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“No other intervention has ever been shown to have such a profound effect on protecting the brain.” Dr. John Day, drjohnday.com

“Exercise is a really, really great thing for the brain. We need to learn more, since we have nothing better at this moment to combat cognitive decline.” Joyce Gomes-Osman, PT, PhD, University of Miami Miller School of Medicine (TIME Health, May 30, 2018)

Fitness Boosts Brain Function Late in Life

Sleep More, Walk Faster, Think Young

We’ve long known that exercise helps keep the heart going strong. New research suggests that the same is true for the brain. Moreover, it affirms Deepak Chopra’s concept of The Healing Self—fitness level in midlife appears to affect the risk of dementia decades later.

Another study assesses the dose and type of exercise required to optimize brain function. Finally, we have new information on the role of sleep and positive thinking.

Fitness in Midlife Wards Off Dementia Decades Later

A study begun in 1968 measured the fitness levels of 191 carefully chosen middle aged Swedish women—and monitored them for dementia over the next 44 years. Cognitive testing was done six times: in 1974, 1980, 1992, 2000, 2005, and 2009. (Hospital records and other data was checked through 2012.)

Researchers from the University of Gothenburg in Sweden reported March 14, 2018, in the journal Neurology, that women with lower fitness levels had a higher risk for dementia. And that’s putting it mildly.

Lead researcher Helena Holder, PhD, and her colleagues were only beginning to lay out their findings regarding a leading cause of death among women in the developed world.

Women with high physical fitness in middle age were nearly 90 percent less likely to develop dementia decades later, compared to women who were moderately fit. Moreover, when highly fit women did develop dementia, they developed the disease an average of 11 years later than women who were moderately fit, or at age 90 instead of age 79.

Five percent of the highly fit women developed dementia, compared to 25 percent of moderately fit women and 32 percent of women with low fitness. The highly fit women were 88 percent less likely to develop dementia than the moderately fit women.

Dr. John Day, whose book The Longevity Plan was featured here a while back http://www.cbass.com/longevityplan.html , wrote in his blog that the study “rocked the neurology/dementia world.”

“Studies show that exercise helps clear the dementia debris that piles up in the brain as we age,” he explained. “Also, physical activity is the most potent stimulator of brain-derived neurotropic factor (BDNF), which causes the growth and development of brain cells,” he continued. See Reboot Your Brain with Exercise http://www.cbass.com/RebootBrain.htm

“The message is clear,” Day concluded. “Bulletproofing your brain against aging is going to require a very high level of physical fitness. Of course, if you haven’t done much more than walking, now is the time to work with your physician on finding the right way to increase your stamina.”

That brings us to the next study.

Forms of Exercise and Dose for Brain Function

A few weeks after release of the Swedish study, researcher from the U.S. reported their findings in the same journal on the amount and types of exercise required to improve cognitive function.

Joyce Gomes-Osman, PT, PhD, and her colleagues reviewed 98 existing studies including 11,061 adults with a mean age of 73 that connected exercise with tests of brain function. Healthy adults represented 59% of the total population; another 26% had mild cognitive impairment, and 15% had dementia.

They found that people who exercised for at least 52 hours over a period of about six months showed the most improvement in cognitive brain health. On average, these people exercised for about an hour, three times a week. Improvement was seen in people with and without cognitive decline.

Interestingly, only total exercise time was associated with cognitive improvement. Session times in minutes, exercise frequency per week, and total number of weeks did not correlate with improved thinking skills.

Dr. Gomes-Osman was surprised by that finding. “I had my bet on weekly minutes,” she told health reporters. “I don’t think 52 hours is really a magic number,” she explained. “There really is a range. But I do think that these results signify to us that in order to get the known benefits of exercise for the brain, to help areas involved in thinking and problem solving—to get the machinery going, you need longer exposure to exercise. Those are all mechanistic processes that take time to develop.”

This coincides with comments by Dr. Day. Exercise affects the brain in a variety of ways, from preserving the integrity of the brain’s components that start to decline with age, by improving blood flow to brain cells and promoting growth factors to help cells involved in higher level thinking. 

When asked by Medscape Medical News to comment on the findings, James A. Hendrix, PhD, director of Global Science Initiatives at the Alzheimer’s Association in Chicago added another important element: “One thing we’re learning from biomarker studies is our brain begins to change 10 to 20 years before the onset of disease.” For a 65-year-old starting to show signs of dementia, their brain may have started changing as early as age 45, he said. “So if you’re concerned about Alzheimer’s disease in your family, don’t wait until symptoms appear.”

