With the pandemic "behind us" (be careful... it's still out there) I have returned the focus of my studying to my career-long passions, those being heart attack and stroke prevention and longevity with health-span coming as close to lifespan as possible. Today let's tackle cognitive decline. The discussion gets a little technical, so feel free to skim.
Mental Acuity & Cognitive Decline Prevention Cognitive decline is largely preventable. The subject is way too broad to be covered comprehensively in one post, so I'll restrict my remarks to recent thoughts and a few things I have learned. The factors that do not bode well for maintaining mental acuity include genetics (though NOTHING is written in stone), retirement (more about this in a moment), sensory loss, social isolation, sedentary behavior, smoking, and insulin resistance/prediabetes/diabetes. If you have the good fortune to have avoided these factors, your risk of cognitive decline is said to be reduced by about 60%—but probably more. The factors that mitigate risk of cognitive decline include social interaction, EXERCISE, brain training (I recommend you check out BrainHQ or Lumosity), education (that one comes in many packages, but mostly applies to what one learned from childhood until the early to mid-20's), SLEEP, music, new skill development, and language. This is not an all-inclusive list. For instance, I didn't mention NUTRITION (the third of the big three), which is hugely contributory to that which promotes or prevents neurodegeneration. Brain Training Let me give you just one example. My very dear patient and friend, Peter, created huge head space with his early education (both academic and life experience). He exercised his brain daily during a 40-year career in law and business. Right after retirement, in addition to pursuit of various interests he was tasked with organizing his family's estate, an estate in somewhat a state of disarray. I think I recall that Peter worked on this for a couple of years. The skills necessary to organize the chaos challenged a number of realms of neurocognition that translate to risk reduction. With the estate now in good order, he has gone on to fairly sophisticated business projects that require "creasing the gray cells" in various thought domains. Of course, there's a bit more to being sharp-witted in your 90's than what I've described about Peter, but he's working on those preventive factors, too, and I fully expect him to be witty and wise for all his years. Methylating Vitamins & Omega Fatty Acids (DHA) I also want to add a couple of pointers about supplements that are useful for maintenance of cognitive function. Almost all of what you hear and read about is unvetted crap. Most of the companies that make nutraceutical and herbal products are unreliable at best, and charlatans at worst. But several supplements have high-quality data. So, in brief, some news you can use (for today) involves methylating vitamins and omega fatty acids, specifically DHA. There are numerous good studies on the benefits of methylation for the preservation of cognitive function. A good one to google is the VITACOG study in which the management of elevated or suboptimal homocysteine levels was studied as it pertains to cognition. Homocysteine elevation is a consequence of disruption in the internal production of enzymes that are critical to this process of methylation. There is damage not only from a dearth of methylating vitamins, but also directly from the accumulation of too much homocysteine. The good news is that your doctor can optimize this metabolic pathway with supplementation of B12, methylfolate, and sometimes B6. Reliable companies from which you might obtain your B12 and methylfolate are Jarrow and Pure Encapsulations. These companies have rigorous production regulations (self-imposed!). You get what you pay for. Two other excellent companies that make supplements are Thorne and Momentous. (I have no financial ties to these companies... just sayin'.) The other important intervention is to make sure your omega fatty acid levels are checked and, if suboptimal, treated. Specifically, DHA (docosahexaenoic acid) is critical in helping with the preservation of neuron integrity. You want those brain messages moving along as slippery smoothly as possible. Methylating vitamins help anchor the DHA into the phospholipids that become part of the cell membrane of the neuron. So, eat your salmon and make sure your doctor checks these levels from time to time. Your doctor has checked them yearly for you for many years. If you don't have good DHA levels, the very best product is Nordic Naturals DHA, 1-2 grams per day. Carlson also makes a reliable version of fish oil.
4 Comments
|