By Simon J. Evans, PhD

Does your job have anything to do with your odds of getting Alzheimer’s disease down the road? Studies have come out recently linking intellectually challenging careers to reduced risk of dementia. Other studies link education level to cognitive health in later years. Overall, people with more education have lower rates of Alzheimer’s disease than those with less education.

This really isn’t that surprising if you think about it. We know that the more you use your brain, the stronger it gets. Just like muscles in your arms and legs, the brain gets more fit when you work it out. Higher education usually means more mentally stimulating jobs and that keeps your brain fit.

But that doesn’t mean that you have to go to graduate school to stay mentally active. Big studies look at large groups of people. On average, when you look at lots of people those with higher levels of education have more intellectually challenging jobs. So overall, they have lower rates of dementia. However, you can be a high-school drop out and still do what’s necessary to keep your brain fit. Just don’t be average.

You can maintain an active mind by committing yourself to life-long learning. It doesn’t take a formal education to teach yourself new skills, read new books and continually challenge your mind – it ain’t rocket science.

There is, however, a flip-side to this coin. Even though higher education predicts lower odds of getting Alzheimer’s disease, those with higher education who do get Alzheimer’s, decline much more rapidly and die sooner than those with less education. Remember, again, this is based on big number averages and is not necessarily predictive for any one person. Still, on average if you have an intellectually challenging career, your odds of getting dementia are lower, but if you do get it, your odds of rapid decline are greater.

At first, this might seem paradoxical. But I think there is a likely explanation for these seemingly odd data. It all relates back to the cognitive reserve theory, which we have discussed in the past.

Essentially, cognitive reserve is something you create throughout your life. The more you learn and the more you experience, the more you create cognitive reserve. This is like ‘extra’ brain circuits to accomplish intellectual tasks.

Think of it like a city building multiple bridges across a river. If you only have one bridge to cross the river and it gets knocked out by a freak storm, you can’t get traffic to the other side. If, however, you’ve created reserve routes to cross the river with multiple bridges and one gets knocked out, you can divert traffic across the other bridges.

This is the same with brain circuits. If you’ve created multiple circuits through a variety of experiences you have different ways to accomplish the same task. If one takes a hit due to age-related damage, you can divert thoughts through different circuits and not really notice a problem.

So people with higher education and more challenging jobs may have reserve brain circuits. That means that even though we may all experience the same age-related damage, someone with more cognitive reserve will show less cognitive decline. There are also ways to minimize the age-related damage through healthy living, but that’s another topic.

So why would people with more reserve show more rapid decline once dementia sets in? Again, this makes sense if you think about it. People with high levels of reserve who get dementia must have experienced severe damage that took out all their bridges. Damage of this severity will take them down quickly.

However, it’s an illusion. Since studies only compare people diagnosed with dementia, they may be comparing apples to oranges. On average, the people with high reserve (mentally challenging careers in these studies) who have Alzheimer’s disease have likely experienced a lot more damage than, on average, the people with low reserve who have Alzheimer’s.

This would explain why people with more challenging careers would have fewer cases of Alzheimer’s; and also why people with higher levels of education who do get Alzheimer’s, decline much more quickly.

Overall, it’s better to boost your odds of not getting dementia in the first place by doing what’s necessary to challenge your mind on a daily basis. Commit yourself to life-long learning and stay mentally active to build more bridges. Couple this with quality nutrition, plenty of exercise and enough sleep, and you will also minimize the storms that create the damage that can damage your bridges.

By Dr. Simon Evans and Dr. Paul Burghardt

For some time now, we’ve been promoting the role of a healthy lifestyle in maintaining brain fitness. Another new study lends more support, but before we get into that we thought we’d focus on some common-sense topics as to why this is true.

One simple concept to understand that doesn’t require a PhD is the fact that any organ in your body, including your brain, needs a healthy blood supply to access nutrients and oxygen. This is one reason why heart disease and mental health problems, including dementia are so often related. If you tied a tourniquet around your leg to cut-off the blood supply, you shouldn’t be surprised when your foot stops working to well.

