Brain Health Now and for the Long Run

If you ask people what is it about aging that concerns them most, you'll likely hear a lot about financial security and heart disease, but increasingly, worries about brain health and cognitive decline are right up there in importance. And it's not just seniors.

In the Brain Health Research Study published by the AARP in 2014, 41 percent of adults aged 34 to 49 ranked brain health as the most important component in their overall health.

Dr. Edward Marcantonio, Director of the Aging Research Program at Beth Israel Deaconess Medical Center and Professor of Medicine at Harvard Medical School, sees this as a good sign. He says that some cognitive changes are to be expected with aging; however, in addition to avoiding serious illness to the extent it is preventable and avoiding injuries to the brain, there's a lot that can be done in the way of prevention.

"Although it's good to start doing things to keep your brain healthy at any age, it's especially important to get going in your 30s, 40s and 50s to try to prevent cognitive problems in your 70s and 80s," says Dr. Marcantonio. "There's a big lag time. By the time cognitive changes start to develop, the pathology has already been going on for 10, 20 or more years."

The Number One Thing is Physical Activity

"If someone were to ask me, what's the most important thing they could do to help prevent cognitive decline, it would be to engage in some form of regular physical exercise," says Dr. Marcantonio. "Research has clearly shown that exercise benefits physical health and the evidence for cognitive health is quite robust as well."

Exercise can play a role in reducing stress, improving mood and helping you get better sleep, all important to brain health. A recent study in the British Journal of Sports Medicine also found that regular aerobic exercise appears to increase the size of the hippocampus, an area of the brain associated with memory. And an analysis in the 2015 Institutes of Medicine (IOM) Cognitive Aging Report found that overall, physically active adults had a 35 percent lower risk of cognitive decline compared with their non-active counterparts.

"We'd like to see people getting at least 20 to 30 minutes of exercise three to five times a week. More than that is even better," says Dr. Marcantonio. "It can be walking or whatever you're comfortable with that gets your heart pumping, but increasing your activity from whatever level you're at would be a benefit."

Maintaining Cardiovascular Health

"Even though we understand the primary cause of dementia to be a build-up of plaques in the brain, there's also an interface with cardiovascular disease," says Dr. Marcantonio. "People who have evidence of cardiovascular, and by extension cerebrovascular, disease seem to be at increased risk for developing dementia."

Because of that connection, he says it's vital to control cardiovascular risk factors like high blood pressure and high levels of cholesterol and other fats in the bloodstream. It's equally important to get good control of diabetes symptoms and to prevent diabetes in those who are at high risk.

"Exercise clearly plays a role here too, as does diet," he adds.

Eating a Healthy Diet

"There's quite a bit of data around the health benefits of eating a healthy diet, and also controlling one's weight, or maintaining a healthy weight," says Dr. Marcantonio. "And again, we're talking about the years through middle age. The period from age 40 to 65 is probably the most critical."

A large multinational study appearing in Neurology in 2015 examined the association between diet quality and brain health and found that a healthy diet, particularly the Mediterranean diet, was associated with a reduced risk of cognitive impairment, possibly by helping to lower overall cardiovascular risk factors or by helping to reduce inflammation in the body that can impact plaque buildup.

The Mediterranean diet emphasizes eating primarily plant-based foods like fruits, vegetables, nuts, legumes, whole grains and olive oil — and limiting the consumption of red meat, instead opting for fish and chicken, and consuming red wine in moderation.

Stimulating Your Brain

"Cognitive activity can range anywhere from continuing to engage in one's occupation, to maintaining some sort of cognitively stimulating avocational activities like playing chess or the piano, to formalized cognitive training programs, such as what's offered in BIDMC's Brain Fit Club," says Dr. Marcantonio. "The important thing is that the phrase, 'use it or lose it' seems to carry some weight."

The 2014 Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, funded by the National Institute of Health (NIH), showed that brain training to improve cognitive abilities had lasting effects that persisted for as much as five years for memory and as long as ten years in the areas of reasoning and speed of processing.

Social Engagement

"We think that being socially active and avoiding social isolation can also benefit brain health," says Dr. Marcantonio.

This may have something to do with the ties between social connection and mental health, or the fact that engaging with others can be another way to stimulate your brain, but studies have shown that people who continue to have meaningful interactions through social connections live longer and have better health.

A Word of Caution

"There's a huge antiaging industry out there, including the sale of supplements that claim to slow aging or help the brain. But, much of what is offered has very little data to support its effectiveness," says Dr. Marcantonio. "I would consider those things with caution. Even though some of them might sound very good, I would urge people to consider carefully before embarking, particularly if it's something that's very costly."

Dr. Marcantonio says that if you do decide to take supplements, be sure to inform your primary care physician because there could be important interactions with prescribed treatments.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted Month 2015