Keeping Your Brain Healthy

In my last column, I wrote about how one can distinguish between normal everyday cognitive failures and signs of dementia. Here, I’ll provide tips to maintain and improve brain health. These are based on a 2020 updated review of strategies to prevent and slow dementia published in the medical journal The Lancet. The review identified 12 potentially controllable risk factors* that account for 40 percent of dementia cases.

#1: Stay healthy. Risk factors directly related to brain health that can be addressed with your physician include high blood pressure, hearing impairment, smoking, obesity, depression, and diabetes.

#2: Stay physically active. A big risk factor identified in The Lancet review is physical inactivity. Physical activity and exercise can also prevent or reduce obesity, high blood pressure, diabetes, and depression. 
This does not mean you have to start running marathons or going to the gym. Vigorous walking, light weight training, and outdoor physical activities such as gardening, hiking, rowing, and pickleball are great. 

Balance training may reduce your risk of falls—many people enjoy yoga and tai chi. Fall prevention is important because falls are a frequent cause of brain injury in older adults—another risk factor in the 2020 review. Also, broken bones due to falls can cause extended infirmity and cognitive decline due to isolation. So, find a physical activity that you enjoy and do it daily for 20 to 30 minutes.

#3: Socialize. Social isolation was another risk factor identified in the review. As one example, I saw a decline in my mother’s cognitive and physical functioning due to social isolation during the first year of the pandemic. She lost all the social contact and activities she had previously enjoyed, which took a toll. Social inactivity can also lead to depression, and it appears that in-person social contact is better than Zoom, Facebook, or other virtual contact. So, see your friends, get involved with a new social group, or volunteer.

#4: Challenge your brain. The Lancet noted that those with less education seem more prone to dementia. Although some may choose to go back to school and add another degree, most will not want to do this. But as we age and are no longer working, continuing to challenge our brains becomes important and may foster the growth of new neurons. The best way is through a new cognitive activity that you find challenging. You might take a class to learn something new such as an unfamiliar subject, a foreign language, or how to play a musical instrument—many of my friends know that I favor the ukulele. If you enjoy puzzles, do more complex ones. Although the benefits of brain games such as Lumosity have been touted as helpful, there is limited research showing long-term benefits. For the most part, people get better at these games, but this does not result in improved daily functioning.

#5: Drink in moderation. Excessive consumption was a new risk factor in the 2020 review. A recent study lowered the amount of daily alcohol considered safe. However, study findings have been inconsistent. So, use good judgment. For men, the thinking has been no more than two alcoholic beverages a day and for women, no more than one.

#6: Get some fresh air. Another new risk factor in the 2020 review was exposure to air pollution. Granted, many people are not fortunate enough to live by the ocean. Also, the impact of air pollution builds over time for those living in cities. But we know that being in nature and green space can improve mood. And because depression is a risk factor for cognitive decline, being outdoors when weather permits is good therapy.
#7: Finally, there are three important, controllable factors that were not mentioned in this review:

First, lower your stress. Excessive stress over time taxes the body and the brain and can lead to depression. Most of the recommended activities can lower stress. However, if you find yourself unable to cope with stress, seek the help of an experienced therapist. 

Second, maintain a regular sleep routine. Most adults need seven to eight hours of sleep. Research has shown that less can affect cognition, especially attention and memory. And, if you are having problems sleeping, speak with your physician about possible causes. 

Third, maintain good nutrition. This can alleviate or reduce obesity, high blood pressure, and diabetes, which are often interrelated.

Want a structured program? Check out two books written by my colleagues: The Brain Health Book, by John Randolph, PhD., ABPP, and High Octane Brain, by Michelle Braun, PhD., ABPP. ▼

*Less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, low social contact, excessive alcohol intake, traumatic brain injury, and air pollution. 

Dr. Robb Mapou is a board-certified clinical neuropsychologist (American Board of Professional Psychology) in Delaware. In addition to evaluating older adults who have concerns about cognitive changes, he specializes evaluating teenagers and adults for autism spectrum disorder, specific learning disorders, and attention-deficit/hyperactivity disorder. His office is in Rehoboth Beach. His website is drrobbmapou.com.