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This is brain Health Week. This week I'm going to share 12 of the best brain health recommendations to reduce your risk for cognitive decline and promote mental well being. And what I mean by cognitive decline is that it can help to reduce your risk for dementia, like Alzheimer's disease or other related dementia disorders like vascular dementia.

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I'm Dr. Regina Koepp. I'm a board certified clinical psychologist and I specialize with older adults and families. I created the psychology of aging podcast to answer some of the most common questions I get about aging, questions about mental health and wellness changes in the brain like with dementia, relationships, and sex, caregiving, and even end of life. Like I say in my therapy group, no topic is off topic, we just have to have a healthy way of talking about it. So if you're an older adult, or caring for one, you're in the right place, let's get started.

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So researchers have been looking at what some of the brain health recommendations actually are, and are doing research to see what actually stands up when it comes to reducing our risk for cognitive decline in older adulthood. And I'll share some of this makes sense, it seems like common sense. But what I really like about this research is that a lot of the tips that I'm going to share today are really about how to live your healthiest life. And a lot of the tips that I'm going to share today, you might already be doing. And so it might just give validation for what you're doing and encourage you to keep it up. So as you're listening to these 12 tips, I want you to kind of keep a list, what are you already doing, and what could you be doing more of, and so and so just kind of jot them all down, and put a checkmark by the ones by the items that you're already doing. And then put a star by the ones that you might need a little more TLC and, and when you come up with the starred items, then look at them and just choose one of the items. As a place to get started. Don't start with all of the stars that you need to focus on or change or modify, just choose one and get started there. Okay, let's dive in to the 12 best brain health recommendations to reduce your risk for cognitive decline and promote mental well being.

1. Engage in your social life: spend time with friends and in your community

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So the first recommendation is to spend time with your friends and in the community. So if you heard my podcast on how older adults are doing during the covid 19 pandemic from a couple of months ago, I'll link to it in the show notes. One of the things that research has shown is that older adults are actually quite resilient, and that they are tending to focus on quality and their relationships rather than quantity. And so focusing on relationships is really important. And that's been one of the things that helps older adults persevere during the pandemic. So social engagement is essential to brain health. It's interacting with others and feeling connected to other people and doing purposeful activities with other people. It's maintaining meaningful relationships with people, or research shows that social engagement helps us to maintain our thinking skills and slows cognitive decline in later life. researchers also found that socially engaged people have lower risk of cognitive decline, and dementia. So here are a couple of ways that you can enhance your social engagement. So during COVID, some of my neighbors have a weekly or twice a week, happy hour and they bring their chairs bring their drinks, and sit in a driveway outside and socialize. Some of my neighbors also go on a brisk walk together or running together. Some of my neighbors volunteers so during the political campaign, some of the recent retirees in my neighborhood, joined together and created a neighborhood activism group and volunteered for the election. You could also volunteer so volunteering is really fabulous for older adults, especially volunteering with generations different from your own. So if you're an older adult, volunteering with middle aged or younger, younger folks. One of the great things about being an older adult is that you have life experience and wisdom to impart to younger folks. So what we know about older adults is older adults have high rates of resilience higher than any other age group and COVID research on COVID coping during COVID has demonstrated this.

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And so what could be so helpful potential, if you're interested, is engaging with local schools or community centers, to mentor youth, especially during this public health crisis and mental health crisis that we're in older adults are proving to be the most resilient during the pandemic. And the people who are the most vulnerable are 18 to 24 year olds. And so if there's a way if this inspires you, to connect with young adults, that might be a really cool and productive and helpful way to share your wisdom.

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So what makes social engagement so good for the brain. So social engagement has been shown to reduce stress. And when we have less stress, our brains are happier, they thrive. When we have more stress and higher rates of cortisol that's unhealthy for our brain, we'll talk about that in one of the later tips, there's a use it or lose it principle around brain health. And so if we have to engage socially, we have to stimulate our cognitive skills and our thinking skills or problem solving skills or communication skills. And that can help our brains. It also increases our network of emotional support. And that is wonderful for our brain. Not only are you receiving emotional support, you're giving emotional support. And there's some studies that show that when we give that it's actually good for her hearts. And heart health is good for brain health. And it actually also gives us access to information and resources so that we have a better sense of problem solving and opportunity and helpfulness for ourselves. And for others, there's a sense of empowerment and when we are better informed, and know where to find resources. So the first tip is to be socially engaged.

