Grow your brain’s capacity for cognitive function

Just as we save money for a rainy day we need to grow our cognitive reserves for older age. Those who have built, grown and replenished these reserves from an early age do better cognitively later in life, even if their brains show signs of disease.  The good news is that you can build your cognitive reserves throughout life, even into later years.  To do this your brain needs to be challenged with novel and varied activities. You cannot just exercise one part of your brain over and over again, for example, you will not build reserves by only playing Sudoku. You must try new things; learn a new skill or a new language, try a new sport, read and write, do calculations, or put together puzzles. When you acquire new skills or knowledge, you rebuild the brain’s networks and increase the number of cells in your brain. Remember, if you challenge your brain, you will protect it from the effects of dementia and you may even find that your memory is increased. 

Reduce the debit calls on your mind 

Debit calls are things that can happen to the brain which diminish our cognitive reserves. Some of these are preventable and others not. Brain diseases that we can’t prevent such as Parkinson’s disease, multiple sclerosis, and aggressive cancers can all lead to dementia. The major unpreventable condition that can lead to dementia is Alzheimer’s disease. However, it has been discovered that vascular disease (abnormalities of the blood vessels) often accompanies Alzheimer’s disease.  The good news is that prevention of vascular disease, particularly in early and middle life represents the best chance we have to decrease our risk of dementia and delaying its onset.    

Monitor and tame your blood pressure 

High blood pressure can lead to multiple complications affecting not only the brain but other areas of your body as well. High blood pressure can lead to a heart attack or stroke, aneurysm, heart failure, weakened or narrow blood vessels in your kidneys, thickened or narrowed blood vessels in the eyes, metabolic syndrome, trouble with memory and cognition and eventually dementia. 

For each 1 mmHg (millimeters of mercury) sustained increase in systolic blood pressure above normal increases the likelihood of dementia in later life by 1%. Therefore it is essential to control your blood pressure as soon as it is elevated as blood pressure in the middle years is the determinant of brain health in later years. The ideal blood pressure at rest which will protect your brain, is a systolic blood pressure of 120 mmHg. Remember that blood pressure rises when you are stressed, and active such as when exercising. Therefore it is important to take your blood pressure when you are at rest with little noise around you. Measuring it in the pharmacy or your doctor’s office might not be ideal. Having your own blood pressure cuff is important so you can have a quiet space to measure your blood pressure.  

Our blood pressure generally increases with age since our blood vessels tend to become stiffer.  However, there are modifiable causes of high blood pressure such as excess salt, sugar, obesity, smoking, excessive alcohol consumption, sedentary lifestyles, poor-quality sleep, persistent loneliness, high anxiety, depression, exposure to air pollution.  Treating these conditions will help you to treat your high blood pressure. 

It is now quite established that you need to keep a systolic blood pressure equal to or less than 120 mmHg and a diastolic blood pressure equal to or less than 80 mmHg you will reduce your risk of stroke and dementia. In fact, decreasing the elevated systolic blood pressure by 10 mmHg will lower the likelihood of stroke by 38%. If you have persistent elevated blood pressure, it can and should be treated, talk to your health care professional.

Vascular disease

Atherosclerosis – large arteries develop thick walls and make the blood vessels less flexible and blood flow through them declines. If the blood flow falls below the level required for brain activity, the cells in the brain become deprived of oxygen and nutrients and can begin to die.  This is known as a stroke. Narrowing of smaller arteries (arterioles) or penetrating blood vessels (capillaries) results in a small area of damage to the brain. These areas of damage can lead to impairments in cognition, judgement and memory. 

Stroke

One of the major causes of dementia is stroke and these are also preventable.  A stroke occurs most of the time due to a blood clot in the brain depriving the brain of the blood supply and causing irreversible damage.  It is very important to treat a stroke as quickly as possible, therefore it is important to learn the warning signs of a stroke:

Cognitive decline is present in 61% of all symptomatic strokes within 3 months and the risk of dementia increases with time after stroke. It is also important to know that you may experience a TIA – transient ischemic attack. It has the same symptoms as a stroke but occurs as a result of a temporary lack of blood supply to the brain.  Typically the symptoms last only a few minutes and then completely resolve.  However, it is important to bring this to medical attention as the risk of having a full on stroke is increased after having a TIA. 

