One of the scariest thoughts (for most of us) is the idea of losing our independence due to cognitive decline. Yet, research is showing that many of us could be headed for this reality. If you don’t think you could lose your independence think again. Dementia is on the rise, and with diminished cognitive function comes an increased risk of losing one’s independence.

Independence is often defined as the ability to perform the basic Activities of Daily Living (ADL) without assistance. Some of the most common ADLs include bathing, dressing, eating, getting in or out of a chair, using the toilet, and walking.

One of the most common forms of dementia is Alzheimer’s Disease. Alzheimer's Disease kills more people each year than breast and prostate cancer combined. In fact, it is the fifth leading cause of death among individuals who are 65 and older. Since the year 2000, deaths from heart disease have decreased by only 14% while deaths from Alzheimer's have increased by a shocking 89%. (2)

The following diagram shows some of the key symptoms of Dementia. Do you, or your loved ones show any combination of these symptoms? If yes, keep reading!

Health Span vs. Disease Span

The subject of dementia is really about Health Span vs. Disease Span. Health Span is how long you can live in a fully functional healthy state. This is in comparison to Disease Span which, is the length of time you spend in a dependent and dysfunctional state, and typically extends until you die.

Personally, I would like to do everything I can to extend my “Health Span” and limit my “Disease Span”. The good news is there are things you can do to extend your Health Span! No matter your genetics, previous history, or even if you have started to notice some cognitive changes, you can still take action. But, first, let’s gain a better understanding of just what is happening with Alzheimer's patients.

Amyloid Beta – The Plaque Former

First, we need to consider the effects of Amyloid Beta. Amyloid Beta is a substance that forms plaques and is commonly found in the brains of Alzheimer's patients. Amyloid Beta is a waste product that starts to accumulate between the synapses of the brain (A synapse is a junction between two nerve cells, and consists of a minute gap across which electrical impulses can jump). (1)

With Alzheimer's, Amyloid Beta starts to pile up in these synapses 15 to 20 years before Alzheimer’s symptoms start to appear. The appearance of symptoms is often called the “tipping point”.

Once someone passes the tipping point, they experience increased inflammation along the synapses of the neurons, along with synaptic damage that leads to the formation of tangles. These tangles choke off the synapse from the inside out eventually leading to synaptic death. Every time a synapse dies, you lose a key pathway to accessing information or retrieving a memory.

Though most individuals develop symptoms of Alzheimer’s after the age of 65, it is important to remember that plaques can develop 20 years before these symptoms arise.

Fortunately, there are many actions you can take now to prevent these amyloid plaques from forming. The first is to consider your sleeping patterns, the second is your cardiovascular health.

Why is Sleep So Important?

In reality, we live in a sleep-deprived society. I myself have been guilty of this; it's all too easy to get caught up in our 24/7 media-intense society. For many of us, we end up spending too much time watching TV, cruising the Internet or doing other activities when we should actually be sleeping.

But sleep is critical for maintaining good brain health. Sleep is the time when our synapses are rinsed out with cerebral spinal fluid. This very effective cleansing system clears out our metabolic wastes (amyloid beta) every night. Research has demonstrated that even a single night without proper sleep will cause an increase in the levels of synaptic amyloid beta.

Interestingly, not only does amyloid beta increase with lack of sleep, but increased levels of amyloid beta will in turn cause sleep disturbances. It is a vicious cycle! The less sleep you get, the more amyloid beta accumulates, and the more amyloid beta in your system, the less sleep you get. All-in-all, decreasing your amyloid beta levels is a very good reason to get at least 8-hours of sleep every night; to ensure your synapses are properly rinsed out.

Improving your Cardiovascular Health

The next critical factor in preventing Alzheimer's is to focus o improving your cardiovascular health. Research has shown that exercise, especially aerobic exercise decreases the amount of amyloid beta in your brain. It will also help to keep your weight in check, reduce blood pressure, reduce bad cholesterol, increase good cholesterol, and increase insulin sensitivity.

Even better when you combine exercise with a heart-healthy diet (such as the Mediterranean diet) you can accelerate the removal of amyloid beta in your body. We all love good food, but let's just make sure it is also healthy food.

If for some reason you don't think that cardiovascular disease is a problem for you, then consider this. Cardiovascular disease is the leading global cause of death in our society. Cardiovascular disease claims more lives than all forms of cancer combined. Research shows that 48% of women and 46% of men have cardiovascular disease. Then consider that 80% of Alzheimer’s patients also suffer from some form of cardiovascular disease. (4)

Understanding Neuroplasticity and Cognitive Reserve!