2. Avoid excessive alcohol & other harmful substances

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So number two is to avoid excessive alcohol or other illicit substances. So if you do Drink, drink in moderation. So this begs the question, well, what is the recommended dose then for moderate drinking. So according to the double AARP global brain health Council, which is a collaboration of internationally, some of the the experts, international experts on aging and brain health recommend that if you do drink any alcohol, it should be done only in moderation, meaning, one drink per day for women, and two drinks per day for men. As we age, our body processes alcohol differently. And so experts recommend older folks consume even smaller quantities of alcohol. There's been a lot of discussion about whether what red wine is good for the brain. And this is likely because the Mediterranean diet includes wine consumed with meals, and that's a recommended diet, and generally no more than five ounces of wine daily for women and no more than 10 ounces of wine daily for men. And really, it's only their red wine on brain health was reported in studies on the Mediterranean diet. And that might be due to the poly phenols which are micronutrients found in plant based foods that exist in in many red wines. These micronutrients are thought to act as antioxidants, which affect blood pressure, and which are not typically contained in spirits or beer. And so, if you're not drinking red wine, the recommendation is not necessarily to start drinking red wine. There are other ways to get micronutrients that don't include the other aspects of alcohol that are not great for your brain. And so if you're not drinking, don't start adding red wine. There are other ways to to incorporate micronutrients. If you are already drinking, then the recommendation or the standard drink is only one drink per day for women and two drinks per day for men if you are drinking at all.

3. Eat a nutritious diet

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So speaking of alcohol and nutrients, the third recommendation is to eat a nutritious diet. So the 2017 double AARP brain health and nutrition survey found that people who often eat a well balanced and nutritious meal also reported better brain health among individuals aged 50 and older. 75% said they ate well, five to seven days per week reported that their brain health and mental sharpness was excellent or very good. And only about 40% of those who said that they rarely or never ate well reported their brain health as only high. What's good for your heart is good for your brain and nutrition is essential for heart health, and brain health. Really a nutritious diet the gold standard is that a nutritious diet is just part of your lifestyle, not an add on. So research shows that long term healthy eating habits promote good brain health, and you can benefit from changing to a healthy diet at any age. Research shows that the typical Western diet for everybody in the US that's like high in salt and sugar and excess calories and saturated fats is not good for the brain.

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So research has looked at diets that are healthier for the brain, and found that the Mediterranean diet, the DASH diet, the mind diet and the Nordic diet, show good results for brain health. A plant based diet that's rich in a variety of fruits and vegetables, particularly leafy greens, and berries is also associated with brain health. And it's recommended that you get fish, not fried fish, but fish. At least weekly. That's high in omega three fatty acids. And finally to be mindful of your salt intake. So salts, excessive salt intake can contribute to high blood pressure. And, and heart health, as I've mentioned before, is directly correlated with brain health. So the healthier our hearts, the healthier our brains. And so just be mindful of your salt intake. Here's a review of the foods to include in your diet. berries, not juice, whole berries, like raspberries, strawberries, blackberries, blueberries, fresh vegetables, like leafy greens. I'm trying to make a green smoothie every day I add Apple, frozen pineapple, kale and spinach and it's so good. healthy fats like those found in oils and extra virgin olive oil, nuts, almonds, that might be a good snack. You know, this is where your your dental health is also really important. Can you chew nuts? And so being mindful about that? Fish and seafood are also great for your health. Not fried, though. Maybe grilled? And then you'd also want to include beans, fruits in addition to berries. So like I said apple and pineapple, low fat dairy like yogurt. poultry, might be okay like chicken, and Turkey and other grains... quinoa anyone. And then the recommendation is to limit fried food pastries. I mean, can I just sneak a pastry and I love pastries, processed foods, red meat, red meat products, and whole fat dairy like cheese and butter. And finally salt. I'm going to link to the Global Council on brain health recommendations on nourishing your brain health with their food recommendations called brain food. And so you'll have a list of what's recommended and what's not recommended a more thorough list. Let's move on. So of course you know that alcohol and diet affect heart health.

