A skipped appointment, confusion about how to take a prescription, or a forgotten instruction from our last visit sends my older patients into a spin of nervous panic, embarrassment, defensiveness, a string of excuses, and several assurances that such “highly unusual” memory blips “never happen” on a normal basis.
My younger patients, on the other hand, simply shrug – “oops, sorry Doc. I forgot.”
This is all very understandable; any sign of cognitive decline or memory loss brings to mind something that most of us dread being accused of – Aging. And with the number of people diagnosed with dementia – whose cause and cure are still unknown – rising rapidly worldwide, it’s no wonder that most people over 50 years old are just a little bit touchy on the subject. Our minds are the seat of all our experiences, our abilities, our cherished memories, our relationships, our wellbeing, our sense of who we are and what the world is around us. As our physical appearance and abilities start to change as we get older, the mind is the anchor that holds us to our lives. So we become – as we should become – defensive about it.
I listen to how many of my senior patients defend themselves against the decline of their brain health, proudly reporting how they successfully complete the newspaper crossword puzzle every morning, how they listen to classical music, how they engage in daily memory games and Sudoku boxes, all in the spirit of keeping their brains nimble and active as they age. And I applaud all of these effort – certainly, they are all good brain-toning techniques that are recommended to maintain brain health.
But the newest research has uncovered that these traditional brain exercises may still be missing the mark when it comes to maintaining full mental capacity, neglecting a far broader understanding of the many ways cognitive ability, function and memory really work.
Based on the latest discoveries and breakthroughs in brain sciences, I want to share some medically proven – yet, perhaps a bit less traditional –- tips, techniques and practices to keep your mind sharp, active, healthy and happy as you age. The golden years are called that for a reason, after all – don’t let yourself miss out on a single moment of them.
1. Backup Your System
As we age, several things can start to happen that interfere with the way we think, remember, and mentally function. Certain brain tissues begin to shrink, some brain cells die, neurotransmitters may not work as well, and protein plaques may deposit themselves on the brain, interfering with functioning. We also become more prone to nutritional deficiencies or negative drug interactions. For some people, further brain deterioration results in the development of dementia or Alzheimer’s disease. Scientists still don’t know exactly why cognitive decline occurs, or how to cure it. But, recently, we have started paying extra attention to groups of senior who have managed to hold on to normal mental functioning and memory – even when their brain scans revealed pronounced physical signs of Alzheimer’s disease!
A new term was coined for how these people seem to be protecting themselves, known as “cognitive reserve.” According to Gary Small, M.D., professor of psychiatry and director of the UCLA Longevity Center, cognitive reserve is like “having an extra mental battery,” that allows people to compensate for age-related or disease-related loss of functioning with other preserved connections in the brain.
How do we build up our cognitive reserve? By stepping out of our norm and learning new things. New sources of stimulation and various, unique forms of experience are key to building up cognitive reserve, creating new, strong channels in the brain and fortifying old ones. Crossword puzzles, Sudoku boxes and traditional memory games are all well and good, but they are not enough. You must also continuously seek out brand new ways to challenge your mental muscles, by learning new things, new skills, and even just by learning new ways of doing what you’ve always done.
So compensate for inevitable brain shrinkage by making sure that your brain continues to grow. Step out of your habitual box by taking a new course; you can check out a local college to additionally benefit from new social experiences, or you can choose from a wide variety of free online courses from Coursera or iTunesU. Take a trip to a new place. Do the things you love, but also try tackling new skills and hobbies that you may have previously shied away from, because they never came easily to you. Take a different route to the grocery store. Practice eating and writing with your non-dominant hand. These challenges may be a bit scary at first, but they will also add excitement and spice to your life, and will allow you to feel new sources of accomplishment and self-esteem as you continue to realize that you can do much more than you ever dreamed you were capable of.
This study goes hand-in-hand with another growing body of research, showing how exercise can significantly slow down cognitive decline. Older adults who were regularly active showed milder rates of cognitive decline, while even sedentary older adults who began exercising later in life were able to significantly slow down the rate of previous mental decline they were experiencing. Even just 20 minutes a day of exercise can stimulate brain growth, and improve your abilities of reasoning, clear thinking, decision making, planning and memory.
