HOW TO SPOT – AND PREVENT – COGNITIVE DECLINE
by Dr. Vivien Brown for CJN:
When we look at the concerns people have about healthy aging, one of the areas that seems mysterious and often worrisome is brain health. This is particularly worrisome for women, because 70 per cent of new Alzheimer’s cases appear in women.
Women are often diagnosed much later in the process of cognitive decline than men. Why? Women have better verbal skills than men overall and often test better than their male counterparts. They are therefore better able to compensate for some memory loss when they’re tested. As a result, women often do well on the test, even when they are losing their cognitive abilities. Thus, Alzheimer’s in women is often missed for months or years, meaning that, in many cases, it doesn’t get treated as early as it should. Most of the drugs on the market are meant to be used as early as possible to protect the brain. When a significant amount of decline has occurred, the drugs do not have as much impact as we would like.
There is, however, a new way of evaluating memory loss, which is called subjective cognitive decline. It looks at the memory loss, or other changes, that the patient is aware of. And although being evaluated for subjective decline doesn’t necessarily mean that the patient has, or will develop, Alzheimer’s or another form of dementia, there is a growing body of evidence showing that this discussion can be a good indicator of who is at risk. This has the potential to allow doctors to find, and start treating, cognitive disorders in women much earlier than they otherwise would have.
So what can we do to prevent cognitive decline, protect our brains and slow the process of impairment? One of the keys is to improve blood flow to the brain by engaging in regular exercise. Studies show that exercise increases brain-derived neurotrophic factor, which is critical for neural plasticity. That refers to the brain’s ability to adapt to stresses, physical or mental, which are often traumatic and unexpected. Exercise is associated with the growth and creation of new brain cells, which helps increase the volume of the brain. Sustained aerobic exercise is not to be taken lightly, or put off for another day.
I like to focus on exercise because it is within our control – we can choose to make a difference.
Other preventions that are both heart healthy and brain healthy include not smoking, maintaining a normal blood pressure and weight, maintaining low levels of cholesterol so our blood is not too oily and our arteries are open and clear to transport that blood to the brain. And, very importantly, we need to maintain our social connectedness. People who are isolated, alone and lonely do much worse with respect to both heart and brain diseases. Staying connected, participating, learning new things and interacting are all ways to protect our long-term health.
I have the honour of being a board member of the Women’s Brain Health Initiative, a charitable organization focused on education and raising money for research into women’s brain health. Its website (womensbrainhealth.org) is very educational for both men and women and I would encourage people to start there, learn something new and then share the information with friends and family.