Use it or Lose it (2004)

Use it or lose it

by Fred Lane PhD

As we see more and more people reporting dementia, a big question arises: should the aging brain and body meditate or activate?

Yes.

On the one hand, completely relaxed lifestyles are not only boring, but well-founded research suggests that they contribute to mental as well as physical problems. Sedentary couch potatoes will probably develop a number of mental and physical disabilities, ranging from memory impairment to obesity and osteoporosis.

“Use it or lose it,” the aging brain literature has been saying for years, loud and clear.

On the other hand, highly active or overstressed lifestyles are also dangerous. Broken bones and torn muscles go with high impact physical activity and highly emotional people are prone to a host of disorders, including heart attacks, brain infarcts and high blood pressure. The aging body is not only more vulnerable to both physical and mental stress, it takes longer to repair itself.

Some stress is inescapable, for instance coping with unforseen financial burdens and the inevitable loss of loved ones and friends. There is also the stress that accompanies age-related physical ailments, such as arthritis, that might limit our favourite forms of physical activity. Even decreased libido, whether due directly to aging or indirectly to the loss of a partner, is frequently reported in the literature to be correlated with harmful stress.

More often than not, how we behave in old age depends on how we behaved in adult life. Long-standing research suggests that within the same cognitive and physical environment, our behavior in later life tends to be an exaggeration of our usual adult behavior.

For instance, according to unbiased observers, if we are predominantly passive, aggressive, trusting or irascible, that kind of behavior tends to become more pronounced as we age. We might not notice this change in ourselves, but if this kind of behaviour has been rewarded in the past, Skinnerian logic says that as the opportunities for those kinds of rewards diminish in retirement, we would strive harder using the same techniques to try to achieve the same satisfaction reward.

There is a sensible middle ground that depends on each person’s prior lifestyle. Exercise is important for both physical and mental wellbeing. We know that simply popping pills can delay but not prevent crippling diseases like osteoporosis. Weight-bearing exercises, like regular daily 30 minutes brisk walking, is strongly recommended to help preserve healthy bones. Oddly enough, simple exercise like this has also been shown to cure common forms of depression found in the elderly, including the form that accompanies bereavement.

Pill popping

Research also demonstrates that popping pills rarely prevents further mental deterioration of the kind that goes with the dementias. Despite claims to the contrary seen in the popular press from time to time, there is no sure cure yet for presently irreversible common dementias, such as Alzheimer’s disease and Multi-Infarct Dementia that account for 70 per cent or so of all the 200 or more causes of dementia. Conversely, there are well-proven simple interventions for the benign forms of mild memory impairment that go with aging and a number of other age-associated disorders, including the reversible dementias.

One of the first signs of Alzheimer’s disease and other dementias is mild memory impairment. That, by itself, might not be important because it is also a symptom shared by half the people over age 65, and only a quarter (not 90 per cent as claimed in some newspaper reports) will ever go on to develop dementia. Importantly, there are a number of differences in the quality of memory impairment that separates benign memory impairment from the malignant (dementia) form of the disorder.

If memory impairment or a minor stroke is detected, one of the worst things to do is to lie back convinced that nothing can be done to halt the inevitable slide towards dementia, decay and death. Instead, get busy. Stay active.

When planning for a healthy post-retirement, consider a number of strategies. Plan ahead and start early. It’s too late and too hard to recover from damage done. Keep up the medical and dental inspections. Annual examinations will not detect every problem, but they do detect many and are an important diagnostic aid when a serious illness pops up. Oddly, investigations suggest poor oral hygiene and gum disease is correlated with an increased dementia risk. Consider regular visits to heart, skin, dental and other specialists to head off problems found in these areas.

Planned maintainence

Get that minor operation done. Why put off that cataract, prostate or tooth implant operation if they are limiting your lifestyle or generating discomfort?

Look after the pump and the plumbing. The brain demands clean arteries, just like the circulation system, so keep bad cholesterol low, by for instance, a healthy low-fat diet, no smoking and planned exercise.

Keep stress manageably low. Don’t switch off. That’s just as bad, but try to monitor emotions like road rage and learn a relaxation technique or assertion skill to handle these and other forms of stress. Another driver shows you road rage? Blow him a kiss. That will really tick him off and defuse the road rage response in you.

Keep up the vitamin and food intake. Maintain a balanced diet that should include seafood, meat, spinach, beans, nuts, etc. Natural foods are much better than the vitamins and supplements found in health stores, but don’t hesitate to take these and other pills if recommended by your GP. Avoid overeating when exercise loads drop.

Hormone Replacement Therapy (HRT)?

The HRT jury is still out. There are clear risks for some aging women, but there are also a number of clear benefits. Consult your GP and read the literature. Beginners might want to start with the Internet, but choose your sites carefully. There are plenty of good USA Government and leading university sites. Studies reported with tens of thousands of subjects are usually more convincing than the four- or five-subject week-long “experiment” favoured by some of our magazines and commercial TV stations.

Drink tea or coffee, take aspirin and use alcohol in moderation. Moderate amounts of theophylline, caffeine and aspirin stimulate the central nervous system and dilate blood vessels, but beware, too much can trigger stomach problems, insomnia and even palpitations. There is some preliminary evidence that half to one aspirin a day helps to ward off dementia. There are similar claims for tooth flossing.

Keep the mind active. Play games that exercise the mind, such as chess, poker, Scrabble and crossword puzzles. Learn to play an instrument. Learn sign language. Play video games to maintain hand-eye coordination, but avoid sitting and watching TV for long periods. Join a theatre group. Go back to school. Travel (and wear anti-DVT stockings when sitting in an aircraft or bus for a couple of hours or more).

Recent scientific literature is full of promise regarding stem cell research and replacement brain cells, but none suggest there will be a practical application here in Australia for many years. There are also ethical and political questions that might limit such work. The most promising line of research of this kind might be in Parkinson’s disease.

Just about any activity increases brain cell activity, but so can relaxation exercises like tai chi and yoga. Have no fear that too much brain activity or trying to remember too much is bad for the normal aging brain. The “brain storm” and “overload” theories are well-demolished by modern research.

There is little doubt that the older aging brain has a slower neural response, in that the speed of transmission of neural signals across the cell network, especially in the frontal lobes, is slower. However, that is no cause for despair. This deficit is more than made up by the amount of knowledge stored away in the elderly brain. That’s called wisdom. In the meantime, enjoy life and stay active, mentally and physically.