The brain is our command center for our daily life. It controls everything from breathing and hunger to emotion and movement; it interprets your senses, tells you to pull your hand away from a hot stove, and stores all your memories. But as people age, the risk of developing a form of dementia increases. Dementia is an umbrella term for symptoms associated with cognitive decline, predominantly memory, severe enough to interfere with daily activities or functioning. The most common type of dementia is Alzheimer’s disease, with approximately 6 million people age 65 and older in the U.S. living with this condition, a number that is projected to rise to 12.73 million by the year 2050, according to the Alzheimer’s Association. While scientists have developed new medications, such as lecanemab, to slow the progress of Alzheimer’s, healthy lifestyle habits can help reduce the risk of developing memory or cognition problems as people get older.
“A healthy lifestyle is an investment into your cognitive future,” says Dr. Silky Pahlajani, a behavioral neurologist and neuropsychiatrist at NewYork-Presbyterian/Weill Cornell Medical Center. “This means exercise, eating well, getting enough sleep. It’s never too late to start incorporating healthier lifestyle changes to help improve your brain health.”
For Alzheimer’s Awareness Month, Dr. Pahlajani, who is also an assistant professor of Behavioral Neurology in Radiology-Brain Health Imaging Institute & Neurology at Weill Cornell Medicine, shares with Health Matters six tips that can help protect the health of your brain.
1. Challenge Your Brain
Many people like to do puzzles, like crosswords or sudoku, to keep their minds sharp. However, Dr. Pahlajani says that successfully completing daily puzzles doesn’t necessarily mean you’re training your brain.
“If you think of the brain as a muscle, it’s important to cross-train it,” she says. “That means learn something new, whether it’s an instrument, a new language, or a new card game.”
The key is to do things you’re not typically good at so you can form new connections in your brain, which can continue to happen at any age.
“If you do something over and over, like crossword puzzles, and you’ve been doing them for many years, your brain gets used to it and you may not be challenging yourself as much anymore. The goal isn’t to be the best piano player or to become fluent in a new language, but rather be in a constant learning mode,” she says.
2. Eat Well
A well-balanced diet can do more than reduce a person’s risk for obesity or high blood pressure. It can also help protect your brain from memory problems, says Dr. Pahlajani. Studies have shown, for instance, that the Mediterranean diet, which is high in fruits, vegetables, legumes, whole grains, fish, and nuts, is good for brain health. Fish and extra virgin olive oil are both great sources of omega-3, a fatty acid that is important for brain function, and so are antioxidant-rich foods like berries. And there’s another source of antioxidants that sometimes gets a bad rap: coffee.
“What a lot of people don’t know is that moderate amounts of coffee, about one to two cups a day, is also full of antioxidants,” she says. “Coffee, in moderation, is good for your brain.”
3. Decrease Stress
A lot of people are stressed out or anxious over something, including getting Alzheimer’s, says Dr. Pahlajani. “I have patients who tell me all the time that they’re worried about getting Alzheimer’s, and what I tell them is worrying about memory loss can lead to memory loss.”
When our brain is occupied by anxiety and stress, it can affect our ability to focus and hence retain information, she explains. And if you have a mental health issue like depression, it’s important to get adequate treatment because that is also stress on the brain.
“Our brain is our powerhouse. Everything comes from the brain,” she says. “So it’s important to reduce stress and anxiety, and take care of our mental health because that kind of stress and strain does impact memory and cognition.”
Women and Alzheimer's
Of the approximately 6 million people in the United States with Alzheimer’s, about two out of three are women, says Dr. Pahlajani. While the exact reasons for the disproportionate rates are not yet known, it’s an active area of research for Dr. Pahlajani and her colleagues. Here, she offers a few theories as to why more women than men suffer from Alzheimer’s.
Age is a factor. Women tend to live longer than men, and age is the biggest risk factor for both men and women in developing Alzheimer’s.
Estrogen levels may play a role. Estrogen is essential for the proper functioning of memory. Research suggests that the loss of estrogen during menopause may partly explain why women with Alzheimer’s outnumber their male counterparts.
Stress can decrease estrogen levels. Men and women have a stress hormone called cortisol, which increases due to stress. When cortisol increases, estrogen levels decrease, which affects women more than men.
Dr. Pahlajani notes she and her colleagues are recruiting patients for two clinical trials at Weill Cornell Medicine to better understand the connection between Alzheimer’s and women. One trial will investigate the effect of phytosome, a plant-derived supplement that has similar qualities to selective estrogen modulators, which are hormone therapies that manage how estrogen works in the body. Click here to learn more about this clinical trial.
The second is called the LUCINDA trial, which uses a repurposed hormonal medication that’s been safely used for decades to determine whether it can slow or prevent the decline in thinking abilities and functioning in women with mild cognitive impairment or Alzheimer’s disease. Click here to learn more about this clinical trial.
Exercise is usually associated with physical health, but what’s good for your heart, like cardiovascular or aerobic exercise, is also good for your brain, says Dr. Pahlajani.
“Anything that raises your heart rate for at least 30 minutes, four to five times a week, is great for your brain,” she says. “Not only does exercise increase blood flow and oxygen to the brain, but it also releases various brain-protective chemicals.”
If someone doesn’t have the time to get to a gym, she says things like taking the stairs instead of the elevator or parking further away from your destination to force yourself to walk are good ways to get your heartrate up. Diet and exercise will also help manage vascular health, such as blood pressure, cholesterol, and diabetes, all of which are big risk factors that can exacerbate cognitive decline and the onset of Alzheimer’s if they go unchecked or uncontrolled.
5. Get Quality Sleep
Most people have experienced how hard it is to focus or keep your attention if you don’t get enough sleep. This is because “sleep is the garbage truck for your brain,” explains Dr. Pahlajani.
“Sleep is when the body gets rid of toxins and replenishes itself, and it’s also a time when memory is consolidated,” she says, adding that adequate sleep means getting seven to eight hours of uninterrupted sleep. “When we don’t get proper sleep, this can lead to memory, focus, and attention issues.”
A lack of quality sleep may result in things like a person not being able to find their words, or it may feel like their memory is all over the place, leading to your brain feeling foggy the next day. This is why it’s a good idea to turn off electronics at least an hour before going to bed, and to see a doctor if you think you have a disorder like sleep apnea, where breathing is repeatedly interrupted during sleep, preventing you from getting deep, quality sleep.
“There are many things besides Alzheimer’s that can cause the symptoms of memory loss,” she says. “This is why we test people for sleep apnea or other sleep disorders if they’ve been diagnosed with Alzheimer’s, to fully understand the underlying cause of a person’s memory problems.”
Challenging your brain with puzzles or new skills is not the only way to strengthen or create neural connections, says Dr. Pahlajani. Socializing and interacting with people can cultivate neuroplasticity, which is the brain’s ability to change and adapt in response to life experiences.
This became even more evident during the pandemic, when Dr. Pahlajani saw a significant decline in cognition for patients who had early stages of memory loss when they didn’t have social stimulation.
“There is nothing that can match the new connections our brain makes when we are actually interacting with other humans,” says Dr. Pahlajani. “This means non-screen kinds of things. If you are going to take a class, for instance, take it in person, not online. Social engagement helps stimulate our brains to make new connections and stay healthy.”