This is where the prevention of Alzheimer's Dementia gets really interesting. Neuroplasticity and what we refer to as cognitive reserve are the reasons why our actions can make such a profound difference in our future cognitive function. Neuroplasticity is the ability of the brain to form new pathways and reorganize neurological connections.

One of the most powerful ways of preventing Alzheimer's Dementia has to do with engaging yourself in new and exciting activities. Like it or not, the path of familiarity is the road to dementia. Whenever we become involved in new, stimulating, physically and mentally challenging activities, our body creates new pathways throughout our brain.

Cognitive Reserve refers to the additional neural pathways that the brain can use to re-route signals. The term “cognitive reserve” first originated in the late 1980s, with some very interesting research that came out of brain autopsies. Researchers dissected the brains of people with no apparent symptoms of dementia, and surprisingly, found that all the brains contained amyloid plaques and many areas of damage that were consistent with advanced Alzheimer's disease. Yet, while living these individuals did not show symptoms of dementia. The researchers also found that each of these people had a large cognitive reserve to counterbalance the damage.

This is incredible news, it means that the activities we engage in, on a day-to-day basis, can actually rewrite our brains, set up new pathways, and even help us to build a reserve of neural pathways that can be used in the future to circumvent the damaged areas of our brain, allowing us to continue functioning at a high capacity.

Embrace Change

Here is the problem. Most people fight change, they get comfortable in their daily lives, they drive to work on the same route, eat similar foods, perform the same tasks day in and day out, recycle the same conversations, perform the same type of recreational activities, and always stay within their comfort zones. But when it comes to maintaining a healthy nervous system, staying in your comfort zone is a big mistake!

If you could ask your brain how it feels about its daily routine of “business as usual” it would probably use words such as: tedi us, dull, monotonous, uneventful, repetitive, uninspired, tiring, mundane, and even lifeless. Not the ideal situation if our objective is to increase neuroplasticity and build a lot of synaptic redundancy!

Basically, we are boring the crap out of our brains by not changing our routines and/or not learning new things.

How to Grow Your Brain

Years ago, I worked as a ski patrol. Most of us could ski the entire day without falling. But all that meant was that we were actually skiing well below our abilities. If we pushed ourselves we would be falling numerous times throughout the day. The benefit of pushing ourselves, after a few weeks of constantly falling, was that our skiing ability improved drastically.

To quote Ray Dalio “If you’re not failing, you’re not pushing your limits, and if you’re not pushing your limits, you’re not maximizing your potential”. I would also add to this, “if you're not pushing your limits you are limiting and inhibiting your neurological potential”.

So… What Can You Do?

Even though the average brain has over 100 trillion active synapses, when it comes to dealing with Alzheimer's Dementia, that number is not enough to prevent the disease.

So the question is, how can we develop these new synapses and increase our neuroplasticity? The answer is really quite simple. Every time you learn something NEW or perform a mentally challenging task that involves NEW challenges, you will create new synapses (neural connections), which in turn increases your cognitive reserve!

Here is the key. To optimize your neuroplasticity you need to choose activities that are not only NEW and mentally challenging, but that also involve sight, sound, and touch. These activities need to evoke an emotional response and engage you on a personal level. This could be learning a new language (at any age), making new friends, learning how to paint, learning to dance, reading a variety of new books, exploring new ideas, travelling to new lands, challenging your existing perceptions, and embracing new ideas.

Leave Your Comfort Zone!

You need to take yourself out of your comfort zone. When you engage in new experiences, you stimulate your brain to develop new synaptic connections and eventually build a new reservoir of neurological pathways. At times you will find the process somewhat frustrating, but that is not a bad thing. Growth often requires a certain amount of pain (whether physical or mental).

This blog is about helping you to maintain your cognitive function for as long as you can. In order to do that you have to fully engage in life in order to reap the benefits of neuroplasticity.

This requires that you do not buy into self-imposed limitations about what activities you can, or cannot, participate in. Don’t restrict yourself because of your age, previous injuries, or even personal preferences. Often the only stumbling blocks you will encounter are the ones you place in front of yourself.

How We Can Help

One of the greatest joys I have in practice is being able to help my patients return to an engaging, active lifestyle.

