Why Are Mitochondria Important in Dementia and Other Neurodegenerative Diseases?
Last Updated: November 2025
Medically Reviewed by Dr Jessica Knape, MD MA. Board Certified in Internal Medicine and Integrative and Holistic Medicine
Brainspan Brief
Mitochondria supply 90% of the brain’s energy and are essential for memory, learning, and repair.
When mitochondria are damaged (by toxins, inflammation, infections, or aging), neurons lose energy and die off faster.
Mitochondrial dysfunction is a hallmark of Alzheimer’s, Parkinson’s, ALS, and other neurodegenerative conditions.
Testing can identify early mitochondrial decline through metabolic and oxidative stress markers.
Lifestyle, nutrition, and targeted therapies can restore mitochondrial performance and slow brain aging.
Key Points
Brain cells require massive amounts of energy to function.
Mitochondrial damage causes oxidative stress and neuroinflammation.
Mitochondria regulate apoptosis (cell death), calcium balance, and neurotransmitter function.
Impaired energy metabolism accelerates protein misfolding and synaptic loss.
Mitochondrial health can be supported through nutrition, exercise, and precision supplementation.
Summary
Mitochondria are the tiny power plants inside nearly every cell in your body—but in your brain, they’re mission-critical. These structures convert food and oxygen into the energy (ATP) that keeps neurons firing, synapses communicating, and thoughts flowing. When mitochondria falter, the brain loses its fuel supply, leading to fatigue, slower processing, and over time, neurodegenerative change.
Mounting research shows that mitochondrial dysfunction is a core driver of dementia, Parkinson’s, and other neurodegenerative diseases. Protecting mitochondrial health may be one of the most important—and overlooked—strategies for maintaining memory and cognitive vitality as we age.
At HealthSpan Internal Medicine in Boulder, CO, we focus on restoring mitochondrial efficiency and reducing inflammation to protect long-term brain health.
What Are Mitochondria—and Why They Matter So Much for the Brain
Each neuron contains hundreds to thousands of mitochondria, constantly working to produce ATP—the molecule that powers every thought, memory, and movement. The brain, while only 2% of body weight, uses about 20% of total energy.
Healthy mitochondria keep neurons charged, remove waste efficiently, and coordinate with glial cells to maintain balance. When these energy producers fail, neurons become unstable, inflammation increases, and communication between brain cells begins to break down.
Mitochondrial Dysfunction in Dementia
Research over the past two decades has identified mitochondrial dysfunction as one of the earliest and most consistent findings in Alzheimer’s disease and related dementias. Even before plaques and tangles appear, mitochondrial activity in neurons declines.
This dysfunction causes:
Reduced ATP production → neurons can’t maintain electrical signaling.
Oxidative stress → free radicals damage membranes, proteins, and DNA.
Impaired calcium regulation → leads to excitotoxicity and cell death.
Altered gene expression → changes in how neurons manage repair and detox.
These changes set the stage for beta-amyloid and tau buildup, two hallmarks of Alzheimer’s. In fact, some scientists now believe these protein deposits are byproducts of mitochondrial failure rather than the primary cause.
Mitochondria in Other Neurodegenerative Diseases
Parkinson’s Disease: Mitochondrial damage in dopamine-producing neurons of the substantia nigra leads to energy loss, tremor, and motor decline.
ALS (Amyotrophic Lateral Sclerosis): Defective mitochondrial transport within neurons leads to progressive motor neuron death.
Multiple Sclerosis (MS): Chronic inflammation and demyelination damage mitochondria, accelerating fatigue and cognitive decline.
Chronic Fatigue and Post-Viral Syndromes: Viral or inflammatory hits (including COVID-19) can temporarily shut down mitochondrial energy production, leading to “brain fog” and exhaustion.
What Causes Mitochondrial Damage?
Inflammation: Cytokines and oxidative stress injure mitochondrial membranes.
Toxins: Heavy metals, pesticides, and mold mycotoxins interfere with electron transport.
Nutrient deficiencies: Low B vitamins, magnesium, CoQ10, or carnitine impair ATP generation.
Infections: Viral or bacterial insults can trigger mitochondrial shutdown to limit pathogen spread.
Hormonal decline: Estrogen, thyroid, and testosterone support mitochondrial density and function.
Sedentary lifestyle: Physical inactivity reduces mitochondrial biogenesis (the creation of new mitochondria).
Symptoms of Mitochondrial Decline in the Brain
Brain fog or slowed thinking
Memory lapses or word-finding difficulty
Fatigue, especially after mental effort
Low stress tolerance
Poor sleep or mood changes
Exercise intolerance or prolonged recovery
These symptoms often appear long before a formal dementia diagnosis. Identifying mitochondrial decline early offers a window for intervention.
How Mitochondrial Dysfunction Is Evaluated
At HealthSpan Internal Medicine, we use functional and traditional diagnostics to detect early mitochondrial stress.
1. Bloodwork and Nutrient Testing
Comprehensive metabolic panel (liver and kidney support)
Fasting insulin and glucose (metabolic efficiency)
B vitamins, vitamin D, CoQ10, magnesium, carnitine
Oxidative stress markers (8-OHdG, lipid peroxides)
2. Advanced Functional Testing
Organic acids test: evaluates mitochondrial intermediates and nutrient cofactor needs.
