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An Article to Remember

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Has anyone seen my keys?

The brain, like the rest of the body, gets a little less limber with time. It slows down, has trouble making connections and may even falter completely from time to time. For many of us, that’s just the normal process of aging. For others, it may signal the onset of a more serious cognitive disorder.

“A century ago, the elderly died from infectious diseases, heart disease, diabetes and other things we can now manage with modern medicine,” says Dr. John Q. Trojanowski, director of the Institute on Aging at the University of Pennsylvania School of Medicine. “As a result, we are living longer and often healthier lives.”

Unfortunately, our brains can’t always keep up.

From the time we are born to the time we turn into raging adolescents, the brain is racing to wire itself, making connections between nerve cells that in turn enlarge vital regions. By the time we reach puberty, we have the largest number of cells we’re ever going to have, says Dr. Carol Lippa, director of the Memory and Cognitive Disorders Center at Drexel University College of Medicine. After that, the process slows down, and the brain, in effect, prunes itself—refining what’s there rather than adding any new wiring.

“The brain is different from other organs in your body,” says Lippa. “If you lose a brain cell, it is gone forever. You have no way of getting it back, and as you get older, you lose cells in a variety of ways.”

We all experience forgetfulness from time to time. Who hasn’t walked into a room for something and forgotten what it is they wanted? It’s when experiences like that become daily occurrences that memory problems turn into something other than annoying. And while the biggest fear is developing Alzheimer’s, some memory problems can be the result of an underlying—and treatable—ailment. For example, Trojanowski points out that both hypothyroidism and vitamin B12 deficiency may cause memory decline and cognitive failure. With treatment, however, those symptoms decline or disappear altogether.

Unlike the old Rolling Stones song, time is not on our side. The unfortunate reality seems to be that the longer we live, the greater our chances are of developing Alzheimer’s. In fact, the national Alzheimer’s Association says 50 percent of people over 85 will develop Alzheimer’s. That’s a staggering number—and one that’s about to get larger as the wave of baby boomers starts crossing the hill into its sunset years.

The upside is that scientists are making new discoveries into the causes of Alzheimer’s every day. We now know that it’s caused by a toxic peptide in the brain called beta-amyloid. Beta-amyloid aggregates into plaques that deposit in the brain, killing cells in the memory and thinking areas of the brain.

The mystery is why some people who have the plaques don’t develop the disease. However, the discovery that plaques are caused by a genetic mutation suggests new areas of research, such as small molecule therapies, that block plaque formation, says Trojanowski.

In addition to possible small molecule therapies, Lippa and her colleagues at Drexel University’s College of Medicine are about to launch into a clinical trial using an immunotherapy vaccine for Alzheimer’s to see if the vaccine will clear beta-amyloid from the brain in those in the first stages of the disease. If it works, the vaccine could be given to people with early symptoms. Someday, Alzheimer’s vaccines may be administered to people who have a higher genetic disposition toward the disease or, perhaps, those of us who are just worried about getting it.
 

Continued on page 2 …
 

“While the ultimate goal is prevention, if we can push the onset of Alzheimer’s back five years, that would be a tremendous achievement,” says Trojanowski.

For aging baby boomers used to fighting the affects of time with gym memberships, medication and cosmetic surgery, even losing one IQ point may be too much to bear. While we may joke about having “senior moments,” we want something done about it.

When Lippa started the Drexel University College of Medicine’s Memory and Cognitive Disorders Center 12 years ago, she saw mostly Alzheimer’s patients. Now she is seeing more and more people with mild forgetfulness and other memory problems not related to dementia. Partly, this is a result of our growing awareness that there are better diagnostics and interventions. “When to get help is a matter of personal choice,” says Lippa. “As you get older, you have a little more trouble learning things. You may forget names for a moment or misplace things more frequently. But if you start losing things consistently, or forgetting what they are or how to use them, you should see a physician.”

Fortunately, all this attention devoted to the brain and its disorders has resulted in plenty of scientifically sound information about how to stay healthier longer.

It will probably come as no surprise that what’s good for our hearts is good for our heads. A rich network of blood vessels nourishes our brain—its health is closely tied to the health of our heart and our cardiovascular system. According to the Alzheimer’s Association, anything that affects the blood flow to the brain—heart disease, high blood pressure and stroke—is a risk factor for dementia. Luckily, there are things you can do about it.

