How to prevent cognitive decline. Bette Davis had it right when she said, "Old age is no place for sissies." As the years accumulate, we are besieged by an onslaught of aches, gray hair and wrinkles, not to mention the specters of disease and death. Some of us fight valiantly, spending a fortune on creams and potions to (we hope) mask the physical changes wrought by the passing years, and doing what we can to keep our vital organs healthy and intact. But is there much we can do for our brains? Should we stock up on ginkgo biloba as well as Grecian Formula, or are we destined to mentally decline as the years pass, regardless?The news is mostly good. Leaving aside diseases that affect the brain, such as Alzheimer's and vascular disease, some aspects of cognition in a healthy person do typically diminish over time. Our ability to remember names, for instance, often begins to suffer in middle age, says Dennis M. McCullough, M.D., Community Geriatric Consultant and Associate Professor of Community and Family Medicine at the Centers for Health and Aging at Dartmouth Medical School.However, when it comes to performing mental gymnastics such as mathematics or puzzle solving, "older people are quite accurate in what they can achieve," McCullough says; it just might take them a bit longer to get there. "That seems to be the course of normal aging," he says. "Processes are slowed down, but the end results tend to be quite good in a healthy person who doesn't have some kind of disease in the brain."Cognitive conditioningFortunately, there are ways to help keep the brain operating at peak capacity. For anyone who is aging normally, much of the secret to remaining cognitively vibrant is simple: use it or lose it. Just as habitual reliance on a calculator will diminish your ability to mentally perform math calculations, lack of brain use in general can dull its effectiveness, says McCullough. "We maintain our cognitive skill levels by using cognition. People who get lazy about cognitive activities are more likely to have a sort of out-of-shape brain, a deconditioned brain."What to do? "Challenge yourself mentally," says Tatiana Nabioullina, M.D., a neurologist at Foundation Neurology and Southern New Hampshire Medical Center in Nashua. "Always learn something new. This is the key." Your brain-boosting workout could be as simple as learning how to cook a new dish, Nabioullina says, putting together a puzzle, reading, playing a cardboard game or memorizing poetry, or you can tackle something more complicated, such as learning how to speak a foreign language or play a musical instrument. The memorization involved in these tasks develops new pathways in the brain, Nabioullina says, which delays the aging process.Physical exercise can also help you stay mentally sharp. Research clearly supports the benefits of exercise in sustaining cognitive health, McCullough says. "If you keep your body in shape," he says, "chances are your brain is going to be healthier."And exercise, although "extremely important," does not have to be vigorous, Nabioullina says. "Even simple walking will help," she says. It decreases stress, boosts resistance to fatigue and improves concentration - especially if the exercise is complex, like dancing for instance, which creates new brain pathways because of the memorization involved, Nabioullina says. Maintaining good overall physical health also lowers your chances of developing diabetes, high cholesterol and high blood pressure, which can lead to problems inside the small blood vessels in the brain and cause sluggish blood flow or a stroke, she says.Other brain-friendly lifestyle factors include avoiding excessive alcohol use and limiting exposure to toxins, tobacco, polluted air, glue and pesticides. "Avoid anything unnatural," Nabioullina says.And don't forget those z's. "Sleep is being shown to be more and more important" to cognitive health, McCullough says. Sleep refreshes the brain and provides a quiet respite from the daily media bombardment and fast pace that most of us experience. "The brain needs that time," McCullough says. "Our brain does a lot more when it's sleeping besides rest," he says. Time spent sleeping "is not lost time. It's very important time for our cognition."Lastly, respect the power of emotions. Cognitive functioning is more likely to stay on an even keel if you feel good about life. Even minor bouts of depression can affect the ability to think in a focused way, McCullough says. So, if you want to prevent cognitive decline, live a life that is, for the most part, pleasing and satisfying. "Social interaction, having a spiritual life, engagement with things that really interest you deeply - those are things that keep your emotional life stronger," he says, and help lower your risk of cognitive decline.In fact, even simple hugs and holding hands offer great cognitive benefits, Nabioullina says. Whether you chat with neighbors or relatives, volunteer or connect with co-workers, social interaction can improve your cognitive skills, she says, plus leave you feeling less stressed, more energetic and better about yourself. NHFood for thoughtWe know that food can affect our heart health and waistline. Turns out our diet also affects our intellect. If you want to keep your brain in tiptop shape, be sure to make cerebral-enhancing ingredients mainstays of your diet. "Smart carbs," found in low-processed foods and whole grains, should be featured frequently on your menu, along with leafy greens to boost folate and B vitamins that are beneficial especially as the brain ages, says Marilyn Mills, M.S., R.D., L.D., C.D.E., a clinical dietitian with Elliot Health Systems. And don't forget omega-3 essential fatty acids. They are directly related to cognitive function and found in salmon and some other types of fish, and as an added ingredient in some foods.Feel free to skip the ginkgo biloba, an herbal supplement marketed as a memory enhancer, since scientific evidence does not fully support its effectiveness in improving cognitive function, Mills says. But taking a supplement that contains the amino acid derivative N-acetyl cysteine can be helpful, she says, along with vitamin E. If you're on medications, check with a healthcare provider before tweaking your diet or adding supplements, Mills says. But once you've got the green light, let the brain-friendly eating begin. "Don't wait until you're already losing some of your memory to start eating better," she says, because dietary changes will not provide an instant fix.
This article appears in the January 2011 issue of New Hampshire Magazine