychotic and of course unable to go home. Your family is given this disappointing news, having no idea the problem was preventable, and you get packed to a nursing home. To make you more manageable, you are kept on psychoactive drugs and treated like a child.

Welcome to "Hospital Induced Delirium & Dementia"
Until recently, hospital-acquired delirium was attributed to old age and not considered important to prevent or treat. But it is critical. People who develop delirium in the hospital end up in nursing homes a staggering 75 percent of the time, five times higher than those without hospital induced delirium. It also leads to longer stays in the hospital, an average of nine days compared to four without delirium, costing an average $60,000 per hospital stay.1 Add to that the average $70,000 yearly cost of being in a nursing home, and the emotional and financial benefits of prevention become staggering.

So How Can I Prevent Hospital Induced Delirium and Dementia?
Begin by simply remembering to provide familiarity for the hospitalized person. In addition, these measures remind staff that this is a real human being with a loving family, rather than 'The demented gallbladder in 26.' Here are simple ways hospital induced delirium and the vicious cycle it leads to can be avoided.

Early warning signs include:
  • Cognitive impairment, such as poor memory, particularly of recent events, disorientation, not knowing where one is, or rambling or nonsense speech.
  • Inability to stay focused on a topic, or getting stuck on an idea rather than responding to questions or conversation.
  • Hallucinations, extreme emotions, or combative behavior.
  • Elderly people who are recovering in the hospital are particularly vulnerable to delirium. Approximately seven million Americans experience delirium in the hospital each year, and it is undiagnosed 60 percent of the time.2

All of the above suggests that avoiding optional hospitalizations are a good idea. Ask these questions:

  1. Can having a visiting nurse or family member avoid the need for hospitalization?
  2. Is the person being admitted for a test or treatment that could be skipped?

The risk-benefit equation can change dramatically in the elderly when the risk of hospital-induced delirium is factored in. Meanwhile, it is not only hospitalization itself that increases risk. A large population-based study conducted by investigators at the Neurological Institute in Taipei Veterans General Hospital showed that the risk of developing dementia nearly doubled within three to seven years of anesthesia and surgery. In addition, the average time to dementia diagnosis was shorter in patients who had anesthesia and surgery compared with their counterparts who did not undergo these procedures.3,4 So ask if a given procedure is truly essential!

Tips for Avoiding Hospital Induced Delirium and Dementia

  1. Keep pictures of the person, spouse, children, grandchildren and even pets all over the hospital room. Even put them on the walls. This not only offers familiarity for the person, but helps the (sometimes exhausted) staff see them as people worthy of respect.
  2. Keep comforting and familiar items from home around, like their slippers, mugs, etc.
  3. Get the family 24/7 visiting hours. Catching disorientation early has a very different outcome when done by a family member who can be soothing and reassuring, and has the time and inclination to be so. This also allows the hospitalized person's needs to be met more quickly (like a glass of water or help to the bathroom), while offering socialization and interaction.
  4. If the family doesn't have the "manpower" or resources to have someone there all the time, have the number of a family member/friend that can be called in if disorientation or agitation occurs kept prominently on the wall by the person's bed, with an order to call that person if needed. Again, catching it early before the above vicious cycle gets a foothold is key.
  5. The more severe the illness, the greater the need to encourage family presence.
  6. To the doctors: Most families will be thrilled to have you share these thoughts with them, and have the option of having someone be present outside of visiting hours. For the rare cases where the person seems to have been abandoned, sometimes a reminder that the government will hunt down all the person's assets to pay any nursing home costs, even any assets transferred to others in the last five years: so abandoning the person can cost the family $70,000/yr if they have any hope of an inheritance.
Other helpful tips?
  1. Have a list of all the person's medications. Over medication can trigger delirium.
  2. Bring their glasses and hearing aids.
  3. Watch for obvious signs like intermittent confusion, that should be a warning to have a family member stay.


  2. Ibid.
  3. Anesthesia, Surgery May Double Dementia Risk. Medscape.

As we grow older, we may grow wiser, but we can also experience age-related memory impairment (ARMI). ARMI is relatively common1 and should not be confused with Alzheimer’s or other dementia, while ARMI is simply mild memory problems associated with normal aging (e.g. “Where did I put my keys?”). Even so, the memory loss and cognitive slowing associated with ARMI can interfere with our daily routines.2 In fact, according to a national survey, worries over retaining mental sharpness with age was the number two health concern among consumers (second only to worries about continuing with normal activities with age).3

So what can we do to help maintain mental sharpness with aging? Aside from eating a healthy diet and getting regular exercise (which is good advice for everybody in all age groups), there are some very specific nutraceuticals (i.e. vitamins, herbs, amino acids), which have been shown to be effective for just this purpose. These include Bacopa monnieri leaf extract, Panax ginseng root extract, Rhodiola rosea root extract, natural caffeine and L-theanine, folic acid and vitamin B12.

