As your "second brain," the state of your gut has been shown to play an important role in your neurological health. Importantly, studies have shown probiotics (beneficial bacteria) can help decrease pathological hallmarks of Alzheimer's disease (AD), including amyloid plaques and tangles.1 One of the most impressive of these studies2 was published in Frontiers in Aging Neuroscience in 2016. Sixty elderly patients diagnosed with Alzheimer's received either a placebo or a probiotic milk product containing Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum and Lactobacillus fermentum for 12 weeks. At the beginning and end of the study, participants underwent a standardized cognitive assessment and a highly sensitive c-reactive protein test, which is a powerful marker of inflammation. As reported by neurologist Dr. David Perlmutter:3
Your Gut and Brain Are LinkedSince then, several other studies have been published, showing probiotics can help improve cognitive function and ward off dementia, including Alzheimer's. While this may seem all too simple to be true, it makes perfect sense when you consider the deep connections that exist between your gut and your brain. As explained by Harvard Health:4
Probiotic Prevents Amyloid-Beta-Induced DysfunctionAccording to a 2017 study5 in Scientific Reports, the Bifidobacterium breve strain A1 may be of particular use in Alzheimer's treatment. Using Alzheimer's disease model mice, the researchers were able to confirm that daily oral administration of B. breve A1 reduced the cognitive dysfunction normally induced by amyloid beta. According to the authors:
One of the mechanisms behind these protective effects was found to be suppression of amyloid-beta-induced changes in gene expression in the hippocampus. In short, the bacterium had an ameliorating effect on amyloid-beta toxicity. Interestingly, B. breve A1 did not actually alter the composition of the animals' gut microbiota to any significant degree; rather, many of the benefits appear to be related to significantly raised blood levels of acetate, a byproduct of fermentation by gut bacteria. As explained by the authors:6
When looking at SCFA levels in the animals' blood, the mice treated with B. breve A1 had significantly higher levels of acetate, but not propionate or butyrate, compared to controls. Other microbiota-derived SCFAs may also play a role, however. A 2019 study7 found that rats given both probiotics and prebiotics performed significantly better on spatial memory tests, and this improvement was attributed to increased levels of brain-derived neurotrophic factor (BDNF). Butyrate — a SCFA produced when gut bacteria ferment fiber — activates the secretion of BDNF. According to the authors, the improvement also correlated with "decreased levels of pro-inflammatory cytokines and better electrophysiological outcomes in the hippocampi." This led them to conclude that "the results indicated that the progression of cognitive impairment is indeed affected by changes in microbiota induced by probiotics and prebiotics." Probiotics Have Preventive and Therapeutic Potential for ADThe 2018 paper,8 "Probiotics for Preventing Cognitive Impairment in Alzheimer's Disease," points out that probiotics can inhibit the progression of neurodegeneration by:
Inflammation and oxidative stress modulation are primarily accomplished through the gut microbiota's effects on your gut-brain axis, which in addition to your central nervous system (CNS) and enteric nervous system (ENS) also includes your autonomic nervous system, neuroendocrine system and immune system.13 These in turn are connected to various pathways involved in the regulation of immune function and metabolic homeostasis. These pathways include your vagus nerve and hypothalamic-pituitary adrenal pathway. According to "Probiotics for Preventing Cognitive Impairment in Alzheimer's Disease:"14
The researchers speculate that gut microbiome alterations allowing for the colonization of pathogens that increase gut permeability can perturb the gut-brain axis, thereby raising your risk of Alzheimer's. They cite research15 in which Enterobacteria infection was found to exacerbate the progression of Alzheimer's as an example of this theory. Immune Activation and Systemic Inflammation in ADMany studies have suggested immune activation and low grade systemic and intestinal inflammation are important factors in Alzheimer's, which can help explain why probiotics appear so beneficial. As noted in a 2018 publication:16
The authors speculate that the increase in immune activation and inflammation seen in Alzheimer's patients may be due to changes in microbiota that tends to occur with age. They also note that "the role of probiotics in preventing dementia seems promising" and that further studies should be done to further tease out the exact mechanisms by which probiotics protect against neurodegeneration. Alzheimer's Prevention and Treatment Beyond ProbioticsWhile optimizing your gut microbiome is an important part of Alzheimer's prevention and treatment, it needs to be part of a more comprehensive plan. Dr. Dale Bredesen, director of neurodegenerative disease research at the UCLA School of Medicine, discusses treatment alternatives in his book, "The End of Alzheimer's: The First Program to Prevent and Reverse Cognitive Decline." Bredesen has identified dozens of variables that can have a significant influence on Alzheimer's, and developed a treatment program based on those findings, called ReCODE. In 2014, Bredesen published a paper detailing how leveraging 36 healthy lifestyle parameters reversed Alzheimer's in 9 of 10 patients. This included the use of exercise, ketogenic diet, optimizing vitamin D and other hormones, increasing sleep, meditation, detoxification and eliminating gluten and processed food. You can download Bredesen's full-text case paper online, which details his program.17 You can also find helpful guidance in my previous article, “Top Environmental Risk Factors for Dementia Identified.” As the prevalence of Alzheimer’s disease continues to climb, it’s important to realize that this disease is primarily driven by preventable lifestyle factors, and that conventional drug treatments are ineffective — or worse. As noted in a December 2018 article18 by Perlmutter, the largest class of medications prescribed for Alzheimer’s, called cholinesterase inhibitors, which break down acetylcholine, have actually been shown19 to accelerate cognitive decline! This, clearly, is the last thing you want, which means making lifestyle changes are all the more important, and the earlier you make them, the better. As for how to nourish your gut microbiome, your best bet is to make your own fermented vegetables, which will provide plenty of beneficial bacteria for a fraction of the cost of a supplement. Instructions and helpful tips can be found in “Tips for Fermenting at Home.” from http://articles.mercola.com/sites/articles/archive/2019/11/21/probiotics-for-dementia.aspx
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