Bret S. Stetka, MD

Disclosures

June 24, 2013

In This Article

Eat Right and Relax

Stress is a known contributor to cognitive impairment and decline. Animal work by Sapolsky and others[21] has linked stress states with memory impairment and decreased brain size; specifically, glucocorticoids released during stress appear to impair neuronal plasticity and lead to dendritic atrophy, particularly in the hippocampus. A 2012 study in rats[22] found that stress hormones impair prefrontal cortical functioning, affecting mental flexibility and attention.

Human studies show that chronic stress leads to an increased risk for dementia,[23] AD,[24] and depression.[25] In another APA 2013 session -- incidentally chaired by Dr. Small -- Helen Lavretsky, MD, also of UCLA's Semel Institute, presented data[26] showing that in addition to just inducing relaxation, meditation affects biomarkers of inflammation and telomerase activity. Small recommends managing stress with psychotherapy and personalized relaxation approaches.

Weight management and nutrition also play major roles in brain health. Several studies support an association between being overweight and increased dementia risk, including a recent twin study[27] controlled for sex, education, diabetes, hypertension, stroke, and heart disease. Concurrent work found that cognitive function improved significantly in obese patients who underwent bariatric surgery.[28]

Mediterranean diets high in omega-3 fatty acids improve working memory[29] and reduce risk for mild cognitive impairment[30] -- per DSM-5, minor neurocognitive disorder -- and AD.[31] Antioxidant-rich fruits and vegetables improve cognition while refined sugars and trans-fats impair it.[32] Moderate alcohol -- defined in many studies as up to 1 drink per day for women and up to 2 drinks per day for men -- is also associated with better brain health, possibly due to both relaxation effects and, in the case of red wine, high levels of the antiaging compound resveratrol. Resveratrol supplements are now available; however, it is uncertain whether the compound delivered in this way actually crosses the blood-brain barrier: "So if you are taking resveratrol capsules, make sure you wash them down with a nice Bordeaux," joked Small.

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