The same is true for your brain. If you continue to do things that are bad for your cardiovascular system, like sit around all day and eat chips, your vascular system will eventually have a problem, and this is not good news for your brain. In fact, your brain uses about 20% of the oxygen that you breathe and the calories that you eat. Your blood supply is responsible to get that stuff to the right place in order to keep your brain in good working operation.

The benefits of life-long learning and continually challenging your mind to keep it sharp are well established. But if you don’t couple that effort with doing what’s necessary to maintain a healthy neurovascular system, you cannot fully realize the benefit. You may have read a lot about neurogenesis and synaptogenesis, which is the constant rewiring of your brain that occurs when you stay mentally active and helps to keep your mind agile. However, this process can only work well if the blood vessels near all this rewiring are healthy enough to do their job. Otherwise, where is the energy, nutrients and oxygen necessary for the remodeling job going to come from?

Think of neurogenesis as a new housing subdivision going into an existing community and the roads as the blood supply to service the houses. If you were the builder constructing this new development you wouldn’t get very far if you didn’t first attend to the new roads. Not only are the roads needed for the new owners to get in and out of their homes; but they are needed for delivering all the lumber and concrete, enabling the different crews to come in and construct the new houses, and take all the trash away. Similarly, new brain cells or new brain cell connections need healthy roads (neurovascular system) to work right.

Related to this, a recent large study, just unveiled this month (April 2008) by Dr. Thomas Montine from the University of Washington, reports that 33% of the risk of dementia stems from disease of small blood-vessels in the brain. In this 12-year study, 3,400 men and women over age 65 volunteered for periodic cognitive testing and a brain autopsy upon their death. In the 221 autopsies performed, researchers discovered that small blood vessel disease accounted for about 1/3 of the risk for dementia. Importantly, this type of small blood vessel disease may go unnoticed for some time. We’re not talking about big events like a stroke or blood clot blocking a large vessel. However over time these small problems can add up, and result in cognitive impairment.

Admittedly, this study comes from the Pacific Northwest, the origin of grunge-rock and Starbucks coffee. We can’t be sure that all these people aren’t suffering from some kind of post-angst cognitive disorder, or a latent flannel shirt allergy! We also can’t rule out suffering from some sort of post-tramautic stress after invading the world with high-priced coffee, equivalent to about $18.00 per gallon; slightly more than we’re currently paying for gas. In fact, one of us (Evans) was raised in Seattle and may be showing some early symptomology.

However, with these potential confounds aside (unless Austin Powers was right, and during the time that Dr. Evil was cryogenically preserved his faithful cronies invested heavily in Starbucks), this study is an incredibly important step that illustrates the diversity of factors that can lead to dementia. Even more importantly, it suggests that you can substantially decrease your odds of developing dementia by attending to life-style factors that can protect against vascular disease.

The beauty is that we have a good idea of how to do this since blood vessels serve to supply active areas of the body with nutrients! So if your brain is active (which requires energy), and you’re maintaining your overall vascular health by eating right and exercising, odds are that you will be greatly reducing your risk of developing dementia from small vessel disease. Now it should be noted that research is ongoing on this subject, but common sense would suggest that this will hold true.

Taken together this highlights some very important reasons as to why exercise and nutrition play such a crucial role in brain fitness. Attending to both of these lifestyle factors is necessary to maintain a healthy blood supply and the creation of new blood vessels, in order to feed new brain circuits established by learning and mental activity. If you neglect this aspect of brain fitness, you may literally limit your ability to benefit from neurogenesis and synaptogenesis induced by many of the ‘brain-training’ programs designed to keep your mind young.

Written by Paul R. Burghardt, PhD

A recent paper in the journal Neurobiology of Learning and Memory by Bernward Winter and colleagues investigated the effects of a single session of exercise of different intensities on individuals’ ability to learn and remember new words.

