By Dr Rajagopal Soondron
The belief so far has been to flex our mental muscles, to train our brain to delay deterioration by getting involved in different intellectual activities. But now this plan is being debunked
“If we want to keep early Alzheimer and dementia at bay, we’ll have to stay away from smoking and alcohol excesses – though people who have a small glass of wine daily are said to do better. Keep moving and beat the pavement as often as possible. And keep working as long as possible; those who retire too early soon feel redundant, cut off from colleagues and deteriorate mentally. If you like your regular fries, sweet dishes and your saturated fatty food, you are welcome, but be prepared to pay the heavy price of early cognitive deterioration…”
In medical school the teaching was that around the time you got your full set of 32 teeth Nature would slowly start to claim back its pound of flesh. After acquiring all our faculties by our 30th year, we humans have learned to capitalize on this fourth decade of our life to be at our best. Unfortunately by our 45th year our cognitive function starts to show signs of deterioration – as reflected by our erratic attention, perception and memory.
In Mauritius, while our birth rate is going down, the percentage of senior citizens keeps climbing, so much so that the financial world is becoming aware of the threat of the heavier burden that a non-productive section of the population will have on national performance. Health providers also are conscious of the problem of chronic cognitive deterioration of our elders.
The belief so far has been to flex our mental muscles, to train our brain to delay deterioration by getting involved in different intellectual activities and all sorts of electronic puzzles and games, like sudoku, and other mental activities. But now this plan is being debunked and is evolving more towards a concept of cognitive reserve (in physiology a reserve is defined as that percentage of the normal function that an individual has in store over and above that normal function).
For instance, at 20 years one can run a 100 metre race thanks to one’s cardiovascular and respiratory reserve; at 60 it’s not possible to do so because that reserve is lost. The same is believed to apply to our mental capacity. The more reserve one possesses, the less Alzheimer and mental deterioration one is likely experience. The greater it is, the better it is correlated to higher IQ, better education and occupational attainment – all helping to protect us against Alzheimer and dementia.
Even the absence of better education can be compensated by being more socially active. The more the individual mingles and mixes with others, the better his chance to stave off cognitive decline. Married couples do better than single persons, for husband and wife are always exchanging ideas, words, views and feelings.
Augmenting the reserve
It has been found that children who learn to play a musical instrument are more likely to benefit positively and cognitively in their old age; so also multilinguists — like us Mauritians – who stand to benefit from a better cognitive function to protect us against deterioration later as more neurons become interconnected to transit from one language to another. Less energy will be required for mental function.
By now most of us would have realised that more physical activity improves our mental functions. It looks as if both body and brain are complementary as far as health is concerned. A substance is secreted which influences the cells of our memory store, and increases the connections between nerve cells. The more we have of them the better we are cognitively; maybe this is consequent to an increase of blood flowing into our brain during exercise.
Similarly, if our hearing is deficient, then we’d better take care and remedy it; for as our audition diminishes we spend most of the time concentrating on what is being said, while tuning the rest of the brain to divert its energy to the hearing process, hence decreasing our cognitive reserve. Unlike normal people, people with hearing handicap remember less of the information they have heard. So finally one’s brain develops less and contributes to early cognitive deterioration. Let’s therefore mind our hearing, especially after 65.
3000 Chinese have been followed medically for 13 years, and it was found that there is some correlation between their teeth hygiene and cognitive functions. Loss of teeth denotes most probably more inflammatory processes in the body which would cause chronic health problems leading to deterioration of brain functions. But the reverse is not necessarily true, as people with a good set of teeth can still have dementia.
There is also the stress of life which triggers chronic inflammation and affects body functions by increasing the glutamate level in our brain. That’s why it is now being recommended that regular meditation and mindfulness will smooth out our stress and contribute to better mental health.
Medical researchers have also noticed that people who have a sense of purpose and authenticity in life, who love their job, who sincerely believe in what they are doing, who have a sense of belonging and direction, and who are in better proximity to colleagues at work have better cognitive functions in later life.
If we want our life in later years to be less troublesome, we must learn to sleep at least 7 hours a day. When we sleep, our brain does not; it goes on reclassifying our emotions and ideas that have preoccupied us earlier during the day – thereby fortifying our memory. Breakdown products of proteins that have accumulated in our nervous tissues are screened and scavenged to maintain our neurons’ health. Better cognitive function is the privilege of those who sleep well.
Do and don’t do
If we want to keep early Alzheimer and dementia at bay, we’ll have to stay away from smoking and alcohol excesses – though people who have a small glass of wine daily are said to do better. Keep moving and beat the pavement as often as possible. And keep working as long as possible; those who retire too early soon feel redundant, cut off from colleagues and deteriorate mentally. If you like your regular fries, sweet dishes and your saturated fatty food, you are welcome, but be prepared to pay the heavy price of early cognitive deterioration. These goodies are the harbinger of chronic inflammation – the antithesis of health. But don’t become underweight in old age; keep some fat for the hard times to come.
Could new concepts be of help in the future to diminish chronic mental deterioration? By ingesting the right probiotics to help our intestines, we may indirectly help it to produce the right substances to influence the functions of our brain. Could we use electrical brain stimulation to revert back some effects of chronic mental disability? Will we be using stem cells therapy or foetal brain cells, which after implant in the old brain could regenerate new neurons to replace the old ones?
In mice it has been found that transfusion of blood from the young into the old mice improve the latter’s mental performance. Will all that be extended to human? We’ll wait and see.
And now a Mind Diet is being recommended by nutritionist Martha Morris of Rush University Chicago (New Scientist, Jan 26, 2019). It is supposed to confer better cognitive performance than the DASH diet for hypertension, or the Mediterranean diet. It has given promising results, better than the latter two.
It must consist of plenty of vegetables, especially green leafy ones, supplemented with whole grains like quinoa, oats or wheat. Nuts and beans must form part of it, together with berries, such as strawberries or blue berries. To a lesser extent, we can have some chicken and fish. Try to avoid all the pastries, red meat, fried food or cheese as far as possible – though their consumption once a week is tolerable. The main source of fat should be from olive oil and a tablespoonful of butter in a week. Add to that a small glass of wine every day.
Do we know better? We thought we were building the best and greatest of civilizations; but lo, we discovered that we are decimating our environment and our species along. Could the dementia and Alzheimer patients be more comfortable with their handicap – being not conscious of death when it comes knocking at the doorstep? Those who have been cognitively very lucid until the last moment — how will they face death? Must they be taught and trained for that fate?
* Published in print edition on 8 March 2019