Learn About Steps To Protect Brain Health (16 min.)

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Most of us are fearful of developing dementia. While some risk factors are unchangeable, others are within our control. Here are six steps we can take in our fight for dementia prevention.

Dementia Rate Declines 

The Framingham Heart Study is a long-term, ongoing cardiovascular cohort study on residents in Framingham, Massachusetts. The study began in 1948 with 5,209 adults and is now on its third generation of participants. Over the past 40 years, dementia rates have fallen by 44 percent! While this is excellent news, the bad news is that the number of adults age 65 and over is growing. The U.S. Census Bureau estimated 52.4 million seniors in 2018 and expects that number to grow to 94.7 million by 2060.

Types of Dementia

There are many types of dementia. The most common form of dementia is Alzheimer’s disease and is responsible for 50-75% of dementia diagnoses. Vascular dementia is the second most common cause of dementia and is 20-30% of dementia diagnoses. Frontotemporal dementia accounts for 5-10% of all dementia, while dementia with Lewy Bodies is <5%. Huntington’s disease, Creutzfeldt-Jakob disease, Parkinson’s disease and Traumatic brain injury (TBI) are all linked to dementia too. While Alzheimer’s is the most common form of dementia, researchers do not yet know what causes this disease. Alzheimer’s is a progressive disease that begins with mild memory loss.

Vascular dementia (and vascular cognitive impairment) is caused when small vessels in the brain become diseased or blocked, depriving brain cells of needed oxygen and glucose. Difficulty in problem-solving, reduced focus, slowed thinking and diminished organizational ability are typically more noticeable in those with vascular dementia over memory loss. While age is the strongest risk factor for vascular dementia, controllable risk factors include high blood pressure, smoking, high cholesterol and high triglyceride levels.  So what can one do to reduce their dementia risk? Below are 6 lifestyle factors largely in our control in our dementia prevention fight:

Step 1: Manage Cholesterol 

Limiting saturated fat in our diet to 7- to 10 percent of calories can help lower LDL cholesterol by 8-10%. This translates as follows:

• 1,400 calorie diet = 10- to 15 grams saturated fat.
• 1,600 calorie diet = 12- to 18 grams saturated fat.
• 1,800 calorie diet = 15- to 20 grams saturated fat.

Limiting saturated fat, the fat that comes from animal protein (meat, cheese and other dairy foods), coconut and palm oil, takes effort and planning. It also requires the avid reading of food labels to assess saturated fat. Calorie King has a wonderful database of foods where you can look up the amount of saturated fat in just about any food. For example, one ounce of cheddar cheese contains 9.4 grams of saturated fat.

Adding 7-13 grams of soluble fiber to our diet can reduce LDL cholesterol by 3-7%. Oatmeal (3/4 cup dry) for breakfast provides 3 grams soluble fiber, while a serving of beans (1/2-3/4 cup cooked) contains 1.5-3 grams soluble fiber. Seek out soluble fiber-containing foods and add them to your daily diet.

From a supplementation standpoint, Berberine and Red Yeast Rice dietary supplements can help support normal cholesterol levels†.

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If diet, weight loss, exercise and supplementation don’t budge LDL numbers, your physician may prescribe statin medications to lower cholesterol.

Step 2: Manage Blood Pressure

The CDC reported high blood pressure was the primary or contributing cause of death in 17.4% of all deaths in 2018. Stroke isn’t our only fear; elevated blood pressure is a circulatory disease. While most studies focus on older adults, high blood pressure damages brain nerve fibers – starting in our 40s and 50s.

For example, a study of 2,505 men between the ages of 71 and 93 found that men with systolic pressures of 140 mm Hg or higher were 77 percent more likely to develop dementia than men with systolic pressures below 120 mm Hg. And a study that evaluated blood pressure and cognitive function in people between 18 and 46 and between 47 and 83 found that in both age groups high systolic and diastolic pressures were linked to cognitive decline over time.

So how does high blood pressure impact dementia prevention?  The take-home here is that high blood pressure is potentially impacting brain health. Take your blood pressure medications, and work to lower your blood pressure with lifestyle modifications.

Mayo Clinic tested patients with nerve fiber damage due to high blood pressure and found reduced nonverbal function, emotional control, decision-making abilities and ability to focus. Lifestyle recommendations can make a huge difference.

