Right now, most of the elderly people in care homes are locked up. They are not allowed to have visitors, to leave, and are often prohibited from their normal intermingling with other residents. How do I know? Because I take care of people living in care homes. What I have noticed is a profound decline in mental function in all of these individuals. Their dementia (if they had it) and mental status are now worse than ever. Many have even developed dementia, in a matter of months! I have had so many families tell me, “when I last saw my mom 3 months ago, she was so much more cognoscente”.
This confirms something I have known and thought about for a long time. If people do not use their brain, engage with other people, and challenge themselves, their minds deteriorate. Just like the body, the brain must be exercised. If we stop moving, we eventually become unable to move. When we stop thinking, we eventually become unable to think. When our thinking becomes profoundly impaired, we call this dementia.
Most people have heard of people who retired from work, only to develop dementia shortly after. So, what is going on here? Did they retire because their minds were starting to go? In some instances, yes. But in others no. In many cases, their minds began to slip only after they were no longer challenged to think and forced to engage with others. A lack of purpose may also contribute. Either way, this further illustrates the ties between brain usage and cognitive decline.
The first pre-requisite to improving your intelligence is believing that it is possible. Studies have shown that believing intelligence is not a fixed variable leads to greater academic achievement and success in life. The brain you are given is plastic. This means it can change. Your brain cells can grow, adapt, re-wire, and get smarter. By learning new things, keeping an open mind, and believing you can become more intelligent, you can get smarter. I promise this is true and I am living proof.
When I was in first grade, I could not read. The other kids in my class could. I remember one time I was asked to go up in front of the class and read something. I was so embarrassed because I couldn’t even say one word. I was diagnosed with a learning disability. Following some tutoring and special education tactics, I eventually learned to read, but it took years. Even in middle school and high school, I was not considered very smart. But I was very curious. I was then and am now, excited to learn new things every day. Now, I read more than most adults, am a physician, a pilot, a published researcher, and so much more. I always believed that I was smart, creative, and had interesting things to say. My science and math skills confirmed this at an early age. But without the ability to read and my curious nature, these skills would have not been enough. You can achieve whatever you want to achieve, period.
People who believe they can do something or will become something, are so often able to do it. I see this with professional athletes all the time. These athletes had the mentality, long before they experienced success on the field. Through believing, they were then able to achieve. Go after your dreams! Do not let some smug scientist tell you your intelligence or capabilities are fixed, they are not!
Brain health requires more than just thinking though. Remember that the body and mind are one. They cannot be separated. It has been well studied and shown that vigorous exercise improves brain function and prevents dementia. On the contrary, sedentary lifestyles lead to brain fog and give you a much higher chance of getting dementia. Exercise increases blood flow to the brain, plasticity between neurons (brain cells), improves neurogenesis (growth of brain cells), and regulation of neurotransmitters (brain communication chemicals) like serotonin, which promote positive mental health. Never underestimate the positive effects of exercise on the brain, body, and mental health. Being sedentary is just not conducive to health. Get up and move. In an Australian study, watching television more than 6 hours a day was associated with dying 5 years sooner. This lifestyle decrease is about the same as that seen in daily tobacco use. As a physician, I can tell you that the last several years of a sedentary person or tobacco users life are often very unpleasant and laden with regret. So both the quality and quantity of life are greatly reduced in the sedentary individual.
Eating healthy food has also been shown to improve mental function. Basically, we have two brains. One is in our head and the other is in our gut. This is highlighted by individuals who are paralyzed with spinal cord injuries. These people cannot use their limbs, but their guts continue to work. Our gut is filled with neurotransmitter receptors just like our brain. When the gut is sad, so are we, and being sad is never good for intelligence. Everyone in the western world eats meat and processed foods constantly. On the contrary, our intake of fiber rich fruits and vegetable is pathetic. When people do not eat fiber, their bowels stop working. When bowels stop, toxins can’t get out, and our guts get mad. So many people are constipated and have unhealthy guts from the trash food most of us eat.
Gut health is about more than just our own body though. The reality is that humans are a walking talking ecosystems. Our skin, urinary tracts, and gastrointestinal tracts from our mouth to our anus are literally covered in micro-organisms. We have a mutualistic relationship with many of these tiny friends, meaning we both benefit from each other. We collectively call these little guys our microbiota. All of these little bacteria, fungi, viruses, and parasites help keep the bad bugs out. They also educate our immune systems, make vitamins for us, and improve both gut and skin health. When we eat trash food, our microbiota gets taken over by bad bugs that promote sickness. These bad bugs even make us stupid. Eating lots of raw vegetable and fruits of different colors supports a diverse healthy body ecosystem. Some estimates say that for every human cell we have 10 bacterial cells on our body. Moreover, our microbiota contains 100 to 200 times the amount of genetic information contained in our human cells. We are just starting to understand the importance of our symbiotic microbial partners. Unsurprisingly, most United States residents have what appear to be profoundly ill microbiomes.
