For those who worry about developing dementia in older age, here’s some very good news: Three important studies released in 2014 suggest that there are specific steps we can take to increase the likelihood of preserving our brainpower as we age.
The research provides evidence that combining a group of lifestyle strategies to simultaneously address multiple dementia risk factors (e.g., poor nutrition, obesity, physical inactivity, cardiovascular risk factors, depression, social isolation, and lack of mental stimulation) can possibly help delay or slow the development of Alzheimer’s disease (AD) or cognitive decline, even in older, at-risk populations. With a doctor’s approval, you can carry out these strategies on your own.
“The research findings support many of the results of earlier studies that focused primarily on lowering risk for dementia by modifying single risk factors, such as lack of exercise or high blood pres-sure,” says Jennifer Gatchel, MD, PhD, a psychiatrist and neuroscientist at Massachusetts General Hospital (MGH) and McLean Hospital who specializes in disorders of aging.
“These new studies, however, raise the possibility that the synergistic effect of simultaneously targeting multiple risk factors may have some effect in certain individuals in promoting successful cognitive aging and possibly protecting the brain from AD and other dementias.”
Sample Day’s Schedule for a Brain-Healthy Regimen
Below is a simplified example of a brain-healthy regimen. Use it as a template to help you devise your own personalized plan, with input and approval from your doctor.
7:30AM: Breakfast. Spinach omelet; slice of whole-wheat toast with jam; ½ cup of fresh strawberries; tea, coffee
9:30AM: Exercise. Strength training for 20 minutes, or 30 minutes of brisk walking, bike riding, or other aerobic activity.
11:00AM: Challenging activity. Read the newspaper or search the Internet for the day’s news. Play a computer game, or engage in an activity that pro-motes socialization, such as visiting a museum with a friend or volunteering for a community organization
1:00PM: Lunch. Green salad with avocado and cold steamed salmon, oil and vinegar dressing. Iced tea, seltzer with lemon, or water
2:30PM: Challenging activity. Attend a community meeting, memorize a poem, play a game of chess with a friend, or take in the latest movie with your signit-icant other. Exchange emails with your friends.
7:00PM: Dinner. Green salad with tomato, oil and vinegar dressing; ½ broiled chicken breast with lemon and herbs; ½ cup of brown rice; steamed broccoli; fresh fruit cup; seltzer with lemon, water, or one 4-ounce glass of wine.
8:00PM: Mild physical exercise. Take a leisurely walk around the block.
9:00PM: Stress Reduction. Wind down your day by engaging in a quiet activity, such as reading. Sit quietly with your eyes closed for 15 minutes. Use progressive relaxation, alternately tightening and releasing each muscle group from feet to head until you are completely relaxed.
The three 2014 studies examined whether addressing a combination of risk factors for AD and other dementias—which are multifactorial disorders—might be more effective than addressing isolated risk factors.
One study represented the first large randomized controlled trial testing this approach. Working with 1,260 participants ages 60 to 77 with modifiable risk factors for dementia, the researchers administered cognitive tests and then randomly assigned participants to one of two groups. The intervention group took part in a program of high-intensity lifestyle interventions that included physical exercise, computer-based cognitive training, nutritional guidance, and management of cardiovascular risk factors. The control group received only health advice.
After two years, the intervention group scored about 40 percent higher on cognitive tests than the nonintervention group, and performed significantly better on tests of executive function, memory, and speed of in-formation processing. The older and/or more impaired a participant was at the beginning of the study, the greater were the benefits of intervention, according to a paper presented at the Alzheimer’s Association International Conference in July 2014.
In a second study, published in August 2014 in The Lancet Neurology, a close examination of world population data revealed that approximately one-third of AD cases worldwide were attributable to modifiable risk factors. The study authors suggested that AD incidence might be significantly reduced through improved access to education, diagnosis and treatment of depression, and more effective management of vascular risk factors such as physical inactivity, smoking, hypertension, midlife obesity, and diabetes.
A third study, published in The World Alzheimer Report 2014 on Sept. 16, 2014, essentially blamed the same modifiable risk factors for a significant proportion of dementia cases and suggested that lifestyle changes in these areas might help lower rates of dementia worldwide.
Formulating a plan
“The research doesn’t conclude that by adopting a healthier lifestyle you can definitely avoid cognitive impairment as you age, but it certainly suggests that lifestyle changes may stack the odds in your favor,” says Dr. Gatchel. “Incorporating the findings from these studies into a blueprint for a healthy daily regimen would likely provide many benefits for your brain. You would also do well to incorporate other lifestyle strategies linked to lower risk for dementia, such as reducing stress, enjoying regular social interaction, and regularly getting sufficient, restful sleep at night.
Address Dementia Risk Factors With This Blueprint for Brain Health
Gatchel recommends consulting with your medical care provider before making significant changes in your lifestyle. With your doctor’s approval, consider working toward the following goals as part of your 2015 Blueprint for Brain Health:
- Get Regular Exercise. Physical exercise lowers stress, improves blood flow to the brain, and promotes growth factors that strengthen communication among neurons. With your doctor’s assistance, you can adapt your regimen to your level of physical strength, balance, and medical health. Aim for 30 minutes of aerobic exercise (such as brisk walking, dancing, or biking) five or more days a week, and at least 20 minutes of strength training twice weekly.
- Eat A Healthy Diet. Choose nutritious, low-fat foods to provide your brain with the fuel it needs to function at its best, and drink at least eight glasses of water daily to keep brain cells well hydrated. Consume complex carbohydrates (such as whole grains, legumes, vegetables, fruits), which supply glucose needed to provide energy for brain functioning. Avoid overconsumption of sweets, sodas, and other sources of excess sugar. Protein—found in animal products such as lean meat, fish, poultry, eggs, and low-fat dairy products, nuts and beans—provides energy and is essential for cell maintenance and growth. Healthy fats provide energy and are important for the absorption of certain vitamins. Choose omega-3 fatty acids (found in cold-water fish, nuts and flaxseed oil), monounsaturated fats including olive and canola oils, and polyunsaturated fats (found in vegetable oils derived from corn, safflower or sun-flower seeds). Avoid trans fats and saturated fats. Micronutrients such as antioxidant vitamins, minerals, and phytochemicals (healthful compounds found in plants) are vital to optimal brain functioning. Good sources of these micronutrients include colorful fresh fruits and vegetables, legumes, liver, oysters, seeds, nuts and green tea.
- Challenge Your Brain. Demanding activities that call on different aspects of your intellect add to the protective effects associated with educational attainment to provide the brain with extra cog-nitive reserve and help keep your mind efficient, flexible and able to focus. You can challenge your brain by adding to your knowledge, exposing yourself to new ideas, and engaging in activities that are mentally stren-uous and require concentration, such as doing math problems in your head, participating in computer training programs, or solving brain teasers.
- Manage Cardiovascular Risk Factors. The health of your heart and circulatory system has a direct effect on brain health and functioning. Get regular checkups, and follow your doctor’s recommendations for improving heart health through strategies such as quitting smoking, losing weight, in-creasing physical activity, and managing high blood pressure and diabetes.
- Get Treatment for Depression. Numerous studies have linked major depression with increased risk for cognitive decline. Individuals who experience feelings of sadness, hopelessness, lack of en-ergy, and other symptoms of depression for two weeks or more should seek professional assessment.