“We also have to think about when we introduce this exercise recommendation,” Gomes-Osman agreed.

Carol took this photo after a workout when I was about 54.
I’d been doing various forms of strength and aerobic exercise for about 40 years.
I’m still going strong 26 years later. My short term memory isn’t what it used to be,
 but this research suggests that my brain will stay in shape about as long as I do.

The best kind of exercise remains an open question; a variety seems best. “In order to achieve the exercise doses above, individuals can participate in aerobic, resistance (strength) training, mind-body exercise, or a combination of these interventions,” the researchers wrote. Gomes-Osman hopes to learn more about what types of exercise have the most benefit for the brain—aerobic is backed by the most research—as well as how those movements should be distributed in minutes, hours and days.

Personal preference is also important.

Dr. Hendrix applauded the finding that many different types of exercise could be beneficial. Giving patients a choice allows them to do the types of exercise they enjoy and “makes it easier to make it part of your lifestyle.”

Gomes-Osman enthusiastically summed up the current state of knowledge for TIME Health: “Exercise is a really, really great thing for the brain. We need to learn more, since we have nothing better at this moment to combat cognitive decline.”  

*   *  *

Sleep More and Walk Faster

Scientists have known for some time that regular exercise and getting a good night’s sleep help prevent mental decline. They now believe that they work together to prevent neurodegenerative diseases like Alzheimer’s.

Animal studies have shown that they boost the brain’s self-cleaning, or glymphatic, system which clears out amyloid protein which clumps together and prevents brain cells from communicating.

Dr. Ian Harrison, from University College London, told the Cheltenham Science Festival that research has shown that the glymphatic system is 60 per cent more active at night proving that sleep is crucial for its correct function.

“That kind of makes sense because, if you think about it, when your brain is active during the day these brain cells are going to be actively producing all these waste products, so it is only at night when our brain switches off that it has the chance to switch on our glymphatic system and get rid of all these waste products.”

Dr. Harrison said that studies in mice have shown similar results with exercise.

“When the animals have voluntary access to exercise there is a massive increase in the amount of lymphatic function,” he told the conference. “The research has postulated that it is the increase in heart rate that drives this cerebrospinal fluid (CSF) into the brain.”

While the primary function of CSF is to cushion the brain within the skull and serve as a shock absorber for the central nervous system, CSF also circulates nutrients and chemicals filtered from the blood and removes waste products from the brain.

So, sleep more and walk faster.

(Sarah Knapton, Science Editor, Telegraph.co.uk/news, June 6, 2018)

Think Young

A new study led by the Yale School of Public Health has found that positive attitudes about aging protect against dementia. Think young—positive—and you are more likely to be able to think clearly as you age, even if you are carrying a gene that puts you at high risk of developing dementia.

We are bombarded by negative stereotypes about aging. Being old is often equated with being frail, helpless, and incompetent. Many people in drug ads look old and beaten down. Most are overweight. They’re offered pre-packaged foods for nutrition and weight control. Medical appliance companies are eager to help old people get in and out of their bath and up their stairs. Senior living facilities, of course, offer to meet their every need.

Carol and I just came back from the one-year follow-up exam on my new hip. Frail old people were everywhere we looked. Even those who weren’t all that old looked infirm. It didn’t have to be that way for many, perhaps most, of them.

Spring chickens we are not. But we plan and expect to age well.

This is another photo Carol took of me at about 54.
Our index page and training pictorial show that I look about the same at 80. I'm going to do all I can to keep it that way.

The new study, published February 7, 2018, in the journal PLOS ONE, says that this attitude is likely to help us age well. It will help us stay well—and think clearly.

Led by Becca R. Levy, professor of public health and of psychology, the study involved 4,765 people, average 72, who were free of dementia at the start. Over the next four years, those with positive attitudes about aging were nearly 50% less likely to develop dementia (2.6% compared to 4.6%) than those who held negative age beliefs.

A surprise was that the 26% who carried the APOE4 genotype, a major risk factor for dementia, were slightly less likely to develop dementia than those without the genotype—2.7% risk compared to 6.1% for those with negative beliefs about aging.

“The results of this study suggest that positive age beliefs, which are modifiable and have been found to reduce stress, can act as a protective factor, even for older individuals at high risk for dementia,” the researchers concluded.

You can read the entire study online: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0191004

July 2018

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