Common Sense for Brain Health and Alzheimer’s Dementia
I have studied dementia for many years and have cared for hundreds and probably thousands of persons suffering Alzheimer’s Dementia (AD) over the past 30 years. At this time I continue to believe this is a very complex disease and unfortunately, I do not believe we have a comprehensive and national strategy to understand, research, manage, and combat this disease. If we do not change our approach AD will eventually overwhelm our emotional, practical, and economic resources.
Our research programs have really been far too targeted on cellular bases and this has not lead to any advancement of treatment. It is refreshing to see research turning somewhat to the immune system and inflammation as other avenues of insight. True, we continue to develop more sensitive technologies to detect earlier presence of the disease, but it is the treatment and prevention that is most important and we should just presume this disease starts in childhood in the brain as some research suggests and as I indicated from common sense even without research years ago. It is a proactive and neurodegenerative disease process. Are we to believe there is a magical age threshold when normal turns to disease in the brain? That is possible, but more likely is the idea that we need to think about neurodegeneration as lifelong and therefore need a strategic plan for brain health that is equally lifelong.
Proactive health promotion is rather foreign to the United States and to our medical institutions. We are great at detecting disease and intervening, a rather reactive model. It is not of value to conditions that are proactive and degenerative. We need a proactive strategy built on the pillar of health promotion that is lifelong in duration. That means beginning at the earliest of ages, indeed in the womb.
We certainly have no cure or even prevention of AD. However, while research is needed to continue on searching for such, we can and should add a National Strategy for Brain Health that is integrated into the very fabric of our society. The goal is to not only educate the general public of our ability to shape our brains for health, but to encourage and assist in the application of such shaping where we live, work, and interact daily. While I am not alone, I have worked on educating the general public for over 15 years on my own Brain Health Lifestyle ® that includes: physical activity, mental stimulation, nutrition, socialization, and spirituality.
Consider the following ideas:
1. I have long championed a basic set of behavioral tips be given to every mother-and-father-to-be so they can be empowered with what behaviors can help shape their baby’s brain while developing in the womb. Imagine if every hospital and birthing center in the US provided such information. A few basic tips might include the parents talking and even singing to the baby in the womb, the importance of brain health nutrition for the mother and baby, and proper exercise for the mother that will be experienced by the baby.
2. We need to create Brain Health environments with proper stimulation and approaches that shape our toddlers’ brain that occurs prior to onset of oral language. One example is the power of sign language to propel the development of the articulatory system and to help increase IQ. The latter has been found to relate to reduced risk of AD later in life. Certainly, promoting each child’s sensory systems and curiosity, filling the environment with love safety and attention, and promoting brain health nutrition are good ideas. This is how proactive brain health works.
3. Our education system is not built on the premise of shaping brains for health. Our children tend not to sleep enough, eat unhealthy foods, and schools now have safety issues as major concerns and unsafe environments are not conducive to learning. Once again, even without focusing on curriculum, the school environment, timing of classes, and even basic education on what foods can help brain processing is needed. Teachers should all understand they are shaping brains and hence can benefit from knowing what structures in the brain are critical to learning and how environment has a major role in brain health. Schools should all begin with meditation and mindfulness as well as stretching and even some aerobic exercise to prepare the brain to learn. Obviously, we need to promote better sleep patterns and a healthy breakfast and lunch to assist the brain in learning, creating, and thinking.
4. Our corporate and work environments can promote brain health by understanding that the Brain Health Lifestyle ® can be integrated into the work culture. Some examples are promoting less sitting, more movement, more socialization and critical thinking, more brain health nutrition in the café and vending machines, and methods of stress reduction such as meditation, prayer, and yoga onsite. Communication between men and women (a brain function) should be emphasized to enhance understanding and even the bottom line.
5. Our medical system can be encouraged to conduct mental status examinations with neuropsychological testing each year beginning at age 50. It strikes me as odd that we have set ages for different medical procedures for men and women across the lifespan, but nothing for the brain! Medical students should have brain health and lifestyle placed in their curriculum so they can teach their patients how to shape their brains for health regardless of age.
6. Technology can certainly help educate persons on the power of the brain and continue to create fun and engaging tools such as we find in brain fitness and cognitive monitoring to keep people thinking and creating. The same can be said for media and educational organizations that can help to tell the story of our individual empowerment to lead a brain health lifestyle ®.
7. Physical fitness companies and the entire mindfulness industry can do a better job of integrating brain health into their focus and understanding so all clients and consumers know that when they exercise, meditate, do yoga, etc. they are shaping their brains for health.
8. Home is our primary brain health environment and it is worthwhile to review how brain healthy your home is. Novelty and complexity promotes brain health as does socialization, spirituality and stress reduction, nutrition, and physical activity. Is your home promoting these lifestyle domains and can some small changes be made to enhance the home environment.
I would hope that such understanding of our own individual role in shaping our brains across our lives continues to become available to more persons. Those who cope with fewer resources are most vulnerable and in need for the things I mentioned above, but all can benefit. Beyond individual responsibility is our society and our approach as promoted by our nation. The time for a real comprehensive and proactive approach to brain health is desperately needed now. It will require a national effort with changes made to all the institutional sectors of our life as noted above. As such, many leaders are needed to work together on such a national strategy that ultimately will define us as a nation. It will require money and effort, but the payoff is beyond measurement.
The cruel reality of AD is that a brain loses access to its life story and we all lose some access to those we love so much who fall victim to this disease. We all hope and pray for a cure for this devastating disease that will cripple our society and world in the next 30 years if we do not change. I hope we can consider a change in our approach, with an emphasis on proactive brain health promotion at the earliest of ages, and a comprehensive national strategy that not only seeks to cure, but also champions brain health!
Paul D. Nussbaum, Ph.D., ABPP
Board Certified Clinical and Geropsychology
Fellow National Academy of Neuropsychology
Adjunct Professor of Neurological Surgery
University of Pittsburgh School of Medicine
President Brain Health Center