BRAIN RECHARGE: 20-1-7 Challenge: Week #4

Dr. Grimes' 20-1-7 CHALLENGE: 

• For the first TWENTY weeks of this year,
• Pick ONE healthy change every Sunday, and
• Commit to that change for SEVEN days.

BRAIN RECHARGE: 20-1-7 Challenge Week #4

MEDITATION. This is something I think about and INTEND to add to my daily routine every year, but have honestly never managed. This week, I will do a 12 minute meditation every day.

Last week, the Journal of Alzheimer's Disease published an interesting study, which is what is pushing me: 

Meditation and Music Improve Memory and Cognitive Function in Adults with Subjective Cognitive Decline: A Pilot Randomized Controlled Trial.

In short, 60 people with "Subjective Cognitive Decline" (think of this as likely pre-Alzheimer's) committed to a six month study. They were randomly assigned to either a daily 12 minute Kirtan Kriya meditation or a 12 minute music listening session for the first three months, and then they could choose to continue that practice or not during the second three months (roughly 70% chose to continue the daily intervention.) Memory and cognitive testing showed "marked and significant improvements" at three months (compared with their baseline) and these improvements were maintained or improved after six months! 

My first question was "what is Kirtan Kriya meditation"? A quick youtube search yielded multiple helpful instructional videos that revealed this is that classic yoga-style meditation where you chant four syllables: "Sa Ta Na Ma".  I'll admit, I had trouble staying focused on the first few instructional videos that I watched, but  after I understood the basics, I connected with Nirinjan Kaur's video, which  beautifully combines the chant with background music and harmony that I find almost hypnotizing. 

Does it have to be Kirtan Kriya meditation? No. For example, this study demonstrated listening to music provided the same cognitive improvement as this type of meditation. 

BOTTOM LINE: We know that meditation may provide many benefits, including improvement in blood pressure, sleep, anxiety, irritable bowel and many other chronic illnesses. Why not give some form of meditation a try for a week? And yes...there's an app (or two or twenty) for that.  

20-1-7 Challenge Week #1: COLOR

20-1-7 Challenge Week #2: Veggie Spiralizer

20-1-7 Challenge Week #3: Medication Dispenser FEEDBACK: using this dispenser for my prescription and recommended supplements worked like a charm, though interestingly I still missed my sublingual B12 one day, because I had just brushed my teeth and thought I would take it "later". This is a no-brainer to keep going long term!

Worried about Dementia? Try Something New...

This week, JAMA Neurology offered an encouraging study for our aging population which demonstrated that continuing to stimulate your brain through intellectually challenging work or leisure activities (such as playing a musical instrument, using a computer or reading) can postpone the onset of dementia. The investigators utilized nearly 2000 participants in the Mayo Clinic Study of Aging, specifically enrolling people aged 70-89 years old, and identifying whether or not they had APOE (a genetic marker linked with increased risk of Alzheimer's disease) and assessing their baseline cognitive performance.

People who had less mentally challenging occupations, less late-life intellectual stimulation and/or weaker educational backgrounds scored lower on the baseline cognitive assessment. Those people with more advanced degrees or continued late-life education scored higher, creating the anticipated advantage of "cognitive reserve"- in other words, they start with more brain power, so they can afford to lose more brain function before dementia is diagnosed. (For the visually-minded, imagine that dementia is diagnosed when the elevator gets below the 10th floor. If you are starting at the 21st  floor, you get there much later than someone who's elevator started at the 11th floor.)

The surprising good news from this study is that regardless of your baseline brain power, life vocation or genetic predisposition for Alzheimer's disease, everyone's memory power benefits from intellectual stimulation after age 40. In fact, this study showed that the intellectually stimulated people postponed the onset of dementia beyond 7 years compared to their peers who did not mentally push themselves.

Of note, there were observed positive snowballs- the more education a person has on the front end, the more likely he or she is to continue a lifetime of intellectual stimulation.

Does it matter what type of intellectual stimulation? We don't know for certain, but psychologists will be the first to tell you to pick what you ENJOY, because you are far more likely to keep it up. Remember that what you enjoy may or may NOT be what your aging friend or parent enjoys…so whether it is learning to knit, playing the piano, learning a new language or even learning how to text on an iPad- push yourself to learn something that sounds interesting to YOU.

Special kudos to my amazing mother-in-law, Bene, for not only continuing to reading medical articles long beyond her nursing career, but for her constant willingness to learn anything! She texts faster than most adults (with far fewer spelling errors than the rest of us), and even learned to add emoji's last month. Pictured above is the two of us taking a "selfie" from her iPad.

BOTTOM LINE: Until we have a cure for Alzheimer's on the treatment end, the "ounce" of prevention  we all need is to STIMULATE our brains…and never stop!

New Study Offers Hope for Alzheimer Prevention

A glimmer of hope shines in the devastating world of Alzheimer's Disease (AD), as this week a study published in the Archives of Neurology journal reveals that a class of blood pressure medications (Angiotensin Receptor Blockers, known as ARBs) may reduce the risk of developing Alzheimer's.
Although the mechanism of Alzheimer's is not fully understood, we do know that abnormal deposits of amyloid (a protein) occur early in brain as an early stage in the disease process. This new study, the Impact of Angiotensin Receptor Blockers on Alzheimer Disease Neuropathology in a Large Brain Autopsy Series, looked post-humously at the brains of 890 people who had suffered from AD and high blood pressure, and found that those patients who took ARBs (for their blood pressure) had significantly LESS of these amyloid deposits built up.

The hope is that if we can find ways to prevent the build up of these amyloid deposits, then this will halt the progression of Alzheimer's both pathologically and clinically. Prior studies have shown    some clinical evidence that patients on ARB's for their blood pressure have a lower risk of developing AD, but this is the first study to show us the actual physical changes in the brain- very exciting news!

So, if you have a strong family history of Alzheimer's disease and/or are experiencing progressive memory loss, should you ask your doctor to prescribe you an ARB today? Well... yes and no. I would NOT prescribe an ARB for a patient in this situation who had normal blood pressure. However, if she had newly diagnosed high blood pressure, I would certainly consider starting her on an ARB (rather than a diuretic or beta-blocker, our other first-line medications), and I would be open to a discussion about changing her to an ARB if she had hypertension and was already being treated with another class of medications. Of course, when choosing a medication, there is a range of different issues- from side effects and drug interactions to cost (and health insurance preferences), but potential "side"benefits such as this are absolutely part of the decision process.

BOTTOM LINE: Alzheimer's research is critical to help us find a cure for this debilitating disease, and this new study offers encouragement that ARB's may play a role in slowing the development of AD.