Right lifestyle choices will keep aging brain healthy

The treatment for Alzheimer’s disease might be as accessible as the anti-inflammatory drugs you now have in your medicine cabinet or maybe the caffeine in your coffee. Some will swear the answer lies in resveratrol, a substance in red wine, while others point to the curative potential of vitamin D and curcumin, a chemical found in turmeric spice. And have you heard the buzz about estrogen?

 

The all-consuming quest to find a way to ward off Alzheimer’s disease and dementia continues as researchers explore a wide expanse of options, including developing new drugs. And although Dr. Gary Small is confident that brain scientists will make major breakthroughs in the next decade, the geriatric psychiatrist and director of UCLA’s Memory and Aging Research Center and the Center on Aging at the Semel Institute for Neuroscience and Human Behavior, isn’t willing to wait for the big "Eureka!" moment.

 

He and his colleagues are now helping people maintain brain health before memory impairment and other cognitive dysfunction starts to seriously interfere with their daily lives.

 

"What we try to do in our lab is to identify people at risk (for Alzheimer’s and dementia) and intervene early so we can change the slope of decline," Small told an audience of staff, faculty and retirees listening intently in Moore Hall to his advice on how to improve memory and brain health as they age. "So the idea is to protect the healthy brain rather than try to repair the damage once it sets in."

 

Small, the author of several popular books on aging and memory, was invited to give the annual lecture in the Emerging Research Speaker Series, created in 2009 to showcase new research initiatives and to foster community between staff and faculty. The series is sponsored by UCLA Staff Assembly, the Academic Senate and Campus Human Resources.

 

Doctors are seeing symptomatic improvement with the development of new drugs to treat Alzheimer’s, Small said. "But you can see the slope of decline really doesn’t change. And If you take people off the medicine, they decline more rapidly," he said. The success rate for these new drugs "has been less exciting than we had hoped at first," although there is a lot of interest in further research of anti-inflammatory drugs.

 

With better brain-imaging tools and chemical biomarkers, said Small, scientists can now see the build-up of amyloid plaques and tau tangles in the brain — the physical evidence of Alzheimer’s disease — long before major symptoms show up. "We’re trying to develop these tools to be able to predict where people are going cognitively," he said.

 

Small and his cohorts have done hundreds of brain stress tests — testing people’s memories, for example, while tracking their brain activity through fMRI images — and found that, over time, the brains of people with a genetic risk for Alzheimers show more activity as their memory worsens. "What we think is happening is that the brain is naturally compensating for a [memory] problem. But at a certain point, that compensation breaks down."

 

Said Small, "We’re all on this slippery slope of worsening cognitive ability as we age. How rapidly this ability declines depends on genetics and lifestyle," with genetics accounting for about one-third of the probability. But there are things we can do to help sway the odds.

 

"A lot of lifestyle choices, we’re beginning to learn, may protect the brain," Small said.

 

     • Exercise — There’s a preponderance of scientific evidence that points to exercise as the best way to protect the brain. "The question is how much," Small said. "We’ve found that you don’t have to become a triathlete to protect your brain." Brisk walking for 90 minutes a week — 15 minutes a day — has been associated with a lower risk of Alzheimer’s disease. And it’s not just aerobic cardio conditioning that has an effect. The data underscore the benefits of weight or strength training to protect the brain. Recent research even points to a connection between weight loss and improved memory. "If you learn nothing else from today’s talk, think about how much physical exercise you’re getting," he advised.

 

     • Stress — Tests on human subjects who have been injected with the stress hormone cortisol have shown that stress can temporarily impair learning and recall. Depression also can be a risk factor for cognitive impairment. While stress is something that we all struggle with, there are things we can do — tai chi, for example, or meditation — to manage it.

 

      • Diet — The Mediterranean diet of olive oil, fish rich in Omega 3 fats, fresh fruits and vegetables that contain antioxidants, whole grains and nuts can be good for the brain, Small said. Avoiding processed foods can also help. In comparing cognitive decline in a group of Nigerians and a group of African Americans in Indiana, scientists from the University of Indiana found a lower rate of dementia among the Nigerians. "They thought a big part of it was [the Nigerians’] simpler diets," Small said.

 

     • Mental exercises — Doing mental exercises can be just as important as doing physical ones. After a two-week course of brain exercises, one woman’s performance on a memory test improved by 200 percent, Small noted. Other studies have shown that people who attend college and those who are bilingual have a lower risk for Alzheimer’s. But the college connection is not clear. "It could be that people with good brain genes are more likely to get on a college trajectory," he noted. Also, Small warned that mastery of Sudoko or crossword puzzles may not necessarily transfer to sharper memory skills.

 

Based on his research, the Center on Aging has developed a four-week memory-training course, taught by trained volunteers across the country, that focuses on memory challenges that people complain about the most, such as forgetting names and faces or keeping appointments.

 

A half-day Brain Boot Camp offers people with age-related memory concerns a three-hour intensive course that teaches them how to live brain-healthy lifestyles and how to enhance their memory ability.

 

"I’m excited about the new science and where we’re going with it," said Small, whose new book, "The Alzheimer’s Prevention Program," is due out next January. Although he is cautious about recommending specific medications, "I have no problem with telling you to take walks, eat healthy and exercise your mind." The bottom line, he said, is that if everybody in the nation started taking walks and making the right lifestyle choices, there would be one million fewer cases of Alzheimer’s within five years.

 

"There’s no reason we have to wait 30 years and spend billions of dollars on studies to absolutely prove this is going to protect our brains," he said.