To keep your brain healthy, keep your heart healthy

Grand Forks Herald (ND)

07-08-13


July 08--If you're searching for ways to keep your brain healthy -- and prevent or delay the onset of Alzheimer's disease or other forms of dementia -- take care of your heart.

"Anything that's good for the heart is going to be good for your brain," said Dr. Lindsay Hines, a neuropsychologist with Sanford Health in Fargo.

Walking, for example, can offer nearly the same benefits as some medications that are designed to slow the progress of Alzheimer's disease, she said.

In adult patients who've been referred to her by primary care physicians, neurologists and geriatricians, Hines studies the "effects on cognitive (thinking) functioning when there's been a physical change in the brain," she said.

She and her colleagues arrive at diagnoses, for example, determining the nature of the patient's illness -- is it Parkinson's, Alzheimer's disease or another form of dementia? -- and its current stage, she said.

They assess how the disease is affecting thinking, memory and problem-solving, and ability to function in society.

They then make recommendations to the referring physician about appropriate interventions or medications, and whether the patient can go back to work or should receive rehabilitation or speech therapy services.

Best for brain health: walking

Any activities that help people reduce their blood pressure and maintain a healthy weight are the most beneficial for brain health, Hines said.

In particular, walking has been proven to delay onset of dementia for up to ten years, she said.

Studies have shown that walking 15 blocks a day, for at least five days a week, is most effective in warding off symptoms of dementia.

"It may sound like a lot," she said, "but this includes being in a grocery store, or any leisure activity."

Several drugs aimed at slowing the progression of Alzheimer's disease, such as Aricept, Namenda and Exelon, have been introduced in recent years.

"Walking is almost as effective as those medications," she said. "It's not right there, but it's close."

The drugs "can make a pretty significant difference in the lifespan of the disease," she said, "to the point that the patient may spend less years -- maybe five versus seven -- in a nursing home."

She recommends that anyone who may be concerned that their loved one has Alzheimer's disease "go for the evaluation and get that diagnosis" for the sake of early detection.

"The earlier you get on (the medication), it slows progression."

Some people assume that, "if it is Alzheimer's, there's nothing we can do," she said. But the medications "are helping in more ways than we initially knew."

When first introduced, the drugs "got a bad rap," she said. "People don't typically get a boost" from them.

But doctors have since found that those who were taking them "are doing much better than those who were not."

Risk cut in half

Neuroscientists, psychologists and physicians agree that, without a doubt, exercise is the single best thing you can do for your brain.

Aerobic exercise "keeps cognitive abilities sharp and slashes your lifetime risk of Alzheimer's in half," said John Medina, an affiliate professor of bioengineering at the University of Washington School of Medicine and author of the book, Brain Rules, according to a report on the AARP website.

Scientists think exercise boosts the flow of blood to certain parts of the brain, spurring the release of a brain chemical, called "brain-derived neurotropic factor" or BDNF, which stimulates the formation of new neurons, or nerve cells, in the hippocampus which plays an important role in formation of new memories.

At the same time, the substance repairs cell damage and strengthens the connections, or synapses, between brain cells.

Exercise also tamps down stress, reduces the risk of stroke, helps control blood sugar and decreases the chances of falling by improving balance and coordination. Heart attack, stroke and diabetes are risk factors for Alzheimer's disease and other dementias.

Some autopsies show that as many as 80 percent of individuals with Alzheimer's disease also have cardiovascular disease, according to the Alzheimer's Association.

Controlling your diet, another way to protect heart health, is important to lowering your risk for Alzheimer's, researchers have found. Studies suggest that high cholesterol may contribute to stroke and brain cell damage.

A low fat, low cholesterol diet is recommended. And there's growing evidence that a diet rich in dark vegetables and fruits, which contain antioxidants, may help protect brain cells.

Routine schedules

Keeping regular sleep and meal-time schedules also helps preserve brain health, Hines said.

"The brain is always working on things that you're not aware of."

Following a set routine allows the portion of the brain that deals with planning and organization, the frontal lobes, to go on "autopilot" and rest, she said, and frees it to work on other memory issues.

This kind of structure is good, she said. "So you don't have to rely on memory as much."

It even helps to write things down on paper, so your brain isn't trying to remember them,

"When you get enough of those things accommodated, you free up space in the brain for other work."

She calls this "cognitive space," she said, and "as we age, we don't have as much space to spare."

Socialization is also critical to keeping the brain healthy as we age, experts agree. It can reduce stress levels, which helps maintain healthy connections among brain cells.

Interaction with other people is "wonderful for the brain," Hines said. "It's a 'whole-brain' exercise" that activates both hemispheres: the right brain which involves visual, spatial and non-verbal activity, and the left which involves language.

