June is Alzheimer’s & Brain Awareness Month
I know what you may think, another month and another health issue to think about. This however, I believe, is worth your time. Our brain does not get the attention some of the more “popular” organs get (heart, lungs, even kidneys), so bear with me.
Many of us may be aware of dementia in a loved one or friend. We might even be worried about our own health. Let’s start with what we do know about keeping our brains as healthy as possible. These recommendations may seem basic, but they have been shown by research to be important!
- Exercise regularly.
Exercise is the closest thing we have to the fountain of youth. This applies to the brain even more. People who are physically active can lessen their risk of Alzheimer’s and may even slow the decline in mental functioning.
Why does it help? It is probably due to the improved blood flow to your brain during exercise. It may even reverse some of the “aging” that happens in our brains.
Try to get about 150 minutes of exercise a week. This can be broken up in whatever way works for you. The easiest may be 30 minutes five times a week. Anything that increases your heart rate is perfect. The best exercise? The one that you will do consistently.
- Get plenty of sleep.
Your goal should be about seven to eight hours of sleep per night, uninterrupted. Talk to your primary care provider if you are having trouble. A medical reason (like sleep apnea) may be interfering with your sleep. The issue may be what we call “sleep hygiene.” These are activities which promote sleep. For example: not watching TV in bed, avoiding any screen activities for 30 minutes to an hour before sleep, no strenuous exercise before bedtime, and sleeping in a cool room.
- Eat a diet which emphasizes plant-based foods, whole grains, fish, and healthy fats.
How you eat has a huge impact on your brain health. “Healthy fats” contain omega fatty acids. Examples of healthy fats include olive oil, avocados, walnuts, egg yolks, and salmon. They may decrease your risk of coronary heart disease and slow cognitive decline as you age.
- Exercise your brain!
Have you ever seen the ruts on a road from cars going over the same path repeatedly? Well, your brain has commonly used pathways as well. We all know is that there are some things that our brains do easily because of repetition or familiarity. So, try to do something that “stretches” your brain occasionally. This might be learning a new task, doing a puzzle, a crossword, or reading something that is outside your usual interest. Think of your brain as a muscle that you are keeping in shape! Try reducing the amount of time you watch TV. Just like our bodies, our brains need some exercise as well.
- Remain socially involved.
Connection, we all need it. We are social creatures. Interaction helps us avoid feeling overwhelmed, stressed, or depressed. Depression, particularly in older adults, can contribute to symptoms of dementia. Connecting with family or other people you share interests with may strengthen the health of your brain.
What about dementia?
For starters, it is not a disease.
It’s a group of symptoms which can be caused by damage to the brain cells. Dementia often occurs in older people. However, it’s not related to normal aging. Alzheimer’s is one kind of dementia and the most common. Other causes of dementia can include head injury, stroke, or other medical problems.
All of us have times when we are forgetful. A memory problem is serious when it affects your daily life. Memory problems that aren’t part of normal aging include:
- Forgetting things more often than you used to.
- Forgetting how to do things you’ve done many times before.
- Trouble learning new things.
- Repeating phrases or stories in the same conversation.
- Trouble making choices or handling money.
- Not being able to keep track of what happens each day
- Changes in visual perception
Some causes of dementia can be treated. However, once brain cells have been destroyed, they can’t be replaced. Treatment may slow or stop more brain cell damage. When the cause of dementia can’t be treated, the focus of care is on helping the person with their daily activities and reducing symptoms. Some medicines can help slow down the progression of dementia. Your family doctor will talk with you about treatment options.
Other signs that may point to dementia include:
- Getting lost in a familiar neighborhood
- Using unusual words to refer to familiar objects
- Forgetting the name of a close family member or friend
- Forgetting old memories
- Not being able to complete tasks independently
How is dementia diagnosed?
A health care provider can perform tests on attention, memory, problem solving and other cognitive abilities to see if there is cause for concern. A physical exam, blood tests, and brain scans like a CT or MRI may help determine an underlying cause. Treatment of dementia depends on the underlying cause. Neurodegenerative dementias, like Alzheimer’s disease, have no cure, though there are medications that can help protect the brain or manage symptoms such as anxiety or behavior changes. Research to develop more treatment options is ongoing.
Long COVID
Yes, even a blog post about brain health needs to mention a COVID-19 connection. There is increasing attention to something called “long COVID” or “post COVID” or “COVID long-haulers.”
For starters, the number is constantly changing, but it seems likely that by the time the pandemic is done, one in every 200 persons worldwide will have been infected by COVID-19. Among non-hospitalized patients with COVID-19, 90% are symptom-free by three weeks. Chronic COVID-19 infection would be those with symptoms beyond three months.
Evidence suggests long COVID is a distinct syndrome, perhaps due to a dysfunctional immune response. This can affect people who were never hospitalized and may occur even in those who never had a positive test for COVID-19.
This means more than 10% of individuals infected with COVID-19 develop post-COVID symptoms. Due to the high infection rate in the United States, more than three million Americans are likely to experience the varied symptoms of post COVID, preventing them from fully recovering.
What are symptoms of post-COVID? Persistent or recurring cough, breathlessness, fatigue, fever, sore throat, nonspecific chest pains (lung burn), cognitive blunting (brain fog), anxiety, depression, skin rashes, or diarrhea.
Disorders in thinking or perception can be the only presenting symptom of COVID-19. This is called delirium. It is present in more than 80% of COVID-19 patients that need care in intensive care units. The cause of this is still being studied. Headache, disorders of taste and smell have often preceded respiratory symptoms in COVID-19. The impact on the brain may be due to an “inflammation effect” and has been seen in other respiratory viruses.
It also seems likely to expect that COVID-19–related cardiovascular and cerebrovascular disease will also contribute to a higher long-term risk of cognitive decline and dementia in recovered individuals.
Evaluation for other causes will need to be considered by your provider if you are having lingering symptoms. Not everything can be blamed on post-COVID. For example, a social history may reveal relevant issues, such as isolation, economic hardship, pressure to return to work, bereavement, or loss of personal routines (e.g., shopping, church), which can impact patients’ well-being.
Finally
If you are having persistent symptoms, the best advice is to contact your primary care provider. The symptoms of cognitive changes or other lingering concerns can have multiple causes. Your provider can help you sort this out. Many have felt the mental health impact and on our general well-being of the pandemic. Social connections, community and peer support are important for us all. Psychiatric referral may be appropriate for some patients.
Resources
https://familydoctor.org/condition/dementia/
https://www.cdc.gov/aging/dementia/index.html
https://covid.joinzoe.com/post/covid-long-term
https://www.aafp.org/dam/AAFP/documents/advocacy/prevention/crisis/ST-LongCOVID-050621.pdf
https://patientresearchcovid19.com/
https://www.aafp.org/afp/2020/1215/p716.html
Rogers JP, Chesney E, Oliver D, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry. 2020;7(7):611-627.
Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain Behav Immun. 2020; 87: 34- 39.