Lactate/pyruvate ratios: detect blocked energy metabolism.
Inflammatory and immune markers (CRP, cytokine panels).
3. Cognitive and Functional Testing
MoCA or CNS Vital Signs for memory and processing speed
VO₂ max or mitochondrial fitness testing for whole-body energy performance
4. Imaging (if indicated)
MRI or PET scans can identify metabolic changes in specific brain regions.
How We Support Mitochondrial Health and Brain Function
Treatment focuses on restoring energy production, reducing oxidative damage, and improving metabolic flexibility.
1. Nutrition for Mitochondria
Mediterranean-style diet rich in antioxidants (berries, leafy greens, olive oil).
Adequate protein for amino acids that repair enzymes.
Controlled fasting or time-restricted eating to stimulate mitophagy (clearing damaged mitochondria).
Reduce refined sugars and seed oils that promote oxidative stress.
2. Foundational Nutrient Support
CoQ10 and PQQ to enhance ATP production.
Acetyl-L-carnitine to transport fatty acids into mitochondria.
Alpha-lipoic acid as an antioxidant and energy cofactor.
B-complex (B1, B2, B3, B5) for enzyme support.
Magnesium and omega-3 fatty acids for nerve and membrane stability.
3. Exercise and Oxygenation
Aerobic activity increases mitochondrial density.
Resistance training boosts brain-derived neurotrophic factor (BDNF).
Breathing exercises and outdoor movement improve oxygen delivery.
4. Targeted Therapies
Peptides like SS-31 or MOTS-c (under research) to enhance mitochondrial resilience.
Hormone optimization (thyroid, estrogen, testosterone) for energy and repair.
Stress reduction: mindfulness and sleep improve mitochondrial turnover.
5. Address Underlying Causes
Remove environmental toxins or mold exposure.
Treat infections and chronic inflammation.
Optimize gut health (the microbiome influences mitochondrial signaling).
Recovery and Prevention Timeline
Improvements in mental clarity and energy often appear within 4–8 weeks of treatment.
Long-term mitochondrial restoration and cognitive resilience build over 6–12 months with consistent nutrition, exercise, and medical support.
When to Seek Medical Evaluation
You should be evaluated for mitochondrial or metabolic causes of cognitive symptoms if you experience:
Persistent fatigue or “brain fog”
Family history of dementia with early onset
Neurological symptoms following toxin or infection exposure
Poor exercise tolerance or unexplained depression
Early intervention offers the best chance to prevent or slow neurodegenerative changes.
How We Help at HealthSpan Internal Medicine
At HealthSpan Internal Medicine in Boulder, CO, we evaluate the full landscape of brain and cellular health—including mitochondrial, hormonal, infectious, and environmental influences.
Our mitochondrial optimization programs include:
Functional testing for metabolic and oxidative stress.
Personalized nutrition and supplementation.
Mitochondrial and peptide therapies.
Neurocognitive monitoring and exercise prescription.
Long-term prevention planning.
Our mission is to help patients restore energy, protect cognition, and age with vitality.
Sources
1. Mitochondrial Dysfunction Is a Core Mechanism in Alzheimer’s Disease
Swerdlow RH.
Mitochondria and mitochondrial cascades in Alzheimer’s disease.
Journal of Alzheimer's Disease, 2018.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711672/
2. Mitochondrial Failure Leads to Neuronal Energy Crisis & Cognitive Decline
Wang W, et al.
The role of mitochondria in neurodegenerative diseases.
Neuron, 2014.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066491/
3. Oxidative Stress and ROS Damage Drive Neurodegeneration
Zheng J, et al.
Mitochondrial dysfunction in neurodegenerative diseases: molecular insights and potential therapeutic targets.
Redox Biology, 2022.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213376/
4. Mitochondrial DNA Damage Correlates With Cognitive Impairment
Rice AC, et al.
mtDNA damage and oxidative stress in neurodegeneration.
Frontiers in Aging Neuroscience, 2021.
https://www.frontiersin.org/articles/10.3389/fnagi.2021.670497/full
5. Mitochondria Regulate Neuroinflammation & Synaptic Plasticity
Joshi AU, et al.
Mitochondrial function and inflammation in neurodegenerative disease.
Nature Reviews Neuroscience, 2020.
https://www.nature.com/articles/s41583-020-0323-z
6. Impaired Mitochondrial Dynamics (Fission/Fusion) Are Linked to Dementia
Knott AB, Bossy-Wetzel E.
Impairments in mitochondrial dynamics promote neurodegeneration.
Nature Reviews Neuroscience, 2008.
https://www.nature.com/articles/nrn2275
Medically reviewed by
Dr. Jessica Knape, MD, MA Board Certified in Internal Medicine and Integrative and Holistic Medicine
Healthspan Internal Medicine — serving patients in Boulder, CO
Book a Discovery Call | About Dr. Knape
This content is for educational purposes and does not replace personalized medical advice.
