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VESTED Magazine

Caring for an Aging Brain

Hearts do it, knees do it, and even faces do it. Every part of our bodies is subject to aging. So why should our brains be any different? They’re not. But the good news is that brain aging is not the same as dementia. Most of us who reach our 60s, 70s, 80s, and beyond will do it without developing severe cognitive impairment.

Hearts do it, knees do it, and even faces do it. Every part of our bodies is subject to aging. So why should our brains be any different? They’re not.

But the good news is that—contrary to the worst fears of aging baby boomers—brain aging is not synonymous with dementia. Most of us who reach our 60s, 70s, 80s, and beyond will do it without developing Alzheimer’s or other forms of severe cognitive impairment. We might misplace our keys, forget the names of new friends, and find multitasking increasingly challenging, but we are not universally bound for mental oblivion.

“When we talk about brain aging, we are not talking about a disease, we are talking about a process that goes on with everyone as they get older,” says Dan Blazer, an emeritus professor of psychiatry at Duke University Medical Center in Durham, NC.

And not everything about that process is negative. Older brains really do tend to be wiser brains, thanks to a lifetime of experience and learning.

That was one positive conclusion of a recent authoritative report on brain aging from the Institute of Medicine (IOM), part of the nonprofit National Academies of Sciences, Engineering and Medicine, based in Washington, DC. Blazer, who chaired the committee behind the report, said research also shows that vocabulary and factual knowledge increase well past typical retirement ages.

Still, most of us are worried about the not-so-positive side of brain aging, including the possibility that declines in memory, attention, thinking speed, and other cognitive abilities will eventually stop us from doing the things we want to do—from continuing to work to driving our own car and managing our own finances.

In a recent survey by AARP, 93 percent of respondents said that protecting their brain health was very or extremely important. But few said they knew how to do it.

Luckily, research is producing some answers.

“Brain aging need not be viewed as a passive process. We can influence the trajectory,” says Ronald Petersen, director of the Mayo Clinic Alzheimer’s Disease Research Center and the Mayo Clinic Study of Aging in Rochester, MN.

Here’s the best advice right now on how to keep those brain cells humming along. (Spoiler alert: staying sharp is going to take a lot more than a few brain games—and it won’t come in a pill.)

Get Moving

“News flash—your brain is connected at your neck to the rest of your body,” says Dan Hurley, author of the 2014 book Smarter: The New Science of Building Brain Power.

Hurley, 57, a journalist based in Montclair, NJ, spent several months investigating and trying out brain-building techniques. Physical exercise “is the best established” of those techniques, he says. The evidence was convincing enough, he says, to get him off his couch and into his wife’s intense boot camp exercise class—for four sweaty months, anyway.

The IOM committee was just as enthusiastic about exercise, naming it the first defense against brain aging.

“There have been studies on exercise and cognition in humans for decades. Not every study finds a positive relationship, but most do,” says committee member Arthur Kramer, a psychologist and neuroscientist who directs the Beckman Institute for Advanced Science & Technology at the University of Illinois.

Early studies, back in the 1970s, showed that athletes, on average, did better than non-athletes on cognitive tests as they aged. Other studies show people who remain physically active in middle age and beyond tend to stay sharper. And intervention studies, in which some older adults are assigned to exercise and others are not, have shown particularly impressive gains in executive functioning—the ability to plan, organize and problem-solve—among exercisers. Kramer and other researchers also have found increases in brain volume. While the best evidence points to the benefits of aerobic exercise (such as walking, running, and biking), some studies also suggest that working out with weights can help.

Why would exercise help your brain? One likely reason is that movement improves blood flow to the brain. “But it’s not just about blood flow,” Kramer says. Animal studies suggest that exercise increases the production of certain brain chemicals and improves connections between brain cells, he says. “In some cases, in some places in the brain, even new neurons can be born,” he says.

Think about that the next time you think about skipping the gym.


