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THERE
are no certainties in life, except for ageing, which occurs from the day of
birth. Although there is a nev
Knowledge
of the brain, which is the most vital human organs, has been limited, until
recently. The increase in life spans and technological advances, like magnetic
resonance imaging (MRI) and positron emission tomography (PET) scans, have
accelerated the understanding of the processes of brain function. This has been
driven by the search to preserve brain function for as long as is possible.
Brain
changes
The
brain, which contains billions of cells (neurons), is responsible for all
physical life support functions like brea
Until a decade ago, it was thought that the brain neurones were
gradually lost from birth. It is now evident that if a person has no specific
disease that causes neuronal loss, most neurones, if not all, will remain
functional until a person dies.
The brain changes with age. Its weight decreases by 5% to 10% between 20
and 90 years. The grooves on its surface widens and the swellings, on the
surface becomes smaller. Some neurones shrink. The ability to rearrange
connections between the neurones is reduced (loss of plasticity ) and there is
formation of clusters of damaged or dying neurones (senile plaques).
There is also an increase of decayed parts of the branch-like denticles
which extend from the neurones (neurofibriallary tangles). Like other body
parts, the brain can also be damaged by free radicals.
The changes are subtle and affect certain areas of the brain more than
others. The areas at increased risk are those involved in learning, memory and
complex mental activities.
Apart from the physical changes, a surprising finding is data that
suggests cognitive decline like age-related memory loss, is not due to neurone
loss, as previously thought. The current thinking is that these changes are
related to complex chem ical interactions in the brain that occur over time.
The age-related loss of dopamine, a brain chemical associated with pleasure and
reward, slows down the metabolism in the brain regions related to cognition.
These changes affect ind
The factors affecting the different rates have still to be elucidated.
It is believed that genetics play an important role.
Recent findings have revealed that lifestyle factors influence the rate
of changes in the brain with age. A healthy lifestyle has been found to be
useful in maintaining brain health with increasing age.
Exercise the brain
The adage, “Use it if you don’t want to lose it”, is very relevant to
brain functions. By repeatedly using the brain neurones’ connectivity patterns,
the synapses between them are probably made broader and their connections
stronger. It would be tempting to make a comparison with the rest of the body,
inactivity of which leads to atrophy and wasting.
There are several ways to challenge the brain to keep it in shape. New
activities are helpful as they can lead to the creation of new brain pathway to
serve as alternatives in the event some neurones are damaged. This could be
games, learning of new skills or volunteering.
Physical activity
Physical activity provides protection against loss of brain function.
Any aerobic activity causes new brain cells to sprout, possibly increasing the
capacity of the capillaries serving the brain so there is better blood flow and
oxygen uptake. Increased blood volume also appears to promote the growth of new
connections between brain cells and facilitate the del
Exercise also helps to sharpen focus, boost mood and dial down stress
levels. All these benefits appear through all exercises, whether you go through
the pace of a hardcore CrossFit workout or rapid walking for about 45 minutes
thrice weekly. It improves significantly the age-related decline in cognitive
function.
One does not have to do strenuous exercise immediately but one can
gradually increase the level of physical activity in daily life, eg walking,
taking the stairs instead of the lift, swimming. If strenuous activities are
undertaken, personal protective equipment may be necessary as head injuries are
a risk factor for memory problems.
Exercise fuels the brain instantly. When someone is huffing and puffing
in their target zone, they are sending more generous amounts of oxygen and
glucose into the brain. Glucose is the brain’s main fuel source and oxygen as
the means to spark that fuel into energy.
In one study performed by the researchers at the University of Il l
Regular exercise is the no. 1 way to preserve brain function into the
golden years. It is proven more effective than brain games, superfoods,
supplements or any other method used to keep the brain sparking on all
cylinders into old age.
Researchers at the University
of Wash ington
Healthy diet
A healthy well-balanced diet goes a long way in preventing chronic
diseases like high blood pressure and diabetes that affect brain function. Even
if one has these conditions, a healthy diet helps in keeping them under
control. It is often forgotten that diabetes can be controlled by diet
alone.