College students were asked to sit quietly for 15 minutes, walk at a moderate pace for 40 minutes, or sprint two times for three minutes per sprint. Fifteen minutes after finishing one of those intensities of exercise, they learned a pairing between a made up word and a picture (e.g. glump/ picture of a car). The subjects were rated on the speed at which they learned the new pairings, and their accuracy when recalling the pairings between pictures and novel words one week and eight months after the single exercise session.

For the record, my money was on the moderate intensity group to perform the best, but……the high-intensity group learned the pairings 20% faster than both the control and moderate intensity exercise groups. Translated that means that after two sprints of less than three minutes each increased peoples’ speed of learning by 20% compared to the other conditions. And that, folks, is the reason why I am not a gambler.

Another interesting finding was that after intense exercise, the students not only learned faster, but recalled those word-picture pairings more accurately after 1-week and 8-months. So do some sprints….you’ll learn it quicker, and remember it longer!

Along with the learning component, this group of researchers also examined levels of hormones in the blood for potential association with peoples’ ability to learn in the word-picture paring task.

Levels of the growth factor BDNF (Brain Derived Neurotrophic Factor) and other hormones involved in our flight-or-fight response were elevated after sprinting. Further, these hormones were associated with better short-term and long-term learning success. This indicates that enhanced learning after this intense, but brief, exercise may be modulated by these hormones.

One of the main questions to ask is whether this type of exercise would produce the same learning effects in non-athletes? Since the subjects of this study were athletic to begin with, their perception of intense exercise is likely to be much different than that of an individual who rarely or never exercises but decides to go out and does some sprints. In fact, this study showed a subtle association between increased mood after intense exercise and overall greater success in learning. What I’m trying to say is that these people probably felt pretty good, amped-up (so to speak) after the sprints. It’s possible that a positive emotional spin on the situation enhanced learning.

We know that the emotional value of a situation influences how strongly a memory is stored, and this happens at both ends of the spectrum. Very happy events often stick in our memories. Unfortunately very unhappy events also stick in our memories, and can cause a lot of problems, for example post-traumatic stress disorder (PTSD).

Now I don’t think that an out-of-shape individual would suffer PTSD from doing a couple of sprints (unless the sprints caused an asthma or heart attack). However, for someone that really enjoys exercise and is familiar with exercise this may have been just enough of a “rush” to make learning a little easier and more memorable.

Another important point to highlight is that this study was specifically looking at the effect of one session of exercise. There are numerous studies indicating that increasing moderate physical activity as a part of one’s daily life has positive benefits on learning and cognition. So don’t feel like you need to start incorporating sprint work into your daily routine to enhance learning. The intriguing thing about this current study is that it provides another way to try and enhance learning, and also starts to address issue of when to learn new things after you have exercised.

Although there is some obvious follow-up that needs to occur after this study, this is a very nice experiment that illustrates the critical issue of timing in maximizing one’s efforts.

The old cliché “timing is everything” should be looked upon as a tried-and-true adage. Much of our biology works on a daily rhythm. Along with that, our bodies respond to environmental ‘pressures’ (eating, exercise, temperature, interacting with other people, etc.) with a variety of finite behavioral, and biological responses. Basically, when our current state of living is interrupted by some environmental (outside) factor, we will respond until those factors are neutralized.

This paper illustrates how we could capitalize on some of that compensatory biology to do a little multitasking. Get some quick exercise in, and while you’re recovering teach yourself a new language. I’m not saying this approach will work for everyone, or for every type of learning, but the possibilities are there; and the combinations will be virtually endless.

Written by Simon J. Evans, PhD

Do you have a sweet tooth in the morning? Do you crave that bowl of high-sugar cereal or a donut with your coffee? We all know that breakfast is the most important meal of the day, and getting something for breakfast is likely better than getting nothing at all. However, a new study from a group in Australia tells us that if you must eat those sweet, high carbohydrate foods, you would do much better putting them off until lunch and grabbing some more protein in the morning.

A g’zillion different studies show us why it is so important to eat a morning meal. Breakfast eaters have an easier time controlling their weight, better energy throughout the day and higher performance on the job or at school. We also know that foods with a lower glycemic index (meaning they are less likely to spike your blood sugar because they have less simple carbohydrates) are better than high glycemic breakfasts for all this stuff.

