In an earlier post I discussed exercise and sleep as important strategies for protecting our mind as we age. This week, I’ll discuss some other steps we can take to lower our risk of dementia.

Control blood pressure

Hypertension is when we have persistently elevated blood pressure. A growing body of research shows hypertension increases the risk of dementia. Blood pressure is the amount of pressure in our body’s arteries at a given time. Arteries are blood vessels that take oxygen and other nutrients to our body’s tissues, including our brain. The top number, systolic blood pressure, is the pressure when the left side of heart is contracting. The bottom number, diastolic blood pressure, is the pressure when the left side of the heart is relaxing. When blood pressure is persistently elevated, it damages the arteries. Think of a hose that you always filled with a massive amount of water pressure. Over time, the lining of the hose would wear out. The same thing happens with arteries in hypertension. When arteries are damaged they become less effective at supplying tissues including the brain. Parts of the brain die when they don’t get the oxygen and other nutrients they need. This is what we call mini-strokes and stroke. 

For many health conditions, we develop symptoms that tell us we have a problem. Not so with hypertension. That’s why it’s known as the silent killer. The only way to know it’s present is to measure your blood pressure. Fortunately, that’s relatively easy to do. Buy a home blood pressure cuff. I recommend the brand Omron and using a cuff that takes measurements at the arm rather than the wrist. When you measure blood pressure, have your feet flat on the ground. Place your arm at chest level, resting it on a desk of table. And wait a few minutes to check the pressure to give yourself time to relax. It’s the average that matters. Enter the readings into app like BP Companion that calculates the average of your readings. Check at least once daily for at around two weeks to get a sufficient sample size. An average above 135 systolic or 85 diastolic is when it’s worth contacting your doctor to discuss if a medicine might be needed. For people with vascular conditions like coronary artery disease, chronic kidney disease, or cerebrovascular disease, we aim for an average less than 130/80. 

While there are several inexpensive, well-tolerated medicines to lower blood pressure, a number of behavioral steps are also effective at doing so. Regular exercise lowers blood pressure. So does a diet low in salt and sugar and high in fruits and vegetables. Taking time to relax and manage stress if helpful. As is getting enough sleep every night. 

Eat Mostly Plants

Multiple studies show a Mediterranean-style diet lowers the risk of developing dementia. It consists of olive oil, nuts, fish, whole grains, fruits, and vegetables. Minimize cheese, sweets, red meats, fried food, and processed foods like white pasta, white rice, white breads, crackers, and chips. A large study over 10 years of a Mediterranean diet called the MIND diet found impressive benefits. People who followed the diet the least had the fastest rate of cognitive decline. People who most followed the diet had a 53% reduction in the risk of developing Alzheimer’s. This makes sense since a healthy diet lowers the risk of conditions like diabetes and hypertension that are harmful to the brain. 

Avoid excessive alcohol

There are long-term risks to brain health from excessive alcohol intake. Current recommendations are for men not to exceed 2 alcohol drinks daily and for women not to exceed one alcohol drink daily. 

Keep Your Mind Active

The idea of “use it or lose it” applies to the brain as much as the rest of your body. When you maintain social connections and participate in stimulating activities you build what is called cognitive reserve. It gives you a buffer or a back-up if your brain is injured by an accident or a disease like Alzheimer’s. Autopsy studies show that different brains of people with the same pathological findings can exhibit very different behaviors when they were alive. One person with signs of Alzheimer’s in their brain may have displayed signs of advanced dementia, requiring continuous caregiving. While another person with identical findings in their brain tissues may have shown no signs of cognitive impairment. The difference in such cases seems to be the cognitive reserve that was present. People who “built up their brain” with regular engagement could afford to lose a bit of it and still effectively function. So how do we create cognitive reserve? Maintain demands on your brain that keep it thinking, strategizing, and solving problems. Focus on activities that are enjoyable, but demand effort. Examples of doing so are learning a new language, musical instrument, or game. Activities that involve other people are especially helpful due to the cognitive demands and benefits of social interaction. 

Prioritize Relationships

Research shows people with few social connections have higher stress hormones, disrupted sleep patterns, altered immune systems, and increased inflammation. The psychiatrist and researchers Dr Robert Waldinger reports that “being in securely attached relationship to another person” is protective for the brain. Waldinger further reports that “one of the key ingredients was that people in relationships where they really feel they can count on the other person in times of need had their memories stay sharper longer.”  

Treat Hearing Loss

There is evidence that hearing loss increases the risk of dementia and that treating it with hearing aids lowers the risk. Theories for these findings are that hearing loss ups social isolation and that there is harm to the brain from receiving less information from the world. In contrast to wearing glasses, there is a stigma to wearing hearing aids. It’s seen as a sign somebody is old. Fortunately, many hearing aids are now designed in a way that makes them hard to notice. 

I hope this summary how to protect your age as you age has been helpful. If you’re interested in digging deeper, Dr Sanjay Gupta’s book Keep Sharp is excellent. I also recommend AARP’s website The Global Council on Brain Health https://www.aarp.org/health/brain-health/global-council-on-brain-health/