Bacopa monnieri leaf extract
The leaves of the Bacopa monnieri plant have been used for centuries in the traditional East Indian system of healthcare (i.e. Ayurveda) for purposes of promoting “healthy longevity, and strengthening life, brain, and mind.”4 While that is certainly impressive, it is even more impressive that several modern, human clinical studies have been conducted showing that supplementation with Bacopa helped:

  • Improve occasional, age-related absentmindedness.
  • Promote a healthy memory.
  • Improve some measures of delayed recall.
  • Promote cognitive function.
Percentage Increase in Total Memory Score

Most of these studies5,6,7,8,9,10,11 found that daily supplementation with 300 mg of Bacopa monnieri leaf extract (standardized for 50 percent total bacosides), provided significant benefits by week 12—although progressive benefits in Total Memory Score were also seen during week four and eight as well.12

It should also be noted that these studies were conducted in men and women who were at least 40 years old, and in most cases more than 55 years old. That means that you’re more likely to experience similar benefits if you’re middle-aged and older, rather than if you’re in your 20s or 30s.

If you’re wondering how Bacopa works, research13 suggests that it helps to maintain healthy levels of acetylcholine, a compound your body makes that works in your brain to help facilitate memory, learning ability and cognitive performance.

Panax ginseng root extract
Panax ginseng root, or ginseng for short, is a traditional Chinese herb, which has been used for thousands of years for various aspects of healthcare. It is also one of the most widely-researched herbs in modern science with over 5,000 published studies. Ginseng belongs to a category of herbs known as adaptogens. Adaptogens are herbs that help stabilize physiological processes and promote homeostasis (i.e. stable, healthy functioning of the body), especially in the case of stress and fatigue. This property was seen in two human clinical studies14,15 examining the effects of ginseng on mental performance. The results demonstrated that 200 mg of ginseng root extract daily:

  • Improved speed of mental performance within 60 minutes.
  • Enhance performance of mental arithmetic within 60 minutes.
  • Reduce feelings of mental fatigue within 60 minutes.
  • Quickly reduced feelings of mental fatigue during sustained mental activity.
  • Quickly improved some measures of mental performance.

While many nutraceuticals may take weeks to work, these studies found that ginseng root extract provided beneficial results in as little as 60 minutes.

Rhodiola rosea root extract
Like ginseng, Rhodiola rosea root is an adaptogen. This plant has been used for centuries in the traditional systems of healthcare throughout Russia, Scandinavia, and other countries where it was used to increase physical endurance, work productivity, longevity, and to treat fatigue, mood and promote a healthy nervous system.16 Currently, there are over 500 studies on Rhodiola demonstrating the value of this plant. The reason for its inclusion in Ageless Memory is that human clinical research17,18,19 shows that supplementation with Rhodiola:

  • Improved capacity for mental work during stress.
  • Supports healthy cognitive function during stress.
  • Reduced fatigue during stress.

These benefits were seen when 370 mg of Rhodiola root extract was used daily, and when it was standardized for 3 percent salidroside and 1 percent rosavins—key compounds in Rhodiola. This standardization is particularly important since most Rhodiola extracts have the opposite standardization: 1 percent salidroside and 3 percent rosavins. Consequently, products with this opposite standardization are not providing the correct balance of Rhodiola compounds used in these cited studies.