A new study took this logic a step further and asked what would happen to your blood sugar if you spread out all your carbohydrates evenly throughout the day, or, conversely, loaded most of them up at breakfast, lunch or dinner. Researchers expected that the peak in blood sugar would be highest right after eating the high carbohydrate meal. In a sense, they were right, but with one big surprise.

A high carbohydrate breakfast meal caused a much bigger spike in blood sugar than a similar meal at lunch or dinner. It appears that our bodies can tolerate a dose of carbs much better in the afternoon or the evening, than we can in the morning. This study utilized type II diabetics to provide and exaggerated normal blood-sugar response, but presumably, this applies to everyone.

Why is this important and what does it have to do with the brain? Your body needs to control its blood sugar (glucose) in a tight window in order for all your systems to operate at their best. Importantly, your brain uses glucose exclusively as an energy source, whereas the rest of your body can tap into energy from fats and proteins. So giving your brain a steady supply of glucose is important for optimal brain function.

If you are constantly eating a big chunk of your daily carbs at breakfast (by scarfing down the donuts, pancakes, French toast or high sugar cereals), then you are probably spiking your blood sugar fairly high in the morning on a regular basis.

This has a couple of problems. First, in the short run, spiking your blood sugar causes your body to respond by releasing insulin to crash it back down. This will cause a drop in energy levels during the mid-morning hours, which is a time when many folks need to be on their toes at work, and kids need to be attentive in school. Second, in the long run, constantly spiking your blood sugar can eventually lead to insulin resistance and type II diabetes, which increases your odds for heart disease and cognitive problems as well.

Obviously it’s best to get rid of the high sugar foods from your diet completely, but let’s be reasonable. Most people, me included, enjoy a fresh-baked cinnamon roll every now and then and we aren’t willing to deprive ourselves of all of life’s pleasures.

So here’s the solution – just don’t eat this stuff for breakfast. It’s the worst possible time of day for these kinds of foods. Unfortunately, these are the common breakfast foods that we feed our kids on a regular basis and find littering the morning menu of our favorite restaurants.

Still, try to switch to higher protein meals in the morning, like eggs or a quick breakfast shake and you will likely notice an increase in energy throughout the morning and the rest of the day. If you just can’t go cold-turkey on the morning office donuts, grab one to stick in your desk and eat it with lunch instead (just keep it to a minimum).

Reference: American Journal of Clinical Nutrition (2008) 87:638-44

Written by Simon J. Evans, PhD

We have are fortunate enough today to expect to live about 20 years longer than our grandparents did. Since the 1950s, we have enjoyed a two-decade increase in lifespan. The downside is there is a big difference between lifespan and healthspan, which is the number of years that you remain healthy.

A new editorial in Archives of Internal Medicine looks at the health of people reaching 100 years of age. Today there are 55,000 centenarians in the US. The people that make it that far today generally fare pretty well. That’s because it’s still difficult to reach that status without some strong genes and a healthy lifestyle.

But modern medicine is pushing more and more people to a ripe old age. In fact, conservative estimates predict 800,000 centenarians by 2050. That’s a lot of people reaching 100 so the issue of healthspan becomes a very important consideration.

A specific component of healthspan that most people care deeply about is their brainspan, or the number of years you maintain a healthy brain. Alzheimer’s disease and other types of dementia are probably the most feared diseases we have. The vast majority of people rate brain health at the top of their list for quality of life indicators. The more fit your brain, the better you feel.

Unfortunately, increases in brainspan have not yet paralleled increases in lifespan. Over the age of 65, there is still a 5% chance of having Alzheimer’s disease. Over the age of 85, those odds jump to 50%. But frankly, those statistics are much scarier than they need to be. When people hear statistics like that, they tend to feel helpless, as if they are rolling the dice. However, when it comes to your brainspan you can weight the dice in your favor.

