Healthy living builds ‘cognitive reserve’ in the brain that can prevent dementia

Healthy living builds ‘cognitive reserve’ in the brain that can prevent dementia

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New research shows that a healthy lifestyle can help stave off dementia, perhaps by building a resilient ‘cognitive reserve’ in the aging brain.

The study was based on brain autopsies on 586 people who lived to an average age of nearly 91 years. The researchers compared lifestyle and mental skills at the end of each person’s life with neurological signs of dementia, such as brain protein plaques or changes in brain blood flow.

None of these brain factors appeared to greatly influence the positive link between healthy living and a person’s cognitive skills at the end of life, said a team led by Dr. Klodian Dhana, of Rush University Medical Center in Chicago.

This means that good nutrition, regular exercise and other factors may instead “provide a cognitive reserve” that protects against negative changes in the brain – allowing older people to “maintain cognitive abilities” over time. the researchers said.

“You can almost cheat the biology a little bit and still not have the symptoms as early” as someone who is less healthy, said Dr. Liron Sinvani, who was not involved in the study. He directs geriatric hospital services at Northwell Health in Uniondale, New York

The study was published February 5 in the journal JAMA Neurology.

As Dana’s team notes, it has long been known that certain lifestyle choices — eating well, exercising, avoiding smoking and heavy drinking — are associated with lower rates of dementia.

But how does healthy living work its neurological magic?

To find out, they used data from the ongoing Rush Memory and Aging project. Over 24 years, the project tracked the lifestyle histories and end-of-life mental functioning of 586 participants, all of whom had died and had their brains donated for autopsy.

The group was long-lived, averaging just under 91. Seventy-one percent were women.

Dana’s team conducted brain autopsies that focused on classic neurological signs of dementia: Accumulation of amyloid protein plaques and tangles in brain tissue, as well as changes in the brain’s vasculature (circulatory system) that may indicate reduced blood flow caused by events such as strokes or mini-strokes.

Unsurprisingly, they found that people who had lived very healthy lives were much more likely to maintain their sanity as they neared the end of their lives. Each one-point increase in a person’s “lifestyle score” was associated with an increase in their “global cognitive score” at the end of life, the researchers found.

However, most of this relationship had little correlation with the brain changes seen at autopsies.

In other words, even though protein plaques and tangles or reduced vascularity may appear in the brain of a deceased person who lived in a healthy way, that person’s cognitive scores remained high.

The only (very slight) effect was seen for the accumulation of amyloid plaques in the brain. Dana’s team estimated that reductions in amyloid plaque may account for 11.6% of the lifestyle/cognition relationship.

All of this reinforces the idea that healthy living provides the aging brain with some sort of “reserve,” allowing it to function well even as changes that typically signal dementia unfold.

So, “if you take two people and they both have the same amount of this bad protein in their brain, the person who has the healthier lifestyle will be able to function better, cognitively,” explained Sinvani, who is also professor of medicine. at the Zucker School of Medicine at Hofstra/Northwell.

“You can function at a higher level, function normally, function without problems for a longer period of time,” he said.

When it comes to exercise, Sinvani believes the study also shows that “you’re never too old and never too weak to start improving your lifestyle.”

Current exercise recommendations call for at least a total of 150 minutes of physical activity per week. For seniors who have been inactive for a long time, Sinvani suggests consulting a doctor and/or a personal trainer before starting an exercise program.

More information:
There’s more on the interplay between lifestyle and brain health at the US Centers for Disease Control and Prevention.

Klodian Dhana et al, Healthy lifestyle and cognition in older adults with common neuropathologies of dementia, JAMA Neurology (2024). DOI: 10.1001/jamaneurol.2023.5491

Journal Information:
Archives of Neurology

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