UNTANGLING THE MYSTERIES OF THE BRAIN “The concept that Alzheimer’s disease will
inevitably destroy people, we can show, is not always true, and we can actually do something to prevent and reduce the risks of the disor- der,” Raji said in a 2017 lecture at the Silicon Valley Health Institute talk on his work in ra- diology, dementia, and brain imaging. A growing body of research suggests that
reducing risks of developing dementia—or at least slowing its progression—can be ac- complished through diet and exercise. Some researchers say specific diets and exercise re- gimes can to a limited extent restore brain health. Human biology and the brain are complex systems that interact with their environments, though. No scientifically rig- orous studies have definitively proved that dementia is 100 percent preventable. Nevertheless, “a menu of strategies can
help you reduce your risk as you age,” said Dr. Keith Fargo, director of the Alzheimer’s Association’s scientific and outreach pro- grams. “So for most people, you’re talking about getting plenty of aerobic exercise, you’re talking about a dietary pattern that’s going to be good for your vascular system, you’re talking about maintaining challeng- ing cognitive activities as you age.” Some aspects of the research findings are
easier to implement than others, said Joel Kroft, executive director of memory care programs at Country Meadows Retirement Communities in Hershey, Pa. “The tricky part is how you put it into
play,” he said. “More and more research is coming out about physical activity and movement delaying disease and improving cognitive outcomes. We can build that into our days in simple ways. For instance, when we’re doing activities, our teams and the resi- dents can get up and walk to another area of the neighborhood to do the next activity.” But trying to change the dietary habits of
residents with dementia presents more of a challenge. People experiencing dementia who are used to eating meat and potatoes generally aren’t interested in converting to the healthier Mediterranean diet dominat- ed by vegetables, fruits, nuts, unprocessed whole foods, and fish. But the most engaged service providers work to constantly update themselves with the latest research so that they can help residents and their families manage dementia’s progress and impact. Belmont Senior Living has started explor- ing opportunities to work with the Buck In- stitute for Research on Aging in California
16 SENIOR LIVING EXECUTIVE JANUARY/FEBRUARY 2019
and the Mayo Clinic, said Sheri Easton- Garrett, Belmont’s senior vice president of clinical services. It also encourages residents with dementia and their families to enroll in clinical trials. The company is working with UCLA Longevity Center Director Dr. Gary Small’s team to recruit residents to partici- pate in a large new, multi-site clinical trial of a 12 week-treatment of Prazosin, a blood pressure control drug that has the potential to mitigate disruptive behavior common to some types and stages of Alzheimer’s dis- ease. The National Institutes of Health is funding the study.
Brain Age Stereotyping Perhaps Andel-Schipper’s story is so com- pelling because it’s not something that doc- tors or the general public generally would expect. Autopsies of seniors have revealed that many people’s brains can still accu- mulate the pathological proteins that cause Alzheimer’s disease—yet in life they never manifested any symptoms. And society as- sumes that an aging brain wears out like the rest of the body: It’s no coincidence that the average age of an Olympic athlete is between 23 and 24. But neuroscientists have found that brains
are remarkably resilient and continually adapt to circumstances. It often rewires itself to compensate for some of its own develop- ing deficits as we age. Diet, sleep, and physi- cal and vascular health are key to maintain- ing brain volume, and brain health. Senior living providers try to help resi- dents wherever they are along the health
spectrum. Country Meadows encourages residents who have just been diagnosed with Parkinson’s to enroll in physical exer- cise regimen called “Delay the Disease,” a system developed by a personal trainer and a nurse in Ohio.
The Life and Death of Neurons Eighty-six billion cells called neurons pack a human’s three-pound brain, and at least 100 trillion synapses enable electrical and chemical communications between each neuron’s communications sender the axon, and the adjacent neuron’s receiving mecha- nism, the dendrite. It is the life and death of neurons and synapses that affect our cognitive abilities. The hippocampus, an inner area of the brain that’s shaped like a seahorse, controls our various kinds of memories. Damage to both the neurons and synapses in our hippocampus impairs our ability use our memories to function normally in everyday life. Neurons in healthy brains don’t die off in significant numbers during the aging process, but they do lose a few synapses. How many varies with the individual, ex- plain scientists in “Cognitive Aging,” a book published by the Institute of Medicine of the National Academies. The brain adapts by strengthening the capabilities of the re- maining synapses, but it is neurons’ routine loss of some of these synapses that lead to not being able to remember as well later in life the names of places you visited a few years ago, what you went to the kitchen for, or the name of someone you met recently.
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