It is important to remember that a person’s energy requirements decrease
with increasing age because of a reduction in the body’s metabolic rate. As
such, body weight should be kept under control.
A well-balanced diet should include proteins that supply the brain with
amino acids (which are the building blocks of proteins), unsaturated fats
(which are an essential constituent of neuronal membranes), glucose to provide
energy for neuronal function, as well as plenty of fruits and vegetables that
provide antioxidants to protect the neurones.
As the brain does not have much storage capacity for glucose, it has to
receive a steady supply from the blood vessels. Foods with a low to medium
glycaemic ind ex, eg brown rice, oats and whole
grain brea
Smoking cessation
There are more than 4,000 substances released in tobacco smoke. Smokers
have twice the risk of Alzheimer’s disease, not to mention heart attact and
lung disease.
Stress management
During stress situations, the body produces cortisol, a hormone which,
in small amounts improves memory. However, when produced in larger amounts,
especially over a long period of time, it leads to neuronal injury in the
hippocampus, which is a factor in memory loss.
The risk of anxiety and depression is increased with stress. Both
conditions can affect memory. Should stress be an issue, there are measures
that can be taken to reduce and manage it.
Regular health checks
Regular health checks help in the diagnosis of diabetes, high blood
pressure and heart disease, all of which increase the likelihood of memory
loss, especially if untreated or inadequately treated. Studies have suggested
that high blood pressure accelerates normal brain shrinkage.
Treatments for these conditions are easily available and accessible, but
the challenge is patient compliance to treatment.
Head trauma
It is known that the brains of some boxers have changes similar to that
of Alzheimer’s disease, except that it occurs at a younger age. There are also
reports of decline in cognitive function of former footballers in relation to
the frequency of their heading the ball. It is probable that the avoidance of
head trauma will decrease the likelihood of premature brin ageing.
Supplements
Various products are marketed as anti-ageing compounds. In order that
readers get an accurate picture, refer to the Cochrane Database of Systemic
Reviews, a global collaborative effort of doctors and scientist that provide ind
Gingko biloba has been used in traditional medicine for its anti-ageing
effects. Its impact on those with dementia or cognitive impairment has been
stated in the Cochrane Review: “One of the four most recent trials to report
results, three found no difference between gingko biloba and placebo, and one
reported very large treatment effects in favour of gingko biloba. Gingko biloba
appears to be safe, with no excess side effects compared with placebo. Many of
the early trials used unsatisfactory methods, were small, and publication bias
canot be excluded. The evidence that gingko biloba has predictable and
clinically significant benefit for people with dementia or cognitive impairment
is inconsistent and unreliable.” (Gingko biloba for cognitive impairment and
dementia. Cochrane Database of systemic Reviews. 11, 2010). However,
there is no evidence that gingko biloba slows down mental decline in healthy ind
DHEA has also been promotd as an anti-ageing supplement. The conclusions
from the Cochrane Review were: “The data offer no support at present for an
improvement in memory or other aspects of cognitive function following DHEA
ttreatment in normal older people.” (Dehydroepiandrosterone (DHEA)
supplementation for cognitive function. Cochrane Database of Systemic Reviews.
1, 2009).
Similar conclusions were found with folic acid. “The small number of
studies which have been done provide no consistent evidence either way that
folic acid, with or without vitamin B12, has a beneficial effect on cognitive
function of unselected healthy or cognitively impaired older people. “ (Folic
acid with or without vitamin B12 for the prevention and treatment of healthy elderly
and demented people. Cochrane Database of Systemic Reviews. 1, 2009)
In short, the jury on the role of supplements in brain health is still
out.
It would be advisable to discuss with the doctor before commencing a
supplement. This is to ensure that it is appropriate and that it does not interact
with medicines that are being taken.
The brain is one of the frontiers of medical research. There is optimism
that better understanding and treatment of brain ageing is on the horizon. What
is already known is that cognitive decline is largely preventable with a
healthy lifestyle.
(Source: An article written by Dr Milton Lum, a member of the board
of Medical Defence Malaysia
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