Can We Avoid Cognitive Decline with Age?

Summary

The Sam and Rose Stein Institute for Research on Aging at UCSD School of Medicine explores ways to promote lifelong health and cognitive well-being. This talk delves into cognitive aging, distinguishing normal age-related cognitive changes from dementia, particularly Alzheimer's disease. It highlights modifiable risk factors and the importance of early intervention to prevent or delay cognitive decline. The discussion also covers the impact of lifestyle choices such as exercise, sleep, diet, and hearing loss on brain health, emphasizing actionable steps individuals can take to enhance their cognitive resilience.

Takeaways

• 🧠 The Sam and Rose Stein Institute for Research on Aging aims to promote lifelong health and well-being through various approaches, emphasizing the importance of both research and community service.
• 🧐 The talk discusses the possibility of avoiding cognitive decline with age, highlighting the difference between normal age-related cognitive changes and dementia, specifically Alzheimer's disease.
• 📊 Dementia is identified as a progressive loss of cognitive function caused by various brain diseases, with Alzheimer's being the most common. The presentation points out the high prevalence and the significant impact on individuals and society.
• 🔬 The script delves into the cellular changes associated with dementia, such as amyloid Beta plaques and neurofibrillary tangles, and emphasizes the importance of early intervention during the preclinical phase.
• 👩‍🦳 The presentation acknowledges sex differences in Alzheimer's disease, noting that women have a higher risk and a different trajectory of the disease, which is a focus of ongoing research.
• 🏃‍♀️ Modifiable risk factors are a significant part of the discussion, with lifestyle factors such as exercise, sleep, and diet being highlighted as crucial for maintaining brain health.
• 💊 The talk mentions that certain medications can have cognitive side effects and encourages reviewing medication with healthcare providers to consider alternatives.
• 🧘‍♀️ The importance of managing conditions like hypertension, diabetes, and sleep apnea is underscored to reduce the risk of cognitive decline.
• 🥗 The script points to diet as a modifiable risk factor, with adherence to a healthy diet, such as the Mediterranean-DASH diet, being associated with slower cognitive decline.
• 🌐 The development of an educational platform called Halt-AD is discussed as a means to disseminate information about modifiable risk factors and provide psychosocial support to individuals seeking to improve their brain health.
• 🌟 The talk concludes with a call to action for individuals to make science-based lifestyle changes, engage in research, and consider philanthropic support to advance Alzheimer's disease research.

Q & A

What is the primary commitment of the Sam and Rose Stein Institute for Research on Aging?

The Sam and Rose Stein Institute for Research on Aging is committed to advancing lifelong health and well-being through research, professional training, patient care, and community service, with a focus on making successful aging an achievable goal for everyone.

What does the term 'dementia' encompass?

Dementia is an umbrella term that covers various diseases of the brain which result in the progressive loss of cognitive function, including memory, language, problem-solving, and other thinking abilities.

What is the significance of the research on modifiable risk factors for cognitive decline?

The research on modifiable risk factors is significant because it has identified areas of lifestyle and health that can be changed to potentially improve cognitive aging, delay the onset of cognitive decline, or reduce its severity.

What is the role of amyloid beta plaques and neurofibrillary tangles in Alzheimer's disease?

Amyloid beta plaques form outside of brain cells, and neurofibrillary tangles form within them. These cellular changes cause brain cell dysfunction and death, leading to cognitive disruption, memory loss, and brain atrophy associated with Alzheimer's disease.

How does vascular health relate to brain health and cognitive decline?

Vascular health is closely linked to brain health. Conditions like high cholesterol or hypertension can lead to clogged blood vessels in the brain, depriving brain tissue of essential oxygen and nutrients, which contributes to cognitive decline.

What is the Women Inflammation and Tau Study (WITS), and what is its purpose?

The Women Inflammation and Tau Study (WITS) is an ongoing study that focuses on women aged 65 and older, aiming to understand whether modifiable risk factors like sleep apnea, exercise, and insulin resistance might predict Alzheimer's disease outcomes, specifically cognition and tau, and whether inflammation is a mediator of that relationship.

