"While a COVID-19 infection itself can directly harm your brain, months of isolation can take a toll as well,” says Sarah Lenz Lock, executive director of the Global Council on Brain Health (GCBH), an independent collaborative of scientists, doctors and policy experts convened by AARP to provide trusted information on brain health. That's why the council has released a report on how the brain health of older adults has been affected by the pandemic and what research is needed to address the problem. Along with the latest scientific findings, the report includes tips for older adults to adopt.
"People know that COVID-19 is a disease that affects the lungs, but they are not as aware that it can affect the brain as well. Even though there is much still to be learned about how COVID-19 affects our thinking, the GCBH wanted everyone to know this is a well-recognized problem, and emphasize that there are ways to address the health of their brain during the pandemic. The council also wanted to address some of the negative effects of the isolation that many people are experiencing,” explains council chair Marilyn Albert, professor of neurology and director of the division on cognitive neuroscience at Johns Hopkins University in Baltimore.
Tip No. 1 is not surprising: Consider getting the COVID-19 vaccine as soon as possible, and be sure to complete all required doses and keep following CDC guidelines. Doing so can protect your brain from the virus's potential neurological harm, and may well save your life — especially if you're over 65.
Here, from the council and its brain-health experts, are other ways you can keep your brain resilient during the pandemic.
Keep — or get — active
It's easy to be a couch potato these days. So many of us are spending more time at home and are not yet comfortable returning to a gym or fitness studio. But as the Global Council report stresses, physical activity is vital to maintain cognition in adults, particularly older ones. Not only have studies linked low physical activity with higher dementia risk, but regularly exercising helps boost your immune system, which may provide additional protection against COVID-19, notes Gary Small, M.D., chair of psychiatry at Hackensack University Medical Center. View a daily walk or other fitness activity as essential to your brain health, and also try to limit how much you sit: Adults between the ages of 45 to 75 who sit for three to seven hours each day have a substantial thinning of their temporal lobe, which is where the brain forms new memories, according to Small's own 2018 study. “This is one of the types of changes that can precede dementia,” he says.
An AARP survey released in summer 2020 found that many older adults had cut back on trips to the grocery store due to fears of contracting COVID-19. As a result, it may be more of a challenge for them to fill up on brain-healthy fare such as fatty fish and fresh fruits and vegetables. “Older adults may be relying on processed foods high in fat and refined sugar that cause weight gain,” Small notes. “It's not only bad for your heart — we know that obesity in middle age increases your risk of developing late-life dementia.” However you shop, try to consistently include the best foods for brain health, which include berries, leafy green veggies, extra virgin olive oil, nuts, fish and seafood, along with beans, low-fat dairy, poultry and grains.
Stay socially connected
As detailed in the new GCBH report, older adults are no strangers to isolation and loneliness, but the effects have become particularly pronounced during the pandemic — with potentially serious consequences. Social isolation is as big a risk factor as smoking, obesity and lack of physical activity when it comes to raising risk of premature death, and is associated with about a 50 percent increased risk of dementia, according to the Centers for Disease Control and Prevention (CDC).
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That's why finding ways to connect with family and friends has taken on some urgency, the council's experts say. If you enjoyed activities like book club or poker night pre-pandemic, try organizing them virtually. Even just calling a friend or loved one each night to chat can help: A University of Michigan study found that just 10 minutes of talking to another person can help boost memory and cognitive performance. Another way to reach out to others is to volunteer, whether it's serving meals at a shelter (masked and socially distanced, of course) or making phone calls for your synagogue or church. Seniors who do so have lower rates of dementia, according to a study published in PLOS One.
Prioritize your sleep
"Our brain-health experts consistently stress that sleep truly is one of the most important things you can do for brain health,” says Lock. Yet even before the pandemic, less than half of adults over the age of 50 reported they were getting excellent or good quality sleep. Why that's worrisome? It's during sleep that your body breaks down the beta-amyloid plaques in your brain that can raise your risk of Alzheimer's, points out Small. In order to make sure you get 7 to 8 hours of quality slumber, try setting an alarm that alerts you when it's time to turn in. An hour or two beforehand, get off of electronics (blue light can interfere with your body's circadian rhythms) and do something like reading or listening to a meditation app to help signal your brain it's time to wind down.
Exercise your brain with challenges you enjoy
Reading, crossword puzzles, even playing a solo card game — these are all cognitively stimulating activities that can help keep your brain active. Another option is to listen to music, which research shows protects your brain by reducing stress and boosting mood. You don't need to waste time or money on brain training games either. Instead, focus on intellectually challenging activities that are interesting to you — painting, relearning a language, taking a course online. A 2018 JAMA study of people 65 and older found that those who regularly participated in all of these types of activities had a significantly lower risk of dementia over six years of follow-up.
Focus on your mental health
People over the age of 65 have been significantly less likely to report feelings of depression and anxiety during the pandemic than younger individuals, which expert say may be due in part to the mental resiliency that develops with age. But the effects of long-term isolation can take a heavy psychological toll, which is why it's imperative you spend time to nurture yourself: take up a new hobby or spend time in nature, and yes, take occasional breaks from news and social media. If you need to, seek professional help: “The silver lining of the pandemic is that it's catapulted telepsychiatry to the forefront,” says Small, adding that research shows that during these times, remote therapy can be just as effective as face-to-face.
Pay attention to signs of confusion if you're hospitalized
As many as half of people over the age of 65 experience delirium after being admitted to the hospital, according to the GCBH. This is especially common when they are hospitalized due to an infection with COVID-19. “This is a virus that invades the brain, and in addition to that you have an accelerated amount of blood clotting in COVID, which stops blood from getting to the brain cells,” explains Wes Ely, M.D., codirector of the Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center at Vanderbilt University Medical Center in Nashville, Tenn. People are also left isolated and immobilized in a hospital room, he notes, which can contribute to confusion.
If a loved one is hospitalized due to COVID-19, look for signs such as confusion, inability to pay attention, and disrupted sleep/wake cycles. If they are being prescribed benzodiazepines (which often happens in hospital settings to quell anxiety) request that they be taken off of them, as they can exacerbate symptoms, Ely says. Since sensory deprivation can worsen delirium, make sure family and other loved ones are nearby, to talk with and touch them, and to help keep them moving as much as possible. The good news is that delirium typically resolves on its own after a few days.
Monitor changes in brain health
It's easy to dismiss things like forgetfulness or confusion as resulting from the stress and isolation of the pandemic. But if you have any doubt, reach out to your doctor, since such cognitive symptoms can be caused by something as simple as a new medication or something as urgent as a stroke. Also watch out for any of the neurological symptoms of COVID-19, like loss of taste or smell, which can show up before other common symptoms such as cough or fever. The report provides a review of neurological symptoms identified so far that occur in adults. Importantly, a study has found that 37% of older adults coming to emergency with COVID-19 had signs of delirium, but no other common COVID-19 symptoms. The GCBH report also stresses the importance of maintaining health appointments to monitor and treat high blood pressure or type two diabetes, which can harm your brain health if left uncontrolled.