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Wednesday, June 21, 2017

Memory Expert Separates Fact From Fiction About Preserving Brain Health

Carol Bradley Bursack @mindingourelder , Health Guide
June 20, 2017

Myths about brain health are as rampant as they are for any feared disease. Neuropsychologist Dr. Michelle Braun is a memory expert who actively fights against these myths. In the process, she helps people learn how to reduce their risk for developing Alzheimer’s disease.

Dr. Braun has worked for 10 years as a clinical neuropsychologist in departments of neurology, neurosurgery, and psychiatry in hospitals and academia. In 2008, she received the Practitioner of the Year Award from the Alzheimer’s Association in southeastern Wisconsin.

Here, in this email interview, Dr. Braun tells HealthCentral readers how they can maintain memory while increasing their overall quality of life.

HealthCentral: Dr. Braun, what do you feel are the most common myths about Alzheimer’s?
Dr. Michelle Braun: The most common myth is that Alzheimer’s is hereditary and that we cannot decrease our risk of developing it. Although there is a strong hereditary risk for early-onset Alzheimer’s, in which symptoms develop prior to age 65, there is not a strong hereditary risk for most cases of late-onset Alzheimer’s, in which symptoms develop after age 65. This is an especially important myth to overturn because 96 percent of all cases of Alzheimer’s are late-onset and lifestyle factors under our direct control can significantly minimize the risk of developing it.

Another myth is that crosswords or online brain games are the best way to minimize the risk of developing Alzheimer’s. Note: Dr. Braun goes into detail below.

Many people also believe the myth that memory supplements can decrease the risk of Alzheimer’s.
Another common myth is that if a person has changes in brain tissue that are associated with Alzheimer’s, they will definitely exhibit the symptoms of Alzheimer’s. Autopsies have shown that some individuals with brain tissue changes linked to Alzheimer’s do not exhibit memory problems or other symptoms of Alzheimer’s in daily life. Protective lifestyle factors are likely responsible for the ability to compensate, or “shield” ourselves, from expressing symptoms, even if our brain tissue is impacted by the changes linked to Alzheimer’s.
One more common myth is that Alzheimer’s or significant memory problems are a part of normal aging. In fact, some older adults are “super agers” and have remarkable memories. For example, a 2016 study showed that the brain functioning of super agers who were 60 to 80 years old was similar to the brain functioning of 18- to 35-year-olds.

HC: If Alzheimer’s runs in the family, what do you suggest that people do to lower their risk of developing the disease?
Dr. B: Even if late-onset Alzheimer’s runs in the family, this does not guarantee that other family members will get the disease. Alzheimer’s is sometimes linked to genes that increase the risk of developing it, but not necessarily. Many individuals with a genetic risk for Alzheimer’s don’t develop it, whereas some individuals without a genetic risk do. This proves that Alzheimer’s is related to much more than genetic factors.
The best techniques to lower the risk of late-onset Alzheimer’s are the same whether or not there is a genetic risk factor for the disease. These include:
  • Engaging in regular aerobic exercise (30 minutes per day, 4 to 5 times per week is ideal)
  • Seeking out “brain building” experiences
  • Following a brain-healthy diet
  • Maximizing vascular health (by controlling blood pressure, cholesterol, blood sugar, and weight)
  • Adequate sleep (at least seven hours per night for most people)
  • Quitting smoking
  • Minimizing stress and depression
Multiple studies have shown the positive impact of exercise on brain health is even stronger for individuals with a genetic risk for Alzheimer’s than those without a genetic risk.

HC: If Alzheimer’s doesn’t run in the family, how significant do you feel lifestyle is in preventing the disease?
Dr. B: Lifestyle factors play a significant role in minimizing the risk of late-onset Alzheimer’s, whether or not it runs in the family. Dozens of studies show that regular cardiovascular exercise — especially when combined with resistance training — significantly lowers the risk of Alzheimer’s, even for adults who are already experiencing memory problems. (As noted above, other lifestyle factors that reduce the risk of Alzheimer’s include following a brain-healthy diet, seeking out brain building experiences, maximizing vascular health, adequate sleep, quitting smoking, and minimizing stress and depression).

