Global rates of dementia continue to rise at an alarming rate, with 78 million people expected to be living with the condition by 2030. Coupled with the fact that it’s a leading cause of mortality, and it costs the global economy over $1.3 trillion, we must find ways to address one of the leading threats to human longevity, and that’s exactly what principal neuropsychologist Dr. Digby Orman-Brown is working to do, providing a research informed and multi-domain holistic treatment to help support patients dealing with dementia and cognitive decline. Helping rewrite the future of brain aging.
Rewriting the Future of Brain Aging with Dr. Digby Ormond-Brown
As a neuropsychologist, Dr. Brown’s area of expertise has him practicing in a neurological rehabilitation hospital, where he works with diagnoses and specializes in how a pathology in somebody’s brain, be it a stroke, neurodegenerative effects, or traumatic brain injury, has affected them.
“For me, the treatment side of things has really blossomed and I’ve become extremely interested in it,” says Brown, revealing that as a neuropsychologist, he doesn’t prescribe medication. As a result, he’s managed to explore treatment alternatives and, in applying them, has borne witness to their phenomenal benefits,
Dr. Digby Ormond-Brown
“Some years ago, for a lot of these conditions, it was effectively just kind of a dead end once the diagnosis was made,” explains Brown, “Whereas now, we’re doing things, and particularly in terms of the dementia arena, we’re able to kind of reverse patients back up the road.”
Now, while Brown emphasizes that he doesn’t have a miracle cure for brain conditions, he does share that he and his team have developed methods to stabilize and bring about positive neurological change, which is quite significant as it indicates how small changes can truly make a big difference.
Understanding the aging brain
The brain is a complex organ, but how can we be sure when there’s something seriously wrong with it? As Brown quips, ‘If you’ve got a memory problem, how would you remember?’
From the patient’s perspective, Brown details how the changes can be very subtle, with you being unable to find the right word,
“This then crosses a threshold where it’s no longer normal, as you habitually now can’t find the right word, and it starts to trip you up when you are engaged in a conversation and you can’t think of that word,” and this can soon begin to impede your capacity to effectively communicate with other people.
Now, while forgetfulness is the most commonly recognized symptom, Brown shares that it may not always be obvious to the person experiencing it, and that’s why it’s often noticed first by spouses or family members,
“When your spouse points out that they’ve already told you something, that kind of cue is alerting you to the likelihood that something is starting to go wrong with your memory.”
Brown adds that others may start to notice other behavioral changes in you, like you’re finding things funny that you’ve never found funny before, or you’re suddenly swearing more than usual, and these kinds of changes can be potential warning signs that something is changing in your brain.
Yet, it’s not just those kinds of changes that may indicate that something may be off with your brain.
A Healthy Body Makes a Healthier Brain Says Ormond-Brown
The gut-brain axis isn’t just a term thrown around, as any changes in your gut can be harbingers of a potential imbalance in the brain.
“I know that might seem very far away from dementia, like literally at the end of the system here, but there’s this connection. There is a connection between what happens in your gut and what happens in your brain. And when things start to go wrong, it also manifests in your gut.”
From a different angle, Brown further adds how changes in your sleep cycle and impairments of your sense of smell can be harbingers of a range of neurodegenerative diseases,
“Notice that when you spray on your underarm in the morning, do you smell it? When your spouse is cooking, are you smelling the food?” asks Brown, adding that one should also examine whether food tastes the same or if it’s kind of tasteless, as there remains a strong linkage between olfaction and one’s sense of taste.
Unfortunately, many of these early warning signs are typically overlooked because some people may not see the connection to cognitive health, but the reality is that these small changes can be the earliest hints that the brain is changing.
A neuropsychologist a day…
Granted, years ago, individuals would avoid getting diagnosed because they believed that nothing could be done, but thanks to strong medical advancements, getting a diagnosis is the first step to getting better.
So, once it’s been acknowledged that memory and brain function have been compromised, it’s imperative to get a diagnosis, and according to Brown, a “neuropsychologist is the appropriate person to go to as a first port of call.”
Through detailed testing, Brown explains that neuropsychologists determine the presence of a genuine memory disorder. While neurologists do have their own screening instruments, Brown believes that they are not sensitive enough to detect early or subtle cognitive impairments, whereas Brown’s evaluation allows them to address differential diagnoses.
“Measures of brain function tell us about what is happening in your brain now, at this point, whereas when you do a brain scan, that doesn’t necessarily tell us what is going on,” explains Brown, detailing that, while there is a little bit of debate about it, you can have a pretty healthy-looking scan and nonetheless have significant cognitive impairment.
Brain testing
Thanks to years of research, the consensus is that Alzheimer’s disease develops decades before symptoms appear, but genetic testing can help provide early insight.
“Someone who is heterozygous for APOE4 has a significantly increased risk of developing dementia,” reveals Brown, before adding that genetic predisposition does not guarantee that you will develop the disease.
For Brown, expression can be modified by lifestyle, environment, and targeted interventions, which means that even if an individual carries multiple genetic risk factors, they can slow and even prevent the disease process with certain habits.
“We are no longer helpless in the face of neurodegeneration. There are actionable steps we can take to reduce risk and protect brain health.”
Actionable Steps for Alzheimer’s Prevention
1. Sleep better
It’s clear that maintaining overall health is essential for brain function, and one area that’s often poorly prioritized, regardless of brain functionality, is sleep.
