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 Challenge Your Mind and Muscles—and Eat Healthy—to Improve Cognitive Function

On my last few visits to the Cooper Clinic I complained to Dr. McFarlin about trouble remembering names. (I can tell you all about a person, but often cannot recall their name.) He responded by telling me about the difficulty he had remembering the names of several couples he and his wife spent time with on a recent cruise. Try as he might, he could not remember their names. He finally solved the problem by writing their names on a note pad he kept in his shirt pocket. He said that memory problems are a normal part of aging. He won’t worry about me until Carol sees a noticeable change in my ability to think clearly. The dividing line comes when you begin having difficulty remembering important information (like Carol’s name) or more trouble than usual with complex tasks such as balancing your bank account or paying bills. There are cognitive screening tests, but they can do more harm than good if given prematurely.

Nearly everyone experiences some cognitive decline if they live long enough. That’s normal. The next stage is mild cognitive impairment (MCI) which includes people who are noticeably impaired, but still able to live independently. MCI can lead to dementia, which includes Alzheimer’s disease.

 I plan to do all I can to keep my body and mind working well. Hiking does both.
Photo by Laszlo

Research is uncovering ways to preserve and improve mental function. What works and how.

Engage and Stay Engaged

The latest on mentally stimulating activities comes from the Mayo Clinic Study on Aging. Published online in JAMA Neurology on January 30, 2017, it followed 1,929 cognitively normal people (ages 70 and older) for an average of four years. Participants provided information about mentally stimulating activities (playing games, doing crafts, using a computer, or engaging in social activities) within one year before the beginning of the study. Evaluations at 15-month intervals showed that 24 percent developed MCI over the four year follow-up.  

The key finding was that the participants who engaged in mentally stimulating activities were 25 percent less likely to develop MCI than those who seldom did these things.

The researchers concluded: “Cognitively normal elderly individuals who engage in specific mentally stimulating activities even late in life have a decreased risk of incident MCI.” (Emphasis added)

A similar study focusing on people over 85, published in the journal Neurology in 2015, adds an important caveat: “Engaging in beneficial lifestyle activities in midlife only, or initiating them in late life, did not consistently confer benefit,” the study found. (UC Berkeley Wellness Letter, May 2017)

For maximum protection you must begin stimulating your brain early on and keep stimulating it. Use it or lose it.

Strength Gains Improve Brain Function

A randomized, double-blind, controlled trial by researchers in Australia, reported October 24, 2016, in the Journal of the American Geriatrics Society, focused on strength training for 100 people, ages 55 to 86, with mild cognitive impairment (MCI). Participant were divided into four groups: progressive resistance training (PRT) plus computerized cognitive training, PRT plus placebo cognitive training, brain training plus placebo exercise (mostly stretching), and placebo exercise plus placebo cognitive training. PRT was done two or three times a week for 6 months.

Only people who did PRT improved global cognitive function, but not memory. What’s more, the greatest overall cognitive improvement came with the greatest strength gains. Stronger muscles and stronger minds went hand in hand.  

The researchers concluded: “High-intensity PRT results in significant improvements in cognitive function, muscle strength, and aerobic capacity in older adults with MCI. Strength gains, but not aerobic capacity changes, mediate the cognitive benefits of PRT. Future investigations are warranted to determine the physiological mechanisms linking strength gains and cognitive benefits.”

“The more we can get people doing resistance training like weight lifting, the more likely we are to have a healthier ageing population,” said lead author Vorgi Mavros, PhD, from the Faculty of Health Sciences at the University of Sydney. (Neuroscience News, October 24, 2016)

(Dr. Mavros acknowledges that aerobic exercise is also important for total body health, but says that “PRT is the only exercise modality known to significantly increase muscle mass and strength, so is not interchangeable with aerobic prescriptions.” For more about the advantages of PRT for the older person: http://www.medscape.com/viewarticle/871152#vp_2 )

The Mind Diet

Our brain tends to shrink and become less efficient with age. It’s an unpleasant fact of life—which can be moderated. Your diet can make a big difference.

A study from Scotland published earlier this year in the journal Neurology found brain shrinkage in people who adhered closely to a Mediterranean-type diet to be half that of non-adherents. Subjects were queried about their eating habits at age 70—and then brain volumes were measured at 73 and again at 76.

A strength of the study is that the diet information was gathered three years prior to brain imaging. That makes the study predictive and not just an association. A longer period of study would, of course, have been better. “A 3-year interval will not tap as much variation in brain change as would much longer intervals, resulting in a much smaller detectable effect,” the researchers wrote. “We cannot judge whether longer adherence to the Mediterranean-type diet (MeDi) is associated with greater protection against brain atrophy,” the researchers wrote. “Future studies incorporating measures of individuals’ lifelong adherence to a particular dietary pattern are needed.”

Interestingly, no one component of the diet appeared to drive the improvement, suggesting that the total makeup of the diet is the key.

The traditional MeDi includes a “high consumption of fruits, vegetables, legumes, and cereals, olive oil as the primary source of fat, moderate consumption of fish, low to moderate intake of dairy products and wine (accompanying meals), and low intake of red meat and poultry,” the researchers explained.

They concluded: “Lower adherence to the MeDi in an older Scottish cohort is predictive of total brain atrophy over a 3-year interval. Fish and meat consumption does not drive this change, suggesting that other components of the MeDi or, possibly, all of its components in combination are responsible for the association.”

You can read the entire study online:  http://www.neurology.org/content/early/2017/01/04/WNL.0000000000003559.full.pdf+html

For more information on the benefits of the Mediterranean diet see our article Mediterranean-Style Diet Good for Brain & Heart; Foods Work Together http://www.cbass.com/Mediterranean_BrainandHeart.htm

Other Steps for Brain Health

The UC Berkeley Wellness Letter (May 2017), where I learned about new developments in cognitive health, compiled a list of steps to help improve and preserve brain function. The following is my short hand list:

1) Avoid or control chronic disorders such as hypertension, diabetes, and heart disease. (Excessive use of blood pressure medication can increase cognitive decline.)

2) Treat depression, along with anxiety and sleep disorders.

3) Undertake stimulating mental, physical, and social activities.

4) Eat healthfully, maintain a healthy weight, and drink alcohol only in moderation.

5) Review any medications you take which may be affecting your cognition.

6) Don’t smoke.

Common sense all. Do all you can to help your doctor keep your body and brain healthy. No one can do more for you than you.

September 1, 2017

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