Mind Your Heart Health

“What is good for the heart is good for the brain,” Petersen says. While that includes exercise, it also includes knowing your blood pressure, blood sugar, and cholesterol levels and taking action if your numbers drift out of the healthy zone. Obesity also may contribute to cognitive decline, just as it contributes to heart disease and diabetes, the IOM report said.

While it’s not clear why some of these conditions might impair brain health—or whether controlling them with medications and lifestyle changes will directly help your brain—it is clear that they contribute to the risk of stroke. And if you value your brain health, you don’t want to have a stroke. One study found dementia in 26 percent of older people evaluated three months after a stroke; another found that a single stroke doubled the risk of dementia.

Stay Mentally Engaged

Use it or lose it? Perhaps. There’s plenty of evidence that people who stay mentally active through stimulating work, reading, hobbies, or other means also stay sharper. It’s a little less clear whether that ongoing stimulation makes the difference or whether people with such habits are benefiting from a lifetime of learning and accompanying socioeconomic advantages.

But the big debate is whether formal brain training through games designed to exercise the mind can make a difference.

Hurley, for one, is a believer. During the same four months he sweated through physical boot camp, he enrolled in Luminosity, the popular online brain-training program. Many of the games in the program are based on games that produce cognitive benefits in lab studies. “They just dress it up … and make it more fun,” he says. The longer he played, the better he got at the games, and he’s convinced that, along with the other methods he tried, they helped make him a bit sharper.

Many scientists are unconvinced. The IOM committee concluded that studies of brain training, while tantalizing, have not been large or rigorous enough to prove the games do more than create better game players. “There’s no question that if you work at these games you will get better at the games themselves,” Blazer says. “But remembering faces in a game does not mean you will remember faces better in real life.”

Stay Socially Engaged

People who spend time with other people maintain better brain power. “We certainly want to avoid the tendency to withdraw and stay home watching TV when we could be going to a church social, going to a movie with friends, or playing bridge,” Petersen says. Whether it’s the socializing or the other mental stimulation in those activities that makes the difference is almost beside the point, he says.

Social withdrawal may lead to cognitive decline, and cognitive decline may lead to more social withdrawal, feeding a downward cycle, the IOM report said.

Get Enough Sleep

How much sleep do you need? Studies suggest a sweet spot of about seven to eight hours a night. People who routinely get less or more than that tend to have more cognitive problems. And quality matters: disturbed sleep and insomnia—trouble falling or staying asleep—are associated with poorer cognitive function. Of particular concern is sleep apnea, a common condition in which people stop breathing many times a night. Treatment for sleep apnea can lead to increases in attention, memory, and other thinking skills, several small studies suggest.

Keep Your Doctor in the Loop

It pays to keep a pro on your brain-protection team. For starters, you should make sure your doctor knows about all the medications you take, including over-the-counter products. Many medications, including sleeping pills, sedatives, and even common antihistamines, can impair thinking.

Your doctor also can help protect your brain by keeping you out of operating rooms and hospitals as much as possible. For reasons not fully understood, many older people suffer bouts of delirium and subsequent cognitive decline after hospitalization or surgery.

Finally, your doctor—perhaps more than your family or friends—may be willing to tell you when cognitive changes mean it’s time to make some lifestyle adjustments.

Blazer recalls treating a quite elderly man who did not have dementia, but had many signs of cognitive aging, including reduced reaction times. Blazer happened to know the neighborhood where the man lived and realized the patient was making a left turn onto a four-lane street to get to his office. Blazer did not think the man needed to stop driving, but he did think he should stop making that left turn and told him so. “I suggested he make a right turn and then a U-turn,” Blazer said. “He started doing that, and I felt much better.”

Forget About Supplements or Smart Pills

Despite many studies, there’s no convincing evidence that any vitamin or other supplement, including vitamin E and fish oil pills, will protect or improve your memory, the IOM committee concluded. More promising, but still inconclusive, according to the report, is evidence that eating diets with lots of fish, plus nuts, olive oil, legumes, and whole grains will help maintain brain health.

And, sorry folks, science has yet to come up with a drug that makes you smarter. “People like to think they can solve these things by popping a pill,” Hurley says. “But they can’t.”