Healthy Aging: Brain HealthRamona Burroughs, MS, PhDClinical Neuropsychologist

Memory Disorders Clinic/Neuropsychology ClinicUNT Health Department of Geriatrics

What is brain health?Brain/cognitive functionsBrain healthy strategies

Healthy aging: Brain Health

What is brain health?• Throughout your life, your brain’s job is to help you make sense of the

world and help oversee your daily operations and life. Brain health refers to the ability to remember, learn, plan, concentrate and maintain a clear, active mind. It's being able to draw on the strengths of your brain—information management, logic, judgement, perspective and wisdom. Simply, brain health is all about making the most of your brain and helping reduce some risks to it as you age.

National Institute on Aginghttps://brainhealth.nia.nih.gov/

What is brain health?

AttentionWorking memoryProcessing speedExecutive functioningLanguageVisuospatial abilitiesLearning and memory

Neurocognitive Domains

• Attention• Initiation/motivation• Response inhibition/impulse control• Working memory• Cognitive flexibility/Responding to novelty• Foresight/Planning/Decision making• Judgement/Insight• Reasoning• Organization• Empathy• Self-monitoring

Frontal lobes & executive functioning

• Receptive language• Hearing/Listening• Reading• Nonverbal communication – social cues

• Expressive language• Speech• Tone of voice

• Recognizing objects • Memory encoding• Hippocampus• Emotional valence

Temporal lobes

• Sensory processing & integration• Spatial awareness/orientation• Internal GPS – mental maps

• Body awareness (contralateral)• Reading• Math• Mental rotation

Parietal lobes

• Visual processing

Occipital lobes

• Physical coordination• Movement• Timing• Problems:• Slowed movement• Slowed thinking• Slowed speech• Poor balance

Cerebellum

• Crystallized intelligence: Facts, body of knowledge about the world increase• Ability to draw connections increases• Fluid intelligence: Working memory, processing speed slow down

Normal age-associated changes

Regular office visitsManage chronic health conditionsRoutine labsPreventative care and screeningKnow your meds:• Minimize polypharmacy• Discuss side effects immediately• Change/decrease under medical supervisionTalk with your surgeon/anesthesiologist

Partner with your medical team

Blood pressure• Increased risk of stroke• Microvascular disease (white matter hyperintensities)

CholesterolBlood sugar• Hemoglobin A1c

Inflammation• Homocysteine• C-reactive protein

Control vascular risk factors

Correct hearing loss• Socializing and conversation engage and activate your brain• Receptive/expressive language

Risks of untreated hearing loss:• Depression• Social isolation • Family stress• Cognitive decline

Correct vision & utilize appropriate lighting• Engage visual pathways

Support your senses

• Handrails on both sides of any stairways• Secure all throw rugs and area rugs with tacks, nonskid pads, or double-sided rug tape• Use non-skid floor wax• Remove soap buildup in tubs and showers• Place non-slip strips in tub and shower; secure bathmats with double-sided tape • Install adjustable-height showerheads • Mount grab bars on both sides of toilet, as well as on bath and shower walls • Keep items used frequently within easy reach to eliminate the need for a step stool• Plug nightlights in hallways, bedrooms, bathrooms and stairways • Install light switches at the top and bottom of stairs• Place a lamp and telephone near the bed• Remove any clutter from hallways and other high-traffic areas

Minimize fall risk

Emphasize: • Fresh, whole, unprocessed foods• Leafy greens, Fresh fruits (esp. berries) & vegetables• Healthy fats: nuts & seeds, olive oil, avocadoes, omega 3 fatty acids• Fish (low mercury - Wild caught salmon, sardines• Eggs• Lean meats

Mediterranean Diet, MIND Diet, Anti-inflammatory Diet

Eat for health

• Aerobic exercise, 30 minutes/5 days per week• Increased heart rate • Increased blood flow to brain• Stimulates neuroplasticity • Stimulates neurogenesis • Improved heart health• Vascular health • Decreases stroke risk• Decreases depression

Get your blood flowing

• Repairs damage• Consolidates memories• Cleans the brain• Slow wave sleep• Glymphatic system• Reduces amyloid buildup in brain

• https://www.urmc.rochester.edu/news/story/3956/to-sleep-perchance-to-clean.aspx

Indulge in healthy sleep

• Keep a consistent sleep schedule• Aim for at 7-9 hours of sleep• Develop a relaxing bedtime routine• Reserve the bedroom for sleep and intimacy• Keep your bedroom quiet, relaxing, and cool• Avoid bright light and/or blue light in the evenings• Limit screens before bed• Keep the bedroom dark

• Don’t eat a large meal before bedtime. • Exercise regularly in morning or afternoon• Limit caffeine and alcohol • Reduce your fluid intake before bedtime

But how…?

