Size Might Just Matter After All

We have known for some time that some persons do not manifest the clinical pathology of Alzheimer’s disease (AD) even though their brains have the hallmark plaques and tangles at autopsy. How this occurs is still not known, but one theory is that those persons who are able to fight the clinical aspects of the disease off may have more brain reserve, developed over the course of their lifetime. It is further thought that particular lifestyle factors such as exposure to enriched, novel and complex environments can help to build reserve.

A new study indicates that the size of the hippocampus, the structures that lie deep in the temporal lobe and help to form new memories and learning, may be important. Researchers at Oregon Health and Science University in Portland found that those persons who avoided dementia had larger hippocampi relative to those who did not avoid the manifestation of the disease. Both groups had the pathologic markers of AD.

Interestingly, the researchers did not find any difference in the two groups on education level or socioeconomic status. However, the study did not explore what the person did in their lifetime, the type of activities he or she pursued, or the quality of learning after graduation. While education level has correlated with reduction in the risk of dementia in other studies, the hippocampus may be stimulated by much more than formal education.

This is most likely the case given the research in 1998 that found the human hippocampus can generate new brain cells. Our goal should be to grow larger hippocampi through enriched environments across our lifetime as a health promoting behavior (see Dr. Nussbaum’s brain health lifestyle www.paulnussbaum.com). In this case, it is to potentially delay onset of dementia.

Lifestyle and Brain Health Early in Life

Two recent studies have further underscored my long held belief that many diseases, including those of the brain, actually begin early in life, perhaps even in childhood. The idea that a disease is proactive demands that we are adopt an equally proactive healthy lifestyle.

One study found that high cholesterol levels in the 40s may raise the chance of developing Alzheimer’s Disease (AD) decades later. The findings presented at the American Academy of Neurology in Chicago studied over 9,000 people in California and found that those with high cholesterol levels between the ages of 40 and 45 were about 50 percent more likely than those with low cholesterol to later develop AD.

Another study from Sweden found those with diabetes in midlife are 1.5 times more likely to develop AD later in life. This study followed over 2000 men for 32 years and while other risk factors for AD were found, the most significant was low insulin secretion in midlife.

These studies and others indicate the lifelong development of AD and that we really should not consider this disease a late life disorder. The studies also underscore our need to develop interventions much earlier in life and to adopt a brain healthy lifestyle (e.g. brain fitness) regardless. Such a lifestyle should be a national priority and begin in early childhood if not earlier.

Golden Era for Brain Health

What a great time to be alive if you are interested in your own brain and how to promote its health! With the daily reports of a new finding on how to promote brain health, the development of new companies with products for brain fitness (e.g. brain games), and with the boomers generating a booming interest in this part of their being, we really are in the “golden era of brain health.”

I am so very fortunate to have been involved with brain health more than a decade ago and to witness what I described then as the emerging “Brain Wave” that was coming. It is here and we will all be better for the fact that the human brain has found its way onto the radar screen of health.

A national and world wide discussion of the human brain with a focus on proactive lifestyle towards promotion of brain health is a great and needed thing. Dementia is a real problem and a growing concern. We have the ability to be proactive and to focus on an optimistic and positive path forward as we try to implement research-based behaviors to brain reserve. By building our own brain reserve across our lifespan we probably increase our chances of delaying the onset of neurodegenerative diseases such as Alzheimer’s.

The next step to this growing brain wave is for the governmental bodies to pass legislation that incorporates national emphasis on the brain similar to what we have done for the heart; for health care payers to include incentives for leading a brain health lifestyle that might recognize lifelong learning, brain fitness, use of pedometers, diet, and meditation as critical ingredients to brain health, and for continued innovation in the business world to apply research to the market.

What a great day to be interested in promoting your own brain health!

Exercise Very Important For The Brain

We have no cure or perfect prevention against progressive dementia such as Alzheimer’s disease (AD). However, research over the past decade or more has established consistent links between lifestyle and the ability to delay the onset of such dementias. I have proposed a “Brain Health Lifestyle” to include five major factors: (1) physical activity, (2) mental stimulation, (3) socialization, (4) nutrition, (5) and spirituality.

A recent interview on ABC News suggested that physical exercise may be the best means of preventing AD today, better than medications, intellectual activity, and supplements. Studies on mice bred to develop plaques in their brains consistent with AD were exposed to an exercise regimen or not. Those mice that exercised had 50 to 80 percent less plaque than the brains of mice that were passive. Other studies have demonstrated generation of new brain cells in animals that exercise and a relationship in humans between physical exercise and increased cognitive performance.

One important point is that our body does not operate in a fragmented manner. I describe the brain and body as a miraculous symphony. One system directly impacts another and both health and disease effects can be experienced as a result throughout the body. Exercise is one example of a behavior that has positive impact on multiple systems of the body including the brain. The same can be said for the other four brain health lifestyle behaviors noted above.

While I am not yet sure that any one behavior such as exercise is better than another in promoting brain health, I do champion regular exercise as a very important behavior with positive brain health effects. My view is to approach brain health from an integrated manner using the five part brain health lifestyle. This approach fits with the complex integrated reality of our bodies and brains.

National Brain Health Policy

A recent report from the National Alzheimer’s Disease Association estimates nearly 10 million to 14 million of the baby boom generation (76 million strong) will be at risk for developing Alzheimer’s disease (AD). These numbers may actually underestimate the overall prevalence of boomers who will develop AD in their lifetime. This estimate places a heavy emotional, family and economic burden on the U.S. States given our current approach and over all understanding of the caregiver demands posed by AD. There is no reason to believe that similar nations across the world will be any different.

One method to begin addressing the rising epidemic of dementia is to establish a national or world priority on the human brain and dementia. Citizens of the great planet Earth need to have a basic understanding of their brain, something that is completely missing even in 2008. We cannot expect citizens to care for their brain if they do not understand it or the importance of a proactive healthy lifestyle across their lifespan. One idea is to include basics of brain and brain health in every elementary curriculum in the world.

National policy also has to prioritize research on treatment and prevention of dementia in ways we have not yet. Research is needed on how the brain functions, how diseases begin, new treatments for dementia, and innovation in the area of prevention. Health insurance companies should begin to incentivize lifestyles that promote brain health including lifelong learning, diets, meditation, and physical exercise. Those who continue to work or remain involved in society may be rewarded with some type of tax break. We need to think in terms of a Brain Enlightened Society.