4. Maintain heart health

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So let's talk a little bit more about why it's so important to maintain your heart health. So the better able you are to manage your heart health, the lower your risk for any type of dementia. So when we have conditions that clog the arteries of the heart, and also they also clog the arteries of the rest of the body including the brain, which also lead to heart disease and heart attacks, strokes, vascular disease and vascular dementia. There is more and more research linking Alzheimers dementia to the same risk factors that cause heart disease strokes in the vascular disease. So when when we experience obesity or high blood pressure, high cholesterol and diabetes, our risk for Alzheimer's dementia also goes up. Here's what's important to know about heart health. In addition to what I'm sharing for these 12 recommendations. You you'll want to if you have a family history of heart disease or a family history of dementia, or mild cognitive impairment, you can still reduce your risk of developing dementia by simply having a heart healthy lifestyle. So that means we're engaging in the activities, the 12 recommendations that we're talking about today, including diet and exercise and quitting smoking and in promoting your social life.

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Here's what's also important. If you have a family history of heart disease or diabetes, it's really important that you work with your medical provider on managing those conditions. And so, if your medical provider recommends certain medications to help you manage cholesterol and heart disease, that's really important to be mindful of and making choices about because managing your heart health will help you manage your brain health and reduce your risk of cognitive decline. So the take home message is to work with your medical provider on ways to optimize your heart health.

5. Engage in physical activity

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Number five is exercise. Experts agree that physical activity has a positive impact on brain health. A physically active lifestyle is important and that provides benefits for brain health. So walking using the stairs if you can gardening, after dinner, doing the dishes, you know, standing up at the sink and moving around a bit and purposeful exercise like taking a brisk walk or taking a bike ride or strength training or Pilates class provides benefits for brain health as well. I'm going to share some research from Lisa Moscone. She's the director of the women's BRAIN Initiative at the Weill Cornell Medical College in New York. And she is a neuroscientist who specializes in Alzheimer's prevention research. Let me share some of the research that she's done on exercise and brain health. Her lab studied 120 sedentary adults sedentary meaning they didn't have much physical activity. 60 of them were assigned to a brisk walking program where they walked as if they were late for an appointment. That means that's what brisk walking is. And for 40 minutes, three times a week. The other half of the group were assigned to a toning regimen that included yoga and stretching but did not include brisk walking, it was a more mild sort of toning activity. So a year later, the stretching group showed one to 2% brain shrinkage, which is normal in older adults, so not terribly concerning. Just status quo. And the walkers on the other hand, who remember, walked for 40 minutes, three days a week briskly had a 2% increase in brain size a year later. This increase specifically took place in the memory centers of the brain and produced a measurable improvement in memory performance. rolling back the clock by two years her lab also and Lisa Moscone also talks about ways that physical activity counter acts many aspects of our genetic DNA makeup. And so we can turn back the clock and reduce genetic risk by exercising, what are the recommendations for exercise. So the recommendations experts agree are to follow the public health recommendations of 150 minutes of weekly moderate intensity aerobic activity, and two or more days a week of moderate intensity muscle strengthening activities. So that means about 30 minutes a day five days a week of aerobic activity and strength based and muscle strengthening activities. In addition to that they recommend leading a physically active lifestyle throughout the day. So what does that mean? That means that, like I said a minute ago, you might take it the stairs instead of the elevator that you might Park further away from your destinations, you have longer distance to walk. Maybe you wear a pedometer, watch where you calculate your steps and make sure that you're just moving around throughout your day. Just being active gardening, maybe going outside with your grandkids, taking a leisurely walk with a friend, walking to a neighbor's house, getting the mail every day. Those sorts of things.

