Mayo Clinic Expert Shares Tips to Reduce Risk of Cognitive Decline, Alzheimer’s Disease

The same lifestyle choices that reduce your risk of heart disease, diabetes and cancer also can reduce your risk of cognitive decline. Bryan Woodruff, M.D., a cognitive neurologist at Mayo Clinic in Arizona, explains the brain-body connection, lifestyle changes to foster brain health and why work to make earlier detection of Alzheimer’s disease and other dementias is important.

“What’s good for your overall health is good for your brain too,” Dr. Woodruff says.

What our brains reveal about cognitive decline

You may have heard that Alzheimer’s disease is caused, in part, by the buildup of beta-amyloid plaques and twisted tau proteins in the brain. While true, other brain changes also are likely involved, Dr. Woodruff says.

“When scientists look at the brains of people with Alzheimer’s disease after they’ve died, they find more than just plaques and tangles,” he adds.

They often find a buildup of fats, cholesterol and other substances in the vessels that supply blood to the brain. They also discover evidence of microscopic strokes — also called micro-infarctions.

Unlike major strokes with noticeable symptoms such as facial drooping, physical numbness, a severe headache and trouble speaking, microscopic strokes are silent. As more occur, they can starve brain tissue of oxygen and nutrition. If enough microvascular changes occur, there may be symptoms like slowed thinking and trouble concentrating.

“Your brain, as with every other organ in your body, depends on your cardiovascular system,” Dr. Woodruff says: This is why it’s so important to care for your heart and blood vessels.

Lifestyle choices help reduce risk

Thanks to this connection, what benefits your heart also protects your brain. To get these benefits:

• Manage heart disease risk factors. Treat elevated blood sugar, high blood pressure and undesirable cholesterol levels. Don’t use tobacco products. Keep your weight in the healthy range. “The earlier you address these, the better the benefit is for your brain,” Dr. Woodruff says.

• Follow a heart-healthy diet. The Mediterranean diet’s emphasis on minimally processed whole foods and fruits and vegetables may improve brain health by helping to keep body fat and chronic inflammation in check. The Mayo Clinic Diet takes a similar approach to establishing a healthy-eating lifestyle.

• Get enough sleep. Research has linked insomnia to cognitive decline. And poor sleep can also increase your risk of other diseases that can impact cognition, such as high blood pressure and diabetes.
• Maintain social connections. Social connections are thought to benefit the brain in many ways. Research suggests that social engagement triggers the release of chemicals such as serotonin and dopamine, which improve mood and outlook. Social connections may help to spur the growth of new connections between nerve cells.

• Treat hearing and vision loss. If you can’t see and hear what’s going on around you, you’ll find it more difficult to communicate and remain social. “Those sensory functions are integral to how we think and interact with the world,” Dr. Woodruff says. “If you don’t see or hear it, then you can’t encode and remember it.”
• Avoid chronic use of sedating medications. Some medicines used to treat pain, insomnia and other conditions can dull thinking, slow reaction time and make you feel sleepy. If you’re not sure of the side effects of the medications you take regularly, talk with your healthcare professional, who can look at what is on your medication list and suggest alternatives, Dr. Woodruff advises.
• Exercise. Physical and mental exercise can benefit brain health. A large study found rates of cognitive decline were twice as common in sedentary people.

Learn new skills

Keeping your mind active through activities you find enjoyable, particularly trying new things, can also exercise your brain. When you have difficulty learning something new, your brain builds new connections between nerve cells.”

“If you continually learn new skills and information over time, experts believe that these networks of nerve cell connections create a cognitive reserve, sort of like savings in a bank account.“Cognitive reserve doesn’t mean you’re immune,” Dr. Woodruff says. “But it buys you some cushion against a neurodegenerative problem.”

Bryan Woodruff MD

The importance of early detection

Dr. Woodruff is among Mayo Clinic researchers working to make earlier diagnosis of dementia and its precursor mild cognitive impairment possible, to allow for earlier treatment. “This will be essential if therapeutic advances eventually make it possible to slow or even halt progression,”  he says.

“It is never too late to make lifestyle changes to protect and improve brain health,”  he adds. “I tell all my patients, regardless of the severity of their cognitive decline, to take care of their overall health.

About Mayo Clinic

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