How to Maintain a Healthy Brain

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					How To Maintain
 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
    of the world”
         Oliver Sacks
We take our
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
   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

  The greater the number
 of connections the lower
  your risk of Alzheimer
Brain Facts
              Brain Facts
 Notwo Brains are alike
 Weighs about three pounds (2% of the body's
 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
   400 miles of capillaries with surface area of
    approximately 100 square feet.
   the health of vessel walls is paramount to proper brain
   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
       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
          Vascular Risks You CAN
   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
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
 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
       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
         • 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

         • Monitor BP sitting and standing
      Risks You Can Change
   Sleep Apnea
     • heavy snorers who stop breathing for several seconds during

     • 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
 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
     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
       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,
     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‖
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?
 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.
  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
 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
      Increase gastrointestinal mobility.
      Increase relaxation, reduce stress
      Improve memory.
 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.
 Must  maintain a certain degree of mental
 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
     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
 Church, volunteering, playing cards, book
 Go to the theatre, concerts, museums etc.,
 Invite friends over for dinner, try new
 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
     Parietal .. Keep track of time and where things
     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
 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
 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
 Reduce distractions and allow your
  memory to work for you.
 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
 Lowers  blood pressure
 Changes our biochemical state
 Protects our heart
 Gives our body a workout
 Improves brain function

―Laughter is a tranquilizer
 with no side effects‖.Arnold Glasgow.

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