These days, it’s vital for seniors to maintain their brain health in order to keep up with all of the changes that are happening in today’s modern world. Not too long ago, it was common to live your entire life in one small town, working at the same job for your entire career and seeing the same people every day. Maintaining executive function, or the skills needed to manage your daily life, was much easier because life was so much simpler. Older adults were able to use their wisdom and experience to get by. There was no need to learn how to use a computer at work, program a GPS to navigate a world outside of your hometown, or video call relatives half a world away. In short, maintaining brain health for seniors is so much more important today than it has ever been.

In addition, people are living much longer lives today. 100 years ago, life expectancy was less than 60 years. In humans, the brain develops more slowly than the rest of the body, but it also ages more slowly. The overall volume of the brain normally peaks sometime between the ages of 30 and 40. After 40 it begins to lose about 5% of its volume per decade. So, if we only live to age 60, the loss of brain volume is around 10%, which is manageable and not life-threatening.

The bad news (which is really good news) is that our life expectancy is now closer to 80 years. We are living longer because of medical advances such as improved infectious disease control, better cancer treatments, and coronary health awareness. But very little has been done to maintain or improve our brain health. We are literally outliving our brains! In the past 20 years, however, there has been a lot of research into ways that we can maintain our brain health. In this post, I’d like to share four of those ways with you.

Maintaining Brain Health for Seniors – Tools and Protocols

Much of the information for this post comes from the Lifespan podcast Enhance Brain Health – The Science of Keeping the Brain Healthy by Dr. David Sinclair. Dr. Sinclair is a professor at the Harvard Medical School who specializes in aging and longevity. His recommendations include eating a healthy diet, exercising, taking supplements and getting proper sleep. WARNING: Although these recommendations are backed by scientific research and are safe for most people, please consult your physician before implementing any of them!

1. Diet

Lately, much has been written about the importance of eating a healthy diet to increase your lifespan. In his book The Blue Zones – Lessons for Living Longer From the People Who Live the Longest, author Dan Buettner identifies five regions in the world that have the highest concentration of people who live to be 100 years old or older. These people had very low rates of heart disease, cancer, obesity, and diabetes, and research has shown that their diets play an important part. What may be less well known is that those who live in these regions also have some of the lowest rates of dementia and Alzheimer’s disease in the world. The diets of two of these regions, the Mediterranean and the Okinawan, have gained attention in recent years because of their health benefits and their culinary appeal.

The Mediterranean Diet

The Mediterranean diet consists mainly of whole grains, nuts, fruits and vegetables, with cheese, fish and poultry as the main sources of protein. Little red meat is eaten. Olive oil is the main source of added fat and red wine is consumed in moderation. There have been over a dozen studies showing that the Mediterranean diet protects the brain from aging and can even reverse the effects of mild cognitive impairment. For more information, including recipes from

Italy, Greece, Morocco and Turkey as well as keto-friendly meals, check out The Complete Mediterranean Cookbook by America’s Test Kitchen.

The Okinawan Diet

Like the Mediterranean diet, the Okinawan diet has low levels of protein and is mostly plant-based. Unlike the typical Japanese diet, the Okinawan diet’s main staple isn’t rice but the purple sweet potato, which is high in DHEA, which have been shown to guard against dementia and other age-related diseases. The Okinawans also have a rule that says that you should stop eating when you are 80% full, which reduces obesity. For more information about the

Okinawan lifestyle and diet, including recipes, The Okinawan Program by Willcox, Willcox and Suzuki is a good place to start. And if you want to know more about the Okinawan concept of ikigai, or your reason for being, please read my post How to Find Your Ikigai in Retirement. Many Okinawans credit having an ikigai as the secret to their long and happy lives.