HC: How do exercise, a healthy diet, and stress management affect the risk of developing Alzheimer’s?
Dr. B: Several studies have shown that cardiovascular exercise is the most powerful tool in minimizing the risk of Alzheimer’s. For example, a 2014 study in Lancet Neurology showed that one hour of weekly exercise decreased the risk of Alzheimer’s by half. In addition, people who were physically inactive had an 82 percent increased risk of Alzheimer’s. The brain-boosting benefit of exercise is likely related to the growth of new nerve cells in the core memory processing area of the brain (the hippocampus).
The impact of a brain-healthy diet is also powerful in reducing the risk of Alzheimer’s. For example, individuals who followed the MIND Diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) showed a 53 percent reduced risk of Alzheimer’s.
The power of diet is likely related to better blood pressure, cholesterol, blood sugar and weight. Antioxidants in brain-healthy diets also help to minimize the destruction of nerve cells by free radicals.
Stress management is crucial in counteracting high levels of stress hormones such as cortisol, which have been shown to impair memory performance. Stress management can take the form of meditation, relaxation, setting limits on our schedules, and reframing how we think about situations that we see as stressful.

HC: Do you feel that brain exercises help people retain their memory?
Dr. B: Yes, brain exercises can help people retain memory, but it’s exciting to know that most brain exercises can be improved upon to increase their brain-building effect. The goal of brain building is to increase the number of connections between neurons, so information is processed more quickly and remembered more effectively.
We can also bank those neuronal connections for later to stave off the symptoms of Alzheimer’s if our brain is impacted by the disease.
By definition, a brain-building activity should be customized to your own interests and should be slightly challenging to you. Examples of brain-building activities include learning a new language, a new route to work, a new gardening technique, new information about a topic you love, watching educational television, and any other task that is engaging, slightly challenging and interesting to you.
To build maximum neuronal connections, activities should be varied and shouldn’t involve tasks that we are already expert in. We should seek out “head-scratching moments” by doing tasks that are slightly challenging, because those tasks are likely to build stronger neuronal connections.
For example, if you are already great at crosswords, you are likely to grow more neuronal connections if you engage in a different task that you don’t know as well rather than doing another crossword. Most activities can be tweaked to be more challenging in order to provide greater brain-building rewards.
An interesting study published early this year by Mayo Clinic researchers demonstrated the breadth of activities that help to minimize cognitive decline. Results showed the risk of developing memory problems decreased by 30 percent when people used computers, by 28 percent when they did craft activities, by 23 percent when they were involved in social activities and by 22 percent when playing games. The effect was strongest when the activities were done one to two times weekly. This study and many others help demonstrate the best brain building activities go well beyond our current conceptions of brain exercises and brain games.

HC: What do you have to say about the controversy over brain games, reading and other mental challenges when it comes to maintaining memory?
Dr. B: Most people engage in brain games assuming there is a connection between their performance on a game and their real-world memory skills or functioning. However, the weakness of brain games is that this link often does not exist. For example, even if your score on a memory game improves, that doesn’t necessarily mean that your memory for grocery lists, names, or other daily information will improve. Brain games are often not the most efficient brain-building activities (as discussed above).

HC: Is it possible for those who have already been diagnosed with Alzheimer’s to slow down its progression?
Dr. B: Yes, cardiovascular exercise has been shown to decrease the rate of memory decline in individuals with Alzheimer’s. For example, a 2014 review of six studies on the impact of exercise in adults with Alzheimer’s showed that exercise slowed the rate of memory decline. Brain building exercises have also been shown to slow cognitive decline. In addition, prescription memory medication may also decrease the rate of memory decline, but the impact of cardiovascular exercise is generally strongest.
HC: Thank you, Dr. Braun. You’ve underscored some of what many of us have been told, as well as explained some finer points that will help us separate fact from myth. Your insight is appreciated.

Carol Bradley Bursack is a veteran family caregiver who spent more than two decades caring for a total of seven elders. She is a newspaper columnist and the author of Minding Our Elders: Caregivers Share Their Personal Stories. Bradley Bursack is also a contributor to several books on caregiving and dementia, and is passionate about preserving the dignity of elders. Her website is Follow Carol on Twitter @mindingourelder and on Facebook at Minding Our Elders.

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