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by Beth Howard and Renée Bacher
Updated September 28, 2022
The message just keeps getting clearer: The healthier your heart is, the stronger your brainpower is. The compelling evidence comes from research cited in a 2019 report from the Global Council on Brain Health (GCBH), an international collaborative of scientists, health professionals, scholars and policy experts.
“We hope the good news from the GCBH’s review of the evidence that you can reduce your risk for dementia will really motivate people to choose healthier lifestyles,” says GCBH Executive Director Sarah Lenz Lock, speaking about the report.
Adults age 50 and older may preserve brain health by following recommendations within the report, including staying physically active, maintaining a healthy weight, quitting smoking, managing diabetes, addressing sleep apnea, working to control stress and keeping blood pressure, blood sugar and cholesterol levels in healthy ranges.
Simple goals, big results
The recommendations are similar to the American Heart Association’s Life's Simple 7 guidelines, which emphasize the importance of managing blood pressure, controlling cholesterol, reducing blood sugar, being active, eating well, losing excess weight and stopping smoking.
When researchers from the University of Miami and Columbia University in New York followed more than 1,000 older adults for six years, noting their adherence to the AHA’s seven goals, they found that adults who met more targets did better on tests of the brain’s processing speed, executive function and memory.
Two measures seemed especially important, says lead study author Hannah E. Gardener, epidemiologist in the department of neurology at the University of Miami Miller School of Medicine. “Controlling for other factors, a lack of smoking and ideal blood-sugar levels were independently associated with better brain performance,” Gardener says.
For optimal brain health, adopt as many GCBH recommendations as possible:
1. Manage blood sugar
High blood sugar levels can cause inflammation, which may harm brain cells: People with type 2 diabetes with elevated levels of blood sugar are at an especially increased risk of memory problems. Lows may be problematic, too: A June 2021 study in the journal Neurology which looked at older people with type 1 diabetes found that a history of very high and very low blood sugar levels increased dementia risk sixfold.
2. Aim for 120 on blood pressure readings
A landmark study cited in the GCBH report found that keeping the first of your two blood pressure numbers less than 120 lowers risk for mild cognitive impairment, a condition that is often a precursor to dementia. Lead author Jeff D. Williamson, M.D., a gerontologist at Wake Forest School of Medicine, says the study proved that the same blood pressure goals that have lowered the risk of heart attacks, stroke, heart failure and death from heart disease by 30 percent have now been shown to lower early dementia by almost 20 percent. Making healthy lifestyle changes (even losing 10 pounds) can get you there. So can taking blood-pressure-lowering medication. Williamson recommends starting with medication, then asking your physician if you can taper off as you adopt healthier habits.
3. Maintain a healthy weight
A heart-healthy diet is brain-healthy, according to an earlier report from the GCBH. To protect your memory, cut back on excessive amounts of salt, sugar, calories, alcohol and saturated fats and try a heart-healthy diet. A few examples include: the Mediterranean diet, which emphasizes olive oil, fresh vegetables, fruits, beans, whole grains, nuts and seeds; the DASH diet, which is high in potassium, magnesium and calcium and low in sodium, to keep blood pressure down; and the MIND diet, a hybrid of the two.
4. Get moving
Regular exercise bathes your brain in freshly oxygenated blood and is one of the most important things you can do to preserve your memory. It’s also a stress reducer. Aim for at least 2 hours weekly of moderate-intensity aerobic activity, such as brisk walking or dancing, and two or more days per week lifting weights, climbing stairs or doing heavy-duty gardening to strengthen muscles. Standing and taking a lap around the house every hour also benefits your cardiovascular health and your mind; set an alarm on your phone as a reminder.
5. Minimize stress
Exercise helps, but so does maintaining an active social life (which wards off loneliness), practicing yoga or meditation and going to therapy if you have woes that weigh on your heart and mind.
6. If you smoke, quit
Everything about smoking that can cause heart attack, stroke and irregular heartbeat can also damage your brain. Even without a catastrophic event, smoking thins the part of the brain that controls memory, speech, language and perception. Lower volume in this area has been associated with mild depressive symptoms. The AHA offers these tips to help stop smoking.
