Brain health is now a popular practice with more attention being drawn to this part of our being everyday. Dr. Nussbaum has proposed a 5 factor lifestyle to promote brain health to include (1) physical activity, (2) mental stimulation (e.g. brain games), (3) socialization, (4) spirituality, and (4) nutrition. While each of these factors has research-based activities that demonstrate a relationship to reduced risk of dementia, there has not been a study that measures the effect of all factors integrated into a comprehensive program.
Teaming with Emeritus Assisted Living, Dr. Nussbaum completed a six week pilot investigation on the effects of his brain health lifestyle on memory, mood, medical measures such as cholesterol, and quality of life. Twelve independent living and healthy adults (mean age 84) took part in the six week study and were compared to a control group of nine older adults. The two groups did not differ on age, education or other demographic variables. No study participants had dementia, psychiatric illness, or substance abuse.
Study participants completed one research based activity in each of the four factors on a daily basis and they consumed a special brain health diet for the nutrition factor. Controls simply lived their life with the same routine. Results include a significant improvement in delayed recall (20-25 minutes delay), reduced weight, enhanced quality of life as measured by self-report and staff based observations, and general knowledge of the human brain and brain health.
This is one of the first studies to look at the effects of a comprehensive lifestyle approach on brain health.
I was very proud of myself recently when I generated enough determination to quit my perceived addiction to caffeine in the form of coffee. While it is true that I only consumed one cup of coffee in the morning to get my jump on the day, it is also true that my brain demanded that one cup. I know this because when I stopped or missed my cup of coffee I felt a bit sluggish and then the headaches set in if I did not get the fix for several days. We refer to this as an addiction, though some do not like to hear that word to describe their (my) behavior.
After nearly one month of not consuming any coffee and getting through the withdrawal symptoms, I pick up a new research discovery in the Journal of Neuroinflammation (volume 6, 2008) that reports caffeine blocks disruption of blood brain barrier in a rabbit model of Alzheimer’s disease. It seems caffeine consumed in the equivalent of one cup of coffee daily protects against high cholesterol diet induced increases in disruptions of the blood brain barrier, and caffeine might be useful in the treatment of Alzheimer’s.
If high levels of serum cholesterol and disruption of the blood brain barrier are indeed underlying mechanisms in the pathogenesis of Alzheimer’s it suggests I need to reconsider starting my habit again!
The important message in the story is that we continue to monitor the new findings of lifestyle and brain health and change our behavior accordingly. This should not occur in an impulsive way. Rather, the negative effects need to be weighed against the positive effects of particular behaviors. For me, I think I will restart my consumption of coffee, but keep it to ½ cup a day. Moderation is typically a great idea. In the meantime, I will keep an eye out for replication of this finding on the relationship between caffeine and protection against Alzheimer’s.
A study published in online Neurology 3-27-08 indicates belly fat is linked to increased risk of dementia. Rachel Whitmer, a researcher at Kaiser Permanente Division of Research noted that belly fat increases the risk of diabetes, heart disease, and stroke. However, her research on 6,583 men and women ages 40-45 living in northern
California found that belly fat was also related to increased risk of dementia.
Indeed those who were obese (30 pounds or more over a healthy weight) and had collected belly fat in their 40s were 3.6 times more likely to develop dementia during the 30 to 40 year study. Even those who were not obese, yet had extra weight around the waist or belly, were 1.8 times more likely to develop dementia compared to those who were lean all over.Whitmer stated that “it is not simply about weight, but where you carry your weight.” She noted that people who are predisposed to carry their fat in their belly region may be at risk. Fat cells in the stomach secrete hormones that may play a role in diseases such as diabetes, heart disease, and now perhaps dementia.
The good news is that anyone with belly fat in their 40s can adopt a lifestyle of diet and exercise that can reduce such fat and reduce the risk of disease related to the fat. Time to get moving and eating healthier!
Stroke is a clinical term that describes cell death in the brain. Stroke is a permanent and can result in significant functional impairment and even death. There are two types of strokes. The first is the most common and is referred to as ischemia. Nearly 80% of all strokes are ischemic and involves a blockage of blood flow that results in cell death. The other 20% of strokes are hemorrhagic that involves a bleeding outward from a weakened artery wall. As the blood gathers increased pressure can be placed on the surrounding brain tissue causing additional damage to the brain.