Lifestyle modifications can dramatically improve blood pressure. Lose weight if you are overweight. Manage stress. Exercise. Increase potassium and magnesium in your diet. And reduce sodium or salt.

Reduce Sodium

While it seems like the salt shaker would be the most prevalent source of sodium in our diet, the top source of sodium in the American diet is actually bread and rolls. Other foods with deceptively high sources of sodium include cold cuts and cured meats, pizza, poultry, soups, sandwiches, cheese, pasta dishes, and snacks. The only way to know sodium content is to check labels.

DASH Diet

Dietary Approaches to Stop Hypertension (DASH) is an eating plan designed to help lower blood pressure. The diet emphasizes fruits, vegetables, low-fat dairy, whole grains, fish, poultry, beans and nuts. The diet limits saturated and trans-fats, while increasing potassium, magnesium calcium, fiber and protein. Based on 2,000 calories, the DASH Diet calls for:

• 7-8 servings grains and grain products
• 4-5 servings of vegetables
• 4-5 servings of fruits
• 2-3 servings of low-fat or fat-free dairy
• ≤2 servings of lean meats, poultry or fish
• 2-3 servings of fats and oils
• Limited sodium and sweets
• 4-5 servings each week of nuts, seeds and beans

The U.S. Department of Health and Human Services has this great, free guide Read Your Guide to Lowering Blood Pressure. The Guide also contains servings for 1,600 and 2,600 calories.

Step 3: Nutrition: MIND Diet Mediterranean-DASH-Intervention for Neurodegenerative-Delay

The MIND diet, which stands for “Mediterranean-DASH Intervention for Neurodegenerative Delay,” was developed by Martha Clare Morris, a nutritional epidemiologist at Rush University Medical Center, through a study funded by the National Institute on Aging. The MIND diet emphasizes eating from 10 brain-healthy food groups and the avoidance of 5 unhealthy food groups.

10 Brain-Healthy Food Groups 

• Green leafy vegetables (daily)
• Other vegetables (daily)
• Nuts (most days)
• Berries (at least twice a week)
• Beans (3+ days a week)
• Whole grains (at least 3 servings daily)
• Fish (at least once a week)
• Poultry (at least twice a week)
• Olive oil (as the primary fat)
• Wine (daily)

5 Unhealthy Food Groups

• Red meats (<4 servings per week)
• Butter and stick margarine (<1 tablespoon per day)
• Cheese (<1 serving per week)
• Sweets and pastries (<5 servings per week)
• Fried or fast food (<1 serving per week)

The research was published online in February 2015 and looked at the food intake of 923 Chicago-area seniors. Over 4.5 years, 144 participants developed Alzheimer’s disease. The longer people had followed the MIND diet patterns, the less risk they appeared to have.

Even people who made “modest” changes to their diets – who wouldn’t have fit the criteria for DASH or Mediterranean – had less risk of developing Alzheimer’s. Brain-healthy foods are a key strategy in dementia prevention.

The study found the MIND diet lowered Alzheimer’s risk by about 35 percent for people who followed it moderately well and up to 53 percent for those who adhered to it rigorously.

Dementia Prevention Supplements 

Cooper Clinic tests vitamin B12 levels in all patients 60 years of age and older. Older adults have less stomach acid and consume lower levels of meat and dairy, and these factors contribute to a deficiency in seniors. Vitamin B12 deficiency is most common in:

• Seniors (60+ years)
• Diabetics on Metformin
• Individuals with diseases of malabsorption (Celiac, Crohn’s)
• Heavy Drinkers
• Those on Acid Blocker Meds (Nexium, Prevacid, Pepcid, Zantac, etc.)
• Those who have had Weight Loss Surgery
• Those with Pernicious Anemia
• Vegans & Vegetarians

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Consider the possibility of a Vitamin B12 deficiency when 1 or more of the following symptoms are present:

• Cognitive difficulty
• Depression
• Fatigue (extreme)
• Hypotension (low blood pressure)
• Incontinence
• Memory problems
• Moodiness
• Muscle weakness
• Numbness/tingling in arms/legs
• Paranoia or hallucinations
• Shakiness
• Unsteady gait

The normal range for Vitamin B12 is 254-1320 picograms per milliliter (pg/mL) of blood serum, but Cooper Clinic physicians want to see a minimum level of 450 pg/mL.

