How To Maintain a Healthy Brain Marge Dempsey Reg. N BA, Director of Client Services Jo O‘Brien Reg. N, Director of Education Alzheimer Society of Niagara Region January 11, 2006 “It is our brain that gives us our experience of the world” Oliver Sacks (1996) We take our brain for granted ABC’s OF Brain Function Affective Emotions Behavioural Actions Cognitive Thoughts Additional Risks Stress Takes a e toll on our bodies and our spirits. Extended exposure causes elevations in a hormone called cortisol. Elevated cortisol levels kill brain cells, particularly the hippocampus - memory area What you can do Identify your stressors Develop strategies to reduce stress • Relaxation techniques • Make time for personal needs Three main components of the brain Neurons - 100 billion - diff types Cell body Axons - send information Dendrites – receive information Glial cells between neurons make up myelin sheath scavenger cells Neurotransmitters 6 major ones Over fifty others It is not how many neurons you have but how connected they are that is important. The greater the number of connections the lower your risk of Alzheimer Disease. Brain Facts Brain Facts Notwo Brains are alike Weighs about three pounds (2% of the body's weight) Reaches full size age 6 Full development – never has the capacity to determine and redirect its own destiny. More connections in the human brain than there are atoms in the universe (Carl Sagan) Brain Facts cont’d gray matter (40%) neurons white matter (60%) axons Arteries, veins, capillaries supply oxygen, glucose and other nutrients removing toxins and cools brain takes 20% of oxygen supply and 20% of the blood flow 400 miles of capillaries with surface area of approximately 100 square feet. the health of vessel walls is paramount to proper brain function If brain cells do not get oxygen for 3 to 5 minutes, they begin to die. Vascular Risk Nun‘s Study - Snowdon et al (1997) 1997 Followed group of cloistered Nun‘s Autopsied Brains Greater the vascular damage the greater the cognitive impairment during later years Even with significant AD pathology not as impaired as with vascular pathology Changing thinking in AD MRI of vascular white matter changes in the brain Vascular Risks You CAN Change High Blood Pressure the higher your blood pressure—systolic or diastolic—the higher the risk of stroke and dementia. (Launer,et al 2000) Japanese-American men who had untreated high blood pressure in middle age were at increased risk for both Alzheimer‘s disease and vascular dementia What to do: get BP Checked routinely Maintain Keep your systolic blood pressure below 140 (ideally below 120) and your diastolic blood pressure below 90 (ideally below 80). Don‘t stop medication unless physician advises Vascular Risks You CAN Change Smoking. Smoking doubles the risk of stroke, in part by making blood vessels stiffer. Ott, et al, 2004, On a standard test of cognitive function, smokers in a large European study declined at an annual rate five times faster than individuals who never smoked. What to do: Quit. Your risk starts to drop immediately. Vascular Risks You CAN Change Diabetes. The risk of stroke is two to six times higher in people with diabetes. diabetics more likely to have high blood pressure, high LDL (―bad‖) cholesterol, and clogged arteries. Logroscino, et al, • Ott et al, 1999; "Diabetes Mellitus and the Risk of Dementia: The Rotterdam Study." Neurology Dec. 10, 1999; 53 (9) 1907 – 1909. Having Type 2 diabetes nearly doubled the risk of developing dementia. What to do: • Monitor sugars • Maintain diet • Exercise • Control blood pressure • Lose excess weight. Vascular Risks You CAN Change Clogged Neck Arteries (asymptomatic carotid stenosis). Up to ten percent of people over age 65 have carotid (neck) arteries more than half clogged. What to do: physical exams Talk to your doctor about aspirin or statins severe cases, may suggest surgery to clear out neck arteries. Vascular Risks You CAN Change Atrial Fibrillation. Atrial fibrillation is an irregular heartbeat that allows blood to pool in the heart, making it more likely to clot. If your heart pumps the clot into the bloodstream, it can get lodged in an artery in your brain, causing a stroke. Twelve percent of people aged 75 or older have atrial fibrillation, six times more likely to have a stroke. What to do: Routine check ups to monitor vital signs Talk to your doctor about taking aspirin or ―blood thinners‖ like coumadin. Vascular Risks You CAN Change Cholesterol. A high LDL cholesterol raises risk of stroke Statin drugs lower the risk of stroke, even in people with only slightly elevated LDL. High Cholesterol Kivipelto, 2004. summarized a growing body of evidence linking elevated midlife cholesterol levels and high intake of saturated fat to increased risk of Alzheimer‘s disease. What to do: Family Doctor for cholesteral levels Use diet or, if necessary, statin drugs to lower your LDL. A transient ischemic attack is a "mini-stroke" caused by temporary disturbance of blood supply to an area of the brain, resulting in a sudden, brief decrease in brain function. (It lasts less than 24 hours, usually less than one hour) Vascular Risk You Can Change Multiple risk factors double the overall risk of dementia R.A. Whitmer,et al 2005 Midlife cardiovascular risk factors and risk of dementia in late life • A decades-long study of more than 8,000 suggests that individuals in their early 40s • smoked or had diabetes, high cholesterol or high blood pressure • have an increased risk of developing dementia later in life. • Each specific factor raises risk from 20 to 40 percent • having all four more than doubles risk