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Psychiatric providers often encounter older adult patients who report difficulty with memory and express the fear they are “developing dementia.” Often, after a thorough evaluation of the reported deficits and history, we find that a serious or progressive neurocognitive disorder is unlikely. However, such occasions are an opportunity to discuss lifestyle changes that may help prevent, or at least slow, development of later-life cognitive decline.
Although I inform my patients that the body of evidence supporting many of these preventive measures still is evolving, I suggest the following approach that may provide a DEFENSE against future cognitive disability.
Diet options that are “heart healthy” seem to be “brain healthy” as well. This may be due, in part, to the antioxidant and anti-inflammatory effects of particular foods.1 Therefore, I suggest patients try to implement a Mediterranean-type diet that emphasizes fish (especially those rich in omega-3 fats, such as salmon and tuna), poultry, fresh fruit, and vegetables, as well as legumes.
ETOH has been shown, in a moderate amount (eg, 1 drink a day for women and 1 to 2 drinks for men), to be brain protective because of the antioxidants found in the alcohol or the direct relaxation effects that are produced—or both. Although red wine often is recommended, recent studies have shown that those who enjoyed an active life into their 70s and 80s had consumed a moderate amount of alcohol over their lifetime regardless of the type of spirit (eg, 12 oz of beer, 4 oz of wine, 1 oz of hard liquor).2
Friends contribute to an active, stimulating, and emotionally supported life. Having a strong social network, an antidote to loneliness and depression, has been shown to reduce the risk of “turning on” specific genes that stimulate an inflammatory process that can lead to brain cell death and neural damage.3
Exercise might be the most important ingredient for a longer, healthier, and more cognitively intact life. Moderate exercise, several times a week, increases blood flow to the brain and, subsequently, stimulates neuronal synapses and the hippocampus.4 The forms of exercise include walking, biking, swimming, resistance training, and even gardening.
No tobacco! It is known that smoking leads to accelerated aging for the heart and brain, so it is our responsibility to remain vigilant in promoting smoking cessation strategies.
Sleep has received increased attention, with recent studies providing evidence that the brain uses that time to “flush out” neurotoxic by-products of cognitive activity that have accumulated throughout the day.5 As evidence continues to be examined on this process, it is reasonable to recommend adequate sleep and a consistent sleep pattern as possible defenses against brain cell insult.
Engagement in tasks that are cognitively stimulating has been promoted as potential “brain exercises” to stave off future memory loss. For example, computer games that are mentally challenging; lively and frequent conversations; and learning a language all appear to increase neural activation and communication throughout the brain.6
As brain research continues to expand, providers will become more knowledgeable and aware of the steps our patients can take when they discuss concerns about their risk of progressive cognitive disability and memory loss. For now, however, it is important to describe what we do know based on current research and help our patients develop the best defense they can against age-related cognitive decline.
Disclosure
The author reports no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
1. Gu Y, Nieves JW, Stern Y, et al. Food combination and Alzheimer disease risk: a protective diet. Arch Neurol. 2010;67(6):699-706.
2. Paganini-Hill A, Kawas CH, Corrada MM. Type of alcohol consumed, changes in intake over time, and mortality: the Leisure World Cohort Study. Age Ageing. 2007;36(2):203-209.
3. Cole SW, Hawkley LC, Arevelo JM, et al. Transcript origin analysis identifies antigen-presenting cells as primary targets of socially regulated gene expression in leukocytes. Proc Natl Acad Sci U S A. 2011;108(7):3080-3085.
4. Small G, Vorgan G. The Alzheimer’s Prevention Program: keep your brain healthy for the rest of your life. New York, NY: Workman Publishing Company, Inc; 2011:71.
5. Xie L, Kang H, Xu Q, et al. Sleep drives metabolite clearance from the adult brain. Science. 2013;342(6156):373-377.
6. Hall CB, Liptor RB, Sliwinski M, et al. Cognitive activities delay onset of memory decline in persons who develop dementia. Neurology. 2009;73(5):356-361.