British adults aged 65 years and older with vitamin D levels less than 12 ng/mL (30 nmol/L) were 2.3 times as likely to have cognitive impairment as those with vitamin D levels above 26 ng/mL (66 nmol/L).

Cooper Complete multivitamins contain 400 mcg vitamin B12. We also offer a standalone liquid vitamin B12 that has 1,000 mcg vitamin B12 per dropper.

Older Italian adults with vitamin D levels below 10 ng/mL (25 nmol/L) had a 60 percent increased risk of decline in global cognitive function compared to those with vitamin D levels above 20 ng/mL (50 nmol/L). There was also a 30 percent increased risk of decline in decision making.

Adults greater than 65 years of age with vitamin D levels below 10 ng/mL (25 nmol/L) had 4 times the increased risk of cognitive impairment compared to those with levels above 30 ng/mL (75 nmol/L).

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Symptoms of a vitamin D deficiency can be vague but sometimes include muscle or joint pain, depression and general fatigue. Vitamin D level is determined through a simple blood test which Medicare will cover.

If you only take one dietary supplement, take omega-3 fatty acids. Found in fatty fish such as salmon, lake trout, barramundi, tuna, sardines, herring, anchovy and mackerel, omega-3 fatty acids support optimal brain, heart, and inflammatory health.

Step 4: Dementia Prevention: The Impact of Midlife Fitness and Later-Life Dementia 

In a study conducted at The Cooper Institute researchers found people who are fit at midlife have a lower risk of developing Alzheimer’s disease and other dementias. The study followed 19,458 participants with an average follow-up of 24 years. 1,659 developed dementia. Researchers saw a 36% decrease in dementia development in the highest fit vs. lowest fit participants.

While a lot of physical activity isn’t necessary, some exercise is required. Just move! Walk, jog, swim or pedal – you decide.  The basic exercise prescription is:

• Cardiovascular/aerobic exercise 150 minutes per week (minutes can be accumulated in chunks as small as 10 minutes at a time)
• Strength training 2 non-consecutive days per week, all major muscle groups
• Flexibility / Stretching 2- to 3 days per week

The big takeaway regarding exercise is that small amounts of exercise make a huge difference in health outcomes and that it is never too late to start being active! And – from an activity standpoint, all movement counts.

Step 5: Protect Your Hearing

Turn down the volume, walk away from the noise, and wear ear protection because hearing loss is associated with higher rates of dementia. There are several theories on why diminished hearing is connected to dementia. They include:

• Cognitive load – garbled messages require more brainpower, and that comes at the expense of memory and thinking ability
• Brain atrophy – with impaired hearing the part of the brain that handles sound atrophies faster – and that part may also serve other areas of brain function
• Social isolation – reduced engagement with others and staying on the sidelines because hearing and conversations are just more difficult

Step 6: Sleep

Dementia prevention demands we focus on our sleep. Research has shown both too little sleep and too much sleep can negatively impact health. The National Sleep Foundation publishes sleep recommendations:

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Extended Release Tablet to Help You Stay Asleep†

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• Adults 26-64 years of age | 7-9 hours recommended | 6 hours to 10 hours may be appropriate | Less than 6 hours and More than 10 hours is not recommended
• Adults 65 years of age and older | 7-8 hours recommended | as little as 5-6 hours to as much as 9 hours may be appropriate | Less than 5 hours and More than 9 hours is not recommended

Sufficient sleep duration requirements vary across the lifespan and from person to person. The recommendations reported here represent guidelines for healthy individuals and those not suffering from a sleep disorder. Sleep durations outside the recommended range may be appropriate, but deviating far from the normal range is rare.

Individuals who habitually sleep outside the normal range may be exhibiting signs or symptoms of serious health problems or, if done voluntarily, may be compromising their health and well-being.

We hope these steps on ways to prevent dementia prevention are helpful. If you’d like more health information from Cooper Aerobics, sign-up for our monthly e-newsletter, The Cooperized.

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Article by Jill Turner, President Cooper Complete.