En español | Want to stay sharp into very old age? Get regular exercise, keep your heart healthy, and mind your medications. Those were the major findings of a report on brain health recently issued by the National Academy of Sciences' Institute of Medicine and cosponsored by AARP. The good news? Cognitive decline is not inevitable as we age. Here's what helps, what hurts and what may not be effective in preserving your brain health.
Aerobic exercise is especially beneficial for brain health, and even better when combined with strength training. Exercising for longer periods — at least 30 minutes or more at a time — appears to be better for brain health than shorter sessions. And it's never too late to start. People older than 65 showed more benefits than those 55 to 65.
Staying socially and intellectually active
Activities that challenge your brain — including reading books, writing letters and learning a new language — all help preserve brain function, as do social activities such as volunteering, playing cards, attending worship services and talking with friends.
Eating a healthy diet
Although no specific diet has been proved to maintain or improve brain health, studies of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets justify eating less meat and consuming more nuts, beans, whole grains, vegetables and olive oil. Omega-3 fatty acids, found in fatty fish such as salmon, have been shown to help cognition in some studies, though not in others.
Getting good sleep
Poor sleep quality is linked to cognitive impairment and Alzheimer's.Breathing disorders, such as sleep apnea, also put older people at higher risk for memory problems and dementia. Several studies have found treating sleep apnea helps delay memory problems.
Keeping your heart healthy
What's good for your heart is also good for your brain. High blood pressure, high cholesterol and diabetes — especially in midlife — are linked to poor brain health later in life. Lowering blood pressure with medication seems to help prevent brain problems, but it's unclear whether lowering cholesterol with drugs helps.
In midlife, depression doubles the risk for cognitive decline and dementia, possibly because depression causes changes in the hippocampus. Late-life depression is also linked to dementia, especially vascular dementia, although it's unclear whether the depression may be an early symptom of undiagnosed brain health problems.
Hearing and vision loss
Problems hearing and seeing are both linked to trouble with thinking, memory and socialization and should be corrected, if possible. One Johns Hopkins study found that older adults with hearing problems appear to have a greater rate of brain shrinkage as they age.
Anticholinergic drugs have been shown to increase the risk of dementia — these include antihistamines such as Benadryl, sleep meds such as Tylenol PM and some antidepressants. "We aren't saying don't take them ever," says Dan Blazer, emeritus professor of psychiatry at Duke University and lead author of the Institute of Medicine report. "But you need to watch out and be aware of the side effects."
Not only can daily stress cause memory problems, but long-term stress is connected with faster rates of decline in brain health, too. Methods to reduce stress — such as meditation and mindfulness — may help, but their effectiveness requires further study.
It may be that pollution increases heart disease, stroke and lung problems — which in turn cause problems with brain health — or that small particles in the pollution directly harm the brain. One new study found that long-term exposure to air pollution is linked with brain shrinkage, brain damage and impaired function.
Brain games and other cognitive training: Although research shows brain training can improve attention and memory as they relate to the games, few studies demonstrate that those skills transfer to real life. The report recommends that consumers carefully evaluate claims of companies selling brain games. "People may fall prey to using products that have not been proven to be effective and think they will help them in all areas of their lives," Blazer says.
"There just is no good, consistent evidence that vitamins provide value in improving brain health," Blazer says. In particular, vitamins E, B6 and B12 provide no clear benefit. And while vitamin D deficiency has been linked to a decline in brain health, taking vitamin D supplements has not been shown to improve memory. Similarly, ginkgo biloba "is not considered effective in preventing cognitive decline," the report found.
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