At the inaugural Swisse Preventative Health Symposium held in Melbourne last Friday, I was privileged to hear a fascinating address by Professor David Smith, Professor Emeritus, University of Oxford on “the role of nutrition in the prevention of cognitive impairment”.
He classes dementia as a disease – not an inevitable part of ageing and certainly not necessarily linked to genetic profiles.

Bearing in mind we have no cure for dementia (and in his view, there might never be), there are some definitive roles that we pharmacists can play.

I’m sure that you are well aware of the methylation pathways in our body and the role of elevated levels of homocysteine in the development of a number of inflammation-related chronic disease.

Mental health and cognition are heavily involved in this pathway.

Essentially, there’s a close correlation, according to the research he presented, between the levels of omega-3 in our brain and the levels of B-vitamins. The latter play a vital role in the methylation pathway, whereby homocysteine levels are controlled.

Experts up until now, have identified each of these nutritional involvements in cognitive decline, but we know now that one nutrient is intimately linked to the other.

The B-vitamins are of no use unless omega-3 levels are adequate.

Omega-3 levels can be measured currently by the Omega-3 Index test that is available to pharmacists at this stage, and soon available for sale to our patients. A simple finger-prick test gives the omega-3 levels in red blood cells.

Admittedly, the blood test gives results for cardiovascular omega-3 levels, but in his view, those levels will be duplicated in the brain.

Here, at last, in a realistic way we can be involved in reducing dementia risk and slowing cognitive decline.

Or, do we really want to be involved at all?
The other option is  to continually dispense Alzheimer’s drugs where the evidence of benefit is rather flimsy?
Family members and carers are naturally concerned for their own mental health.
Choose therefore the best combination of B-vitamins – not something that is available at the grocery store.

I term this “informed medicine” as distinct from the academically demanded “evidence-based medicine”. The evidence is there, but don’t waste your time by getting bogged down in it.

Take responsibility for the combination and brands you choose, and prescribe 1000mg of krill oil night and morning. Encourage your patients to use the Omega-3 Index test to demonstrate how their omega-3 levels rise after supplementation.

Admittedly, there’s no Guild-endorsed protocol here with a fixed fee attached.
No forms to fill in.
No complicated strategies to follow.

Just plain, simple, sincere care for your patients.