Strokes you are unaware of

Not all blockages in our brain’s blood vessels result in symptoms that the individual feels. These are called covert strokes and occur at 5-10 times the frequency of evident strokes.  These covert strokes are a major contributor to dementia because they leave small areas of the drain damaged, and this damage accumulates over time resulting in dementia.  

There are a number of conditions which can increase your risk for suffering a stroke such as high blood pressure, obesity, smoking, diabetes, stress and depression. Keeping these conditions treated will help to reduce the debit calls on your mind and reduce your risk for strokes and dementia.

Eat right, weigh light and stay bright 

Obesity is an illness with major health impacts, including impacts on our cognitive function. It is a growing epidemic in most parts of the world, especially in North America.

Obesity in children can have many long-tern negative consequences and can lead to chronic health problems as well as social challenges and poor academic performance.  Obesity reprograms the brain, dampening the brain regions that tell you when you are full and regions which seek out food as a reward are heightened. The diet you have as an adolescent determines the effect on subsequent food tastes, so if you eat high fat foods as a child your brain will create a preference for fatty foods in later life. 

Individuals who are obese are more likely to develop type 2 diabetes, high blood pressure, and abnormalities in cholesterol leading to strokes both overt and covert.  In addition the fat accumulated in the body sends inflammatory chemicals into the blood stream, weakening the immune system. There is also a positive correlation between obesity and dementia as being overweight or obese at midlife independently increases the risk of dementia.  Studies have shown that an increase in abdominal fat, especially visceral fat, is linked to a decline in total brain volume. Essentially, the bigger the belly the smaller the brain volume. This happens because the fat in the body sends inflammatory molecules to the brain which interfere with the blood supply to the brain, causing cell damage and death. This will promote small vessel disease in the brain and leads to brain shrinkage. 

It is therefore important to eat high quality food that is made up at least 50% by vegetables, 25% with meat, preferably fish or chicken and the last 25% with a carbohydrate like potatoes or rice. The Mediterranean diet has recently had scientific confirmation of its ability to decrease the likelihood of dementia by 33%; this may be in part due to its ability to reduce the likelihood of diabetes by as much as 40%.  Those who adhere to this diet also live longer healthier lives.  

It is not just what we eat but also how we eat that matters.  Individuals that are distracted during lunch, playing computer games, or watching videos for example, don’t remember as well what they ate and feel less full after lunch.  They are more likely to snack after lunch as compared to individuals that ate while non-distracted. 

There is no easy way to lose weight, however, changing your attitude can help you on you weight loss journey.  You must have a deep determination to protect your health and cognitive function.  It is essential to have social support and realistic goals.  It is important not to skip meals but instead to substitute nutritious food for unhealthy varieties. Snack carefully, eat a variety of fruits, nuts and vegetables and not foods from shiny bags. 

Move your hind…to save your mind

There is an abundance of evidence that being physically active prevents your brain from deteriorating. In today’s society people are increasingly sedentary and inactive. In fact, the percentage of dementia attributed worldwide to physical inactivity is 12.7%, but in North America this number increases to 21%. 

The benefits of exercise for your body are vast. Physical exercise causes the muscles to demand more blood, causing the blood vessels to relax.  The benefit for your body is seen after you complete the exercise, your resting blood pressure will be reduced, your resting pulse will be reduced because your heart will be in better shape, blood glucose levels are stabilized, reducing your risk of diabetes, and inflammation is reduced. 

How muscle activation improves brain health is still not clear, but there is no doubt that it does. Your muscles talk to your brain, particularly the memory centers, and so when you move them, the muscles send “positive” messages to your brain through the release of hormones and other molecules such as a protein called “brain derived neurotrophic factor” which provides brain cells with a healthy environment for growth. Aerobic exercise increases the size of the hippocampus, the memory area of the brain, leading to improvements in spatial memory. 