Experts say even simple exercises like walking, gardening, bicycling, and doing Tai chi or yoga for about 30 minutes a day can help. Staying socially engaged is important. Problem-solving exercises—playing card games like bridge, working on puzzles, figuring out your driving route, engaging in a team sport, or making choices—are all great for helping your brain strengthen nerve connections.

“Your brain is like a muscle—if you don’t use it, it withers away,” says Lippa. “You can increase the strength and number of your connections with other brain cells—make it stronger and healthier. Both physical and mental exercises are very useful in preventing memory loss.”

While it won’t turn back time (after all, we have BOTOX for that), there is increasing evidence to suggest that a diet rich in green leafy vegetables, fruit, fish, olive oil and lean meat—all washed down with a glass of red wine—may help us stay sharper longer. There are no firm guidelines on what quantity of these foods is most beneficial, but the Alzheimer’s Association cited one study of older women that found those who ate the most green and cruciferous vegetables functioned at mental levels one to two years younger than their counterparts who ate few vegetables. That may be because there are substances found in fruits and vegetables that prevent cell damage of the sort that can lead to a number of diseases associated with aging, as well as reduced mental function.

“The good news is that the change from an unhealthy lifestyle to a healthy lifestyle may have benefits in our 60s [and] 70s,” says Trojanowski. “So it’s never too late to modify how you live in order to reduce your risk of Alzheimer’s.”

Aha! My keys!
 

Ways to “Feed Your Head” on page 3 …
 

Feed Your Head

Not surprisingly, the things we can do to help reduce memory loss are also the things that are good for us. Here’s what Dr. Carol Lippa, director of the Memory and Cognitive Disorders Center at Drexel University College of Medicine, and other experts recommend:

Stay connected. It’s important to maintain social connections. Research has found that elderly people who have deep family and personal ties do better on the whole than those who are isolated. Visit friends, volunteer whenever you can, and stay in touch with loved ones.

Put on your walking shoes. Walking, gardening, dancing, Tai chi—the Alzheimer’s Association says it doesn’t matter what exercise you do as long as you do something. There is good evidence to suggest that a mere 30 minutes a day helps keep our brains more active.

Have some chocolate with that glass of red wine. In the movie Sleeper, Woody Allen woke up in the future to discover that chocolate was good for you. Turns out, it’s true—as long as it’s dark chocolate. Research has shown that chocolate with 80 percent cocoa or more has important antioxidants. Wash it down with a glass of red wine for an extra boost of brain-protecting antioxidants.

Do what your mother told you: Eat your fruits and vegetables. A low-fat, low-cholesterol diet rich in dark-skinned vegetables and fruits may be just the ticket to a longer, healthier life. So go ahead, eat that spinach. There’s evidence to show that eating dark-skinned vegetables like kale, spinach, brussels sprouts, alfalfa sprouts, broccoli, beets, red bell peppers, onion, corn and eggplant is good for you. They’re loaded with natural antioxidants and low in fat. Also try prunes, blueberries, blackberries, strawberries, plums, oranges, red grapes and cherries.

Take your vitamins. Particularly vitamins B6, B12 and folate. A vitamin B12 deficiency can cause a form of dementia. Fortunately, treatment can often reverse the effects. Vitamins C and E are also useful in keeping your brain sharp. Consult your doctor to learn which vitamins are right for you, as it is possible to overdose on them.

Eat cold-water fish. Wild salmon, halibut and trout are excellent sources of omega-3 fatty acids, according to the Alzheimer’s Association. They also have the lowest levels of trace mercury. If you’re worried about mercury in your fish, you might want to opt for omega-3 supplements instead.

Keep your weight down. Obesity is a high risk factor for dementia. The Alzheimer’s Association cited a long-term study of 1,500 adults that found that those who were obese in middle age were twice as likely to develop dementia in later life. Those who also had high cholesterol and high blood pressure had six times the risk of dementia.

Go nuts. Some nuts can be a useful part of your diet. Almonds, pecans and walnuts are a good source of vitamin E, an antioxidant.

Play games. While there is no firm scientific evidence, anecdotal evidence suggests that crossword puzzles, Sudoku, card games like bridge, and other problem-solving games increase vitality and strengthen those all-important connections in your brain.

Watch your noggin. Traumatic brain injuries are one of the leading causes of dementia. If you ride a bike, ski or roller-skate, wear a helmet. Unclutter your house to protect against trips and falls. And always use your seatbelt.

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