Being of Okinawan descent, I am familiar with the Okinawan diet and try to eat purple sweet potatoes as often as I can. I also enjoy the Mediterranean diet and an occasional glass of red wine. But you don’t have to be too rigid or dogmatic with your food choices to keep your brain healthy. I think a good rule of thumb to follow comes from Michael Pollan in his book Food Rules: An Eater’s Manual: “ Eat food. Not too much. Mostly plants.”

2. Exercise

It is well known that exercise is important for keeping the body healthy. Your heart, lungs, bones and muscles all benefit from a regular exercise routine. Exercise is another tool that is crucial to maintain brain health for seniors.

Aerobic Exercise

recommends getting 150 minutes (30 minutes a day, five times a week) of moderate aerobic activity such as brisk walking per week.

Strength Training

Strength training is also beneficial to brain health. Pereira et al. found that just 10 weeks of strength training can increase the amount of brain derived neurotrophic factor (BDNF), a protein in the brain that plays an important role in neurogenesis, or the growth of new brain cells. Alzheimer’s patients often have low levels of BDNF in their brains. The CDC recommendation is

to exercise the main muscle groups (legs, arms, back, abdominals, chest and shoulders) two times a week.

For most seniors who do not have serious cognitive impairment, it is crucial to begin exercising NOW. Once Alzheimer’s or other forms of dementia become severe, it is very difficult to begin or maintain an exercise program. The irony is that, at a time when most people become less active, it is more important than ever to exercise.

3. Supplements

Omega-3 Fatty Acids

There are several types of Omega-3’s, but the most important for brain health in seniors are ALA, EPA and DHA. ALA is found mostly in plant-based foods such as walnuts, soybeans and flaxseed. The body converts ALA into EPA and  DHA, which are the forms of Omega-3 that the brain uses. Unfortunately, this conversion is not very efficient, so if your diet is vegan or vegetarian, supplementation may be necessary. EPA and DHA are found mainly in ocean fish such as salmon and sardines. Interestingly, fish do not

produce EPA or DHA; it is made by microalgae that the fish consume. It is recommended that we should eat 2-3 servings of fish per week, but most Americans don’t eat this much. This is another case for supplements.

Several studies have shown that DHA and EPA reduce the risk of dementia and Alzheimer’s disease. Specifically, a 100 mg/day dose of DHA lowered the risk of dementia by 14% and Alzheimer’s by 37%. Also, in older adults with no cognitive impairment, a combination of 500 mg of DHA and 100 mg of EPA per day was shown to reduce the risk of cognitive impairment to near zero. The important take-away from this study is that Omega-3’s help protect cognitively health adults from decline.

Resveratrol

1-2 mg of resveratrol. In clinical trials of woman between the ages of 45-85, it was determined that a daily dose of 150 mg/day in supplement form was optimal for improving cognitive function. That would mean that you would have to drink around 100 glasses of wine a day to get that effect. I don’t know about you, but I can’t drink that much wine, so I’ll stick to resveratrol in pill form!

NAD and Metformin

Both Omega-3’s (found in fish) and resveratrol (found in red wine) are fairly well-known because they are found in diets that promote longevity. Two lesser known supplements that are under investigation by brain researchers are NAD+ and Metformin. NAD is an enzyme that helps the body and brain repair itself. Levels of NAD tend to be lower in patients with Alzheimer’s disease than in the general population. NAD+ has been shown to increase NAD levels and reverse Alzheimer’s in mice, and clinical trials to determine if it can improve brain health for seniors are being conducted on human subjects now.

Metformin is a common drug that is  used to treat Type 2 diabetes. It lowers blood sugar levels, which can be helpful in reducing the risk of dementia. Although sugar (in the form of glucose) is necessary for the brain to function, too much is harmful. Just as sugar on a hot stove will caramelize and become a sticky mess, metabolized sugar in the brain can form a sticky coating that reduces blood flow and neural connections. Metformin has been shown to decrease the risk of dementia by a remarkable 55% in diabetic patients. Unfortunately, Metformin is only available by prescription in the United States to treat diabetes for now. Hopefully, it will eventually be approved as treatment to increase longevity and maintain brain health for seniors.