• Snoring• Irregular breathing or stopping breathing• Leg movements• Kicking, punching, acting out dreams• Sleepwalking• Falling out of bed

• CPAP 5+ yrs. old• Poorly fitting mask• Just hate the thing

Do I need a sleep medicine evaluation?

• Formal education builds cognitive reserve• Intellectually demanding career• Adult learning• Take a class, Museum talks• Learn a foreign language

• Lifestyle• Chess, bridge• Travel• Read/Join a book club

• Creativity• Music, Dance, Art – pottery, painting, drawing, watercolor

Challenge yourself intellectually

• Calendars, lists, reminders• Smart phone• Give yourself extra time to complete tasks• Avoid multitasking• Plan ahead• Pace yourself• Take rest/quiet time as needed• Talk to your loved ones in advance for their support

Use cognitive strategies

Trouble with• Finances• Medication• Driving• Meal preparation• Housekeeping

• Mood: Anxiety/Depression/Anger outburst/irritability• Behavior: Withdrawal/apathy/loss of interest• Perceptual changes/disturbances: visual, auditory, olfactory, sensory• Physical symptoms: Dizziness, numbness, balance, falls, gait changes

When to seek medical attention

ACT FAST

• Stress & resilience• Faith/Spirituality • Sense of purpose• Cultivate wisdom

Prioritize emotional health

• National Institute on Aginghttps://www.nia.nih.gov/

• Centers for Disease Control and Prevention: Healthy Aginghttps://www.cdc.gov/prc/study-findings/healthy-aging.html

• World Health Organizationhttps://www.who.int/ageing/healthy-ageing/en/

• Sleephttp://sleepeducation.org/

• UNT Health Department of Geriatrics/Neuropsychology Clinic(817)735-2200

For more information

Stress and VolunteerismEmily J Clark, LCSW, LCDC, CDP

Common Physical Symptoms of Stress:Headaches

Back and/or Neck TensionChest Pain or DiscomfortOther Pain or Discomfort including Chest PainProblems with Digestion including NauseaSweating

Dizziness

Symptoms of Stress

Common Emotional Symptoms of Stress:Irritability / Frustration / Impatience

CryingAnger

Emotional OutburstsEmotional Fatigue / BurnoutDecreased Productivity

Concentration DifficultyMemory Problems including Confusion

Symptoms of Stress

Quick Steps – The 5 As• Avoid – people, places, things (learning to say no)

• Alter – communicate your feelings, time management, creating limits• Adapt – adjust your own standards, reframe, look at the big picture

• Accept – talk with someone, forgive, positive self-talk• Adopt a healthy lifestyle

How do we deal with stress?

• Exercise and eat regularly

• Avoid excess caffeine intake• Avoid illegal drugs, excessive alcohol, and tobacco• State feelings in polite, firm tones using “I Statements”• Rehearse and practice situations which cause stress. • Learn practical coping skills

• Take a break from stressful situations• Decrease negative self-talk • Don’t demand perfection

How do we deal with stress?

Remember: A sense of humor can save the day!

“Everybody can be great. Because anybody can serve. You don’t have to have a college degree to serve. You don’t have to make your subject and your verb agree to serve. You only need to have a heart full of grace. A soul generated by love.” – Martin Luther King, Jr.

“Alone we can do so little; together we can do so much.” – Helen Keller

Volunteering

• Healthy body / Healthy Mind – multiple studies show volunteering has health benefits

• Trying new things• Leaving a legacy• Connecting with others

Benefits of Volunteering

• Schools

• Hospitals• Animals

• Military • Libraries• Where is your passion?

Volunteering at Any Age

Konrath, S., Fuhrel-Forbis, A., Lou, A., & Brown, S. (2012). Motives for volunteering are associated with mortality risk in older adults. Health Psychology, 31(1), 87-96.

Cohen, R., Bavishi, C., & Rozanski, A. (2016). Purpose in Life and Its Relationship to All-Cause Mortality and Cardiovascular Events: A Meta-Analysis. Psychosomatic Medicine: Journal of Behavioral Medicine(2), 122-133.

Sneed, R. S., & Cohen, S. (2013). A prospective study of volunteerism and hypertension risk in older adults. Psychology and Aging, 28(2), 578-586.

Fight stress with healthy habits infographic. American Heart Association. https://www.heart.org/en/healthy-living/healthy-lifestyle/stress-management/fight-stress-with-healthy-habits-infographic#.VsTL6-aVTwA.

How stress affects your health. American Psychological Association. http://www.apa.org/helpcenter/stress.aspx. Accessed Feb. 12, 2016.Seaward BL. Essentials of Managing Stress. 4th ed. Sudbury, Mass.: Jones & Bartlett Publishers; 2017.

References