Vascular Risks You CAN Change HYPOPERFUSION (reduced blood flow/oxygen to the brain) Low Blood Pressure • Over 65 diastolic ideally over 70 Monitor BP regularly Orthostatic Hypotension • drop in blood pressure when moving from sitting to standing position • Monitor BP sitting and standing Risks You Can Change Sleep Apnea • heavy snorers who stop breathing for several seconds during sleep • Sleep clinic • C-PAP machine Chronic Obstructive Pulmonary/lung Disease (COPD) • Heavy smokers • Chronic respiratory disorders • Exposure to inhaled toxins Try to reduce risk • Quit smoking • use puffers Risks You CAN'T Change Age The risk of stroke doubles each decade after age 55. Dementia risk increases with age • 65 – 8% • 75 - 15% • 85 – 30 – 40% • 95 – 50% Risks You CAN'T Change Gender. Men are more likely to have a stroke, Women are more likely to die of one, because they‘re usually older when the stroke occurs. Risks You CAN'T Change Race. Blacks, Hispanics and Asian have a higher risk of stroke than non-Hispanic whites. Native Indians have high risk of type two diabetes Genes. People with a family history are at greater risk. Nutritional Risks The myelin sheath needs essential fatty acids The neurotransmitters, such as serotonin, dopamine, and norepinephrine, use the food we eat as part of their make up to help us think. Neurotransmitters are probably the biological explanation for the food -mood connection. Nutritional Risks B Vitamins are essential to central nervous system functioning Thiamine (B1) deficiency - Alcohol related dementia B12 and Folic Acid, B6- neurological symptoms including cognitive changes VitaminC and E are antioxidants help reduce the oxidative stress that can lead to neurons dying Nutritional Risks Minerals Sodium, potassium, calcium and magnesium are the key ions in the brain must be maintained in critical balance. Being either too low or too high can cause problems. Glucose is the brain's primary energy source. The more complex the carbohydrate the better for the brain – Maintains a balanced level No ups and downs as with simple sugars Protein is needed to maintain and develop nerve cells and their branches through out life. Nutritional Risks Fatty Acids 70% of brain is comprised of fat Fatty acids are what dietary fats are comprised of membranes of neurons and the myelin sheath are made up of fatty acids Omega 3 and Omega 6 Must be balance at ratio of 1:1 Western diets tend to have at least twenty times more omega-6 fats (from meat and dairy) than omega-3 fats unhealthy ratio of 20:1. Nutritional Risks Imbalance in fatty acids corrected by: • eating more omega-3-rich fish and flax seed oil, • Eating less sugar, • completely avoiding trans fatty acids found in partially- hydrogenated oils, margarine, and shortening Morris et al, 2003 Found that weekly or more frequent consumption of fish was associated with a 60 percent reduction in risk of Alzheimer‘s disease. Higher dietary intake of omega-3 fatty acids was also linked to reduced risk. Nutritional Risks Mood Disorders : Andrew Stoll, director of the psychopharmacology research lab at McLean Hospital in Belmont, Massachusetts. Because brain cells are encased in fat, omega-3s help maintain brain cells and keep neurotransmission fluid. Fish oils may be of help in the treatment of unipolar and bipolar depression, Nutritional Risks Trans fatty acids found in foods like french fries, margarine, potato chips and anything else with partially hydrogenated oil have altered a basic building block of the brain By modifying natural fats, we have altered the basic building blocks of the human brain – weakening the brain‘s architecture. disrupt communication in your brain. Trans fatty acids are rarely found in nature and are mostly man made. Like unstable buildings that come apart in an earthquake or storm, poorly structured human brains are failing to cope with the mounting stress of modern life Additional Risks Brain Injury Falls Sports activities Motor vehicle accidents Skull is thin barrier between outside world and brain What you can do Environmental assessments Always wear a helmet in impact sports, biking, skating, rollerblading skate boarding Always wear a seatbelt How to Maintain a Healthy Brain ―A sound mind in a sound body‖ Juvenal. How is your Brain Functioning? Forgot where you put your wallet? Forgot the name of a person that you have met many times? Forgot a certain ingredient in your favourite recipe? Walked into a room and forgot what you are there for? YOU ARE NOT ALONE! Avoid the Self-fulfilling Prophecy! Mason, Kohn & Clark,2005. Tellyourself that you have a good memory and that it is improving every day. Focus in successes and actively navigate your mindset. Praise yourself for remembering, but never punish yourself for forgetting. Recipe for a Healthy Brain Physical Activity. (ABS OF STEEL) Diet. Socializationand Leisure. Stress Management. Continued Learning. Organization. Brain Aerobics. (LOBES OF STEEL) Nurturing. Exercise and the Brain Physical Activity Studiesshow that those not engaged in regular physical activity were found to have suffered the greatest decline in memory and other mental abilities. Khristine Yaffe,UCLA. ‗90 Those with the highest level of regular physical activity had cut their likelihood of having cognitive impairment and dementia by half. Ken Rockwood, MD. CSHA. ‘92,‘97 Physical Activity How much is enough? Data shows the more the better. It has to be a priority in your life. We know that it is absolutely beneficial to your overall health in the long run. Check with your doctor first. Start with a low level and gradually build up to an effective level. Physical