Never underestimate the negative effects of mental health disease on our health and intelligence. Those with Bipolar type 1 know that mania leaves their brains cloudy and disheveled after the high is over. Cumulative mania episodes have compounding effects on intelligence. But even just regular old depression has been shown to greatly effect intelligence and learning. Treating mental health with lifestyle is the first step toward a long healthy and cognitively engaging life. For those with true mental illness, more aggressive medical therapy is often warranted.
Perhaps the most important way we keep ourselves sharp is engaging with others. So many people are lonely. They do not put themselves out there and as a result do not adequately engage with others. Communities that live the longest, engage in society at every age level. We are social creatures. Surrounding yourself with intelligent, good, and hardworking people will keep you honest, on your toes, and provide meaning through civic duty.
Just as important as what we do to help our brains is what we do not do. As stated above, excessive eating, and especially an overdependence on processed and animal-based foods are detrimental to our health. But drugs can be even more harmful.
Any drug that impairs our ability to think as well as our overall health can be expected to negatively affect intelligence and lead to dementia. This includes both prescription medications, over the counter drugs, tobacco, alcohol, and illicit substances. Opiate medications like hydrocodone and oxycodone are notorious for this. They keep us from thinking, engaging with others, and over time lead to profound cognitive deficits and dementia. Drugs like tobacco and methamphetamine effect our cardiovascular and mental health. They can damage the flow of nutrients to the brain and lead to cognitive decline, rapidly and over time. Avoid harmful substances and anything that impairs thinking. On the contrary though, using substances like wine in moderation, to facilitate socialization and wellness, have been shown to keep people alive and well a long time. So, some harmful substances in moderation, may be ok.
Make sure to take good care of your eyes and ears. Loss of vision, hearing, and other senses throughout one’s life makes developing dementia more likely. This makes complete sense and hearing is the most common culprit. If people cannot hear they cannot engage well with other people and it is harder for them to learn information. They spend more time straining to hear information that thinking about what was actually said. Occupational sound exposures, loud concerts, and loud headphones are some of the biggest culprits. Protect your ears! It will pay dividends for you later in life.
Simply put, use your brain, exercise your body, put good things inside your body, stay positive, and engage in positive ways with others. Your intelligence and brain power are not fixed. They are dynamic and can be improved. It starts with believing they can be improved.
Education is so important. We have to get our children back in school! My grandma Lourie used to say that education is something you always carry with you. Moreover, it is immediately apparent to anyone you interact with. To her, education was always a good investment and she worked as a teacher for longer than I have been alive. She lived to 101 and attributed her advanced age to her positive attitude. Grandma Lourie visited Europe for the first time at age 50 and returned to that continent over 50 times before she passed away. I was priveledged to join her on her last 2 trips! Education is not just important for developing brains, it also keeps us adults on our toes. Never stop learning!
As the health of our population deteriorates, we are going to see more dementia. Vascular dementia, caused by diseased blood vessels to the brain, will likely be much more common as rates of cardiovascular disease rise. Quite frankly, dementia sucks. We need to all make serious lifestyle changes now to prevent a catastrophe.
While dementia has a few pharmaceutical drug options available for treatment (acetylcholinesterase inhibitors and NMDA antagonists), these medications do not actually work. If they do work, their benefits are marginal at best. Just like diabetes, our best shot at preventing and treating dementia is through lifestyle medicine. Stop looking to pharmaceutical companies to save us. These companies only goal is to get us all on their monthly payroll. Use your brain and exercise your body, it will pay dividends for years to come.
Thank you for reading!
Bill Brandenburg, MD
References
- Cabral et al. Exercise for Brain Health: An Investigation into the Underlying Mechanisms Guided by Dose. Neurotherapeutics. 2019.
- Erickson et al. Physical Activity, Brain Plasticity, and Alzheimer Disease. Archives of Medical Research. 2012.
- Blackwell, L., Dweck, C., & Trzesniewski, K. (2002). Achievement across the adolescent transition: A longitudinal study and an intervention. Manuscript in preparation.
- Dweck, C., & Leggett, E. (1988). A social-cognitive approach to motivation and personality. Psychological Review, 95,256-273.
- Wikipedia. dementia, donepezil, memantine, blue zone.
- Uptodate. Evaluation of Cognitive Impairment in Adults and Treatment of Dementia.
- Montreal Cognitive Assessment. Available at (https://www.parkinsons.va.gov/resources/MOCA-Test-English.pdf)
- Sirishinha Stitaya. The potential impact of gut microbiota on your health: Current status and future challenges. Asian Pac J Allergy Immunol. 2016.
- Veerman et al. Television viewing time and reduced life expectancy: a life table analysis. BMJ. 2012.
- Ray et al. Dementia and hearing loss: A narrative review. Maturitas. 2019.
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