Have you ever wondered how to maintain your brain health as you age?
Or wanted to know what are the best things to do, to prevent memory loss, cognitive decline, or even diseases such as Alzheimer’s dementia?
I get asked about this quite a lot. And after spending years following the research on cognitive health and cognitive decline, I’ve settled on ten suggestions.
Maintaining brain health is not just about what you do, it’s also about learning what to avoid.
Here’s what to avoid, and what to do:
1. Avoid brain-slowing medications.
Why: Several types of commonly-used medications diminish brain function in the short-term and are linked to higher rates of Alzheimer’s in the longer term. Learn to identify these medications, so that you can avoid them, or at least use them only as a last resort when the likely benefits outweigh the risks.
Common health problems often treated with risky medications include anxiety, insomnia, overactive bladder, vertigo, and allergies. In many cases, such problems can effectively be treated with non-drug approaches, or with safer medications.
For more information: 4 Types of Brain-Slowing Medication to Avoid if You’re Worried About Memory.
2. Avoid chronic sleep deprivation.
Why: Chronic sleep deprivation can cause irritable mood, worse thinking, and many other problems. Fortunately, most sleep problems can be treated if properly identified.
Note: Many sleep problems are due to health problems, such as sleep apnea. But it’s also common to have insomnia due to stress, worry, or even suboptimal sleep habits (like long naps in the afternoon and looking at screens late at night). If you have anxiety or frequent insomnia, it’s very important to learn to sleep without sedatives or sleeping pills. This usually requires a big effort in the short term, but it is worthwhile for long-term brain health and will reduce fall risk as well. Clinical studies have shown that older adults who depend on tranquilizers can successfully wean off of them.
For More Information: 5 Top Causes of Sleep Problems in Aging, & Proven Ways to Treat Insomnia
3. Avoid delirium.
Why: Delirium is a state of worse-than-usual mental function, brought on by some kind of illness or stress. (If you’ve ever known an older adult who got confused while hospitalized, that was almost certainly delirium.)
Note: Studies have found that delirium is associated with acceleration of cognitive decline. In older adults, delirium is often brought on by the stress of hospitalization or serious illness. Although not all delirium can be avoided or prevented, older adults and families should be careful about elective surgeries, and can learn ways to reduce the chance of developing delirium.
For more information: 10 Things to Know About Delirium.
4. Identify and treat hearing loss as early as possible.
Why: Research shows that hearing loss in midlife and later life is clearly associated with a higher risk of cognitive decline. Experts are still teasing out why this is, but it’s probably in part due to many people cutting back on social engagement when there is untreated hearing loss. We also know that the part of the brain responsible for processing sound and speech (the auditory cortex) starts to wither if it’s not getting used properly.
Note: The longer hearing loss has gone untreated, the harder it is for a person to adapt to hearing aids successfully. For these reasons and more, if you’ve noticed any signs of hearing impairment in yourself or a loved one, be sure to check for hearing loss and get treatment with some form of hearing assistance technology.
For more information: Age-Related Hearing Loss (Presbycusis): What to Know & What to Do
5. Pursue positive social activities, purposeful activities, and whatever activities nourish the soul.
Why: Loneliness and boredom are harmful to brain health and emotional health. Studies find that older adults feel better when they are socially engaged, and also when they feel a sense of purpose. This may also help prevent or delay cognitive decline.
Note: Purposeful activities and social activities provide stimulation and satisfaction to the brain, and are definitely associated with better brain health in later life.
6. Find constructive ways to manage chronic stress.
Why: Chronic stress is an important quality of life issue. It also can change the brain, and has been linked to changes in cognitive function.
Note: To manage chronic stress, it’s best to combine general approaches (such as improving sleep, exercising, meditation, relaxation strategies, etc) with approaches that can help you cope with your specific source of stress, such as caregiving coping skills or relationship counseling.
7. Seek treatment if any signs of depression or chronic anxiety.
Why: Although studies find that many people feel happier as they age, it’s still quite common for older adults to experience late-life depression. Chronic anxiety is also common, and can co-exist with depression. These problems diminish quality of life, and also have been linked to cognitive decline. Fortunately, they are treatable.
Note: It’s most common for these problems to be treated with medication. However, a number of non-drug treatments are available for depression and anxiety, such as cognitive-behavioral therapy. Research has found these can be as effective as medication. These are often safer for older adults in that there’s less risk of side-effects or interactions with any treatment for other health problems, so it’s often worthwhile to ask about non-drug treatments.
For more information: Depression in Aging: Diagnosis & Treatment When the Golden Years are Blue
8. Stay physically active and exercise regularly.
Why: Regular physical activity has been shown to benefit brain health as well as mood. Studies have found that exercise can help treat depression or anxiety, and is also linked to a lower risk of developing a dementia such as Alzheimer’s.
Note: This CDC resource clarifies how much exercise to get. But research has also shown that even less-than-recommended exercise brings health benefits. So remember: it’s better to do a little bit every day than nothing at all!
9. Address risk factors for cardiovascular disease.
Why: Cardiovascular disease includes cerebrovascular disease, which means brain health problems related to blood vessels in the brain. Reducing cardiovascular risk factors helps preserve good blood flow to the brain. This reduces the risk of a major stroke, and may help prevent the smaller brain vessel blockages that cause vascular dementia.
The main cardiovascular risk factors to address are high blood pressure, high cholesterol, diabetes and pre-diabetes, smoking, obesity, and physical inactivity. Exercise (plus a brain-healthy diet) is a safe and effective way to help treat most of these risk factors, but medications or other approaches may also be necessary.
10. Eat a brain-healthy diet that keeps glucose, inflammation, and weight in good control.
For the vast majority of people, this will be the Mediterranean diet or the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet.
Why: Several studies over the past several years have indicated that the Mediterranean diet and the MIND diet are associated with maintaining better cognitive function. They also improve other health outcomes.
The likely reason these diets work well for the brain is that they often help control blood glucose in a healthier range (not too high) and also they reduce inflammation in blood vessels and elsewhere in the body.
The exact specifics of what to eat and not eat on these diets can vary, depending on which diet and which version you find. Here are the general principles:
- Eat lots of vegetables, greens, fruits, whole grains, beans, and lentils.
- Minimize added sugars, fast food, and processed foods, including processed meats.
- Minimize simple starches (e.g. refined flour, most sweets), especially if your bloodwork suggests problems managing blood sugar.
- Research has also suggested that intake of several specific types of foods may be beneficial to older adults. Some to consider include:
- Nuts and seeds (especially flaxseed)
- Foods containing polyphenols, which include olive oil and berries
- Cocoa and tea
- Fish, especially oily fish, which contains omega-3 fatty acids. (Randomized control trial data of fish oil supplements often does not find much effect, so supplements may not be as effective.)
Note: The medical literature on dietary vitamins and supplements for cognitive health is mixed. I personally believe it’s more useful to focus on maintaining a diet that is generally healthy for the body, such as the Mediterranean diet, than it is to focus on taking specific foods or vitamins for brain health.
How Are You Doing on Promoting Brain Health & What Will You Do Next?
Don’t panic if you realize you aren’t doing most of the ten things I recommend.
Do, however, give yourself credit for any items you are doing well on. And then make a plan to improve just one thing, and pick one little next step. It might be committing to walk 20 minutes every day. Or scheduling an appointment with the pharmacist to review medications.
Whatever it is, pick one thing and schedule it. And then commit to reviewing this list and taking one more action next month.
If you take an action at least once a month, you’ll eventually be on track for maintaining better brain health while aging.