S1E26. What I’ve Learned So Far

This is my 26th blog post, putting me at the halfway point in my first year of doing this, so I thought it might be a good time to summarize what I think I’ve learned so far.

I’ve been reading articles, attending virtual seminars and gathering information wherever I can. What follows is my impression of what we know about age-related cognitive decline, mild cognitive impairment and dementia. (Feel free to correct anything that isn’t right as I fully acknowledge that I might well have misinterpreted or mis-remembered things I’ve come across.)

Here’s my big-picture impression:

The brain is a marvelously complex organ and, as much as we know about it, we really know very little. It has the capacity to re-generate itself and re-wire itself. The more you activate it, the more connections are created between neurons and the stronger it becomes.

However, there are processes at work that can short-circuit the wiring and/or cause cell death. When the damage reaches a critical level, we experience symptoms of cognitive decline, or, as I’ve been describing it, we make more errors.

The brain is resilient and appears to have reserves that can be called upon when atrophy or injury occur, but these reserves have their limits.

We are just at the beginning stages of understanding all of this and the science has a long way to go before we will have any definitive answers. Nonetheless, we have enough information and tools available to begin to fight back.

Here’s what it appears we know:

All of us will experience age-related cognitive decline that is noticeable but does not interfere with our well-being. For about 20% of us, that decline will become pronounced enough to be cause for concern, but it can be managed with a few accommodations. The longer we live, though, the more likely it becomes that we will develop a full-blown dementia.

We don’t really know what causes our brains to misfire. There are correlational studies showing relationships between cognitive symptoms and beta amyloid, tau proteins, plaques & tangles, and inflammation, for example, but the evidence is not yet in confirming that any of these things are causal.

It pays to be born lucky. There are genetic factors in play making some people more at risk and others seeming to possess inherited protective qualities. White males are less prone to dementia than other groups.  

Lifetime experiences influence your risk of developing dementia in later years. It helps to have attended a good elementary school and to have earned an advanced degree. Diabetes, concussions and strokes are very harmful. Having a career in which you interact with a lot of people is protective.

About 40% of all dementias can be prevented with fairly simple behavioral changes. Another way of phrasing this is to say that there are things you can do to reduce your risk of developing dementia by 40%. The earlier you adopt a brain-healthy lifestyle, the greater the benefits in your later years, but benefits can accrue no matter when you start.

There are 5 aspects to living a brain-healthy lifestyle:

1. Exercise: Maintaining a strong system of blood vessels in the brain to provide nourishment and remove debris and strengthening the vast multitude of neurons involved in movement provide a one-two punch against decline.

2. Diet: A heart-healthy diet is a brain-healthy diet; eating lots of whole grains, nuts, berries, colorful vegetables, leafy greens, beans and olive oil, while minimizing your intake of animal products and saturated fats is protective.

3. Cognitive Challenge: it goes beyond ‘use-it-or-lose-it,’ encouraging us to embrace and engage in new and novel activities to force our brains to grow connections which are protective and add to our brain’s resilience against atrophy.

4. Social Engagement: Interacting with others is the apex of brain activity and triggers a wide array of beneficial neurotransmitters and hormones.

5. Miscellaneous: Eliminating risk factors like smoking and drinking alcohol are important; getting a good night’s sleep and managing stress are known to reduce symptoms.

I’ll try to spend some time exploring each of these pillars of brain health in the months ahead. But I won’t just be exploring them from an academic standpoint. Although I consider myself a ‘subject’ in this self-styled experiment of mine, that doesn’t mean I have to guess whether I got the placebo or the real treatment! I will be actively implementing behavioral changes in each category to try to gain whatever advantage I can squeeze out.

I invite you to join me!

___________________