Dr. Kristine lokken Functional neuropsychologist Co-founder/ceo brain health Institute, Inc Director of rehabilitation neuropsychology, birmingham vamc Assistant professor, department of psychology, uab Clinical assistant professor, department of psychiatry and behavioral Neurobiology, UAB

Preventing and Treating Cognitive Decline: A Different Approach PRESENTED AT THE: Alzheimer’s of Central Alabama 2017 Annual Conference Tuesday, October 17, 2017 Canterbury United Methodist Church

Learning objectives Participants will gain basic knowledge of effective strategies for preventing and treating cognitive decline Participants will be introduced to the brainH.E.A.L.T.H.TM model of intervention Participants will walk away with practical tips, tools, and information to transform fear and resignation into hope and determination

Impact. Changing the landscape on how we view and treat AD Power of One Direct Patient Quality of Life Patient Functional Abilities Indirect Spouse, family risk and caregiver burden Medical and Long-term Care Cost Global Impact of Dementia: Financial and Emotional

POINTS OF INTERVENTION Prevention Before any cognitive symptoms are detected Targeting those with APOE 4 genetic marker Restoration Subjective Cognitive Impairment (SCI) Mild Cognitive Impairment (MCI) Early Alzheimers Disease (AD)/Other Neurological Disorder (FTD, VAD, etc) Stablization When disease process has taken hold Cognitive, mood, quality of life

A different approach Getting at the Root Cause Personalized Adjuncts To Standard Conventional Therapy Systems Biology Approach - OPTIMIZATION Regulation of mood, stress, eating behaviors, dietary selection, and sleep Incorporating Targeted Exercise Cognitive Rehabilitation Reducing Toxicant Exposure Load

GETTING TO THE ROOT CAUSE Functional Medicine Asks how and why illness occurs Interpret Symptoms as a Message Reason for Amyloid Work by Bredesen Gut-Brain Connection Work by Perlmutter

”Doctor, my toe hurts!”

Functional Medicine Approach One condition, Many Causes One Cause, Many conditions Alzheimers Disease Inflammation Infections Cancer Heart Disease ALZHEIMERS DISEASE Hormones INFLAMMATION Toxicants Depression Type 3 DM Arthritis

Many underlying causes of memory impairment Seek an excellent work-up to confirm diagnosis Seek to personalize your treatment A one-size fits all approach does not work There is no silver bullet – so try for silver buckshot 36+ points of intervention (Based on Bredesen Protocol)

36+ Points of Intervention Systems Biology Approach - OPTIMIZATION Regulation of mood, stress, eating behaviors, dietary selection, and sleep Incorporating Targeted Exercise Cognitive Rehabilitation Reducing Toxicant Exposure Load EASY MOD HARD Vit D Int Fasting Sleep Hormones Keto Diet Exercise

brainH.E.A.L.T.H.TM Intervention H = HEALTHY EATING E = EMOTIONAL REGULATION A = ACTIVITY L = LEARNING STRATEGIES T = TOXICANT REDUCTION H = HABITS

brainH.E.A.L.T.H.TM Intervention From SAD to KETO (and the many iterations in between) Begin by ridding of sugar (all forms), artificial sugars, processed food, processed carbohydrates Contributes to inflammation Diabetes Type 3 Incorporate Intermittent Fasting Ketones provide alternate fuel source Begin to limit carbohydrates and increase healthy fats Needs to be medically supervised H = HEALTHY EATING E = EMOTIONAL REGULATION A = ACTIVITY L = LEARNING STRATEGIES T = TOXICANT REDUCTION H = HABITS

brainH.E.A.L.T.H.TM Intervention Interventions for overt emotional issues (Anxiety, Depression, Other Psychological Disorders) Role of Cortisol on Brain Function ”STRESS” Management Techniques Meditation fMRI Studies Memory Studies brainH.E.A.L.T.H.TM Intervention H = HEALTHY EATING E = EMOTIONAL REGULATION A = ACTIVITY L = LEARNING STRATEGIES T = TOXICANT REDUCTION H = HABITS

brainH.E.A.L.T.H.TM Intervention Exercise Isometric Movement Cardiovascular Stretching/Yoga/Pilates Restorative Sleep Sex Joy Meaning and Purpose H = HEALTHY EATING E = EMOTIONAL REGULATION A = ACTIVITY L = LEARNING STRATEGIES T = TOXICANT REDUCTION H = HABITS

brainH.E.A.L.T.H.TM Intervention Neuropsychological Testing Specific strengths and weaknesses Emphasize the strengths, challenge the weaknesses BrainHQ and other brain training programs Individual Cognitive Rehabilitation Self-challenging Activities Video Clip H = HEALTHY EATING E = EMOTIONAL REGULATION A = ACTIVITY L=LEARNING STRATEGIES T = TOXICANT REDUCTION H = HABITS

brainH.E.A.L.T.H.TM Intervention Environmental Exposures Water Mold Heavy Metals Health and Beauty Aids No federal law since 1938 Environmental Working Group Skin Deep (ewg.org or EWG Healthy Living App) www.beautycounter.com/kristinelokken H = HEALTHY EATING E = EMOTIONAL REGULATION A = ACTIVITY L = LEARNING STRATEGIES T=TOXICANT REDUCTION H = HABITS

brainH.E.A.L.T.H.TM Intervention “I did then what I knew how to do. Now that I know better, I do better.” ― Maya Angelou brainH.E.A.L.T.H.TM Intervention H = HEALTHY EATING E = EMOTIONAL REGULATION A = ACTIVITY L = LEARNING STRATEGIES T = TOXICANT REDUCTION H = HABITS Knowledge has little power without implementation Begin with a good night’s sleep Then with a good breakfast Then a good morning routine ….and so on Continue in incremental steps until that criticial threshold is met

Emotional Regulation HEALTHY EATING Activity Participants will walk away with practical tips, tools, and information to transform fear and resignation into hope and determination Emotional Regulation HEALTHY EATING Activity Avoid Proc Carbs Avoid Sugar Easy Add Healthy Fats Clean Protien Mod No Sugar Alkaline Keto Diet Hard Rx Supplements Easy Self Care Remove Stressors Mod Meditate Daily Change Response Hard Add Movement Isometrics Easy 8 hrs restful sleep Cardio/Yoga/Wts Mod Meaning & Purpose Tabata/HIIT Hard

Toxicant removal LEArning Strategies Habits Participants will walk away with practical tips, tools, and information to transform fear and resignation into hope and determination Toxicant removal LEArning Strategies Habits Brain HQ Use it! Easy Cog Rehab Actively Engage Mod Self-Challenges Learn New Skills Hard Water Filters Swap HBA’s Easy Check Home, etc Detox (Pizzorno) Mod Fx Med Workup Invest in Treatment Hard Sleep Schedule Intermittent Fast Easy Good Breakfast Morn/Eve Routines Mod Daily Schedule Trouble Shooting Hard

Contact Info: Dr. Kristine Lokken lokken@bhibrainhealth .com tele#205-757-8947 www.bhibrainhealth.com LOCATION: 3125 Independence Drive, Suite 114 Homewood, AL 25309