Never too late

The good news, says Dr. Paul Nussbaum, clinical neuroscientist and adjunct associate professor at the University of Pittsburgh medical school, is that it's never too late -- or too early, for that matter -- to consider and do something about preserving and even improving brain health.

In addition to following a program of physical exercise and good nutrition and challenging the mind with experiences, he cites the need to manage stress, according to the AARP website.

Managing stress can delay or slow the progress of dementia, Hines said.

It's a particularly important factor in maintaining brain health -- whether it's short-term (stuck in traffic on the way to a job interview) or long-term (death of a loved one).

"We all know what it's like when you've been through a break-up or a death, you feel you can't focus or concentrate on anything," she said. "With that much stress, the mind is consumed by something else."

In such situations, the body releases the powerful fight-or-flight stress hormones, adrenaline and cortisol. While these hormones help focus our attention and prompt us to take needed action, humans weren't designed to handle high levels of stress hormones day after day, year after year.

In the brain, these hormones weaken blood vessels, destroy neurons and shrink the hippocampus, the area that is involved in memory, learning and the ability to plan and make decisions. This shrinkage is a known risk factor for late-life Alzheimer's disease.

Stress, in and of itself, isn't the enemy of brain health, experts say; the way we perceive and handle it matters a lot too. In fact, research shows that stress reduction techniques, coupled with exercise and a healthy diet, can slow and even reverse the damage inside cells.

Unfortunately, worrying about your inability to remember where you put your keys is a problem in itself -- and may bring on exactly what you fear.

"It's not uncommon to stress about your memory. That may lead to dementia," she said.

Hines does not think that dementia is inevitable, she said. "It's different for different people. For the most part, brains do decline. Aging is a big factor.

"With dementia, the older we are, the more at risk we are for it. It's happening in a large percentage of the population."

Research has uncovered "a 'marker' in the brain that is present 15 to 20 years before we see changes in functioning," she said. "There are people who have this marker (and) in whom you don't ever see functional signs of dementia.

"We won't be able to affect the prevalence of it until we get to where it starts."
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Knudson covers Health and Family for the Herald and can be reached at (701) 780-1107, (800) 477-6572, ext.1107 or pknudson@gfherald.com.
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Keep your brain active every day

Mental decline as you age appears to be largely due to connections among brain cells, according to the Alzheimer's Association.

But research has found that keeping the brain active seems to increase its vitality and may build its reserves of brain cells and connections. You could even generate new brain cells.

You don't have to turn your life upside down, or make extreme changes to achieve many of these benefits, the association advises. Start with something small, like a daily walk. After a while, add another small change.

Here are some tips to maintain or improve your brain health:

--Stay curious and involved -- commit to livelong learning
--Read, write, work crossword puzzles or other puzzles
--Attend lectures and plays
-- Enroll in courses at your local adult education center, college or other community group
--Play games
--Garden
--Try memory exercises

Source: Alzheimer's Association

Brain games: flexing your mental muscles

Mentally stimulating activities strengthen brain cells and the connections between them, studies show.

Playing bridge and chess and working crossword puzzles, along with other mind-stretching games, have been credited with keeping the brain "flexible."

An abundance of brain-exercising games aimed at warding off Alzheimer's and other forms of dementia has captured the attention of those who are concerned about troublesome signs that they may be losing mental sharpness.

But science has not proven yet that they act on the part of the brain that makes the memory, said Dr. Lindsay Hines, a neuropsychologist at Sanford Health in Fargo.

"There are a lot of programs on the market right now that say they improve cognitive functioning but we have not yet found any that improve memory," she said.

With repetition, "they have shown to improve one's ability to play those games," she said.

"That's not bad, as long as you're not doing them to the point of being overwhelmed or stressed."

Such games "are using a part of the brain other than the one that actually makes the memory," she said. They "use parts of the brain that are stronger, to compensate for those that are weaker -- accommodating changes in function by using another part of the brain."

For example, "if I keep forgetting to take my purse and I put a note on the door to remind me, I haven't changed my brain but I'm accommodating what's happened in the brain.

"It's another strategy, or route, to memory but it doesn't create memory. That's where the gap is in the research."

These games can be helpful, though, especially if paired with structure, consistency and a healthy lifestyle, especially activities that maintain or improve the health of the heart and cardiovascular system.

"But (playing games) in place of walking or socializing or taking care of oneself, that's not good," she said.

"Walking, socializing and keeping your heart healthy -- those we know make a difference. The games, we don't know yet," she said.

But "they can't hurt, unless they present a financial burden which leads to stress. Or loved ones are expecting to (see) that boost (from games) and don't get it."

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