6. Get 7-8 hours of sleep a night (consistently)

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Number six, is to make sure that you get 7-8 hours of sleep a night. Sleep is vital to brain health, including cognitive function. I've worked with older adults who will come to my office and and describe cognitive and memory concerns. And when I do an assessment, we discover that they're slowly Sleep is impaired in some way, like maybe they have insomnia or maybe they have sleep apnea, and they're not getting good sleep. And so their, their brain is not working so well. One of the rule outs for a dementia disorder is to make sure that there is no sleep disorder getting in the way of cognitive function. So, as I said before, sleep is vital to brain health. Sleeping on average, seven to eight hours a day, is related to better brain health and physical health and older adults. And a regular sleep wake schedule is also connected to better sleep and better brain health. This is one area I actually need to improve in, I'm really bad at going to bed at the same time every night, and waking up at the same morning, at the same time, every morning, some mornings I wake up at four and I'm ready to work and I just get to work. And, and some days I don't other days, I'm up at later at night and working. Some days I'm not I'm so bad at this. And then I have little kids. So that interrupts my, my sleep as well. Sometimes they wake up in the middle of the night, they're scared or whatever's going on. So there are some changes that happen to sleep. As we age, sleep becomes less deep, and there are more awakenings at night, like maybe you have to go to the bathroom more often that's very common sleep, and it could, you know, be harder to go back to sleep, sleep becomes more vulnerable to to disturbances. So you might be experiencing a physical change or a health change and might have more pain. And that might be keeping you up at night. If you're not getting outside and seeing natural light or you don't have enough physical activity that could affect your sleep at night. And so or if you're drinking too much or using other substances are smoking a cigarette before bed that could keep you awake. certain medications that you're prescribed can affect your sleep, menopause can affect your sleep. Stress can affect your sleep. We know that sleep disorders are more common with age. But here's the good news. sleep disorders are highly treatable by therapy. There's a cognitive behavioral therapy for insomnia that is highly effective for older adults. And so just know that if you have a sleep disorder, and you have trouble, like with insomnia, or trouble falling asleep or staying asleep, there is a therapy that does not include medications that could be helpful for you. It's also you know, there's there's this old belief that older adults can't change that sort of a myth and a stereotype that is placed on older adults. And that is not true. Older Adults can change for any of these tips and recommendations. Older Adults can change and and make healthy changes and incorporate these changes into their lifestyle. So studies show that when we have inadequate sleep, we're at a higher risk for dementia, depression, heart disease, obesity, diabetes, falls, and cancer. So we really, really need to get our sleep on track. I'm saying that to myself, I need to get my sleep on track.

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Oh, I also want to say that persistent and excessive daytime sleepiness is not a normal part of aging. And so if you are noticing that you're very sleepy, you'll definitely want to check that out with your physician and see what's going on that's causing that.

7. Find meaning and purpose in life

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Number seven is to find a sense of meaning and purpose in life. Having a sense of purpose in life was associated with a 20% reduction in dementia risk. That's so important. Even if you do have mild cognitive impairment and dementia, having a sense of purpose in life is also good for the brain. So what is purpose in life mean? So purpose in life is the extent that people see their lives as having meaning, a sense of direction, and goals to live for. There is a large body of research that shows that having a sense of purpose in life is associated with a wide range of positive health outcomes like reduced risk of Alzheimer's disease and cognitive impairment, reduced risk of heart attacks, strokes and death. Research shows that people with a higher sense of purpose in life are more proactive and taking care of their health. So there's a commonly known phenomenon that happens in aging called generativity. And this is a sense that we want to make a lasting contribution to the world and to the younger generations. And so, throughout life generativity can occur in numerous ways like parenting and mentoring and care caregiving and, and civic engagement. And so the more that you are able to engage And finding and cultivating a sense of purpose in your life, whatever that means for you, the healthier your brain will be.

8. Think positively about aging

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Okay, here's another one that's really, really important and often goes under the radar, but I want to change that. Number eight is thinking positively about aging. So, ageism, which are stereotypes and bias, and discrimination based on age, influences the way we think about ourselves and each other as we age, and it is harmful. Or, you know, there's that old saying old dogs can't learn new tricks. And so I've heard people say that and even in medical systems about older adults, which is false, of course, older adults can learn new things and benefit from change. And so when we have negative views about aging, this directly affects our lifespan. So people who have negative views on aging, like believe that it's normal to have depression when you're older, that it's normal to need care when you're older, that you become childlike, that you're you regress, all of those thoughts are negative about aging, and also not true about the grand scheme of aging. And so but directly affect how we age. So Becca Levy, who is a researcher at Yale has hundreds of studies about ageism, and the effects of ageism on mental health and health care. And I recently did a big webinar for health providers within the Veterans Health Administration nationally and maybe 500. for health providers where they're taught and I was teaching about the effects of ageism on health and mental health care. And so, ageism, when we have negative beliefs about aging, we're more likely or we're more likely to experience a heart attack, we're more likely to develop dementia and cognitive decline. That's huge. Simply shifting the way you think about aging can shift your risk for dementia and heart disease and mental health conditions and so many others. So in one year, ageism cost the United States $63 billion and resulted in 17, more than 17 million cases of the most expensive health conditions like cardiovascular disease, chronic respiratory disease must kill a skeletal disorders, diabetes, mental health conditions, dementia, cancer injuries, smoking.

