Brain changes occur twenty to thirty years before symptoms appear so early action is recommended.

Ben Franklin’s quote from 1736 is still relevant today in many areas including brain health.

“An ounce of prevention is worth a pound of cure.”

But if signs have begun and you are forgetting the names of people you know, can’t recall the name of the book you are reading, or struggle to find the words that you want to use, listen to these early warning signs. This is called “Subjective Cognitive Decline.” Perhaps, if you took a cognitive test, you would not get a dementia diagnosis, but in your heart, and your head, you know something is up.

So what is up and what can you do about it?

Dr. Dale Bredesen has identified many areas that influence brain health and most people are influenced by more than one category of dementia risk. There are many causes so there are also many areas of intervention. The same areas of intervention impact prevention and reversal but are applied by practitioners and health coaches with different levels of intensity.

In his book, The End of Alzheimer’s Program, Dr. Bredesen writes, “Nearly everyone with any degree of cognitive decline has a least one of most common contributors…”

  1. insulin resistance
  2. mycotoxin exposure
  3. reduced oxygen while sleeping
  4. leaky gut
  5. poor dentition
  6. chronic infection
  7. nutritional deficiencies
  8. vascular disease

“…Therefore it is critical to test for these contributors, and treat any that are identified.” (p. 51)

The Why

If all is well in the brain, (no infection, no inflammation, no insulin resistance, nutrients are optimal, etc.) something called APP, or amyloid precursor protein, signals that it is time to build, grow, and focus on maintenance. When this synaptoblastic (building) activity occurs, we are creating new synapses in the brain. This is what we want!

When the opposite is true, there are challenging environmental influences signaling to APP to go on the defensive. The signal now communicates that it is time to downsize and decrease the number of synapses. This is called synaptoclastic activity (cutting).

All of the above contributors (1-8) are synaptoclastic and are impairing the brain more and more over time. The interventions below (1-7) can lead to synaptoblastic activity in the brain so we can continue to build our brain late into life and extend our health span.

What Can You Do?

  1. Become Insulin Sensitive

Insulin is a hormone that impacts metabolism and it also is a growth factor for neurons. Eating sugar and carbohydrates increases the level of glucose in the blood causing the pancreas to secrete insulin to push the glucose out of the blood and into tissue. If we continue challenging this system with a high carbohydrate and high sugar diet, over time we lose insulin sensitivity.

Only about 12% of the population in the United States is metabolically healthy (healthy weight, healthy fasting glucose, optimal cholesterol balance, healthy blood pressure). The vast majority are insulin resistant and have higher than optimal glucose levels. The good news is that restoring insulin sensitivity is possible by reducing stress, optimizing sleep, exercising, optimizing key nutrients, and following a healthy ketogenic diet (eg. Bredesen’s KetoFlex 12/3).

  1. Achieve Ketosis

Ketones are an effective fuel for the brain and becoming metabolically flexible (using glucose or ketones) is an excellent early goal to optimize brain health. There are many steps to becoming insulin sensitive and achieving ketosis but removing ultra-processed foods (including flour and sugar), compressing your eating schedule so you are not eating three hours before bed, and not eating for at least twelve consecutive hours daily are good places to begin. Adding healthy unsaturated fats, a variety of high-fiber plants, and free-range or wild animal protein, if desired, is the next step. Fats, carbohydrates, and protein may need to be tracked initially to find the optimal ratios that support ketosis. Continuous glucose monitoring, a ketone meter, and a health coach may come in handy as well.

  1. Optimize Nutrients, Hormones and Growth (Trophic) Factors

Cells are dying and being replaced daily. If we do not have optimal raw ingredients to serve as building blocks, we can’t expect optimal results. Optimizing B vitamins, vitamin D, vitamin C, copper, zinc, magnesium, selenium, Omega 3 fatty acids, sex hormones, thyroid hormones, cortisol and more are critical to support optimal cell growth and repair. Often the recommended daily allowance (RDA) is sub-optimal and testing may be necessary to verify that you are utilizing the nutrients that you are putting into your body.

  1. Resolve and Prevent Systemic Inflammation

Inflammation is the cause or a contributing factor for all, or nearly all, chronic diseases including cardiovascular disease, cancer, diabetes, chronic kidney disease, non-alcoholic fatty liver disease, and autoimmune and neurodegenerative disorders. Acute inflammation is critical for life but ongoing systemic inflammation causes ongoing systemic damage. Lifestyle factors including poor diet, psychological stress, impaired sleep, and inactivity all impact inflammation.