3. Stop and Smell the Roses
Our sense of smell is associated with the first cranial nerve, and this is one of the first areas to be negatively affected by aging and cognitive decline. Likewise, in Alzheimer’s patients, one of the first brain areas to show damage is the temporal lobe, which is involved in both smell and in the formation of new memories.
While many of us don’t tend to consciously rely on our sense of smell as heavily as we do on our other senses, our sense of smell is tightly connected to our mental functions. The smell center of our brains is intimately linked to the brain’s limbic system, the amygdala, the hippocampus and the prefrontal cortex, which are responsible for memory, emotion, learning, thinking and reasoning. Our sense of smell is interwoven into all of our learning experiences, and serves as a very powerful and useful trigger of memory that is often taken for granted. A study reported in Harvard Health Publications showed that people demonstrated better recall of an image when they originally saw it in combination with a scent – they remembered these images better even when the scent was no longer present.
The more senses you utilize during a learning experience, the more parts of your brain that will be activated, which also leads to stronger memory formation. Practice examining objects and experiences by taking note of what each of your senses is detecting. And regularly challenge all of your senses. Try to use your sense of smell to identify the ingredients in a new dish before you’ve tasted it. Close your eyes and practice identifying objects just by how they feel. Listen to a piece of music and try to identify which instruments you are hearing. Your senses are deeply connected to your mental functioning, and it could be a case of “using it, or losing it.”
4. Get a Longer Stretch of Sleep
Most of us already know what kind of difference a good night’s rest can make for how clear minded we feel in the morning. However, new studies show that a good night of sleep could actually make the difference between a brain that appears normal and healthy, and a brain that shows clear biomarkers of Alzheimer’s disease.
While previous studies had already established a link between poor sleep and cognitive impairment in older adults, a recent study published in JAMA Neurology may have established why: older adults who reported shorter sleep and poorer sleep quality showed higher levels of beta-amyloid plaque in their brains, a substance that deposits itself between brain cells and impedes their functioning. The brains of people with Alzheimer’s disease are characterized by high levels of these beta-amyloid plaque deposits.
This may strike up a bit of fear, as more than half of men and women over the age of 65 complain of sleeping problems. But there are many strategies you can use to improve your sleep quality, no matter how old you are. Refrain from drinking caffeinated or alcoholic beverages three hours prior to bedtime. Find something that relaxes you – like a warm bath, reading, rocking in a rocking chair, meditating, etc. – and make it part of your bedtime ritual every evening. Light incense or candles in the evening that give off relaxing scents, such as lavender, chamomile, jasmine, rose or vanilla. If you experience poor sleep at night but take many/long naps during the day, try shortening your day-time nap, or refrain from napping all together, and see if this improves how long and how deeply you sleep in the night.
5. Learn Proper Brain Hygiene
New research is showing that brain health isn’t just something you have – it’s an entire lifestyle that you have to upkeep. We are discovering staggering connections between cognitive decline and things that most people believed had nothing to do with the brain.
The University of Florida found a clear association between poor dental hygiene, gum disease and oral bacteria with brain tissue degeneration and Alzheimer’s disease. Dutch researchers recently discovered that heavy smokers had lower cognitive function and weaker memory than light and non-smokers. One study found that people with high blood pressure were more likely to have small areas of vascular brain damage and lower scores on tests of reasoning, while people with the highest risk of heart disease performed 50 percent worse on cognitive tests than heart-healthy people. Diabetes was found to be a very strong determinant of someone’s cognitive function – Charles DeCarli, MD, at the University of California, found that “people with diabetes in middle age lost volume in the hippocampus at a faster rate than those without diabetes.”
All of these studies and facts may seem discouraging and frightening to you. Obviously, the brain is a precious and fragile organ, and almost everything you do to your body, put into your bodies or expose your bodies to will have a major impact on it.
I, on the other hand, find these studies to be deeply calming and reassuring. For, while we already know that some of our risk for cognitive decline and the development of dementia is determined by our genes, all of this research shows us that a larger part of our fate lies in our own hands. Overeating, a diet full of fat and sugar, smoking, not exercising, not sleeping enough, neglecting oral hygiene – these are all lifestyle choices that we make in our lives. They are also choices that we get to rethink, to change, and to shed for positive lifestyle choices, such as:
When it comes to nurturing a healthy brain, it is never too early – and never too late – to begin cultivating it towards its highest potential.