Who’s Afraid of the Aging Brain?
I think we all are! We are living longer, caring for our aging family members, and hearing reports of age-related dementia and neurodegenerative diseases like Alzheimer’s and Parkinson’s on a daily basis. Of course we’re frightened!
The good news is that we’re learning more and more about the science behind the aging brain. These insights are helping to shape prevention measures that start with our own lifestyle choices. So let’s talk a little about brain health and what we can do to stay sharp as we age.
What Drives Brain Aging?
It may be obvious, just through observation, that our bodily functions decline as we age. We don’t heal as quickly as we used to, we have a tendency to get sick more readily, and we often lack the energy of our youth. Much of this can be attributed to cellular function. If our cells are in tip-top shape, our organs operate ideally, and as an organism, we thrive.
So how do we take care of our cells? Let’s look at five factors linked to brain health and briefly discuss the mechanisms behind them.
1 – Inflammation & Oxidative Stress
We discussed inflammation here, noting that it’s a natural process meant to protect our health. In a healthy individual, inflammation acts to protect and defend, resolving with the abatement of the threat. A problem arises when these threats fail to resolve and inflammation becomes constant, resulting in chronic health problems.
Oxidative stress works in the very same way. In a perfectly healthy person, oxidative stress occurs all the time. In it’s infinite wisdom, the body naturally counteracts this oxidation by creating it’s own antioxidants. Amazing, right? Again, health problems arise when this system falls out of balance and healthy cells fall victim to oxidation.
In the brain, inflammation is related to age, gut health (microbes!), elevated blood sugar, personality and behavior [ 1, 2]. This inflammation ends up creating excess oxidative stress, which negatively influences brain cell function. Cognitive impairment, neurodegeneration, and even stroke (caused by vascular inflammation) are all related to these mechanisms.
2 – Diet and Nutrition
It’s no secret that diets rich in processed foods, refined sugar and inflammatory fats are not ideal for our health. These foods are pro-inflammatory, increasing inflammation (and therefore oxidative stress) as discussed above. So what should we eat to support an aging brain?
Both the Mediterranean and Okinawan diets, known for being Blue Zones, correspond to areas where age-related brain health remains strong and resilient within the population. Each of these diets feature whole foods that are low-glycemic and mostly plant-based. They are low in pro-inflammatory fats, include probiotics through fermented foods, are low in sodium and even allow for some alcohol. Remember, quality red wine and beer are fermented and contain health-supportive nutrients in modest doses.
It’s especially important to mention that poor blood sugar control is linked to Alzheimer’s Disease (AD), which is now considered Type III Diabetes in clinical circles . Insulin resistance and advanced glycated end-products (AGEs), measured in HbA1c levels, are present in patients with AD and Type II Diabetes Mellitus . This underscores the importance of a whole foods, low-inflammatory, low-glycemic diet – especially in the management of metabolic syndrome or type II diabetes.
3 – Sleep
Sleep, which can be elusive in our modern culture, is absolutely vital to brain (and overall) health. The brain is full of immune cells that clean up damaged cells and waste products when we sleep. Sleep loss, measured at less than 7 hours of sleep per night, impairs the ability of these cells to “mop up.” As you can imagine, this increases brain inflammation. Lack of sleep is also related to lower immunity overall, increasing our risk of infection, inhibiting natural healing processes, and even driving insulin resistance . For the sake of our brain health, it’s worth prioritizing sleep as we age!
4 – Stress
We’re all familiar with stress, but did you know that chronic stress can have a negative impact on your brain? When we feel stressed, the hormone cortisol is released. Cortisol is an anti-inflammatory hormone (think about corticosteroids as anti-inflammatory medications), but just like inflammation and oxidative stress, too much of a good thing has the opposite effect. Chronically high levels of cortisol are related to poor sleep, insulin resistance and altered gut bacteria – all of which lead to inflammation and increased oxidative stress.
Stress is interesting, though. Some people experience it very little and some are chronically stressed. We’re learning more and more about the influence of mindset upon our health, and this absolutely pertains to brain health as well . The evidence shows that individuals with a positive attitude and a problem-solving approach to life have lower levels of stress hormones, increased immunity, and engage in more self-care compared to others . Maybe you’re thinking that the amount of stress you’re under is something you can’t control, and maybe that’s partially correct. None of us can anticipate emergencies, immediately rectify bad job situations, or feel confident in our bank balances overnight. What we can do is reshape our approach to these stressors by thinking of them as challenges rather than knock-out blows. According to the research, shifting our mindset in this way will support our aging brains.
5 – A Sedentary Lifestyle
I sometimes have the “use it or lose it” conversation with aging clients when we talk about mobility. This idea also pertains to the brain! Whether you’re engaging in physical activity such as walking or weight lifting, or practicing mind-body exercises like restorative yoga, meditation or massage, you’re supporting your brain health .
Depression is often linked to cyclical activity in the right medial prefrontal cortex . In short, this part of the brain drives our sense of self, stress responses and coping mechanisms. As you can imagine, cyclical activity in this part of the brain leads to many depressive symptoms. Physical activity, and even physical manipulation like massage, can hijack this prefrontal cortex action by driving the brain to react more primally to these stimuli .
6 – Disuse
In addition to physical stimuli, mental work is also very important for an aging brain. Often people pass more complex, logical tasks on to younger caregivers because they feel theselves slipping and fear inaccuracy (in balancing finances, for example). While this might be necessary in some cases, it’s important that aging adults continue to engage their brains – again, the “use it or lose it” idea. Again, as inflammation and depressive symptoms mount, using the logical, problem-solving left lobe of the brain can disrupt the cyclical nature of that right prefrontal cortex. Here are a few practices and their associated risk to cognitive decline [11, 12]:
- Someone stuck in a routine (the same daily meals, activities, etc.) – INCREASED RISK
- Someone with a negative aspect/ attitude – INCREASED RISK
- Someone who plays an instrument for 10+ years (non-consecutive) – REDUCED RISK
- Someone who takes up dancing – REDUCED RISK
- Someone who is involved in volunteer work – REDUCED RISK
- Someone who practices Tai Chi – REDUCED RISK
- Someone who regularly plays Mah Jong – REDUCED RISK
You may notice that the activities that reduce the risk of cognitive decline require a lot of focus, timing and coordination. Another important thing to note is that many of them include a social component to the activity. Social support and interaction is another hallmark of healthy aging, as demonstrated in the Blue Zones.
Mood & Cognitive Symptoms of Brain Aging
Increased inflammation in the brain can lead to “sickness behavior,” which is common during aging. The following symptoms fall into this category:
- Depression & anxiety
- Increased sensitivity to pain
- Loss of interest in food
- Social withdrawal
- Disordered sleep
- Fatigue & brain fog
It’s possible that some of these symptoms may be manipulated by addressing the factors above, but we also must remember that these things are bi-directional in nature. For example, social withdrawal is linked to increased inflammation, reduced quality of life, and higher mortality rates. At the same time, increased brain inflammation can result in social withdrawal.
As you can see, the science surrounding the aging brain is burgeoning with new research to inform our lifestyle decisions. The good news is that many of our whole-health recommendations focused on diet, sleep, stress, physical activity, and social engagement also apply to retaining our cognitive skills as we age.