Saying that people over 85 have a 50% chance of having Alzheimer’s disease is a little misleading. The real statement is that by the age of 85, 50% of people have Alzheimer’s disease. That may seem like the same thing, but it’s really a very different statement. Putting it the first way, it seems that everyone has a 50-50 chance of getting the disease, but that’s not really true. Some folks have a very high chance, while others are completely safe. Your chance of developing Alzheimer’s by the age of 85 is not necessarily 50% – so what is it?

The new editorial cites a 2004 study that looked at correlations between metabolic syndrome and cognitive decline. Metabolic syndrome is a collection of problems, including abdominal obesity, high cholesterol, high blood pressure and difficulty controlling blood sugar (usually insulin resistance).

About 1 in 5 (23%) adults have metabolic syndrome in the US today, but almost 1 in 2 (43%) of folks over 75 find themselves in this state, curiously similar to the number of people with Alzheimer’s disease at that age.

In fact, researchers found that those with metabolic syndrome had a much greater chance of experiencing cognitive decline. The good news is that metabolic syndrome is highly preventable by simply eating better and exercising. It just takes a little investment of effort to dramatically shift the odds in your favor.

Now, this study was only observational, meaning researchers can’t conclude that metabolic syndrome causes Alzheimer’s. However, many other studies show that similar risk factors are involved in both diseases and it’s not a stretch to think that if you take care of your body you will also be taking care of your brain.

We understand perfectly well the relationship between saving and investing money throughout your career to enable a comfortable retirement. If you choose not to save anything, you aren’t surprised when you retire broke.

Yet, this association of investing in the health of your body and brain doesn’t seem to be as obvious to many folks. Perhaps it’s because we don’t get monthly balance statements to watch our ‘health accounts’ grow or shrink. Yet, the relationship between lifestyle and late-life brain health is clear.

This is more important today than ever. Since modern medicine will likely help you stretch your lifespan by many years, wouldn’t it be nice to do the same for your brainspan?

Written by Simon J. Evans, PhD

This is a short post on the incredible efforts of a local elementary school principal in my hometown. Nancy Tetens is the principal at my 5^th grader’s school (Symon’s Elementary) who is putting herself on the national stage in order to be a good example for her students.

Ms. Tetens, admittedly struggles with her weight, and felt like she wanted to show her students that adults can step up and take responsibility to improve their health. For the past couple of years Ms. Tetens has been doing just that. She is actively involved in promoting healthy behavior in her school and, more importantly, practicing what she preaches.

Recently, Ms. Tetens joined a national contest called, Clean Start Challenge, sponsored by Lifetime (the TV channel). And guess what…she was chosen as a finalist. Now she is ‘competing’ as one of only ten contestants over the next three months, to transform her life. You can check out Ms. Tetens story and cast your vote for her by clicking here.

More important than winning the prize is the chance to show hundreds of students how to turn their health around. It’s no surprise that kids today are not as healthy as they were decades ago. In fact, child obesity rates have risen dramatically over the past 30 years. In the 1970s the percentage of overweight kids was only a couple of percent. Today, nearly 1 in 5 fit into that category. On top of that, the center for disease control expects about one third of today’s kids to become diabetic.

There are all kinds of reasons for this, mostly boiling down to poor nutrition and less (way less) physical activity. One issue that has received serious national attention is the disappearance of daily P.E. in our schools.

Forced by current political policy and budget crunches, schools have reduced physical education programs in favor of more classroom instruction in order to meet the imposed national standards (some call it ‘no child left without a big behind’). Ironically, the more we learn about how the brain works the more we realize these kids would do better in school if they received more PE, not less.

Study after study has shown that kids boost their math, science and language performance with regular physical activity. But it goes way beyond grades. Physically active kids also have greater self-esteem and lower incidence of mood problems. Given that about 2 million American kids are on anti-depressants or anti-psychotics, this alone should be a strong reason to reintroduce more PE.

This is why Ms. Tetens’ story is such an inspiration. She is swimming against the tide to promote good health in kids. And the kids are taking notice. They are getting behind her and cheering her on all the way. This effort has the real potential to change lives. I strongly encourage you to take 30 seconds right now to cast your vote for Nancy to help promote this movement.