Physical activity in older adults is particularly important as it helps to build cognitive reserves and has been shown to slow the accumulation of the toxic molecules observed in Alzheimer’s disease and reduce brain atrophy. In fact, it has been shown that physical activity can even improve cognitive function after difficulties have already started. So it is important to keep in mind that exercise can grow your brain.  It is recommended that we all commit to at least 20 minutes of vigorous activity each day, if we do this, we will reduce the risk of dementia by 25%. Increasing the time to 27 minutes a day will reduce the risk of dementia by 40%. Aerobic exercise may be the most beneficial to fight off dementia, however, resistance training once or twice a week will also have a positive impact on cognition.

So it is essential to take an opportunity every day to get out of breath but there are also other lifestyle changes that you can adopt to increase your physical activity.  Take the stairs for less than 4-5 floors. Park away from the entrance of the shopping center and jog to the door.  Take quick walks around the block.  Disconnect from your computer and phone every hour for 5 minutes and go for a walk. 

Sleep enough…if you want to think with ease 

Sleep is essential – every living creature sleeps even though it disconnects us from the environment and potentially exposes us to danger. We need good quality sleep of adequate duration if we want our minds and bodies to be alert and function properly.  

The brain is the most active organ in the body and because of this, it has a high consumption of energy and therefore produces many toxic metabolites. Sleep is the opportunity for your brain to get a nightly tune-up, ridding the brain of the toxic molecules which are accumulated during the day.  During sleep the brain will repair itself and the production of myelin (the coating surrounding neurons) is ramped up. Learning is also consolidated during sleep.  

Sleep deprivation has many negative consequences including feeling fatigued, becoming more sedentary, increasing blood pressure and increasing the risk of stroke and heart attacks.  The mind is not spared with sleep deprivation.  It can accelerate brain shrinkage and has a particularly negative impact on memory function and cognition, especially executive function. It has been shown that insomnia can increase the risk of developing depression, and getting good sleep can actually have therapeutic benefits for depression. 

So how can we get adequate sleep? Limit daytime naps to 30 minutes, avoid caffeine, nicotine and alcohol close to bedtime. Exercise during the day promotes good quality sleep, but avoid strenuous workouts close to bedtime, steer clear of food right before sleep, ensure adequate exposure to natural light during the day, but seek darkness when trying to sleep. Establish a regular relaxing bedtime routine, this tells your brain you are going to bed so get ready to sleep, make sure the sleep environment is pleasant and don’t keep your phone close at night to avoid disruptions.

Socialize and feel useful: Loneliness and depression can make you crazy 

It is innate that we interact with others and develop emotional bonds.  Our mental health thrives when we maximize our positive interactions with people. However statistics suggest that many of us feel lonely, with 20% of older people in Canada affected, and one-third of all 25- to 34-year-olds feeling more alone than they would like. 

Social activity and the feeling of connectedness activate the brain in positive ways, and lead to a decrease in the activity of stress hormones and inflammation, conferring protection for your brain and blood vessels. Studies have shown that socially active individuals have longer lives, better memory function, and appear to be protected from cognitive decline as they age.  

Depression can damage the brain by causing inflammation, slowing the heart down and causing structural changes. This can lead to small vessel disease, stroke and finally dementia. Loneliness is also associated with many health conditions such as obesity.  Food brings many people happiness, so people who are depressed and lonely often turn to food for comfort. 

There are ways that we can avoid loneliness such as postponing retirement if you find your job fulfilling. If you do retire try to create opportunities for yourself to avoid loneliness by meeting new people through volunteering, by learning a new skill or even adopting a pet. 

We want to avoid feeling lonely because loneliness can morph into depression and prolonged depression can lead to dementia. Depression brings about changes in our bodies that favour many of the risk factors associated with dementia.  It seems to accelerate the process of aging and increases the chances of small strokes.  

Having good friends, a close family network, and interacting with these people contributes to a longer and happier life.  A life where cognitive function is more likely to be preserved and dementia is more likely to be kept at bay.