Psychiatric providers often encounter older adult patients who report difficulty with memory and express the fear they are “developing dementia.” Often, after a thorough evaluation of the reported deficits and history, we find that a serious or progressive neurocognitive disorder is unlikely. However, such occasions are an opportunity to discuss lifestyle changes that may help prevent, or at least slow, development of later-life cognitive decline.
Although I inform my patients that the body of evidence supporting many of these preventive measures still is evolving, I suggest the following approach that may provide a DEFENSE against future cognitive disability.
Diet options that are “heart healthy” seem to be “brain healthy” as well. This may be due, in part, to the antioxidant and anti-inflammatory effects of particular foods.1 Therefore, I suggest patients try to implement a Mediterranean-type diet that emphasizes fish (especially those rich in omega-3 fats, such as salmon and tuna), poultry, fresh fruit, and vegetables, as well as legumes.
ETOH has been shown, in a moderate amount (eg, 1 drink a day for women and 1 to 2 drinks for men), to be brain protective because of the antioxidants found in the alcohol or the direct relaxation effects that are produced—or both. Although red wine often is recommended, recent studies have shown that those who enjoyed an active life into their 70s and 80s had consumed a moderate amount of alcohol over their lifetime regardless of the type of spirit (eg, 12 oz of beer, 4 oz of wine, 1 oz of hard liquor).2
Friends contribute to an active, stimulating, and emotionally supported life. Having a strong social network, an antidote to loneliness and depression, has been shown to reduce the risk of “turning on” specific genes that stimulate an inflammatory process that can lead to brain cell death and neural damage.3
Exercise might be the most important ingredient for a longer, healthier, and more cognitively intact life. Moderate exercise, several times a week, increases blood flow to the brain and, subsequently, stimulates neuronal synapses and the hippocampus.4 The forms of exercise include walking, biking, swimming, resistance training, and even gardening.
No tobacco! It is known that smoking leads to accelerated aging for the heart and brain, so it is our responsibility to remain vigilant in promoting smoking cessation strategies.
Sleep has received increased attention, with recent studies providing evidence that the brain uses that time to “flush out” neurotoxic by-products of cognitive activity that have accumulated throughout the day.5 As evidence continues to be examined on this process, it is reasonable to recommend adequate sleep and a consistent sleep pattern as possible defenses against brain cell insult.
Engagement in tasks that are cognitively stimulating has been promoted as potential “brain exercises” to stave off future memory loss. For example, computer games that are mentally challenging; lively and frequent conversations; and learning a language all appear to increase neural activation and communication throughout the brain.6
As brain research continues to expand, providers will become more knowledgeable and aware of the steps our patients can take when they discuss concerns about their risk of progressive cognitive disability and memory loss. For now, however, it is important to describe what we do know based on current research and help our patients develop the best defense they can against age-related cognitive decline.
Disclosure
The author reports no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
Psychiatric providers often encounter older adult patients who report difficulty with memory and express the fear they are “developing dementia.” Often, after a thorough evaluation of the reported deficits and history, we find that a serious or progressive neurocognitive disorder is unlikely. However, such occasions are an opportunity to discuss lifestyle changes that may help prevent, or at least slow, development of later-life cognitive decline.
Although I inform my patients that the body of evidence supporting many of these preventive measures still is evolving, I suggest the following approach that may provide a DEFENSE against future cognitive disability.
Diet options that are “heart healthy” seem to be “brain healthy” as well. This may be due, in part, to the antioxidant and anti-inflammatory effects of particular foods.1 Therefore, I suggest patients try to implement a Mediterranean-type diet that emphasizes fish (especially those rich in omega-3 fats, such as salmon and tuna), poultry, fresh fruit, and vegetables, as well as legumes.
