Updated: May 2
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 for 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 ADL’s 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 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 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 within Alzheimer 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 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 the 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 upon 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 the bad cholesterol, increase the 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 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 prevention of Alzheimer 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 had 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 was 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.
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: tedious, 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 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, traveling 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 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 its 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 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.
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.
Till next time!
Dr. Brian Abelson
Come see us at Kinetic Health
Make an appointment with our incredible team at Kinetic Health in NW Calgary. Just scan the QR code with your phones camera and click the link, or call Kinetic Health at 403-241-3772 to make an appointment today!
Lisa Genova’s 2017 TED talk in Vancouver BC “What you can do to prevent Alzheimer's”, and Ray Dalio’s book “Principles”.
Kochanek KD, Murphy SL, Xu JQ, Tejada-Vera B. Deaths: Final Data for 2014. Natl Vital Stat Rep 2016;65:1–122
Holmes C, Boche D, Wilkinson D, Yadegarfar G, Hopkins V, Bayer A, Jones RW, Bullock R, Love S, Neal JW, Zotova E, Nicoll JA. Long-term effects of Abeta42 immunisation in Alzheimer’s disease: follow-up of a randomised, placebo-controlled phase I trial.Lancet.2008;372:216–223.
Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després J-P, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler ER 3rd, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB; on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics— 2015 update: a report from the American Heart Association [published online ahead of print December 17, 2014]. Circulation. doi: 10.1161/CIR.0000000000000152.
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