02.25.09 Brain Fitness Blog
Welcome to our inaugural Optimum Life Blog. As Brookdale Senior Living’s Optimum Life medical director, I am excited to use this venue to discuss important senior health issues and answer your questions. Each month we will focus on a specific area and welcome your questions related to the issue. Please understand that I cannot answer specific medical questions related to your personal health situation. That is best done by your personal physician.
Our first topic is related to brain health. Studies have suggested that Americans fear Alzheimer’s disease only secondary to cancer. Researchers are investigating some promising new areas that may hold the key to modifying the course or even arresting the disease. The good news is that some of these things like our diet, physical activity, intellectual pursuits, and social engagement are under our control. I welcome your questions related to this very important topic.
Q: Sara, IL - What's the most important thing we can do to preserve brain health?
A: Dr. O'Neil - The most important thing is keeping our bodies moving with regular exercise. This increases blood flow to the brain and helps form new brain cells. In addition, staying socially active and intellectually stimulated are important.
Q: Holly, IL - Why is practicing "brain fitness" so important?
A: Dr. O'Neil - Research has confirmed that keeping our brains stimulated helps brain cells to survive. This needs to be coupled with physical activity.
Q: Eleanor, IL - People in our age group face a lot of changes that seem to be more difficult for us to manage. How shall we deal with depression? Medication? Keeping busy? What do you suggest one can do to fight off or deal with depression?
A: Dr. O'Neil - Depression is quite common as we grow older due to losses that may come with age. It is important to keep a positive attitude and sense of humor. Physical activity releases hormones that elevate mood. There are medications that can help but the above things can be as important if not more so.
Q: Carol, CA - How can I prevent Alzheimer's?
A: Dr. O'Neil - We can not say until more research is available that we can prevent Alzheimer’s disease, but we may be able to reduce the risk by maintaining a good diet with fruits and vegetables for antioxidants and folic acid, exercising and staying socially engaged. Life long learning—including doing new tasks and learning new information can also help.
Q: Sheldon, IL - Besides doing a crossword puzzle, what other activities do you recommend to improve brain health/cognition?
A: Dr. O'Neil - Playing board games, bridge, and Sudoku as well as participating in creative arts such as painting and sculpting are all good examples. Computer assisted brain games may also stimulate different areas of the brain but does not replace other activities. Dancing is good for memory because it is a physical activity, has a social aspect and we have to memorize the steps.
Q: Ruth, IL - What are the best exercises to increase brain health? Dancing? Walking? Others?
A: Dr. O'Neil - Aerobic activity is important—things like biking, rowing, walking. Strength training is also being recommended. Dancing has been shown to be better than most activities for reducing the risk for Alzheimer’s disease. Try to get 30 minutes of moderate exercise most if not all days of the week. Gradually build up if you have not been active.
Q: Rita, NY - If you have reached a stage where you have noticeable reduction in brain function (such as forgetfulness, loss of vocabulary recall etc.) is it possible to reverse this?
A: Dr. O'Neil - It depends. Cases of age-related memory changes may have some reversibility with cognitive stimulation through occupational or speech therapy. However there are some conditions or certain types of dementia where changes may not be reversible. Studies show that good lifestyle habits, such as exercise, social and intellectual stimulation can slow the progression of dementia.
Q: Ann - What causes Alzheimer's disease?
A: Dr. O'Neil - No one knows the exact cause. There is a lot of research going on. It may be a combination of genetic, environmental and lifestyle factors. The amyloidal hypothesis in which a toxic protein accumulates in the brain is coming under scrutiny because recent drugs designed to attack this process have not met with much success. Lifestyle factors, things we have control of, are our best defense right now.
Q: Dorothy, IL - What is the effect of socialization on brain fitness? I think it is important to mingle and meet people.
A: Dr. O'Neil - Dorothy, you are absolutely right! Social isolation has itself been identified as an independent risk factor for dementia. Social engagement stimulates our minds in many ways including emotionally.
Q: Alice, IL - What specific foods contain folic acid and antioxidants? What specific foods do you recommend?
A: Dr. O'Neil - Folic acid: spinach, dark green lettuce, beans, breakfast cereals that are fortified, asparagus, chickpeas, pinto beans and sunflower seeds. Antioxidants: blueberries, cranberries, pomegranates, green tea, red onions, dark chocolate, broccoli, tomatoes, carrots and red grapes contain resveratrol which studies suggest enhance our longevity enzymes. Drink red wine in moderation.
Q: Dorothy, IL - How can we improve our short-term memory? Are there different ways to improve long-term memory?
A: Dr. O'Neil - I suggest that you keep lists to help jog your short-term memory. This is where computer assisted learning games can be very helpful. Exercise and social engagement will help with all types of mental processes.
Q: Shirley, IL - Is Alzheimer's disease genetic? What percentage of Alzheimer's patients have a hereditary form of Alzheimer's?