Activity Set reasonable goals. Make it fun. Do it with a friend/friends. Do something you enjoy. Make it fit into your activities of daily living. Mix it with calisthenics. Physical Activity Look at improving: Endurance Increase your heart, lungs, and circulatory system as well as your energy. Flexibility Gently reaching, bending and stretching. Keep your muscles relaxed and joints mobile. Improves agility. Physical Activity Strength and Balance Lift weights, do resistance activities Improve balance and posture Keep muscles and bones strong Prevent bone loss Walking Is known to: Lower blood pressure Increase the level of good cholesterol Reduce the risk of stroke by half. Reduce the risk of osteoporosis in women by 30%. Increase gastrointestinal mobility. Increase relaxation, reduce stress Improve memory. Dancing One study showed that of all the physical activities that people participated in dancing was the only one that conferred beneficial effects on the mind. Unique demand for mental effort with the physical exertion. Listening to the music, coordinates movements with those of partner and remembering the complicated dance steps. Dancing Must maintain a certain degree of mental flexibility. Be ready to modify the routine in the event of an unexpected misstep. The most complex is the Tango. Continued Learning Take a course on a new topic for you Reading Process new information A good Intellectual Diet, combined with physical exercise, is going to keep you sharper, longer," says Lawrence Cahill, a professor of neurobiology at the University of California, Irvine. Brain Food Here's how you can do it. Duke University neurobiologist Dr. Katz says: By creating a rich environment around yourself, you're also creating new pathways for neurons to meet. This aids in the creation of neurotrophins, a kind of "brain fertilizer" that stimulates the brain's ability to refresh itself. Leisure and Socialization One study found that those who participated in multiple activities on a regular basis had a 38% less risk of developing dementia. There was also 8% less risk for dementia for each additional leisure activity. Those who preferred intellectual activities did better than those who enjoyed mainly physical or social options. Yaakov Stern, Ph.D., Columbia University. Leisure And Socialization Maintain or reestablish social ties of your choosing. Church, volunteering, playing cards, book clubs. Go to the theatre, concerts, museums etc., Invite friends over for dinner, try new recipes. Join a dance class. Leisure and Socialization Exposure to thought provoking environments and social gatherings may indeed increase the number of synapses in your brain and enhance your brain reserve. At a minimum, it slows down the loss of synapses that occur as part of the normal aging process. Fotuhi, Ph,D., John Hopkins. 2003 Leisure and Socialization They stimulate large areas of the brain. Frontal.. Organize appropriate speech, behaviour and action. Temporal.. Remember names and backgrounds. Parietal .. Keep track of time and where things are. Motor areas coordinate movements, walking and speaking Spiritual Needs Spirituality and belief can come in many forms: Prayer and meditation also increases levels of Dopamine.‖ Newburg A. Centre of Spirituality and the Mind. Penn U. ―The feelings of enlightenment and well being some derive from religion can come to others through artistic expression, nonreligious meditation, watching a beautiful sunset or listening to stirring music. Brain Aerobics. Brain Gym Program helps the brain use all its abilities in an efficient and organized manner leading to whole brain functioning and whole brain learning. Memory Improvement. Zaldy s. Tan. 2005 Remembering by creating a visual mental image. Remembering by association e.g. linking a person to a special characteristic Remembering by use of a familiar route. Brain Fitness Exercise your perceptive abilities: in all five senses. Visuospatial Abilities. What is on the right as opposed to the left. Structuralization Ability. Jigsaws, reading and restructuring the words to mean the same. Logic Abilities: card games, board games. Brain Fitness VerbalAbilities: the precise use of spoken words. Give the main point of news that you have listened to. Brain Gymnastics: Let the Games Begin! "Use it or lose it," is a favorite saying among those who study the brain. That's a way of saying an unused mind is more prone to decay that an active one. "If synaptic connections don't get used, they'll die," says Dr. Joel Kramer, an assistant professor of Neuropsychology at the University of California, San Francisco. Love and Nurturing Enriched conditions accelerates the growth of dendrites. give and get lots of TLC. * Assess your Lifestyle Overcome monotony and routine. It generates mental lethargy and resignation. Watching TV puts our brain into neutral mode. Reduce distractions and allow your memory to work for you. Sleep During sleep the brain repairs itself and boosts the immune system. During rapid eye movement (REM) sleep the brain consolidates information learned during the previous day. Poor sleep or sleep loss leads to fatigue, immune suppression, memory, concentration and mood changes. Optimal learning cannot take place against a background of sleep debt. Use of Humour Humour is a powerful emotional medicine that can: Lower stress Dissolve anger Elevate mood Connects us with others Increases energy Good for mental health Laughter Lowers blood pressure Changes our biochemical state Protects our heart Gives our body a workout Improves brain function Laughter ―Laughter is a tranquilizer with no side effects‖.Arnold Glasgow.