A Focus on Brain Health for Caregivers

Actor Seth Rogen and his wife, actress and filmmaker Lauren Miller Rogen, have seen dementia up close: her mom died of early-onset Alzheimer’s disease at age 68. That’s why the two support caregivers through their organization, Hilarity for Charity. And it’s a big reason they do everything they can to keep their own brains healthy – including getting good sleep, eating well, staying active, managing stress and constantly learning new things.

“Anyone at any age should be prioritizing their brain health,” Miller Rogen says. “It’s never too early.” The Rogens opened up about their personal experience as caregivers in a 38-minute documentary, “Taking Care.” It’s an honest look at navigating the complexities of living through a loved one’s journey through Alzheimer’s disease.

Video: How Lauren and Seth Rogen Prioritize Brain Health

Putting brain health first can be especially important for caregivers, experts say.

“Caregivers are really facing tremendous challenges,” to their cognitive health, says Kate Zhong, M.D., a geriatric psychiatrist who is an adjunct professor in the department of brain health at the University of Nevada, Las Vegas. She’s also a founding member of AARP’s Global Council on Brain Health (GCBH).

Some caregivers have dementia risks they can’t control, such as their family history. But research suggests 40 percent of dementia cases can be prevented by a brain-healthy lifestyle, Zhong says. And yes, that applies to people with a family history too.

Here are the brain health strategies, also known as the six pillars of brain health, every caregiver should know and try to follow.

1. Get enough sleep

“Do whatever you need to do to sleep,” says Helen Lavretsky, M.D., a geriatric integrative psychiatrist and professor in residence at UCLA. The sleeping brain “rejuvenates, recuperates and gets rid of toxins,” she says. A sleep-deprived brain is at increased risk for harmful inflammation, she adds.

Zhong says sleep may be the single most important thing that caregivers can do to protect their brains. “You consolidate and strengthen … memory” as you sleep, she says. Lost sleep can cause long-term harm, but it also immediately muddles your thinking and dampens your mood, she adds.

Your brain needs at least 7-8 hours of sleep every 24 hours, according to the GCBH. While a little napping is fine, it’s best to get most of your shuteye at night, Zhong says.

That can be challenging, especially for caregivers trying to “steal a few hours of ‘me time’” at the end of the day, says Elizabeth Edgerly, senior director of community programs and services at the Alzheimer's Association.

But winding down with a consistent nighttime routine can pay off, she says. Basic “sleep hygiene,” like sticking to a regular bedtime and wake time, and avoiding intrusive light and noise, are key, she says.

Lavretsky suggests sprinkling a little lavender oil on your pillow. Miller Rogen’s sleep routine includes sleeping on a cooling pad and using a weighted blanket, eye mask and white noise machine.

But if such things don’t work, talk to your doctor, Edgerly says: “You can only go so long without sleep.”

2. Get moving

There’s “strong data” showing regular physical activity can protect your brain, Zhong says. It makes sense, she says, because when you exercise, “you really increase the blood flow to your brain.”

Adults need at least 150 minutes of moderate aerobic activity, like brisk walking, or 75 minutes of vigorous activity, like jogging, each week, along with some strength-building activity, according to the Centers for Disease Control and Prevention.

You can up your physical activity a little at a time, Lavretsky says: even a 10-minute walk counts.

So does taking the stairs instead of the elevator and other bursts of activity, Zhong says.

For extra benefit, do some exercise outside, with your loved one, in daylight hours, Edgerly suggests. It will help you both sleep better.

3. Manage stress

Caregiving can mean “chronic stress that lasts years, if not decades,” Lavretsky says. That can lead to cognitive decline, poor mental health and disorders like heart disease and cancer, she explains.

In her own research, Lavretsky has found that stress-reducing practices like meditation and yoga, done for 15 minutes a day, can trigger a “profound biological shift,” that includes better blood flow to the brain.

When you can’t find 15 minutes, she suggests to “just close your eyes and breathe slowly.”

Taking a moment to take a breath can “make huge impact on your mental health,” Miller Rogen agrees.

Lavretsky also urges caregivers to develop a personal stress-reduction “toolbox.” You might watch sunsets, listen to music, dance – whatever works for you. Look for something that brings you joy, she says: “That’s the key.”

But don’t feel pressure to feel joy all the time, cautions Natali Edmonds, a geropsychologist and founder of Dementia Careblazers, a support service for families and professional caregivers based in Phoenix. “Make room for feeling the grief and the sadness and the discomfort that comes with the caregiving process…We’re human beings. In a really difficult situation, we’re going to probably have really hard feelings.”

4. Keep learning

Your brain needs exercise, too. For some people, brain-stimulating activities might include crossword puzzles, Sudoku or other games. But don’t do those things if they don’t appeal to you, Zhong says. Instead, “be curious… challenge yourself, learn something new…and pick something you enjoy.” You might find that you love mahjong, ballroom dancing or playing a musical instrument. The Rogens took up pottery.

5. Eat well

Good food “really feeds your brain,” while “junk food” increases brain-damaging inflammation, Zhong notes.

What’s good food? Start with the principles of the so-called MIND diet (the Mediterranean-DASH Intervention for Neurodegenerative Delay), she says. That’s a diet that includes lots of leafy greens, beans, nuts, whole grains and berries, along with fish and poultry, while limiting sugar, red meat, cheese and fried foods. In some studies, people who stick closest to that diet are shown to have lower Alzheimer’s risks and slower rates of cognitive decline.

Eating better is easier when you do it as a whole household, Edgerly says, calling it a “win-win scenario” for you and your loved ones.

Planning meals a week or more ahead and stocking your pantry with healthy snacks – like low-sugar protein bars and mixed nuts – can help you stay on track, Zhong says.

6. Stay connected

Many caregivers are socially isolated, and that’s a risk factor for dementia. So, finding ways to connect with others is crucial.

It’s ideal to line up regular dates to see friends, attend a club meeting or have other outings, Edgerly says. When you have a commitment, “you’re much more likely to do it.”

If you need someone to come in so that you can get out, find that support, she urges, whether it comes from friends and family, respite services, home care agencies or other sources.

Who you connect with matters, too, Edmonds says: “It's important to surround yourself with people who are supportive.”

That can include in-person and online caregiver support groups, such as those offered by the Alzheimer’s Association, Edgerly says. Memory cafes are another option for finding local ways do activities with your loved one and connect with other caregivers.

“I think people's ability to share the burden of caregiving has grown,” Rogen says. “And that's probably a very good evolution.”

Visit AARP’s Family Caregiving resources here.