Maintaining Your Brain: The Latest Updates On Brain Health Preservation

We’re starting off June with a recognition of the importance of brain health, as June is Alzheimer’s & Brain Awareness Month. Dementia is the most feared health condition in the United States (surpassing cancer), but up to 45% of dementia cases might be prevented with lifestyle changes that target risk factors. So, it behooves us all to know what we can do to sustain and maintain our best brain functioning and lower our risk for dementia. The Alzheimer’s Association website has an array of resources and opportunities to make sure you’re up to speed, and the Cleveland Clinic recently developed a web resource to provide up-to-date materials and videos to help you stay current and to understand when it may be time to further investigate your own situation or that of a loved one. And of course, agebuzz continues to provide regular information on the range of factors that can affect, support, or harm your brain health. 

There are essential habits that protect and nurture your brain health, including regular exercise, good nutrition, restorative sleep, social engagement, cognitive challenges, and stress relief. Brain health experts often live by the advice they give patients. So, for example, Dr. Majid Fotuhi, a renowned neurologist and adjunct professor at Johns Hopkins (and author of the new book The Invincible Brain: The Clinically Proven Plan to Age-Proof Your Brain and Stay Sharp for Life – Johns Hopkins Neuroscientist’s 12-Week Program to Reverse Cognitive Decline) recently shared with The Washington Post his daily habits to help keep his brain healthy. With particular focus on brain volume shrinkage, Dr. Fotuhi suggests that exercise is likely the best way to support and grow brain volume as you get older. In fact, in a recent study published in Cell, physical exercise was described as critical for activating signals from the liver that are associated with improvements in memory, underscoring that systems throughout the body, beyond the brain, can be influential in supporting brain health. In essence, brain health depends on the health of the entire body. As Dr. Fotuhi himself has made clear, “It’s important for people to understand that their daily habits have a huge impact on their brain health.”

More and more, we are learning that these lifestyle factors, along with your social and environmental surroundings, play a critical role in your brain health. And apparently, it’s not just a matter of your current lifestyle and surroundings. It appears that brain health as you get older is connected to a broad range of factors to which you have been exposed throughout your life (known as your exposome). So, in a series of recent studies published in Nature Communications and Nature Medicine, researchers report that it’s not only the type of risk factors you’ve been exposed to, but also the length of that exposure and the stage of life at which it occurred that can influence your brain health in later life. Factors like smoking, high blood pressure, or those out of your control, such as pollution exposure and financial insecurity, all play a part in what happens to your brain, even if they happened years ago. For more on this topic, read here.

Data show that nearly ⅔ of people living with Alzheimer’s are women. It’s not entirely clear why that is, though one working hypothesis is that the loss of estrogen that women experience post-menopause may negatively affect the brain’s ability to protect against neurodegeneration and memory loss. In a new study from Northwestern and published in Aging Cell, there is evidence that seems to support this hypothesis. According to this mouse study, the aging female brain, in combination with post-menopausal estrogen loss, appears associated with a disturbance of the extracellular matrix (ECM) in the brain, which is a network of molecules that fills in the spaces between brain cells, and accounts for about 20% of brain volume. Post-menopausal females may experience the disruption of the ECM due to estrogen loss, thereby leaving females more vulnerable to Alzheimer’s. 

This is the first study to consider the relationship between estrogen loss and ECM. ECM provides structural support between the cells so that brain cells can communicate and function properly.  Knowing that estrogen levels drop significantly post-menopause, and that women with Alzheimer’s have even lower estrogen levels than post-menopausal women without Alzheimer’s, it therefore seems that estrogen levels may play an important role in brain health. Estrogen may also play an important role in future therapeutic options for women with Alzheimer’s. But no human studies have been done to test this, and we cannot currently say that hormone replacement therapy (usually prescribed to lower the impact of menopausal symptoms) might have a role in reducing the risk of Alzheimer’s. Nonetheless, this gives a strong indication of where new research should be directed, to determine why women are more burdened than men by Alzheimer’s, and what can be done to lower the risk of dementia in women. So stay tuned.