One of the scariest thoughts (for most of us) is the idea of losing our independence due to cognitive decline. Yet, research shows many of us could be headed for this reality. If you don’t think you could lose your independence, think again. Dementia is on the rise, and with diminished cognitive function comes an increased risk of losing one’s independence.
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Introduction
Independence is often defined as the ability to perform the basic Activities of Daily Living (ADL) without assistance. Some of the most common ADLs include bathing, dressing, eating, getting in or out of a chair, using the toilet, and walking.
One of the most common forms of dementia is Alzheimer’s Disease. Alzheimer's Disease kills more people each year than breast and prostate cancer combined. It is the fifth leading cause of death among individuals who are 65 and older. Since the year 2000, deaths from heart disease have decreased by only 14%, while deaths from Alzheimer's have increased by a shocking 89%. (2)
The following diagram shows some of the key symptoms of Dementia. Do you or your loved ones show any combination of these symptoms? If yes, keep reading!
Health Span vs. Disease Span
The subject of dementia is really about Health Span vs. Disease Span. Health Span is how long you can live in a fully functional, healthy state. This is in comparison to Disease Span, which is the length of time you spend in a dependent and dysfunctional state and typically extends until you die.
Personally, I would like to do everything I can to extend my “Health Span” and limit my “Disease Span”. The good news is there are things you can do to extend your Health Span! No matter your genetics, previous history, or even if you have started to notice some cognitive changes, you can still take action. But first, let’s gain a better understanding of just what is happening with Alzheimer's patients.
Amyloid Beta – The Plaque Former
First, we need to consider the effects of Amyloid Beta. Amyloid Beta is a substance that forms plaques and is commonly found in the brains of Alzheimer's patients. Amyloid Beta is a waste product that accumulates between the synapses of the brain (A synapse is a junction between two nerve cells and consists of a minute gap across which electrical impulses can jump). (1)
With Alzheimer's, Amyloid Beta starts to pile up in these synapses 15 to 20 years before Alzheimer’s symptoms start to appear. The appearance of symptoms is often called the “tipping point”.
Once someone passes the tipping point, they experience increased inflammation along the synapses of the neurons and synaptic damage that leads to the formation of tangles. These tangles choke off the synapse from the inside out, eventually leading to synaptic death. Every time a synapse dies, you lose a key pathway to accessing information or retrieving a memory.
Though most individuals develop symptoms of Alzheimer’s after the age of 65, it is important to remember that plaques can develop 20 years before these symptoms arise.
Fortunately, there are many actions you can take now to prevent these amyloid plaques from forming. The first is to consider your sleeping patterns, and the second is your cardiovascular health.
Why is Sleep So Important?
We live in a sleep-deprived society. I have been guilty of this; it's too easy to get caught up in our 24/7 media-intense society. Many of us spend too much time watching TV, cruising the Internet, or doing other activities when we should be sleeping.
Sleep is critical for maintaining good brain health. It is the time when our synapses are rinsed out with cerebral spinal fluid. This effective cleansing system clears out our metabolic wastes (amyloid beta) every night. Research has demonstrated that even a single night without proper sleep will increase the levels of synaptic amyloid beta.
Interestingly, not only does amyloid beta increase with lack of sleep, but increased levels of amyloid beta will, in turn, cause sleep disturbances. It is a vicious cycle! The less sleep you get, the more amyloid beta accumulates; the more amyloid beta in your system, the less sleep you get. All in all, decreasing your amyloid beta levels is a good reason to get at least 8 hours of sleep every night to ensure your synapses are properly rinsed out.
Improving your Cardiovascular Health
The next critical factor in preventing Alzheimer's is to focus on improving your cardiovascular health. Research has shown that exercise, especially aerobic exercise, decreases the amount of amyloid beta in your brain. It will also help to keep your weight in check, reduce blood pressure, reduce bad cholesterol, increase good cholesterol, increase insulin sensitivity and increase neuroplasticity.
Even better, combining exercise with a heart-healthy diet (such as the Mediterranean diet) can accelerate the removal of amyloid beta. We all love good food, but let's ensure it is healthy.
If, for some reason, you don't think that cardiovascular disease is a problem for you, then consider this. Cardiovascular disease is the leading global cause of death in our society. Cardiovascular disease claims more lives than all forms of cancer combined. Research shows that 48% of women and 46% of men have cardiovascular disease. Then, consider that 80% of Alzheimer’s patients also suffer from some form of cardiovascular disease. (4)
Understanding Neuroplasticity and Cognitive Reserve!
This is where the prevention of Alzheimer's Dementia gets interesting. Neuroplasticity and what we refer to as cognitive reserve are the reasons why our actions can make such a profound difference in our future cognitive function. Neuroplasticity is the brain's ability to form new pathways and reorganize neurological connections.