Why is sleep apnea a significant concern in relation to cognitive health?

Sleep apnea is a concern for cognitive health because it can lead to intermittent oxygen deprivation in the brain during sleep. This affects the brain's memory center and can disrupt the brain's clearance mechanism for amyloid, potentially contributing to cognitive decline.

What is the relationship between diet and cognitive decline?

Diet plays a significant role in cognitive decline. Adherence to a healthy diet, such as the Mediterranean-DASH diet, is associated with slower cognitive decline over time.

How does the Halt-AD program aim to educate and support individuals in maintaining their brain health?

The Halt-AD program is an educational platform that provides quality information about modifiable risk factors for brain health. It offers personalized learning programs, psychosocial support groups, and access to modules on various areas of brain health, aiming to empower individuals to make science-based changes to improve their cognitive well-being.

What are some non-modifiable risk factors for Alzheimer's disease mentioned in the script?

Non-modifiable risk factors for Alzheimer's disease mentioned in the script include age, gender (being female), race, and genetics, specifically the presence of the APOE E4 allele.

What are some of the modifiable risk factors for cognitive decline discussed in the script?

The modifiable risk factors for cognitive decline discussed in the script include education, hearing loss, hypertension, excessive alcohol consumption, obesity, depression, social isolation, physical inactivity, diabetes, and vascular risk factors like cholesterol and high blood pressure.

How does the script address the issue of diversity in research studies?

The script acknowledges the importance of diversity in research studies and mentions efforts to include more diverse groups, such as the launch of the B-Witz study focused on black women and the Selinker study looking at Latinas and Latinos, to better understand the risks and factors related to Alzheimer's disease in these populations.

What is the role of inflammation in Alzheimer's disease and cognitive decline?

Inflammation plays a significant role in Alzheimer's disease and cognitive decline. It is associated with an increased risk of other inflammatory disorders and seems to be particularly important in driving tau pathology, the spread of tau through the brain, which contributes to cognitive decline.

What are some of the interventions and clinical trials mentioned in the script that aim to improve cognitive health?

The script mentions the FINGER Study, which is a multi-domain intervention focusing on diet, exercise, cognitive training, and vascular risk monitoring, and has shown improvements in cognition. Another trial mentioned is one that adds metformin to the intervention to explore its potential protective effects.

How does the script discuss the potential of lifestyle changes to impact cognitive health, even in older age?

The script suggests that lifestyle changes can have a positive impact on cognitive health even in older age. It references research showing that maintaining a healthy lifestyle can protect cognition, and even individuals with a high load of tau pathology in the brain can benefit from a healthy lifestyle.

What is the significance of the research on sleep and its relationship to cognitive decline?

The research on sleep is significant because it has found that sleep apnea, especially in older adults, is associated with a higher risk of dementia. Treating sleep apnea with CPAP use has been shown to delay cognitive decline, and poor sleep has been linked to increased tau pathology and memory issues.

How does the script address the role of diet in brain health?

The script emphasizes the importance of diet in brain health by discussing the Mediterranean-DASH diet and its association with slower cognitive decline. It suggests that a diet rich in green leafy vegetables, berries, nuts, olive oil, whole grains, and fish, while limiting fast food, pastries, and excessive wine, can contribute to better cognitive outcomes.

What are the script's recommendations regarding supplements for brain health?

The script recommends a cautious approach to supplements for brain health. It suggests that while a multivitamin may be beneficial for those with deficiencies, there is not strong evidence to support the use of most brain health supplements. It emphasizes the importance of making science-based changes rather than relying on supplements without evidence.

How does the script discuss the potential impact of exercise on cognitive health?

The script highlights the importance of exercise in maintaining cognitive health. It cites research showing that physical activity at different life stages, including in older age, is predictive of better cognition and can have a positive impact on cognitive outcomes.