Natural Caffeine and L-Theanine
Black tea leaf extract provides natural caffeine as well as the amino acid L-theanine. This is an important distinction because not all sources of caffeine are natural, and not all sources provide L-theanine as well. Consider that if you buy one of those popular energy shots that are supposed to last a few hours, they contain caffeine anhydrous. That’s a synthetic form of caffeine. And while coffee certainly contains natural caffeine, we all know about the jittery effect on your nerves if you get too much—and some of the freshly brewed coffee you get from popular coffee houses can contain hundreds of milligrams of caffeine. Tea, on the other hand, also provides L-theanine, which has a calming effect. That’s likely the reason why drinking tea isn’t typically associated with caffeine jitters like coffee—it contains L-theanine, which helps sooth over-stimulated nerves. Now to be clear, the amount of caffeine used in research with L-theanine is only 50 mg—that’s the amount of caffeine you’d typically find in one-half cup of moderately brewed coffee. Furthermore, 100 mg of L-theanine was used alongside the caffeine. When this combination was used together, human clinical research20,21,22,23,24,25 has shown that supplementation:

  • Helped maintain focus.
  • Helped with mental flexibility, the ability to shift attention from one task to another and efficiently adapt to different situations.
  • Helped improve focus on the information while filtering out other stimuli.
  • Helped improve focus during cognitively demanding tasks.
  • Helped improve speed and accuracy of cognitive performance.
  • Helped improve mental alertness.

Folic Acid and Vitamin B12
Folic acid and vitamin B12 are both critical B vitamins that perform a variety of functions in the human body. Among those functions are the roles they play in cognitive performance. For example, in one study26 older adults were supplemented with 400 mcg of folic acid and 100 mcg of vitamin B12 daily. The results showed that this combination:

  • Supported healthy cognitive function in older adults.
  • Promoted healthy memory performance in older adults.

Furthermore, vitamin B12 deficiency can result in memory loss, and supplementation can help prevent it.27,28 Since vitamin B12 deficiency is estimated to affect 10 –15 percent of individuals over the age of 60,29 supplementation is certainly worthwhile.

What to Expect When Taking Ageless Memory
It should be noted that the aforementioned nutraceuticals tend to provide their effects at different times, so even if you use all of them your results will be progressive rather than instantaneous. Essentially, here’s how it will likely work (although everyone is different and results and timing may differ for you as well):

Nutraceutical Effects on Memory and Cognitive Function


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  2. Hedden T, Gabrieli JDE. Insights into the ageing mind: a view from cognitive neuroscience. Nat Rev Neurosci. 2004;5:87–96.
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  5. Morgan A, Stevens J. Does Bacopa monnieri Improve Memory Performance in Older Persons? Results of a Randomized, Placebo-Controlled, Double-Blind Trial. J Altern Complem Med. 2010; 16(7): 753–9.
  6. Calabrese C, Gregory WL, Leo M, Kraemer D, Bone K, Oken B. Effects of a Standardized Bacopa monnieri Extract on Cognitive Performance, Anxiety, and Depression in the Elderly: A Randomized, Double-Blind, Placebo-Controlled Trial. J Altern Complem Med. 2008;14(6):707–13.
  7. Roodenrys S, Booth D, Bulzomi S, Phipps A, Micallef C, Smoker J. Chronic effects of Brahmi (Bacopa monnieri) on human memory. Neuropsychopharmacology. 2002 Aug;27(2):279–81.
  8. Stough C, Lloyd J, Clarke J, Downey LA, Hutchison CW, Rodgers T, Nathan PJ. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology (Berl). 2001 Aug;156(4):481–4.
  9. Stough C, Downey LA, Lloyd J, Silber B, Redman S, Hutchison C, Wesnes K, Nathan PJ. Examining the nootropic effects of a special extract of Bacopa monniera on human cognitive functioning: 90 day double-blind placebo-controlled randomized trial. Phytother Res. 2008 Dec;22(12):1629-34.
  10. Raghav S, Singh H, Dalal PK, Srivastava JS, Asthana OP. Randomized controlled trial of standardized Bacopa monniera extract in age-associated memory impairment. Indian J Psychiatry. 2006 Oct-Dec; 48(4): 238–42.
  11. Pase MP, Kean J, Sarris J, Neale C, Scholey AB, Stough C. The cognitive-enhancing effects of Bacopa monnieri: a systematic review of randomized, controlled human clinical trials. J Altern Complement Med. 2012 Jul;18(7):647–52.
  12. Raghav S, Singh H, Dalal PK, Srivastava JS, Asthana OP. Randomized controlled trial of standardized Bacopa monniera extract in age-associated memory impairment. Indian J Psychiatry. 2006 Oct-Dec; 48(4): 238–242.
  13. Stough C, Lloyd J, Clarke J, Downey LA, Hutchison CW, Rodgers T, Nathan PJ. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology (Berl). 2001 Aug;156(4):481–4.
  14. Reay JL, Kennedy DO, Scholey AB. Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity. J Psychopharmacol. 2005 Jul;19(4):357–65.
  15. Reay JL, Kennedy DO, Scholey AB. Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained ‘mentally demanding’ tasks. J Psychopharmacol. 2006 Nov;20(6):771–81.
  16. Brown RP, Gerbarg PL, Ramazanov Z. Rhodiola rosea: A Phytomedicinal Overview. HerbalGram 2002; 56:40–52.
  17. Darbinyan V, Kteyan A, Panossian A, Gabrielian E, Wikman G, Wagner H. Rhodiola rosea in stress induced fatigue—a double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty. Phytomedicine. 2000 Oct;7(5):365–71.
  18. Spasov AA, Wikman GK, Mandrikov VB, Mironova IA, Neumoin VV. A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen. Phytomedicine. 2000 Apr;7(2):85–9.
  19. Shevtsov VA, Zholus BI, Shervarly VI, Vol’skij VB, Korovin YP, Khristich MP, Roslyakova NA, Wikman G. A randomized trial of two different doses of a SHR-5 Rhodiola rosea extract versus placebo and control of capacity for mental work. Phytomedicine. 2003 Mar;10(2–3):95–105.
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  24. De Bruin EA, Rowson MJ, Van Buren L, Rycroft JA, Owen GN. Black tea improves attention and self-reported alertness. Appetite. 2011 Apr;56(2):235–40.
  25. Walker JG, Batterham PJ, Mackinnon AJ, Jorm AF, Hickie I, Fenech M, Kljakovic M, Crisp D, Christensen H. Oral folic acid and vitamin B-12 supplementation to prevent cognitive decline in community-dwelling older adults with depressive symptoms—the Beyond Ageing Project: a randomized controlled trial. Am J Clin Nutr. 2012;95:194–203.
  26. Food and Nutrition Board, Institute of Medicine. Vitamin B12. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, vitamin B12, pantothenic acid, biotin, and choline. Washington, D.C.: National Academy Press; 1998:306–56.
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Dementia is a devastating condition affecting upwards of 10,000,000 Americans, with—5 million having Alzheimer's Disease (AD). Dementia can be triggered by numerous causes including Alzheimer's, multi infarct dementia, and nutritional deficiencies. Treatment currently is geared towards giving the two barely helpful (but very profitable) medications, Aricept and Namenda, and beyond this; little is usually done.

