Mental Health Matters—A Monthly Column


Most of us have heard---and many of us expect---that as we age our memory and mental capacity in general will decline. However numerous, recent research studies are providing evidence that this is not a certainty. Not only that, but some of studies of “super-agers” show that some of us actually become mentally sharper as we age. Of course, as in other areas of health, genetic predisposition can in fact result in premature cognitive impairment and lead to diseases such as early onset dementia, but there are a specific steps that we can all take to reduce our risk of cognitive decline as we grow older. Here are a few important ones:

  1. Keep mentally active. Just like physical exercise for the muscles, lungs and heart, the brain needs regular “workouts” to keep it functioning optimally. Reading, doing puzzles and word games and memorizing things like phone numbers (almost a lost art since cell phones became so popular) can enhance blood flow to the brain, promote brain cell growth and foster new connections between brain cells.
  2. Speaking of exercise, physical exercise also is good for the brain and has been shown to decrease the risk of developing Alzheimer?s dementia. This probably has its effects through several different means including an increase in hormones and other substances that helps us deal with stress and stimulate brain cell growth, improving blood flow, helping control blood sugar and lowering abnormal blood levels of blood lipids like cholesterol. We should start out with modest exercise and if possible try to build to 30 minutes per day at least 5 days per week. (Note: anyone under medical care should, of course check with their medical provider).
  3. Get adequate sleep; most people need at least 6 hours per night of quality sleep per night. Sleep deprivation can lead to build up of toxic plaques in the brain made up of a substance called beta-amyloid which occurs in Alzheimer?s dementia. We can avoid this by practicing good sleep hygiene which includes minimizing caffeine and alcohol use, limiting daytime naps, avoiding heavy meals close to bedtime and getting morning sunlight to help regulate the brain?s normal sleep cycle. If we still can?t sleep well we should seek help for potential causes such as depression, anxiety, sleep apnea or other medical conditions which can interfere with sleep
  4. Control blood sugar and blood pressure. Recent research has shown that diabetes vastly increases the risk of dementia and other studies show a strong association between blood pressure and development of Alzheimer?s dementia especially if you have certain genetic risk factors. Both blood pressure and blood sugar can be helped by exercise and stress reduction strategies but if the top number of our blood pressure (systolic) is more than 140 and the bottom number (diastolic) is more than 90, it is well worth our future heart and brain health to seek medical help.
  5. So, even though some of us may inherit an increased risk of mental decline and even dementia, our genes do not have to “determine our destiny”. There is a lot we can do stay mentally sharp as we age and with a little creative application of some of the strategies mentioned above, we?ll enjoy our journey through life a lot more than we otherwise would.

James L. Fleming, MD

Dr Fleming is a board certified psychiatrist and is medical director of the Senior Life Solutions program at Putnam County Memorial Hospital.