One of the most powerful ways of preventing Alzheimer's Disease is by engaging in new and exciting activities. Whether we like it or not, the path of familiarity is the road to dementia. Whenever we become involved in new, stimulating, physically and mentally challenging activities, our body creates new pathways throughout our brain.
Cognitive Reserve refers to the additional neural pathways that the brain can use to re-route signals. The term “cognitive reserve” first originated in the late 1980s, with some very interesting research from brain autopsies. Researchers dissected the brains of people with no apparent symptoms of dementia and, surprisingly, found that all the brains contained amyloid plaques and many areas of damage that were consistent with advanced Alzheimer's disease. Yet, while living, these individuals did not show symptoms of dementia. The researchers also found that each person had a large cognitive reserve to counterbalance the damage.
This is incredible news, and it means that the activities we engage in on a day-to-day basis can actually rewrite our brains, set up new pathways, and even help us build a reserve of neural pathways that can be used in the future to circumvent the damaged areas of our brain, allowing us to continue functioning at a high capacity.
Embrace Change
Here is a major problem. Most people fight change. They get comfortable in their daily lives, drive to work on the same route, eat similar foods, perform the same tasks day in and day out, recycle the same conversations, perform the same type of recreational activities, and always stay within their comfort zones. But when it comes to maintaining a healthy nervous system, staying in your comfort zone is a big mistake!
If you could ask your brain how it feels about its daily routine of “business as usual,” it would probably use words such as tedious, dull, monotonous, uneventful, repetitive, uninspired, tiring, mundane, and even lifeless. This is not the ideal situation if our objective is to increase neuroplasticity, build synaptic redundancy, and lead a joyous life!
We tend to become uninterested when our routines remain static and not exposed to new learning experiences. This lack of stimulation can set us on a path toward cognitive decline. A path you DO NOT need to follow!
Enhance Your Cognitive Abilities
Years ago, I worked as a ski patrol. Most of us could ski the entire day without falling, but that meant we were actually skiing well below our abilities. If we pushed ourselves, we would be falling numerous times throughout the day. After a few weeks of constantly falling, the benefit of pushing ourselves was that our skiing ability improved drastically.
I like this quote from Ray Dalio: “If you’re not failing, you’re not pushing your limits, and if you’re not pushing your limits, you’re not maximizing your potential.” I would also add, " If you're not pushing your limits, you are limiting and inhibiting your neurological potential.”
Taking Action at Any Age!
Despite the human brain's complexity, with roughly 86 billion neurons and an estimated 100 trillion synaptic connections, these numbers are insufficient to prevent the onset of Alzheimer's Dementia.
The key question then becomes: how do we form new synapses and enhance neuroplasticity? The solution is surprisingly straightforward. By engaging in new learning experiences or tackling mentally stimulating tasks that present fresh challenges, you create new synaptic connections (neural connections). This process, in turn, boosts your cognitive reserve.
To maximize neuroplasticity, it's crucial to select activities that are new, mentally stimulating, and encompass sensory experiences like sight, sound, and touch. These activities should also resonate emotionally and personally engage you. This is precisely the approach I have adopted in my life. Whether it's learning a new language at any age, forming new friendships, taking up painting, dancing, reading diverse books, exploring novel concepts, travelling to unfamiliar places, challenging preconceived notions, or embracing new ideas, each of these experiences contributes significantly to enhancing cognitive flexibility.
Leave Your Comfort Zone!
Stepping out of your comfort zone is essential. When you immerse yourself in novel experiences, your brain is prompted to create new synaptic connections, paving the way for a network of fresh neurological pathways. It's normal to find this process challenging at times; growth often entails a certain level of discomfort, whether physical or mental.
The focus of this blog is to guide you in preserving your cognitive abilities for as long as possible. To achieve this, it's vital to engage actively with life, harnessing the advantages of neuroplasticity.
This journey involves breaking free from self-imposed limitations regarding the activities you believe you can or cannot partake in. Don't let age, past injuries, or personal biases confine you. More often than not, the real barriers are those we set for ourselves.
Conclusion
It's incredibly fulfilling for me to help patients reclaim an active, enriching lifestyle. Witnessing the transformation from limited mobility to achieving remarkable feats is a core part of our mission.
Imagine someone with arthritic knees, once challenged by mere steps, now conquering the majestic Peruvian Andes. Picture musicians, once hindered by nerve entrapment, joyfully playing their instruments against all odds. Most importantly, consider the numerous individuals we've assisted in preserving their independence. By alleviating physical constraints, we've opened doors for them to engage in activities that not only bring joy but also significantly enhance their neuroplasticity and cognitive health.
If you're passionate about an activity but feel held back from it, share it with us. We commit to working alongside you to turn that dream into a tangible reality.