As explained by Brown, Alzheimer’s disease accounts for roughly 80% of dementias and is characterized by the accumulation of the protein beta-amyloid that can eventually lead to nerve degeneration. Now, this is where getting your eight hours of sleep becomes vital,
“During sleep, the glymphatic system becomes active,” says Brown, before elaborating on how this recently discovered brain system, an extension of the lymphatic system, operates as an evening cleaning system by clearing out metabolic debris, including excess beta-amyloid.
“Proper sleep essentially performs the same function as certain Alzheimer’s medications that target beta-amyloid.”
Unfortunately, factors like stress and aging can affect sleep quality, which then reduces slow-wave sleep and inhibits glymphatic clearance, which then influences beta-amyloid accumulation and thus increases the risk of cognitive decline.
Getting enough quality sleep can also support memory consolidation, whereby short-term memories become long-term, but poor sleep can impair memory retention.
Now, if you’re looking to improve your sleep patterns and subsequently protect your cognitive function through sleeping pills, Brown warns against that, as certain sleep medications, such as Z-drugs, may increase the risk of developing Alzheimer’s disease.
2. Avoid alcohol
It would be hard to encourage individuals to sleep better without addressing their drinking habits, especially when alcohol itself can have quite an effect on the brain.
Referencing large-scale studies from the UK Biobank, Brown shared how the findings suggest that even moderate consumption of alcohol can still cause damage to the brain,
“We’re finding that people who consume a moderate amount of alcohol have atrophy in the hippocampi (regions vital for memory) in their brain that correlates to their self-reported drinking patterns.”
The key to dealing with this is pretty straightforward, with the solution being avoiding or at least reducing alcohol consumption and staying clear of binge drinking.
3. Stay active
We all know exercise and staying active are good for the brain and body, but it’s often underappreciated,
“There’s a lot of research that shows that aerobic exercise helps to literally increase the size of the hippocampi in your brain.”
With that, Brown cautions against believing that this means it is the only useful form of exercise, as regular, sustained physical activity of any kind is beneficial.
4. Try supplements
The world is in love with supplements, but due to the lack of regulations around the products, how can you know which ones can support brain health, and which ones are just a placebo?
For Brown, omega-3 fatty acids continue to be exceptionally valuable compounds by playing a major role in reducing cardiovascular risk, which is itself closely linked to dementia risk.
In addition, high-quality, simple multivitamins can also be beneficial, as can resolvents, which are compounds involved in actively addressing inflammation, as chronic inflammation can contribute to the development of dementia.
5. Neuroharmonics – Vagal nerve stimulation
With Neuroharmonics, Brown and his team have developed an integrative approach featuring multiple aspects of physiology, lifestyle, and targeted neurological interventions. In addition to sleep, supplementation, and exercise, Brown and his team also incorporate vagal nerve stimulation (VNS), which involves using a handheld, mobile device to deliver a mild electrical current to the brain, specifically the locus coeruleus.
“The locus coeruleus is the major nucleus in your brain that controls neuroplasticity, and neuroplasticity is what you need if you’re going to kind of counter the effects of neurodegeneration and so on.”
Neuroplasticity is vital for learning, recovering from injury, and maintaining memory. Now, in terms of the effectiveness of their Neuroharmonics program, which includes VNS, Brown shares that he and his team have noted significant improvements in memory, reasoning, and other cognitive domains.
“What we’ve seen after a roughly 18-month intervention is that people’s scores on those particular measures have gone up by three years.”
6. Social connections
Blue Zones are five areas scattered across the globe filled with centenarians and virtually free of diseases, including the neurodegenerative kind. Now, one of the common themes across these areas is their prioritization of community and social connections, and for Brown, that has strong neuroregenerative benefits.
The amygdalae are regions of the brain involved in emotional regulation, and they can shrink under chronic stress; this kind of shrinkage (atrophy) is a hallmark of dementia. With that, research has identified an association between the size of the amygdalae and how big your circle is.
“The size of the amygdala in your brain is linked to how many friends you have, quite simply put.”
Yet, it doesn’t stop there, as research has found that individuals who are not only more socially connected but also emotionally intelligent tend to have more resilient brains as they age,
“People who get their kicks out of caring for others and being nice have a significantly reduced inflammatory profile compared to people who get their kicks out of being self-indulgent.”
Takeaway
While it was definitely a detailed and introspective discussion, Dr. Brown’s work and intellect prove that the brain is more changeable than we ever realized. Now, in drawing all his points together, Dr. Brown shares his decades of intellect into 5 simple principles:
- Be kind to yourself and others.
- Practice moderation with alcohol, stress, and inflammatory foods
- Move your body.
- Connect with people.
- Smile more and help others:
“Make a positive difference in people’s lives. Your brain will love you for it.”
Watch The Interview
Watch the full interview with Dr. Digby Ormond-Brown below.
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References
Bickart, K. C., Wright, C. I., Dautoff, R. J., Dickerson, B. C., & Barrett, L. F. (2010). Amygdala Volume and Social Network Size in Humans. Nature Neuroscience, 14(2), 163. https://doi.org/10.1038/nn.2724
Topiwala, A., Ebmeier, K. P., Maullin-Sapey, T., & Nichols, T. E. (2021). Alcohol consumption and MRI markers of brain structure and function: Cohort study of 25,378 UK Biobank participants. NeuroImage: Clinical, 35, 103066. https://doi.org/10.1016/j.nicl.2022.103066
Venkatesh, S., & Fischer, C. E. (2019). Cognitive factors associated with emotional intelligence. International Psychogeriatrics, 31(9), 1229-1231. https://doi.org/10.1017/S1041610219000917
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