Aging Diseases that Affect the Brain

Treating medical conditions that become more common with age can lower risk for memory impairment and cognitive decline.

Many diseases that grow more common with age are associated with deterioration in brain health and cognitive decline, warns Deborah Blacker, MD, ScD, director of the Gerontology Research Unit in the Department of Psychiatry at MGH and a professor of psychiatry at Harvard Medical School.

“That’s why it’s important to get regular medical examinations to identify these illnesses as early as possible, and to follow your doctor’s advice about treatment so that damage to the brain can be prevented or reduced,” she says.

Consequences for the Brain

“People often don’t realize that medical conditions may have consequences beyond the local environment,” Dr. Blacker continues. “For example, a disease that affects the heart or thyroid is not isolated to that organ—it can have serious negative effects on the brain, as well.”

Among the aging diseases that can adversely affect the brain are:

WHAT YOU CAN DO

If finding the cause of your cognitive impairment is challenging, consider these options:

  • Ask your doctor if a medication may be causing your symptoms and can be changed.
  • Ask your doctor for a referral to a neurologist who specializes in cognitive problems.
  • Seek a mental health assessment to see if a mood disorder such as depression or anxiety may be causing cognitive problems.

▶ Atherosclerosis. The buildup of plaques in the blood vessels, which many people know increases the risk of heart attack and stroke, can also cause cognitive impairment. Treatment: Prevent plaque buildup by following recommendations for heart health: careful attention to cholesterol levels through diet and medications, treatment of high blood pressure, exercise, and maintaining a healthy weight.

▶ Hypertension, or high blood pressure, increases the risk of cognitive decline by causing tiny strokes, promoting atherosclerosis, and damaging white matter that relays signals among brain cells. Treatment: Hypertension is addressed through heart-healthy lifestyle changes, medication, reduction in salt intake, and stress reduction.

Atrial fibrillation (Afib), arrhythmia of the upper chambers of the heart, can cause the blood to pool and form clots that may move to the brain. These clots may trigger strokes linked to problems with cognition, and increased risk for dementia. Treatment: Afib can be treated with drugs to address underlying health problems, such as hypertension and inflammation, blood-thinning medications, and sometimes through interventions like cardioversion (a procedure in which cardiac arrhythmia is converted to a normal rhythm using electricity or drugs) or the implantation of a pacemaker.

▶ Diabetes, a condition characterized by chronically elevated levels of glucose (blood sugar), affects up to 27 percent of older adults in the U.S. Some are people who develop type 1 diabetes (caused by too little insulin) early in life, but the great majority have type 2 diabetes (insensitivity to insulin). Chronic high blood sugar and insulin are linked to impaired thinking and memory problems, although the exact mechanism isn’t clear. Treatment: Prevention of type 2 diabetes relies on maintaining a healthy weight and exercising, as well as consuming a healthy diet. These factors can also help reverse diabetes in its earliest stages, or at least minimize damage. Once diabetes is firmly established, medications, and sometimes insulin injections, may also be needed to maintain healthy glucose levels.

▶ Respiratory disease. Lung function declines and lung conditions such as pneumonia, chronic obstructive pulmonary disease (COPD) and emphysema become more common with age, reducing delivery of oxygen to the brain and increasing risk for cognitive decline and dementia. Treatment: Smoking cessation is key to preventing COPD and emphysema, and reducing risk of pneumonia. Regular checkups to spot lung problems, as well as flu shots and a pneumonia shot, may also help protect your lungs. See a doctor if you are short of breath or develop a persistant cough. Drugs and breathing treatments can help with lung disease, as can supplementary oxygen and other therapies.

▶ Anemia, a condition characterized by abnormally low numbers of red blood cells, affects an estimated 23 percent of seniors. Red blood cells deliver oxygen to the body and also the brain, where they are critical to maintaining cognition. Treatment: A number of conditions may cause anemia, notably vitamin B12 deficiency, which can also lead to cognitive impairment directly, and is treated with pills or shots. Other causes of anemia include iron deficiency and kidney failure.

Depression involves a change in mood (sadness or loss of pleasure), often accompanied by changes in sleep, appetite, and energy, and problems with concentration, memory, and thinking. Treatment: Mild depressionmay improve with lifestyle changes, such as exercise and social engagement, but the full syndrome requires medications or formal talk therapy.

▶ Thyroid problems. Hypo-thyroidism (low function of the thyroid gland) affects about one in 10 older adults, causing slowed mental processes, deficits in attention and memory, and confusion. Treatment: Hypothyroidism is addressed with thyroid hormone replacement therapy.

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