ETOH has been shown, in a moderate amount (eg, 1 drink a day for women and 1 to 2 drinks for men), to be brain protective because of the antioxidants found in the alcohol or the direct relaxation effects that are produced—or both. Although red wine often is recommended, recent studies have shown that those who enjoyed an active life into their 70s and 80s had consumed a moderate amount of alcohol over their lifetime regardless of the type of spirit (eg, 12 oz of beer, 4 oz of wine, 1 oz of hard liquor).2
Friends contribute to an active, stimulating, and emotionally supported life. Having a strong social network, an antidote to loneliness and depression, has been shown to reduce the risk of “turning on” specific genes that stimulate an inflammatory process that can lead to brain cell death and neural damage.3
Exercise might be the most important ingredient for a longer, healthier, and more cognitively intact life. Moderate exercise, several times a week, increases blood flow to the brain and, subsequently, stimulates neuronal synapses and the hippocampus.4 The forms of exercise include walking, biking, swimming, resistance training, and even gardening.
No tobacco! It is known that smoking leads to accelerated aging for the heart and brain, so it is our responsibility to remain vigilant in promoting smoking cessation strategies.
Sleep has received increased attention, with recent studies providing evidence that the brain uses that time to “flush out” neurotoxic by-products of cognitive activity that have accumulated throughout the day.5 As evidence continues to be examined on this process, it is reasonable to recommend adequate sleep and a consistent sleep pattern as possible defenses against brain cell insult.
Engagement in tasks that are cognitively stimulating has been promoted as potential “brain exercises” to stave off future memory loss. For example, computer games that are mentally challenging; lively and frequent conversations; and learning a language all appear to increase neural activation and communication throughout the brain.6
As brain research continues to expand, providers will become more knowledgeable and aware of the steps our patients can take when they discuss concerns about their risk of progressive cognitive disability and memory loss. For now, however, it is important to describe what we do know based on current research and help our patients develop the best defense they can against age-related cognitive decline.
Disclosure
The author reports no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
1. Gu Y, Nieves JW, Stern Y, et al. Food combination and Alzheimer disease risk: a protective diet. Arch Neurol. 2010;67(6):699-706.
2. Paganini-Hill A, Kawas CH, Corrada MM. Type of alcohol consumed, changes in intake over time, and mortality: the Leisure World Cohort Study. Age Ageing. 2007;36(2):203-209.
3. Cole SW, Hawkley LC, Arevelo JM, et al. Transcript origin analysis identifies antigen-presenting cells as primary targets of socially regulated gene expression in leukocytes. Proc Natl Acad Sci U S A. 2011;108(7):3080-3085.
4. Small G, Vorgan G. The Alzheimer’s Prevention Program: keep your brain healthy for the rest of your life. New York, NY: Workman Publishing Company, Inc; 2011:71.
5. Xie L, Kang H, Xu Q, et al. Sleep drives metabolite clearance from the adult brain. Science. 2013;342(6156):373-377.
6. Hall CB, Liptor RB, Sliwinski M, et al. Cognitive activities delay onset of memory decline in persons who develop dementia. Neurology. 2009;73(5):356-361.
1. Gu Y, Nieves JW, Stern Y, et al. Food combination and Alzheimer disease risk: a protective diet. Arch Neurol. 2010;67(6):699-706.
2. Paganini-Hill A, Kawas CH, Corrada MM. Type of alcohol consumed, changes in intake over time, and mortality: the Leisure World Cohort Study. Age Ageing. 2007;36(2):203-209.
3. Cole SW, Hawkley LC, Arevelo JM, et al. Transcript origin analysis identifies antigen-presenting cells as primary targets of socially regulated gene expression in leukocytes. Proc Natl Acad Sci U S A. 2011;108(7):3080-3085.
4. Small G, Vorgan G. The Alzheimer’s Prevention Program: keep your brain healthy for the rest of your life. New York, NY: Workman Publishing Company, Inc; 2011:71.
5. Xie L, Kang H, Xu Q, et al. Sleep drives metabolite clearance from the adult brain. Science. 2013;342(6156):373-377.
6. Hall CB, Liptor RB, Sliwinski M, et al. Cognitive activities delay onset of memory decline in persons who develop dementia. Neurology. 2009;73(5):356-361.