Alzheimer’s and a Cognitive Reserve

The healthy memory blog has made frequent mention of the fact that many people have died with the defining amyloid plaque and neurofibrillary tangles of Alzheimer’s, yet who never exhibited any behavioral or cognitive symptoms of the disease.  Although healthy memory regards this as the most important fact bearing upon Alzheimer’s, it is rarely mentioned or discussed.  The cognitive reserve is assumed to result from studies and activities which enriched the brain earlier in life.

The July/August issue of “Scientific American Mind” contained an article titled “Banking Against Alzheimer’s” by Dr. David A. Bennet.  He is the Director of the Rush Alzheimer’s Disease Center in Chicago, where about 100 scientists are searching for ways to treat and prevent a range of common neurodegenerative disorders.  For almost a quarter of a century he has led two longitudinal investigations—the Religious Orders Study and the Rush Memory and Aging Project—which have enrolled more than 3200 older adults across the U.S.  These volunteers enter these studies dementia free, anywhere from their mid-50s, to their 100s and agree to hours of testing each year.  They undergo comprehensive physical examinations, detailed interviews, cognitive testing, blood draws and, in some cases, brain scans.  Most importantly, they all donate their brains after death for research.  To date tens of thousands of clinical evaluations and more han 1,350 autopsies provide an unprecedented set of data.

These autopsies have indicated that it is rare to grow old with a completely healthy brain.  Virtually every brain examined exhibits at least some of the neuron killing tangles associated with Alzheimer’s disease, which is, by far, the most common cause of dementia.  In about half of the autopsies, scars of previous strokes, both big and small, are found.  In almost a fifth of the autopsies so-called Lewy bodies—abnormal protein clumps that are the mark of Parkinson’s disease and Lewy body dementia are found.  But when they trace these laboratory finds back to each individual’s records, they can account for only about half of the cognitive changes measured on tests of memory, processing speed and the like.  In other words, the condition of someone’s brain post-mortem only partially tells how well it functioned in the years leading up to the person’s death.

So why is this the case?  What provides this cognitive reserve?  Rush epidemiologist Martha Claire has found that the so-called MIND diet—which is rich in berries, vegetables, whole grains and nuts—dramatically lowers the risk of developing the defining physical symptoms of Alzheimer’s.

But other life choices seem to actually bolster the brain’s ability to cope with the disease, helping it compensate for any loss of mental firing power.  In particular, they have found that the more engaged our volunteers stay throughout their live, socially and intellectually—the more resilient they are to dementia at its end.   Reader should note that the healthy memory blog has been sending the same message, to which healthy memory will add, having a purpose in living.  In fact, there is a Japanese word for this, “ikigai.”
Here are some tips for building a better brain.

Get a good education, a second language and music lessons.  Avoid emotional    neglect.
Engage in regular cognitive (building a growth mindset) and physical activity.
Strengthen and maintain social ties.
Get out and explore new things (growth mindset)
Chill and be happy.
Avoid people who are downers, especially close family relatives.
Be conscientious and diligent.
Spend time in activities that are meaningful and goal-directed.
Be heart-healthy:  what’s good for the the heart is good for the brain.
Eat a MIND Diet
Remember ikigai and have a purpose for living.
Professor Clive Holmes and his co-workers at the University of Southhampton in the UK found that research participants with gum disease for over the next six months was more rapid for those with gum disease.  Gum disease is associated with increased biomarkers for inflammation.  Research has shown that illnesses that cause inflammation such as chest infections, rheumatoid arthritis and diabetes are linked to greater cognitive impairment.

HM would add the following items
meditate and be mindful

© Douglas Griffith and healthymemory.wordpress.com, 2016. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

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2 Responses to “Alzheimer’s and a Cognitive Reserve”

  1. AlzScience Says:

    It should be noted that the cognitive reserve hypothesis is largely backed up by correlational rather than causational evidence. For example, while people who are extroverts are less likely to develop Alzheimer’s, it’s not clear which is the cause of the other. Of course, there’s certainly no harm in trying to become more extroverted as loneliness is associated with a variety of conditions including depression. Thanks for posting!

    • healthymemory Says:

      The types of experiments that would provide causational evidence cannot be done. I could also argue that there is no causational evidence that smoking causes cancer. The significant fact is that there have been and are many individuals who have the diagnostic criteria for Alzhgeimer’s yet never evidence any behavioral or cognitive manifestations. The relevant criticism of the cognitive reserve is that it is ill-specified. So it serves as a box in which to place correlational evidence as to why some people have the diagnostic criteria but none of the devastating criteria. One of the factors that goes into the c0ognitive reserve box are people who are and remain social engaged. To the extent that extraversion contributes to this behavior, it would also go into the box.
      Thanks for both your interest and your comment

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