A: Dr. O'Neil - In some cases Alzheimer’s is clearly genetic. However most cases do not seem to have a strong hereditary pattern to them. If you have a first degree relative with Alzheimer’s it does indicate a higher genetic risk. There is a gene called the APO E-4 gene that does confer a higher risk. However, often the inheritance pattern is obscure. There are many cases where there is not family history and other risk factors may be involved.
Q: Ben, IL - What exercises can one do if one has low mobility?
A: Dr. O'Neil - If someone has low mobility because of problems with arthritis etc., an upper extremity exercise such as swimming is good. Occupational and physical therapists can help to design a program for your specific condition.
Q: Ben, IL - Is dark chocolate a good food for brain health? What are other "superfoods?"
A: Dr. O'Neil - Yes. Other "superfoods" include nuts like walnuts, almonds, peanuts and flaxseed are all rich in Omega 3 fats. Berries, wild salmon, pomegranates, dark chocolate and green tea also offer health protection. There is also some exciting research regarding coffee. It seems that people who drink coffee later in mid-life may reduce their risk for Alzheimer’s disease in later life. However, some persons are advised to restrict coffee drinking for other health reasons, such as gastro esophageal reflux disease (GERD) or heart palpitations. Discuss the benefits versus risks of coffee drinking with your doctor if you have questions on whether or not coffee is appropriate for you.
Q: Thea, IL - At what age do people generally become at risk for getting Alzheimer's disease?
A: Dr. O'Neil - When Dr. Alzheimer firs described the disease-it was in younger people. Age is a risk factor. The risk doubles every five years. 1-2% at age 65, 2-4% at 70, 4-8% at 75, 8-16% at 80 and nearly 50% at 90. What we know is that the lifestyle factor we have been mentioning can delay the onset of the disease by as much as 5-10 years.
Q: Dorothy, WI - Can the brain regenerate?
A: Dr. O'Neil - Recent research has shown that we can develop new brain cells no matter how old we are. Exercise spawns new nerve cells and intellectual stimulation helps them survive. However, there are certain pathological conditions that may permanently destroy brain cells.
Q: Shirley, IL - Why does it seem that women have a higher risk of getting Alzheimer's disease?
A: Dr. O'Neil - There has been the discovery of a gene on the X chromosome which women have two copies of. This may be associated with a higher risk, but we don’t know how big that risk really is. However, women do live longer than men. The female hormones are protective but do decline after menopause. The risks of hormone replacement do not warrant taking them for this purpose.
Q: Rita, NY - Is there a way to distinguish between ordinary age-related memory loss vs. Alzheimer’s?
A: Dr. O'Neil - There is. What I recommend is to know the 10 warning signs of Alzheimer’s disease which include significant memory loss that impacts daily functioning, difficulty performing familiar tasks, disorientation to time and place, difficulty with abstract thinking, and significant change in mood or behavior. For more information see the Alzheimer’s Association website at www.alz.org.
Q: Ben, IL - How does the length of time one spends watching television affect brain health?
A: Dr. O'Neil - If it is educational programming it can be beneficial. Most TV watching gives as much stimulation as when you are sleeping. I encourage different forms of stimulation other than TV.
Q: Ruth, IL - What pathological conditions may permanently destroy brain cells?
A: Dr. O'Neil - Alzheimer’s disease is by far the most common. The second most common in older adults is dementia with Lewy bodies, the third is vascular dementia which is related to strokes. Less common is fronto-temporal dementia (formerly called Pick's disease). However there are many other causes of dementia such as HIV infection and other viral infections of the brain and a host of other more rare conditions. Serious head injuries can permanently damage brain cells.
Q: George, WI - Does sleep play a role in brain health?
A: Dr. O'Neil - Yes. Although sleep deprivation does not cause dementia—it can affect mood and daily functioning. Sleep is very important and allows the brain to replenish itself. During sleep we may be stimulating areas of the brain that are not stimulated during the waking hours. Current recommendations vary but most suggest 7-8 hours per night. A good night’s sleep is important.
Q: Thea, IL - What is the difference between Alzheimer's and dementia?
A: Dr. O'Neil - Very good question! Dementia is a global term describing and loss of brain function severe enough to interfere with daily living activities. Alzheimer’s disease is by far the most common type of dementia, but as mentioned there are others. Proper diagnosis requires a doctor’s evaluation.
Q: Jennifer, IL - How is Alzheimer's disease diagnosed?
A: Dr. O'Neil - Diagnosis is a clinical one. Generally when there are warning signs, doctors will look for reversible conditions like under active thyroid condition, vitamin B12 deficiency, subdural hematoma etc. The evaluation will include a brain imaging test such as MRI, blood tests and perhaps a neuropsychological evaluation.
Dr. O'Neil - I would like to thank each and every one of you for joining us today. I hope you found the topic interesting and the discussion worthwhile. My wish is that you recognize some practical steps in your own life that you can implement to enhance your brain fitness. I welcome you back next month when our topic will be “Your Arthritis Questions Answered”.
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