We have helped patients with arthritic knees who struggle going up and down only a few stairs to complete long treks in the Peruvian Andes. We have helped musicians with nerve entrapment syndromes to continue playing their music years after they thought they would never play again. And best of all we have helped many patients maintain their ability to live independently by working with them to release their physical restrictions. Restrictions which would otherwise have kept them from engaging in new and unique activities. Activities that would increase their neuroplasticity and cognitive reserve!

If there is some activity you would love to get into, please let us know. We will do our best to work with you to help make that reality come true.

Bottom line!

We are all aging, and not one of us will get out alive. However, we can greatly increase the odds of living a fully independent life if we never stop learning and start physically engaging with the world around us.

We can either spend the last decade of our lives in a diminished dependent state or reach the end of our lives fully engaged. Personally, I will do everything I can to make my life, and those of my patients, one in which they are fully engaged, active and happy.

DR. BRIAN ABELSON DC. - The Author

Dr. Abelson is committed to running an evidence-based practice (EBP) incorporating the most up-to-date research evidence. He combines his clinical expertise with each patient's specific values and needs to deliver effective, patient-centred personalized care.

As the Motion Specific Release (MSR) Treatment Systems developer, Dr. Abelson operates a clinical practice in Calgary, Alberta, under Kinetic Health. He has authored ten publications and continues offering online courses and his live programs to healthcare professionals seeking to expand their knowledge and skills in treating musculoskeletal conditions. By staying current with the latest research and offering innovative treatment options, Dr. Abelson is dedicated to helping his patients achieve optimal health and wellness.

REFERENCES

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2. National Institute on Aging. (2017). Alzheimer's Disease Fact Sheet. Retrieved from: https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet

3. Xie, L., Kang, H., Xu, Q., Chen, M. J., Liao, Y., Thiyagarajan, M., ... & Takano, T. (2013). Sleep drives metabolite clearance from the adult brain. Science, 342(6156), 373-377.

4. American Heart Association. (2021). Heart Disease and Stroke Statistics—2021 Update. Circulation.

5. Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8(3), 448-460.

6. Park, D. C., & Bischof, G. N. (2013). The aging mind: neuroplasticity in response to cognitive training. Dialogues in clinical neuroscience, 15(1), 109.

7. Jessen, F., Amariglio, R. E., van Boxtel, M., Breteler, M., Ceccaldi, M., Chételat, G., ... & Wagner, M. (2014). A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease. Alzheimer's & Dementia, 10(6), 844-852.

8. Lambert, J. C., Ibrahim-Verbaas, C. A., Harold, D., Naj, A. C., Sims, R., Bellenguez, C., ... & Kamatani, Y. (2013). Meta-analysis of 74,046 individuals identifies 11 new susceptibility loci for Alzheimer's disease. Nature genetics, 45(12), 1452-1458.

9. The Lancet Neurology. (2019). World Alzheimer Report 2019: Attitudes to dementia. The Lancet Neurology, 18(10), 930.

10. Ahlskog, J. E., Geda, Y. E., Graff-Radford, N. R., & Petersen, R. C. (2011). Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. In Mayo Clinic Proceedings (Vol. 86, No. 9, pp. 876-884). Elsevier.

11. Whitmer, R. A., Gunderson, E. P., Quesenberry, C. P., Zhou, J., & Yaffe, K. (2007). Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study. Bmj, 330(7504), 1360.

12. Voss, M. W., Prakash, R. S., Erickson, K. I., Basak, C., Chaddock, L., Kim, J. S., ... & White, S. M. (2010). Plasticity of brain networks in a randomized intervention trial of exercise training in older adults. Frontiers in aging neuroscience, 2, 32.

13. Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of internal medicine, 256(3), 183-194.

14. Scarmeas, N., Luchsinger, J. A., Schupf, N., Brickman, A. M., Cosentino, S., Tang, M. X., & Stern, Y. (2009). Physical activity, diet, and risk of Alzheimer disease. Jama, 302(6), 627-637.

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17. Cabeza, R., Albert, M., Belleville, S., Craik, F. I., Duarte, A., Grady, C. L., ... & Rajah, M. N. (2018). Maintenance, reserve and compensation: the cognitive neuroscience of healthy ageing. Nature Reviews Neuroscience, 19(11), 701-710.

18. Xie, L., Kang, H., Xu, Q., Chen, M. J., Liao, Y., Thiyagarajan, M., ... & Takano, T. (2013). Sleep drives metabolite clearance from the adult brain. science, 342(6156), 373-377.

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