Not because other treatments are not very helpful. But rather because they are so low cost that no one shows the data to your doctor. Well meaning as your doctor is. Wondering if this is so? Ask yours if they've seen the studies we discuss below. If not, they may want to explore why, as it will blow their minds to realize just how much Big Pharma controls their education! Fortunately, A LOT can be done to prevent or slow Alzheimer's and dementia. In fact, repeated autopsy studies have shown that 30–50 percent of those diagnosed with Alzheimer's NEVER has the slightest bit of the illness. Instead, they had other potentially reversible causes of their dementia!

SO in addition to using your brain, here are my top 7 tips! I have organized them using the pneumonic "DEMENTIA." The good news? These can also help optimize and maintain brain power in most people.

1. DRUGS—Get people off unneeded ones. Anticholinergic (AC) Meds (benadryl, tricyclic antidepressants, incontinence meds) are especially problematic. Risk for cognitive impairment was increased by 50 percent in adults receiving at least three mild ACs for more than 90 days and by 100 percent in those receiving one or more severe ACs for more than 60 days. Acid Blockers like omeprazole are also associated with a 44 percent increased risk of dementia. Blood pressure pills can be protective however, especially Beta Blockers (like Inderal) and ACE Inhibitors.

2. EMOTIONS—Depression, Anxiety and Sleep. Natural remedies can be especially helpful here, without the worsening often caused by the medications. For example, a special form of Curcumin (called Curamed 500 mg 2 x day) was more effective for depression that antidepressants in two six week head on studies (and see nutrition below). For both anxiety and sleep, a special component of Echinacea (called AnxioCalm by Terry Naturally) can be very helpful with no side effects. Terrific ZZZZ, Revitalizing Sleep Formula, and a special melatonin (Dual Spectrum 5 mg by Natures Bounty) can also be very helpful.

3. METABOLIC—This means optimizing bioidentical hormone levels. For example:

A. Low normal thyroid levels were associated with a 240 percent higher risk of dementia in women. Borderline elevated thyroid had as much as a 800 percent higher risk in men.

