Category: Alzheimer’s Disease

Lifestyle and Mental Health

Business Logo for Psychological and Neuropsychological IssuesThe following is a condensation of a literature review by Dr. Roger Walsh.  It appeared recently in the American Psychologist, a journal of the American Psychological Association.  Please review the suggested Therapeutic Lifestyle Changes (TLC).  These scientifically derived principles for living may benefit those suffering from cognitive and emotional impairments.  Fortunately, most of the article is less abstract than practical, and has the additional appeal of common sense.  Let us not forget that common sense is anything but common-to paraphrase Mark Twain.

Exercise is one of the most reviled words in the English language.  When most people feel like exercising, they lay down until the feeling passes.  Another paraphrase of Twain.  Joking aside, the influence of exercise on mild to moderate depression has been studied extensively.  Its therapeutic benefits compare favorably with medication and psychotherapy.  Higher intensity workouts appear to be more effective than lower intensity, but the exact guidelines for each level of intensity is unclear.  The effect of exercise on cognition is very good news.  For the young, it enhances academic performance.  For the elderly, it is an important aide to stroke recovery.  Exercise reduces geriatric memory loss, reduces the risk of Alzheimer’s Disease by 45%, and reduces the risk of other dementing conditions as well.  Exercise programs of one to three months offer significant cognitive benefits, but those lasting more than six months are more beneficial.  The benefits are even more significant if the exercise lasts more than thirty minutes, and combines both aerobic and strength training components.

Diet may be the second most reviled word in the English language.  It is often used to denote controlled starvation in popular literature, but it is not the meaning discussed in Dr. Walsh’s article.  It simply means one’s choice of food items.  Not surprisingly, the chemicals ingested into our body from food have a significant impact on cognitive and emotional health.  The best diet is miserably close to what our parents forced us to eat!  The diet should be rich in fruits and vegetables, contains some fish, and an eye should be kept on reducing calories. This sort of dietary intake appears to enhance cognitive and academic performance in children, and reduce the severity of mood and psychotic disorders in adults.  There is also a reduction in age-related cognitive decline, Alzheimer’s Disease and Parkinson’s Disease.
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The influence of supplements on lifestyle has skyrocketed in the last twenty years.  The supplements that appear to have a real benefit on cognition and/or mood are Vitamin D, S-adenosyl-methionine, folic acid and fish oil.  The benefit appears to be the greatest with fish oil, in relatively high doses of nearly one gram per day, which entails the ingestion of multiple capsules.  The fish oil may slow the clotting of blood, such that mixing with other anticoagulants is not suggested.  In older adults, the use of fish oil reduces cognitive decline, but is not effective as a treatment for Alzheimer’s Disease.  Fish oil may also reduce aggression in children and adults, prevent the onset of psychosis in high risk youth, and have a modest benefit for those suffering with schizophrenia and Huntington’s Disease.  Lastly, given its action as an anticoagulant, consider reducing or discontinuing it usage if unusual bruising appears, as well as bleeding from the nose or in the throat.  Do not forget that supplements and medications are to enhance and prolong our life.  Be quick to reduce or discontinue usage if it is having an overall negative affect.  It is easy to focus on the intended benefits, to the exclusion of significant detriments.

The next post will delve further into Dr. Walsh’s literature review.  The role of relationships, spirituality, nature and giving to others will be examined in terms of their effect on mental health.

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categories Alzheimer's Disease, Dementia, Depression, Neuropsychology, Psychology | | datetime November 25, 2011 10:22 am | comments Comments Off on Lifestyle and Mental Health

Cognitive Reserve

Dr. Holzmacher's Business Logo for online psychotherapyCognitive reserve is a term often used in neuropsychology.  It is invoked to explain the differences in functioning between people with a similar level of dementia.  One person at the fourth level of a senile dementia may be able to live independently, yet another person at this level may require supervision.  Current research suggests that cognitive reserve is not related to human brain size or circumference of the head.  It is related, however, to years of education and the level of one’s physical activity.

Education has been extensively studied for its influence on the incidence of Alzheimer’s Disease.  Large studies on Alzheimer’s risk factors have been performed around the world, and years of education is consistently an important variable.  The greater the years of education, the lower the incidence of Alzheimer’s Disease.  Though it may actually reflect the intelligence of the person, these huge studies rarely obtain IQ scores on thousands of subjects.  Educational attainment is a number that is much easier to acquire than an intelligence quotient, which takes approximately two hours to measure.  Currently, a person’s educational attainment is the single most valuable estimate of dementia risk.

Exercise is another factor that appears to lower the risk of dementia and increase cognitive reserve.  It lacks the practical appeal of education’s influence on cognitive reserve.  Why would straining one’s heart and muscles lead to better cognition?  As mentioned in the Lifestyle section of this website, exercise has a significant impact on the cognitive performance of children.  It is associated with improved academic performance.  For the elderly, exercise is an important aide to stroke recovery. Exercise reduces geriatric memory loss, reduces the risk of Alzheimer’s Disease by 45% (Walsh, 2011), and reduces the risk of other dementing conditions as well.  Exercise programs of one to three months offer significant cognitive benefits, but those lasting more than six months are more beneficial.  The benefits are even more significant if the exercise lasts more than thirty minutes, and combines both aerobic and strength training components.
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Cognitive reserve is definitely not related to the conjecture that most humans use only ten percent of their brain.  This statement is absurd, both academically and evolutionarily.  Watch a child sticking out their tongue while drawing a novel figure.  They are using one hundred percent of their brain capacity.  The brain’s subconscious processing of streaming data is far more than ten percent.  This is neglecting the intentional conscious processing of sensory data that occurs throughout our waking lives.  Evoluntionarily, neurons are the most expensive kind of cells.  They use ten times the energy of a muscle cell by volume.  Mother nature distributes brain cells in a very jealous fashion, and it requires a very high return on investment to make them worthwhile.

It appears that education and exercise are two variables that increases cognitive reserve.  The whole notion of cognitive reserve is a bit sloppy, as it is vague explanation for a complex phenomenon.  As researchers learn more about dementia risk factors, the term may die a natural death.  For example, innate intelligence or a specific type of cognitive activity may underlay the differences in functioning between a similar level of dementia.   Subsequent research may define specific factors explaining the variance that is now broadly labelled as cognitive reserve.  Perhaps the dementia tests themselves are biased towards those with less education, falsely classifying the level of dementia in those with more education.  It is too early to tell.  Much like the use of “dark matter” in astronomy to explain the inexplicable, “cognitive reserve” serves as a patch to bridge this gap in knowledge.  Perhaps it should be called “dark cognition,” as a nod to our friends in astronomy.

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categories Alzheimer's Disease, Dementia, Neuropsychology | | datetime November 11, 2011 4:36 pm | comments Comments Off on Cognitive Reserve

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