Most people in their middle or later ages are acutely aware of what they might face in terms of brain function deterioration or mental decline for their coming years. This is one of the most dreaded things that can happen to us because it makes us dependent on others and creates a burden, both emotionally and financially, for ourselves and our families.

I recently read the book by Dharma Khalsa, M.D. on Brain Longevity and noted that the principles of aging of the body in general also apply to aging of the brain. Interestingly, Dr. William B. Grant, Ph.D., a NASA scientist whose mother developed Alzheimer’s, was able to contribute dynamic research in this field. He noted that countries with the highest intake of total calories and fat seem to have more loss of brain function and that some aspects of nutritional intake, such as eating fish and whole grains, are helpful in the brain-aging process.

There are approximately 5.4 million Americans living with Alzheimer’s disease or other types of cognitive decline; 3.4 million (two-thirds) are women. Alzheimer’s was one of the top six causes of death in the US in 2009. By 2050 as many as 16 million Americans will have the disease. Although we have discussed this topic in the past (April 2005 & May 2009), it bears discussing again because of the tremendous implications of not following a good pathway to brain health.

As with other programs for antiaging, nutritional intake is probably the most important consideration, followed by adequate levels of vitamins and added nutrients, stress modification, and plenty of exercise. We know that developmental problems in our bodies often take many years to be manifest. For instance, the incubation period for cancer can be up to 25 years, and this can be true for heart disease, chronic lung disease, and some types of renal disease. The same can be said of Alzheimer’s and other diseases causing cognitive decline. The question is, can Alzheimer’s disease and other diseases causing cognitive decline be delayed or prevented?

By the time we reach early middle age, we exhibit some age-related cognitive decline. When you see changes on the external body such as gray hair and wrinkles, you can imagine there are changes taking place inside the body as well. This is true in the heart, liver, and kidneys, and also the brain. We have many millions of nerve cells or neurons in the brain, which are sensitive to genetic signals that allow some to die on a timed basis. Each cell has the ability to react negatively to free-radical damage. An example of what can cause this damage is the ingestion of “bad fats” such as hydrogenated or transfat. Also, the body makes free radicals every day, and if you have less antioxidant protection, you will have more rapid cognitive decline.

In John Robbins’ book, Healthy at 100: The Scientifically Proven Secrets of the World’s Healthiest and Longest-Lived Peoples, he quoted the authors of the Okinawa Centenarian Study, noting that the elders “have remarkable mental clarity, even over the age of 100.” We know that this group drinks the least milk, eats the most fish, and keeps the best body mass index level of just about any culture in the world. They are lean, active with exercise, eat a lot of fish and seafood as well as seaweed, and take their vitamins regularly.

Some of the people involved in research for Alzheimer’s disease are looking for drugs to slow progression of the disease, but this research has not been very fruitful, even though a lot of research funding and hours have been spent. But no matter how much we study age-related cognitive decline including Alzheimer’s, the more we see that it is related to continued lifestyle habits over the years preceding the actual decline.

Exercise has been known to improve the statistics for cancer and heart disease, as well as for age-related cognitive decline. A five-year study in the Archives of Neurology showed that people with the highest activity levels were only half as likely as inactive people to develop Alzheimer’s and were substantially less likely to suffer other forms of dementia. Those who had even some light or moderate exercise had significant reductions in their risk. The Journal of the American Medical Association produced a series of studies confirming that regular exercise helps preserve clear thinking even at advanced ages. Women over 70 who have higher levels of physical activity scored better on cognitive performance and had less age-related cognitive decline.

Like every other aspect of our health, it is important for us to be on a program that is specific to our own age, medical history, genetic inheritance, and other risk factors. The question is where to start? I would say that being aware of all the information related to your own particular pathway is the best place. According to Dr. Khalsa, the best pathway is a lifestyle pathway and not a drug-based one. Your lifestyle program should include nutritional therapy, stress management, exercise, and vitamin supplementation. Note that certain nutrients such as folic acid and vitamin B12 reduce the homocysteine levels in the body, and this in turn reduces the incidence of Alzheimer’s disease. Vitamin B12 can only be obtained by the sublingual route, intramuscular route, or by eating small amounts of red meat

In summary, if you eat a diet high in meat, hydrogenated fat, excess saturated fat (fried foods), cholesterol, sugar, and white flour, you will almost certainly accelerate the appearance of age-related cognitive decline. But if you are eating fresh vegetables, whole grains, fresh fruits, and legumes along with omega-3 fatty acids and vitamin supplementation, you will be in the company of healthy individuals, including the extremely healthy Okinawans. So, eat well, minimize your caloric intake, take your supplements, exercise, and you will be able to think more clearly in your later years and avoid the mental decline we all fear. 

Dr. Carraway is the director of the Plastic & Cosmetic Surgery Center of EVMS. Call 757-557-0300 for more information.