B.–Every 50 percent increase in free testosterone in the bloodstream was associated with a 26 percent decrease in the risk of developing Alzheimer's.

C.–Men who went on to develop Alzheimer's disease had about half the free testosterone in their bloodstreams as men who did not.

4. EARS AND EYES—Have vision and eye exams to optimize function.

5. NUTRITION—Optimize key areas of nutrition. Begin with good common sense and a whole food diet, low in gluten:

A. Optimize folate, B12 and B Vitamins. Check a Vitamin B12 level (keep over 540) and homocysteine level (keep under nine). Better yet, simply take a high potency vitamin powder (I use the Energy Revitalization System), which supplies virtually all the needed nutrients in optimal amounts in one low cost drink. Research in the recent issue of JAMA Psychiatry supports this. “The recent VITACOG study, in which 271 individuals older than 70 years who had mild cognitive impairment received supplementation with high-dose folic acid and vitamins B6 and B12, confirmed what other studies showed. They lost less brain compared to people who had normal homocysteine and normal vitamin levels, meaning that those with high levels of homocysteine or with clinical or biochemical vitamin deficiency can benefit from supplementation.”

B. Take a special highly absorbed form of Curcumin called CuraMed. Take 750 mg 2 x day (it would take 14–600 caps a day of other forms to get the same effect, so brand matters). The prevalence of Alzheimer's in India is 70 percent lower than in the US, and this has been traced to the curcumin in the diet, which shows promise in many neurodegenerative conditions, including also Parkinson's.

C. Explore ketogenic diets, coconut oil, etc.

6. TUMORS AND OTHER BRAIN ISSUES—Dementia is a very good reason to get a CT scan or head MRI.

7. INFECTIONS & ANEMIA and other overt medical problems. Dementia means it's time to get a thorough checkup from both the neurologist and your holistic physician (see www.ABIHM. org to find one).

With these common sense research proven tips, you can often prevent, and even reverse, dementia!

Sleep deficit you chalk-off as, “no big deal” actually creates a decreasing tolerance within your body and brain with dangerous implications more than just tired and sleepy daytime symptoms. Underlying causes of sleep disorders are as diverse as individuals but the consequences are now scientifically linked to cognitive decline, memory loss, brain-fog, premature aging, and even Alzheimer’s.

Brain Facts

  • Your brain clears toxins—it does NOT sleep, parts of it actually get more active at night than during the day. According to brain researcher, P.M. Doraiswamy, MD, at Duke University, a newly discovered drainage system called the glymphatic system, goes to work processing and clearing out the brain’s toxins ten times more when we’re sleeping than when we’re awake. A primary protein actively recycled during sleep is responsible for creating amyloid plaque—a marker to Alzheimer’s, although not the only cause.
  • Researchers clearly state chronic sleep deprivation (less than 7–8 hours of regenerative sleep) can lead to irreversible brain damage! A study found extended wakefulness injures neurons essential for alertness and cognitive functions—and—damage can be permanent. The studies also showed short sleep cycles are also linked to a shrinking brain. In addition, studies showed chemicals secreted during deeper sleep are vital for repairing the body and brain.
  • Your internal brain computer does its work of archiving memories from all that stimuli—auditory, visual and neurosensory—like a hard drive in your computer. AND it cannot do its job adequately on 4–5 hours sleep; memory tests prove it.
  • Acetylcholine, a chemical involved in restorative sleep and the dream state, declines in people who begin developing Alzheimer’s because the cells that produce it are destroyed. Lack of deep restorative sleep contributes to destruction of these cells.
  • University of Pennsylvania studies found that prolonging wakefulness damages a type of brain cell called locus ceruleus (LC) neurons that play important roles in keeping us alert and awake.

Keep in mind that long-term sleep deprivation saps the brain of its power even after many days of sleep recovery. More recent studies shined a bright light of concern about brain changes from sleep deprivation showing disruptions in gene function that can affect overall metabolism, inflammation, and autoimmune disease risk to the body and vital detox for the brain. The CDC reported sleep deprivation is now “epidemic” in the U.S.—is it any wonder disorders like fibromyalgia and other inflammatory disorders are also “epidemic?” The body AND brain need time to rejuvenate, get professional help to identify underlying causes now or you’ll be forced to once a life-altering disorder develops. There ARE effective non-drug options to get you stress-less restorative sleep, consult your natural health provider.

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