Both types of stroke are dangerous and can result in deficits of language, attention, information processing speed, and motor skills. Risk factors for stroke include advanced age, high blood pressure, diabetes, obesity, smoking, and poor diet. Typical preventative measures for stroke include the same protocol as used for the healthy heart. We have learned relatively recently how important blood flow to the brain is, particularly when we recognize that the brain commands 25% of the blood from every heart beat.
It seems everyone knows what “stress” is and what it feels like. Most of us agree that stress typically does not feel very good and places the mind and body in a precarious position. We know many things can cause stress and some of the reaction of being stressed is subjective, based on a personal perception. These examples might include being in traffic, waiting for an elevator, waiting for the doctor, or having to deal with perceived incompetence. However, more life threatening stressors such as near death from a motor vehicle accident, child abuse, sexual trauma, war, etc. can impose a more chronic form of stress.
The brain reacts to stress by having a survival type instinct in which you will either run or fight the stressor. Some research indicates this is primarily a male response and that women may be better at actually working with the stressing agent to ameliorate the stress. Perhaps the latter is a more adaptive response to stress and might relate to the fact that women live longer than men.
If the stressor does not go away the effects of the stress can become chronic and result in a clinical condition known as Post-Traumatic Stress disorder (PTSD) or chronic anxiety. Both of these conditions seem to have a hormonal component underlying them in which an explosion of hormones are released in the body—“stress response” and if not turned off can potentially do damage to the body and brain. Some of the hormones such as cortisol and glucocorticoids can actually cause potential damage to the brain.
Animal and some human studies indicate that chronic stress with the persistent hormonal issue described above affects the hippocampus, structurally and functionally. The hippocampus is critical to memory and new learning and it is not coincidental that persons with chronic anxiety or PTSD have memory problems.
Most people understand that it is important to first identify what causes their stress and then to try and develop more adaptive coping strategies to manage the stress in their lives. However, most people probably do not understand that such stress, if not managed can become chronic and may be a negative influence on brain function.
It is a good idea to take some time and list two or three things that represent your chief stressors in life. Once you do this identify how you are presently coping or managing these stressors and try to determine how you might better reduce the negative effects of these stressors on your body and life.
Your brain operates electrically and chemically. Neurochemicals form the dynamic foundation for our thoughts and emotions. Many neurochemicals have been identified while many more have not. Neurochemicals important to mood include Serotonin, Neuropinephrine, Neuroadrenaline, and Dopamine. These neurochemicals remain in healthy balance for most of us, but for some there is imbalance and a mood disorder can result.
Effects of a mood disorder such as depression or mania include functional decline, interpersonal difficulty, and cognitive impairment. Depression is far more common than realized and represents a major chronic illness similar to high blood pressure. Depression not only affects the specific person, but it can also affect negatively those close to the patient and to potential colleagues. Depression and mania impairs thinking by reducing focus, attention, memory, and ability to execute plans. A depressed brain cannot process as deeply as necessary and this can result in rather significant cognitive impairment at times. Uncontrolled mania results in high distractibility, poor attention, and generally impaired cognitive functions across the board.
Treatments for mood disorder are effective and include use of antidepressants, mood stabilizers for mania, psychotherapy, and following a brain health lifestyle as espoused by Dr. Nussbaum (www.paulnussbaum.com). Use of software similar to that of FitBrains that helps to stimulate mental activity can also be of some use for a brain that may be sluggish. The most important thing is to first identify depression when it arises, take it seriously, and get some help.
I have proposed a five factor brain health lifestyle to include (1) Mental Stimulation (e.g. brain games), (2) Physical Activity, (3) Socialization, (4) Nutrition, and (5) Spirituality. For this blog I want to provide some information on the power of socialization.
Research teaches us that social isolation and segregation, particularly in the later years of life is related to increased risk of dementia. Dementia is a general clinical term that describes a decline in general intelligence, loss of memory, language or visuospatial deficit, change in personality, and decline in functional ability. Alzheimer’s Disease (AD) is the number one cause of dementia in the United States.
Other research indicates passivity in the forties is related to increased risk of dementia in later life. There is a relatively strong message to remain integrated and involved in something meaningful across your entire lifespan. It is also important to be engaged with other people and to develop strong relationships. A study this year taught us that loneliness actually increases the risk of dementia. It is not simply being with others, one needs to feel included and related to the group.
It is never too late to develop a personal inventory of your social network and relationships. Assess your life and determine if you are spending time doing the things that inspire you, more importantly that might inspire others. Socialization and all that is discussed in this blog is a brain health issue and one that should be taken seriously.