Cognitive decline is a scary thought but like most illnesses, the sooner you start to address it, the better your likely outcomes.
No-one likes the concept of “losing your marbles”…not being able to remember names and faces or how to do simple tasks, perhaps having to give up work or stop driving your car. The resultant loss of independence is not something most of us want to contemplate. But the statistics on mild cognitive impairment (or it’s more serious form, Alzheimer’s disease) really should cause us to sit up and take notice.
The incidence of Alzheimer’s disease (AD) is growing at a rapid rate and expected to double every 20 years. It affects more women than men (approximately 2:1) and is the greatest cause of disability in Australians over 65 years of age. According to Dale Bredesen women it is now more likely that women will develop AD than breast cancer.
I recently attended the 2017 Science of Nutrition in Medicine conference where the focus of the two days was brain health and it was so exciting to hear the latest research into the causes and risk factors of AD along with all the emerging information on the positive things that show great promise for reducing risk and even potentially reverse or slowing cognitive decline (If this is of interest, read the work of Professor Dale Bredesen).
“Alzheimer’s disease is thought to be 5-10% genetic and 90-95% lifestyle.”
Assoc. Professor Ross Grant
Risk factors for developing cognitive impairment as you age
The list of possible factors which can increase your risk of AD is long and subject to change as we learn more however, we are now confident that it includes the following:
- Genetics – some genetic markers (eg variants in the ApoE gene) have been identified as associated with an increased risk (however these are still influenced by diet and lifestyle and it should be noted that over 50% of people with variants of the ApoE gene live into their 90s)
- Head trauma or concussions
- Poor sleep – both difficulty falling asleep (sleep latency) and poor or insufficient sleep results in increased brain atrophy and a build-up of waste (sleep is when the “garbage collectors” do their best work)
- Exposure to toxins such as air pollution, illicit drugs, biotoxins, mould or heavy metals
- A diet high in sugar, saturated fats, and refined carbohydrates and low in key nutrients (especially vitamins B12, folate and omega-3 fatty acids)
- A diet containing Advanced Glycation End Products (“AGEs”) which come from foods cooked at high temperature (think fried food, food cooked over flame or food which is “browned”)
- Prolonged periods of stress
- Alcohol intake – especially if greater than 1 standard drink/day (it has been shown that within 10 minutes of having a blood alcohol reading of 0.05, brain damage occurs which may not fully repair)
- Sedentary lifestyle
- Being overweight
- High cholesterol
- Low vitamin D levels
- Poor blood sugar regulation (i.e. poorly managed diabetes or insulin resistance)
- Leaky gut – permitting the unwanted movement of certain molecules into the blood stream
- Lack of social interaction
- Lack of mental stimulation
Prevention is key…start now!
Practical steps you can take to keep your brain healthy as you age
While the above list of risk factors might be a bit depressing (especially if you can currently tick a few of them), there were numerous positive messages coming out of the conference.
When you look through this list you will see that many of them are not new (they apply to good health generally) but we now have specific research into the healthy brain to inform these recommendations.
- Increase your anti-oxidant rich fruit and vegetables (unless you are one of the <5% who eat the recommended 2 serves of fruit and 5-6 serves of vegetables every day). Especially important are the blue/purple fruit and vegetables along with orange and yellows…..basically you want to “eat the rainbow” every day if possible.
- Boost your omega-3 fatty acids (aim for 2-3 serves of fish per week) – those with higher levels show less cognitive decline
- Keep your red meat intake to no more than 1-2 serves per week
- Keep dairy to 1-2 serves per day
- If you enjoy a tipple, keep it to a minimum and make it red wine
- Keep refined carbohydrates and sugar to a minimum
- Avoid fried, chared or overly browned foods
- Fasting for 12 hours overnight has been demonstrated to increase the body’s ability to maintain healthy cell turnover
- Aim for 8 hours of good sleep per night (to help with removal of waste, reduction in brain atrophy and blood sugar regulation)
- Exercise for 30-60 minutes per day (it doesn’t have to be strenuous) to help with waste removal and increase the benefits gained from sleep
- Engage your brain – do puzzles, solve problems, continue to learn (maybe a language, musical instrument or new skill), seek out new experiences
- Practice “single-tasking” instead of multi-tasking (multi-tasking has been shown to result in increased mild forgetfulness)
- Reduce stress – eliminate the stressors or practice stress reduction (even 5 minute of meditation has been shown to reduce inflammatory markers)
- Maintain social networks (and not just online) – engage, discuss, laugh, share
- Know your numbers – cholesterol, fasting insulin, fasting blood glucose, hsCRP, albumin/globulin ratio, B12/folate, ferritin waist/hip ratio and blood pressure are good places to start
- Address any underlying illnesses or health conditions
- Consider targeted nutritional and herbal supplements to support nutritional vulnerabilities and to aid in the management of underlying causes of disease, inflammation and metabolic dysfunction.
The list of things you can do is long and will really depend on your individual health and risk factors. You can make a good start by following the steps above but to maximise your health, work with a naturopath or healthcare provider trained in functional medicine to ensure you get exactly what you need in the right dose and at the right time.