7. Practice good sleep hygiene
Always exhausted? Chronic poor sleep can put you at a higher risk for heart disease, depression, dementia and other diseases. Shoot for seven to eight hours of sleep nightly. When you fall short, a 20-minute early-afternoon nap may help. If you have trouble falling asleep, staying asleep or you suspect you may have sleep apnea (loud snoring and gasping for air are symptoms), talk to your doctor about seeing a sleep specialist. These physicians can lend you a device to take home that monitors sleep quality, so you can get treatment for any problems.
• “Ideal cardiovascular health and cognitive aging in the Northern Manhattan Study,” Journal of the American Heart Association, March 2016. In this study, 1033 black, white and Hispanic participants (average age of 72 at the start of the study) living in northern Manhattan underwent physical, neurological and neuropsychological testing to establish a baseline, and then underwent a second round of neuropsychological testing around six years later. Participants who had more ideal cardiovascular health factors as defined by the American Heart Association (physical activity, diet, blood pressure, cholesterol, glucose, body mass index and smoking) had better mental processing speed at the start of the study and less decline in processing speed, episodic memory and executive function by the end of it. A lack of smoking and ideal glucose levels were particularly important. Read the full study.
• “Association of type 1 diabetes and hypoglycemic and hyperglycemic events and risk of dementia,” Neurology, June 2021. In this study, researchers followed 2,821 participants (average age of 56 at the start of the study) with type 1 diabetes from 1997 to 2015. In that time, 153 participants developed dementia. The researchers found that participants who had an extremely low blood sugar event, requiring an emergency room visit or hospitalization, had a 66% greater risk of dementia than participants who did not, and participants who had an extremely high blood sugar event had more than twice the risk of developing dementia than others. Participants who had both an extremely high and an extremely low blood sugar event had a sixfold greater risk of dementia than participants who had neither. Read a summary of the study. (A fee is required to access the full study.)
• “Effect of intensive vs standard blood pressure control on probable dementia: A Randomized Clinical Trial,” JAMA, January 2019. In this study, researchers recruited 9,361 adults over 50 (average age of 67.9 years) with hypertension (systolic blood pressure between 130 and 180) and measured their cognitive function, with follow-ups at two and four years. The “intensive” treatment group was given guidance and medication to lower their systolic blood pressure to below 120, and the “standard” treatment group was given guidance and medication to lower their systolic blood pressure below 140. During the trial, the intensive group had an average blood pressure of 121.6 and the standard group averaged 134.8. The researchers did not see a significant difference in the risk of probable dementia between the two groups, but they did find that the intensive group had an 18.7 percent lower risk of mild cognitive impairment than the standard group. Read the full study.
• “Cigarette smoking and thinning of the brain’s cortex,” Molecular Psychiatry, February 2015. In this study, researchers analyzed data and brain scans from 504 participants born in 1936 (average age of 73). In addition to participating in cognitive and psychological tests, blood analyses and physical examinations, the participants reported detailed information about if, when and how much they had smoked cigarettes, cigars or pipes. The researchers found that current smokers had a generally thinner cortex than people who had never smoked, and the cortex was increasingly thin in people who reported higher numbers of cigarettes smoked per year. The brains of people who stopped smoking seemed to be able to recover, but it took around 25 years for the cortex of the average smoker in the study to completely recover. Read the full study.
• “Cortical thickness and depressive symptoms in cognitively normal individuals: The Mayo Clinic study of aging,” Journal of Alzheimer’s Disease, June 2017. In this study, researchers measured the prevalence of mild depressive symptoms in 1,507 participants age 70 and older who were part of the ongoing Mayo Clinic Study of Aging and conducted MRI scans of participants’ brains. They found that mild depressive symptoms were associated with a thinner cerebral cortex, but not with the volume of the hippocampus. Read a summary of the study. (A fee is required to access the full study.)
• “Association of sleep duration at age 50, 60 and 70 years with risk of multimorbidity in the UK: 25-year follow-up of the Whitehall II cohort study,” PLOS Medicine, October 2022. In this study, 7,864 people (ages 35 to 55 at the start of the study) employed in the London offices of the British civil service participated in clinical exams, including reporting how much they typically slept, every four to five years between 1985 and 2016. Researchers analyzed their data to see how sleep duration is associated with the onset of one or more chronic diseases, such as diabetes, cancer, heart disease and depression, at ages 50, 60 and 70. At all three ages, the researchers found that sleeping less than five hours was associated with a higher risk of developing multiple chronic diseases. Read the full study.