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And we could change that. Ageism is linked to cardiovascular events. So in Becca levy study, one of her studies found that people who held more negative age stereotypes were significantly more likely to experience a cardiovascular event over the next 38 years. So if you had a negative belief, when you were 30, about aging, when you were in your 60s, you were more likely to have a cardiovascular event. And another study, she found that those who had negative age stereotypes were two times as likely to have a cardiovascular event after the age of 60. ageism is also linked to Alzheimer's disease. So in one of her in one of Becca levy studies, in groups with a greater negative age stereotypes, there's a part of our brain, the hippocampus, which is important for memory. And so in is also significant when it comes to Alzheimer's disease, she found that the rate of the volume decline in the hippocampus was three times the rate of decline. Then, if you had positive views about aging, and also related to Alzheimer's disease, there was a greater accumulation of amyloid plaques and neurofibrillary tangles, and those, that's what happens in the brain. When you have Alzheimer's disease. You develop these plaques and tangles. And so when those accumulate and there's more accumulation of those, there's more impairment in your cognitive function. And so what she found was that in groups where there are negative age stereotypes, there's more of those plaques and tangles. Okay. Then there's another study that just blows my mind. And people with the Alzheimer's gene, the APOE 4 gene, those with positive age beliefs, were almost 50% less likely to develop dementia than those with negative age beliefs. They both hold the gene if you have positive beliefs about aging. You're close to 50% less likely to develop dementia than if you have a negative view on aging. So, let's shift the way we think about aging to a more positive, accurate view. Okay, that's maybe one of my most favorite recommendations.

9. Engage in enjoyable activities- hobbies, time in nature

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Number nine is to engage in enjoyable activities and hobbies and spend time in nature. I had an episode where I interviewed Dr. Paula Hartman Stein and we talked about the benefits of spending time in nature. And even if you're, you're living in a long term care community, and you're bed bound, even having pictures of nature, or birds in your living environment, or animals come to visit you, or a window looking out the window has been shown to improve brain and mental health.

10. Be mindful of medications contraindicated for older adults

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10. Be mindful of medications that are contra indicated for older adults. So there's a list called the beers list than the beers list lists, medications that are not good for the brain health of older adults. So medications like Benadryl, like a Tylenol PM, these medications are not healthy for the brain, especially in older adults, and can create sort of cognitive issues and mimic what looks like cognitive impairments. And so really being mindful of medications and what medications you're taking, or what supplements you're taking. It's really, really important. And so you'll want to review with your physician, what medications you're taking, and what medications you should not be taking if you're an older adult. And those decisions really need to be made with a medical health professional. And my plug my recommendation is a medical health professional who specializes with older adults, because back to that ageism, we all carry with us ages beliefs, it's just embedded in the fabric of our society, and I don't like it when I want to change it. But until we get a mass, collective movement around us to change it, we need to be working with physicians who's and mental health providers who specialize with older adults, because they'll be more aware of what's typical with aging and what's not typical with aging, what's contra indicated medications and so on.

11. Avoid smoking and other environmental toxins

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Number 11 is to if you're smoking cigarettes, or near other environmental toxins, to to stop, if you can, so to stop smoking to stop exposure to other sort of environmental toxins. When I was growing up, I remember lots of people smoking, I was even burned by a cigarette accidentally somebody was sitting at a chair and turned while they were talking and I was standing right there and they burned my arm accidentally. And so when I was a kid, so many people smoked in the 70s and 80s. And that's really shifted the other day we went on a hike my little family and I and and there was somebody standing outside smoking and it was so unusual to see somebody smoking. But if you are smoking and you're an older adult, consider stopping and stopping will help your brain health and will help your mental health and there are some great resources for stopping smoking. And I highly recommend them you could talk with your doctor about Nicorette sort of gum, a medication that might help reduce cravings, that and then and then a stopping smoking groupers smoking cessation group could be very helpful as well.