4. Sleep

During the day, your brain produces a protein called amyloid beta, which is thought to help protect it. At night when you are sleeping, this protein gets flushed away, taking with it harmful substances that can damage the brain. If we don’t get enough sleep, this process doesn’t get completed and these harmful substances (called plaque) can accumulate. Amyloid beta build-up is widely know as one of the main causes of Alzheimer’s disease.

To make matters worse, patients with Alzheimer’s often find it more and more difficult to fall and stay asleep as the disease progresses. This leads to more plaque build-up, which makes the disease worse, which causes more sleep difficulties, etc. A downward spiral is created for which there is no escape.

That is why getting enough sleep is crucial for maintaining brain health, starting in mid-life. It has been shown that those with poor sleep quality at age 50 have an increased risk of dementia 25 years or more in the future. A study published in the journal Nature found that people who consistently slept for six hours or less per night at ages 50, 60 and 70 had a 30% increase in dementia risk compared to those who got seven hours of sleep per night (this risk is about the same as those who smoke moderately). Those who consistently got fewer than five hours per night were twice as likely to develop dementia.

Note that these studies mentioned the word “consistently.” An occasional late-nighter probably won’t do harm, but it is important to get a good-night’s sleep whenever possible. One way that I found to do this comes from the Huberman Lab podcast episode titled Master Your Sleep. Our bodies are governed by a Circadian rhythm that tells us when to be awake and when to sleep. This rhythm is triggered and patterned after the natural day and night cycles of the sun.  Early in the day (no more than two hours after sunrise or waking), it is important to get at least 20 minutes of indirect sunlight into our eyes to trigger the waking cycle. The shorter wavelength blue-green light of the morning tells the brain to produce cortisol, a hormone that wakes you up. Get another 20 minutes of sun in your eyes about two hours before the sun sets to trigger the sleep response. The longer wavelength red light of sunset tells the brain to produce melatonin, a hormone that helps you fall asleep. Bright artificial lights can be used if sunlight isn’t available, but keep all lighting to a minimum after 10 or 11 pm. Artificial light, specifically the blue light given off by computer and phone screens, is  especially harmful because, like the morning sun, it tells the brain to produce cortisol.

I have been following this practice of getting early morning and late afternoon sun in my eyes for about six months now and it’s made a big difference in my sleep quality. I am averaging seven solid hours of sleep per night without using any supplements or sleeping pills, which can disrupt normal brain wave patterns in sleep. I can’t think of a better free, effective and relaxing way to maintain brain health for seniors.

Conclusion

No matter how old you are, it’s never too late to start taking steps to maintain your brain health. But the earlier you start, the easier it is to make the necessary changes in your lifestyle. Food addictions, especially to sugar, are real and get harder to overcome as eating habits become more entrenched. If you have lived a mostly sedentary lifestyle, it is difficult to start an exercise routine. And even if you do exercise, it becomes harder as you age. The same is true of sleep. Getting enough sleep is crucial to reduce your dementia risk, but many older adults report that they  have to work harder at falling and staying asleep.

The good news is that the things that you do to maintain your brain health for seniors are the same things that you need to do to maintain the health of the rest of your body. The rewards are worth the effort because you will feel and think better. And the risks of not making the effort, at least for me, are also greater. For some reason, I am tolerant of my body aging; it’s okay if I can’t run as fast as I once did or play tennis as well as I used to. But if I forget where I left my keys or can’t recall someone’s name (both only temporarily), a wave of anxiety comes over me. Even the slightest hint that I am losing cognitive function causes fear in me, and I don’t think that I’m the only one who feels this way.

And similarly, watching someone suffer through the downward progression of dementia is more difficult than watching their body decline. I know this first-hand because I have lost close family members to dementia. So you owe it to not just yourself, but to your family as well, to do whatever you can to maintain your brain health for as long as you can.