Aging Gracefully
by David Dunaief
Dec 12, 2018 | 9126 views | 0 0 comments | 614 614 recommendations | email to a friend | print
Dr. David Dunaief is located in Downtown Brooklyn and focuses on the integration of medicine, nutrition, fitness and stress management.
Dr. David Dunaief is located in Downtown Brooklyn and focuses on the integration of medicine, nutrition, fitness and stress management.
What does it mean to age gracefully? While we want to avoid physical ailments, such as achy joints, cognitive decline is one of the scarier prospects as we age.

Mild cognitive impairment is not a normal stage of aging. It may lead to dementia, which is defined as affecting the memory and also at least one other part of the brain, such as executive functioning. The most common form is Alzheimer’s disease.

There are tests to determine whether you are at increased risk for dementia. These range from a short mental exam in the physician’s office to a saliva test that measures cortisol levels, the stress hormone.

Higher levels of cortisol at night than normal have been associated with significantly less brain volume and reductions in cognitive function in study participants who did not have signs of impairment yet.

As location is important to real estate, it seems that lifestyle, including exercise and diet, may be important to cognitive functioning.

Exercise, exercise, exercise

Three studies show exercise’s benefits for cognitive functioning - not just in prevention, but also in treatment.

Two studies were presented at the Alzheimer’s Association International Conference. In one, results showed that exercise reduced tau proteins in patients over the age of 70 with prediabetes and amnestic mild cognitive impairment. These are patients considered at very high risk for Alzheimer’s disease.

The patients who saw a benefit did moderate to high intensity aerobic exercise four days a week, compared to those who did stretching.

The key to success in patients, who were 55 to 89 years old, was to gradually increase the intensity and duration of exercise over a six-week period until 30 out of 45 minutes were spent at 75-to-85 percent of their maximum heart rate.

The exercise increased blood flow to areas of the brain typically affected by

Alzheimer’s disease

In a six-month study, results show that walking 40 minutes in addition to warm-up and cool-down periods, totaling one hour of exercise three times a week, could improve cognition in those with vascular cognitive impairment (VCI), another form of dementia.

This population was composed of 56- to 96-year-olds with mild VCI.

A third exercise study was a four-month randomized controlled trial (RCT) of patients with mild to moderate Alzheimer’s disease at baseline. Here, participants trained to moderate to intensive aerobic exercise levels, 70 to 80 percent of maximum heart rate.

The population that maintained at least 80 percent adherence saw a significant positive change in the Symbol Digit Modalities Test of attention and mental speed, compared to the control group. This is the first study to indicate that exercise could have an impact on Alzheimer’s disease.

The role of diet

In a study of the MIND diet, those who had the greatest adherence were cognitively 7.5 years younger compared to those who had the least adherence. The MIND diet is a modified combination of the Mediterranean diet and the dietary approach to stop hypertension (DASH) diet.

This was a prospective (forward-looking) observational study over a 4.7-year period involving almost 1,000 patients with a mean age of 81 years.

Lifestyle modifications

We have seen the potential benefits of diet and exercise separately. But what if we brought them together? In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study, results show that a multidisciplinary approach to lifestyle modifications potentially slowed cognitive decline in a healthy older population.

The treatment arm participants had a 25 percent improvement in cognitive scores, compared to the control group given health advice only. The lifestyle modifications in the treatment arm included diet, exercise, brain training and management of vascular risk factors.

This was a 1,260-participant RCT over a two-year duration. The population, though healthy, was at risk for mild cognitive impairment.

Thus, lifestyle modifications may have powerful effects in preventing and potentially treating mild cognitive decline and dementia.

For further information, visit or consult your personal physician.
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