Published April 17, 2025
Sometimes it’s the overlooked therapies—those a little off the beaten path—that shine a light on what’s really driving dementia. We’re learning that neurodegeneration often stems from a slow burn: neuroinflammation (from genetics, lifestyle, or even infections), vascular dysfunction, and deficiencies that quietly accumulate, eventually tipping brain chemistry into dysfunction. Here are four tools worth discussing:
1. Lithium: Not Just for Mood Anymore
While traditionally used for bipolar disorder, lithium has quietly emerged as a promising neuroprotective agent. Multiple studies now suggest it may reduce the risk of dementia, including Alzheimer’s disease:
- A large retrospective study showed patients on lithium had nearly 50% lower dementia risk (HR ~0.56). [Chen et al., 2022]
- A randomized trial in older adults with MCI found that low-dose lithium slowed cognitive decline and improved Alzheimer-related CSF biomarkers. [Forlenza et al., 2019]
- A 2024 meta-analysis confirmed these effects, showing a 41% reduction in Alzheimer’s risk and 34% reduction in overall dementia. [Lu et al., 2024]
The caveat? Lithium isn’t a supplement; higher doses require careful monitoring due to potential effects on thyroid, kidneys, and neurological function.
That said, some clinicians and researchers are exploring low-dose or microdose lithium, including lithium orotate (available over-the-counter, often in 1–5 mg doses). While it doesn’t require prescriptions, unfortunately there’s minimal research on its efficacy or safety at these doses. Until more data emerges, I don’t routinely recommend OTC lithium, but it’s an area to watch closely.
2. Losartan: A Blood Pressure Pill with Brain Benefits?
Losartan, a common angiotensin receptor blocker (ARB), might offer more than cardiovascular protection. In animal models, it has:
- Reduced brain inflammation
- Improved memory performance
- Protected against Alzheimer-like changes [Royea et al., 2017; Ongali et al., 2014]
Mechanistically, losartan appears to support cerebrovascular health by interacting with brain angiotensin receptors (AT1 and AT4), reducing oxidative stress and improving blood flow.
In humans, results are mixed. The RADAR trial didn’t show significant effects on brain atrophy in Alzheimer’s over 12 months. [Kehoe et al., 2021] However, a meta-analysis suggests ARBs, including losartan, significantly reduced dementia risk compared to other antihypertensives. [Scotti et al., 2021]
If you’re on blood pressure medication—especially if you’re at elevated dementia risk—losartan may offer a modest edge worth exploring.
3. Omega-3s: The Brain’s Favorite Fat
The brain thrives on omega-3s, especially EPA and DHA. Here’s what the data says:
- A meta-analysis of over 100,000 participants found that higher omega-3 intake reduced dementia risk by 20%. [Lu et al., 2024]
- In the Alzheimer’s Disease Neuroimaging Initiative, long-term omega-3 users had a 64% lower risk of developing Alzheimer’s.
- A network meta-analysis showed EPA-dominant formulas (1500–2000 mg/day) combined with antioxidants provided the strongest benefits in slowing cognitive decline.
These fats reduce inflammation, enhance neuronal membrane fluidity, and may reduce amyloid plaque formation—key contributors to neurodegeneration.
In clinic, I typically recommend 1,000–2,000 mg of combined EPA + DHA daily, taken with food. Brands like Nordic Naturals or Carlson’s are reliable options.
4. Shingles Vaccine: A Surprising Ally in Dementia Prevention
Emerging research indicates that the shingles vaccine may offer more than just protection against varicella-zoster—it could also help protect against dementia. A 2024 study published in Nature Medicine reviewed data from over 200,000 individuals and found that those who received the recombinant shingles vaccine (Shingrix) had a 17% lower risk of developing dementia over six years compared to those who received the older live-attenuated vaccine. The effect was consistent across sexes but particularly notable in women. While the mechanism isn’t fully understood, it’s believed the vaccine may reduce neuroinflammation or prevent viral reactivation in neural tissue—both contributors to cognitive decline. This adds another compelling layer to the public health value of routine vaccination.
Bonus: The Lifestyle Multivitamin for Your Brain
The FINGER trial—a landmark Finnish study—showed that a multi-domain lifestyle approach (exercise, diet, brain training, vascular monitoring) meaningfully slowed cognitive decline in older adults at risk.
Exercise in particular boosts BDNF (brain-derived neurotrophic factor)—essentially Miracle-Gro for your neurons. A colorful, Mediterranean-style diet, restful sleep, and social engagement round out the core pillars of brain preservation.
In Summary: A Systems Approach to Cognitive Health
What do lithium, losartan, omega-3s, and the shingles vaccine have in common? They all appear to work—at least in part—through neuroinflammation reduction, cerebrovascular support, or immune modulation.
Here’s your brain health checklist from today’s newsletter:
- Keep an eye low-dose lithium; research is promising – more needed
- If hypertensive, consider losartan might be a smart option – others in this family also seem to show promise (for ex Telmisartan – there are both angiotensin receptor blockers)
- Take omega-3s daily for cognitive and cardiovascular support
- Consider the shingle vaccine
- Commit to movement, nutrition, rest, and relationship
Some interesting angles on a pressing problem – dementia. It’s about applying evolving science with grounded curiosity – as we look for sound preventative strategies for neurodegenerative disorders.
God bless.
Dr Ponke
Forest DPC
Leave a comment