Saving your brain

Over 5 million people in the United States currently suffer with dementia.  And if you are fortunate enough to live to age 85, it’s estimated your chances of exhibiting signs of dementia are at least one in four, and perhaps as high as one in two (50%).

These are alarming statistics but there is hope.  In a moment we’ll look at options that are estimated to cut your risk by a third.

Dementia refers to a set of symptoms (impaired decision making, misuse of language, and memory lapses) which can be found in a number of diseases.

Alzheimer’s is the most common cause, responsible for 60 to 70% of all  cases of dementia.

“Vascular dementia”, the result of diminished blood flow to the brain, comes in second with another third of the cases.

Prevention is the key to beating dementia as once symptoms develop, indicating the presence of ongoing damage, they are generally irreversible.

As you will see, options include many of the lifestyle changes that are common to other vascular or blood flow related diseases such as heart attacks and strokes. But to be effective they will need to be adopted in midlife.  

Diabetes and Blood Pressure Management

Diabetes, high blood pressure and obesity all contribute to premature aging of blood vessels. Whether it is preventing heart attacks, stroke (the major vessels to the brain), or vascular dementia (the small blood vessels), control of blood pressure and blood sugar levels are of unquestionable benefit.

Diet

Diet can have a powerful effect. And it is about both the negative effects of foods you should avoid as well as the positives of those you should add to your diet.

One study showed that those following a Mediterranean diet had less brain atrophy — an effect similar to 5 years of aging — than those who did not. And another that those who consumed two servings of green leafy vegetables a day had a rate of cognitive decline equivalent to someone 11 years younger.

And the foods to be avoided?  Red meat, butter, margarine, cheese, sweets, fried and processed foods, and empty sugar calories such as sodas.

Although it is not traditionally considered a “food”, alcohol in large amounts has been firmly linked to dementia, and even small amounts on a regular basis produce brain damage on neuroimaging studies.  This finding implies there is no “safe” level of intake for alcohol.

Social Engagement/Marriage

Having strong social networks as well as marriage are dementia protective.

Being a loner is associated with a number of poor health outcomes including cancer survival.  Why? Those in a relationship or with strong social networks tend to live healthier lifestyles.

Or perhaps being able to share worries moderates life’s stresses which are know to correlate with an increased risk of subsequent dementia.

Exercise

Last but not least is exercise. Of all the prevention options, this is the most powerful.

A group of 191 Swedish women, 38-60 years of age in 1968, were given an ergometer cycling test. When their mental status was valuated in 2010 (fourty years later), it was found that the women with high physical fitness at middle age were nearly 90% less likely to have developed dementia compared with the women who were only moderately fit.

Medications

Are there any medications of preventive value?

Vitamin E and Selenium, commonly suggested anti oxidants, have no protective benefit.

There is limited information on metformin, an insulin “sensitizer” and effective anti-aging medication in a mouse model.  Although it does diminish the incidence of dementia in diabetics (presumably via treatment of the diabetes itself) there is no solid evidence that it has a protective benefit for those with normal blood sugar metabolism.

But there is a glimmer of hope on the medication horizon. Smoking dope. The long term administration of THC, the main psychoactive ingredient in marijuana, ameliorates age related learning and memory deficits in elderly mice even though, paradoxically,  it impairs learning and memory in young mice.

How can that be? One of our many neurochemical pathways is the cannabinoid system.  As we age, this pathway, along with the others, becomes less active. In old animals, THC treatment restores the failing cannabinoid system activity, whereas it overactivated the normally functioning cannabinoid system of young animals.

So we once again see a theme that is common to many of the diseases of aging - an active lifestyle paired with a vegetarian leaning diet. But for the brain, we will add the importance of avoiding social isolation. Three lifestyle changes that you can add in small amounts to daily routines and will add years of benefit down the road.

References:

https://www.amjmed.com/article/S0002-9343(18)30643-0/fulltext

https://tandfonline.com/doi/abs/10.1080/1028415X.2017.1324357

http://www.aginganddisease.org/EN/10.14336/AD.2017.0501

https://www.ncbi.nlm.nih.gov/pubmed/26491085

https://www.frontiersin.org/articles/10.3389/fnagi.2017.00183/full

https://www.nature.com/articles/nm.4311.epdf

https://www.ncb i.nlm.nih.gov/pubmed/29263222

https://www.bmj.com/content/361/bmj.k1675

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894933/

https://jnnp.bmj.com/content/early/2017/10/30/jnnp-2017-316274

https://www.thelancet.com/commissions/dementia2017

http://www.drmirkin.com/fitness/exercise-preserves-brain-function.html 

http://www.health.harvard.edu/press_releases/regular-exercise-releases-brain-chemicals-key-for-memory-concentration-and-mental-sharpness

http://www.health.harvard.edu/press_releases/regular-exercise-releases-brain-chemicals-key-for-memory-concentration-and-mental-sharpness

https://www.nytimes.com/2018/03/28/well/mind/fitness-in-midlife-may-help-fend-off-dementia.html

https://www.nytimes.com/2017/10/04/well/move/for-your-brains-sake-keep-moving.html

https://www.bmj.com/content/361/bmj.k1675 Exercise no help once you have it.


http://www.drmirkin.com/morehealth/risk-for-dementia-goes-down-with-steps-to-prevent-heart-attacks.html

https://www.drmirkin.com/health/morehealth/dementia-risk-increased-by-harmful-bacteria-in-your-colon.html  Dementia risk is influenced by the microbiome (and your diet).