As we age, the inevitability of time affects us all. Yet, how we choose to live those years can make a world of difference. We can either face a future of dependence in our later years or stride towards the end, fully independent, mentally sharp, and engaged.
My pledge, both for myself and my patients, is to foster a life brimming with engagement, activity, and happiness. Let's not just age – let's thrive, with minds and bodies in harmonious action.
References
Alzheimer's Association. (2021). 2021 Alzheimer's disease facts and figures. Alzheimer's & Dementia, 17(3), 327-406.
National Institute on Aging. (2017). Alzheimer's Disease Fact Sheet. Retrieved from: https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet
Xie, L., Kang, H., Xu, Q., Chen, M. J., Liao, Y., Thiyagarajan, M., ... & Takano, T. (2013). Sleep drives metabolite clearance from the adult brain. Science, 342(6156), 373-377.
American Heart Association. (2021). Heart Disease and Stroke Statistics—2021 Update. Circulation.
Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8(3), 448-460.
Park, D. C., & Bischof, G. N. (2013). The aging mind: neuroplasticity in response to cognitive training. Dialogues in clinical neuroscience, 15(1), 109.
Jessen, F., Amariglio, R. E., van Boxtel, M., Breteler, M., Ceccaldi, M., Chételat, G., ... & Wagner, M. (2014). A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease. Alzheimer's & Dementia, 10(6), 844-852.
Lambert, J. C., Ibrahim-Verbaas, C. A., Harold, D., Naj, A. C., Sims, R., Bellenguez, C., ... & Kamatani, Y. (2013). Meta-analysis of 74,046 individuals identifies 11 new susceptibility loci for Alzheimer's disease. Nature genetics, 45(12), 1452-1458.
The Lancet Neurology. (2019). World Alzheimer Report 2019: Attitudes to dementia. The Lancet Neurology, 18(10), 930.
Ahlskog, J. E., Geda, Y. E., Graff-Radford, N. R., & Petersen, R. C. (2011). Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. In Mayo Clinic Proceedings (Vol. 86, No. 9, pp. 876-884). Elsevier.
Whitmer, R. A., Gunderson, E. P., Quesenberry, C. P., Zhou, J., & Yaffe, K. (2007). Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study. Bmj, 330(7504), 1360.
Voss, M. W., Prakash, R. S., Erickson, K. I., Basak, C., Chaddock, L., Kim, J. S., ... & White, S. M. (2010). Plasticity of brain networks in a randomized intervention trial of exercise training in older adults. Frontiers in aging neuroscience, 2, 32.
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of internal medicine, 256(3), 183-194.
Scarmeas, N., Luchsinger, J. A., Schupf, N., Brickman, A. M., Cosentino, S., Tang, M. X., & Stern, Y. (2009). Physical activity, diet, and risk of Alzheimer disease. Jama, 302(6), 627-637.
Twamley, E. W., Ropacki, S. A., & Bondi, M. W. (2006). Neuropsychological and neuroimaging changes in preclinical Alzheimer's disease. Journal of the International Neuropsychological Society, 12(5), 707-735.
Selkoe, D. J. (2002). Alzheimer's disease is a synaptic failure. Science, 298(5594), 789-791.
Cabeza, R., Albert, M., Belleville, S., Craik, F. I., Duarte, A., Grady, C. L., ... & Rajah, M. N. (2018). Maintenance, reserve and compensation: the cognitive neuroscience of healthy ageing. Nature Reviews Neuroscience, 19(11), 701-710.
Xie, L., Kang, H., Xu, Q., Chen, M. J., Liao, Y., Thiyagarajan, M., ... & Takano, T. (2013). Sleep drives metabolite clearance from the adult brain. science, 342(6156), 373-377.
Voss, M. W., Nagamatsu, L. S., Liu-Ambrose, T., & Kramer, A. F. (2011). Exercise, brain, and cognition across the life span. Journal of applied physiology, 111(5), 1505-1513.
Mielke, M. M., Vemuri, P., & Rocca, W. A. (2014). Clinical epidemiology of Alzheimer's disease: assessing sex and gender differences. Clinical epidemiology, 6, 37.
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DR. BRIAN ABELSON, DC. - The Author
With over 30 years of clinical practice and experience in treating over 25,000 patients, Dr. Abelson created the powerful and effective Motion Specific Release (MSR) Treatment Systems.
As an internationally best-selling author, he aims to educate and share techniques to benefit the broader healthcare community.
A perpetual student himself, Dr. Abelson continually integrates leading-edge techniques into the MSR programs, with a strong emphasis on multidisciplinary care. His work constantly emphasizes patient-centred care and advancing treatment methods. His practice, Kinetic Health, is located in Calgary, Alberta, Canada.
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