12. Get treatment for mental health conditions, like anxiety and depression

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And number 12, my all time favorite is to get treatment for mental health conditions like anxiety and depression. So anxiety and depression are not normal parts of aging. Depression is, however, the most prevalent mental health condition among older adults. And I want to let you in on a secret that should not be a secret. So let's shout it from the rooftops. Depression is highly treatable in older adults. In fact, treating depression and older adults you get the same benefits and effects as if we're treating depression for younger adults. Depression is highly treatable. It's the most treatable condition among older adults. It's really important that you work with a provider who understands this a mental health provider who understands this because you don't want a provider who hasn't done their work around ageism. If you're an older adult, you want a provider who believes that you can manage your depression and get better because you can and so and so it's really important to get treatment for mental health conditions like anxiety and depression. We know that untreated mental health conditions in older adults increases the risk for dementia disorders. When we have high levels of stress that go untreated, or we have high levels of anxiety or depression that go untreated, or stress that goes on managed, that increases our risk for dementia and cognitive decline. And there are great tools for helping you to manage stress and depression and anxiety. And really effective treatments for older adults that don't include medication necessarily. And so working with a mental health provider who can help you with that, to manage the stress like especially if you're caregiving, or going through significant losses, especially if you're always you've always lived with a depressive disorder. And now COVID has sort of gotten under your skin and the social withdrawal from others, please, please get help for mental health and, and stress related conditions. Stress is the silent killer. And there are lots of tools and activities that you can do to manage that stress and reduce depression and anxiety. And yes, it's as effective as an older adults as it is for any other age group. So please get connected.

Exciting News

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And this leads me to a really exciting, really exciting news. In the coming months, I'm launching a new website, the Mental Health and Aging website. And my hope is that I will have links to mental health providers who can indeed work with you on your own on your mental health care if you're an older adult, mental health providers who specialize in older adults. So stay tuned for that new website. I'm so excited to share it with you, I really want to make mental health easier to access for older adults and their families.

12 brain health recommendations summary

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There you have it 12 brain health recommendations, and I'm going to review them now. Number one is to engage in your social life and spend time with friends and in your community. Number two is to avoid excessive alcohol and other illicit substances. Number three, eat a nutritious diet. Number four, maintain your heart health. Number five, get exercise and physical activity. Number six, be sure to get seven to eight hours of sleep a night. Number seven, cultivate a sense of meaning and purpose in your life. Number eight is shift the way you think about aging to a more positive view of aging. I have a great podcast where I interview Ashton Applewhite, and she talks about becoming an older person in training and combating ageism, it's great. I'll link to it in the show notes. Number nine is to engage in enjoyable activities and hobbies and spending time in nature mindfulness, which I didn't talk about, which would be great here. Practicing gratitude. All of these things help to manage stress. Number 10 is to not take medications that are contraindicated for older adults and to work with your physician on reviewing which medications are best for you, or you you might not need or might be harmful to your brain. Number 11 is to avoid smoking, and other environmental toxins. And number 12 is to get treatment for mental health conditions like anxiety and depression.

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Now, I would love to hear from you and to hear which of these strategies you're already using to cultivate brain health and which you would like to do more of so you can message me on Facebook, you can message me on Instagram, you can email me from enjoying my weekly email and and reply and tell me what you're doing. I would love to hear from you. And stay tuned for my very exciting new website, which will have more resources on Mental Health and Aging and will help to promote access if you're looking for a mental health provider for an older adult in your life.

Free Download

If you are concerned about a loved one with memory loss, download my free memory loss guide. In it I talk about the signs to be mindful of. I talked about the benefits of early diagnosis of dementia and what to do if you're worried that your loved one is showing some of the signs and symptoms of dementia. So head on over to the show notes and download that free memory loss guide now. That's all for today. Now it's your turn. All you have to do is subscribe, leave a review and share this episode with others so that they can be part of the conversation too. One last thing, a special thanks to Jhazzmyn Joiner, our psychology of aging podcast intern, for all you do. Lots of love to you and your family. Bye for now.