Identify Inflammation:

The blood biomarkers, hs-CRP, homocysteine, and Omega 6 to Omega 3 ratios can identify inflammation.

Causes of Inflammation:

Leaky Gut: If the tight junctions in the gut wall open up, larger molecules exit the gut and get into the bloodstream. The body then ramps up the immune system to attack the threatening protein, virus, parasite, fungus or bacteria that was supposed to enter the toilet. Fortunately, the gut wall can heal very quickly, but we have to take consistent action to heal it and keep it functioning optimally. A leaky gut is common, is a common source of inflammation, and can be caused by poor diet, stress, medications, and infection.

Poor Oral Health: Gingivitis and periodontitis increase the risk of cardiovascular and neurodegenerative disease. So a healthy mouth is more than just having a good smile. The bacteria in the mouth do not stay contained to the mouth, they can travel north and south. But we need good bacteria so using an alcohol-based mouthwash is not recommended because, like an antibiotic, it does not discriminate and kills the good bacteria with the bad. A functional or integrative dentist will look at options to optimize oral and systemic health if there are advanced issues that require intervention.

Metabolic Syndrome: High blood pressure, elevated triglycerides or fasting glucose levels, increased waist circumference, and cholesterol imbalance contribute to metabolic syndrome.

The above risk factors are modifiable and within our control through lifestyle modifications.

  1. Treat Chronic Pathogens

Tick infections and co-infections can impact brain health even if an acute infection was already treated years earlier. Viruses, such as herpes and Epstein-Barr virus, can live in the body for decades without obvious symptoms but can impact ongoing inflammation. Oral bacteria resulting from poor dentition, and high levels of the fungus Candida or mycotoxins resulting from mold exposure can impact the immune system and thus brain health. Identification of specific pathogens and appropriate treatment to optimize immune function are necessary to reduce dementia risk and optimize brain health. Working with a skilled practitioner who is cognizant of keeping the good bacteria while getting rid of the bad is recommended.

  1. Identify and Remove Toxins

Environmental toxins, including heavy metals and Volatile Organic Compounds (VOCs) impact our brain health and may be in our food and personal care products but are not listed on any ingredient label. Mycotoxins resulting from moldy homes, office buildings, and duct work impact dementia risk, and a significant percentage of the population is genetically predisposed to health impacts from mold exposure. To protect our current brain health and reduce risk going forward, identifying, removing, and avoiding ongoing exposure is critical.


  1. Optimize Sleep

The brain detoxifies and cleans up debris while we are in deep sleep and we organize memories during REM sleep. So we need optimal amounts of each as well as nourishing amounts of oxygen so sleep is a place of restoration not a time of insult. Snoring can be a sure sign of sleep apnea but is not the only indicator of reduced oxygen. It is best to play it safe and check nighttime oxygen levels.

You are not alone!

This list can seem daunting but there is a roadmap to prevent or reverse cognitive decline. So if you have forgotten your keys one too many times, can no longer handle planning or organizing, or get stressed out when trying to learn new information, it may be time to follow your intuition. Subjective Cognitive Decline left untreated can lead to Mild Cognitive Impairment and then to dementia or Alzheimer’s. The time to act is now.

You are not alone! There are thousands of others in your shoes and together we are taking this journey toward joyful healing and healthy aging! Reach out to connect.


Araújo, J., Cai, J., & Stevens, J. (2019). Prevalence of optimal metabolic health in American adults: National Health and Nutrition Examination Survey 2009–2016. Metabolic syndrome and related disorders, 17(1), 46-52.

Bredesen DE. Inhalational Alzheimer’s disease: an unrecognized – and treatable – epidemic. Aging (Albany NY). 2016 Feb;8(2):304-13. doi: 10.18632/aging.100896. PMID: 26870879; PMCID: PMC4789584.

Bredesen, D.E. (2020). The End of Alzheimer’s Program: The First Protocol to Enhance Cognition and Reverse Decline at Any Age. Avery.

Liu, J., & Lewis, G. (2014). Environmental toxicity and poor cognitive outcomes in children and adults. Journal of environmental health, 76(6), 130–138.