Monday, March 29, 2010

Improving the Aging Brain

I just finished a course on The Aging Brain. I was very interested in how to reduce the risk of brain deterioration and Alzheimer’s Disease (AD) and Dementia in particular. What would you guess is the best thing you can do? If you answered exercise, you would be correct. A fast-paced workout boosts the production of a brain nourishing protein called brain-derived neurotrophic factor (BDNF). Exercise builds better connections between brain cells and increases the production of new cells in the hippocampus, the region of the brain involved in learning and memory. Exercise is the most powerful way to prevent cognitive decline and delay the onset of AD.

Something to add to your exercise program is intellectually engaging activity. It protects against memory loss, decreases beta amyloid levels (a key factor in AD), and increases synaptogenesis (increase of connections). Keep making your life interesting by taking on new mental challenges.

More research is pointing to diet as central to brain health. The Mediterranean Diet appears to be the healthiest for the brain. This is a diet high in vegetables, fruit, whole grains, nuts, fish, olive oil, low in saturated fat, and a modest amount of wine. Diets high in saturated fat cause cognitive decline.

The leading theory of the cause of aging is free radicals. Many diseases are linked to free radical oxidative damage, which is viewed as a slow “rusting” of our organs and tissues. There is nothing we can do to stop it, but many things we can do to slow it down. Along with eating a healthy diet, we can supplement with Vitamin E (d type) 400mg, Vitamin C 500mg, Vitamin B complex of 50mg, Folate 800mcg, Vitamin B-12 1000 mcg, Zinc 40mg, Selenium 400mcg, Coenzyme Q10 100mg, and Lipoic Acid 100mg.

Keep your overall stress level down. Acute stress is needed for a healthy body and brain. When the stress becomes chronic, however, the high levels of cortisol damage the brain’s hippocampus, the area important for short-term memory. Over time, the hippocampus shrinks, leading to memory deficits and cognitive impairment. In my office, I offer several strategies to break the chronic stress cycle. These include HRV training, Alpha-Stim SCS, and the Symmetron.

Other things you can do that will reduce your risk are to maintain normal blood pressure (especially systolic) and keep your cholesterol levels within normal range. Of course, I recommend non-medication strategies to achieve these goals, and can coach you on how to lower these risk factors.

As we age beyond 40, it is almost inevitable that we begin to forget things. Age-associated memory impairment (AAMI) is part of normal aging and is not a sign that AD will occur. There is a relatively small cognitive loss that tends not to get worse with AAMI. Wisdom, judgment, and language skills remain stable. In contrast, AD starts decades before symptoms appear. In the Latent Period, there is no cognitive impairment, but beta-amyloid plaques are forming. The second stage of AD is Mild Cognitive Impairment (MCI), which appears very similar to AAMI’s short term memory problems.

If you are concerned about whether you have memory impairment, you can take a free on-line test at http://www.preventad.com/.

If you are concerned about whether you have AD or AAMI, you can take an on-line MCI test administered in my office. The MCI Screen is reported to be 97% accurate in discriminating between MCI vs. normal aging and costs $75.

Unfortunately, the course I took did not address factors that might cause Alzheimer’s Disease or Dementia. The presenter was very cautious about environmental or lifestyle influences that might directly cause these disorders. We have a lot to learn yet in this area, and I hope that more research will answer these important questions.