By: Brad Hankins
Consult Your Primary Care Provider Before Making Changes to Your Medications, Diet or Beginning/Changing an Exercise Program
We are continuing our exploration of brain health this month by looking at cognition and how we may be able to improve our cognitive abilities in daily life.
Cognition collectively means the processes taking place in the brain, including thinking, attention, language, learning, memory and perception – in other words, everything that connects us to the world and the world to us. When we experience a change in cognition, we also experience a change in self and in how we perceive the world. I think we agree anything we can do to maintain and, perhaps, improve cognition is in our favor. But before we enter that discussion let’s look at some of the things that can affect cognition.
Mild cognitive impairment (MCI) https://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/symptoms-causes/syc-20354578 is described as having symptoms such as, simple (but habitual) forgetfulness, difficulty following directions and tracking conversations. There is no single cause of MCI, instead MCI is caused by a constellation of conditions to include genetics and living/working/social environments. Aging related brain shrinking, especially in the area of the brain that controls memory, brain fluid retention and decreased blood flow are some diagnosable causes.
Some studies https://pmc.ncbi.nlm.nih.gov/articles/PMC9013315/#S16 indicate up to one third of all adults over the age of 65 have a range of cognitive issues from MCI to dementia. However, having MCI is not always a path to dementia or Alzheimer’s. In fact, in some cases, MCI can be improved by making lifestyle and environmental changes.
A medical condition https://pmc.ncbi.nlm.nih.gov/articles/PMC8090478/ getting recent attention as one of the causes of MCI is metabolic syndrome (MetS). The combination of type 2 diabetes, hypertension (high blood pressure), hyperlipidemia (high cholesterol) and, in my opinion, chronic depression are the diagnosis’s which make up MetS. Any of the four diagnoses’ can, over time, affect brain performance, however the four together present a greater combined risk.
Type 2 diabetes causes blood to become thicker, due to increased sugar, which blocks off tiny blood vessels in the brain. High blood pressure causes micro tears in the same tiny blood vessels leading to blood clotting in those vessels that also block blood flow. High cholesterol increases the number, and type, of fats circulating in the blood and (you guessed it) interfere with brain blood flow to include blocking microscopic blood vessels. Lastly, and again this is only my opinion, though it is not a metabolic condition over time chronic depression changes brain chemistry in both availably and utilization leading to areas of the brain not having the right balance of brain chemicals and/or not using brain chemicals correctly.
Reduced blood flow is not the only cause of MCI but some of the factors causing reduced blood flow are, in part, manageable. Some modifiable causes can include medications (do not stop or change the dosage of any prescription medications without consulting your medical provider), vitamin deficiencies, thyroid disorders, reducing emotional and psychological stress, sleep disorders and changes in sight and hearing. There are things under our control that may improve cognition and lessen MCI, but how do we incorporate cognitive improvements into our lives?
- The first and easiest brain friendly choice you can make is – take your medications as prescribed. If it has been a while since you reviewed your medications with a medical provider schedule an appointment to do so.
- If you have MetS, or any of its individual medical conditions, stay on the treatment plan given to you by your provider. If the treatment plan is difficult to follow, consult your provider.
- Schedule an annual eye exam, and a semi-annual hearing test.
- Stay hydrated, remember the brain is 75% fluid. Current fluid recommendations https://pmc.ncbi.nlm.nih.gov/articles/PMC7694182/ for adults over the age of 65 (with good daily nutrition) is 1.6 liters (7 cups) a day for females and 2.0 liters (9 cups) per day for males. When exercising these numbers should increase.
- Take charge of online information/make your own algorithm. Limit/schedule screen(s) time, modify your news feed and social media, delete/block triggering information, turn off/manage notifications, as scary as it may sound – switch off your devices for brief periods and slowly (re)learn to embrace quiet.
- Exercise regularly. Exercise at least three days per week for an hour a day, mix up types of exercise – walk/dance/swim/yoga/run/pickleball/lift weights (yes you need to lift weights), schedule exercise times, consult a trainer to help get started, and make exercise a disciplined part of your life.
- Now is the time to learn something new. Try a new sport/activity – hiking/archery/kayaking/Tai Chi/fly fishing, learn an instrument, make art, start writing/blogging, take online classes, go after a certification in something interesting, become an observer and teacher.
- Reacquaint yourself with relaxing/de-stressing. Remember when people did nothing for the simple enjoyment of it? Read books – the kind with paper pages.
- If you have a deck/porch/patio try sitting on it – in a chair, with no devices, go for a walk – just a walk, or sit and breathe and get comfortable with your own thoughts.
I would enjoy hearing about your fitness journey, please feel free to email me at hankinsb@ssymca.net.
Brad Hankins RN, CPT
