Wednesday 4 April 2018 9:00am
Medical technology, health care and lifestyle awareness have improved tremendously in the past few decades. We’re now living longer than we ever have before, but the question is how can we keep our brains healthy for as long as our bodies? During Brain Week, Professors Ngaire Kerse, Cliff Abraham, and Associate Professor Liana Machado came together in a public forum to answer your questions about the ageing brain.
Who are these people and why should you believe them?
Professor Ngaire Kerse is a trained GP, and is a highly respected researcher from the University of Auckland. Her research focuses on people, how we can live as successfully as possible into later age, and teasing out the factors that make people prone to developing dementia.
Professor Cliff Abraham is a researcher in the Psychology department of the University of Otago. His work focuses on the more basic level of the brain, looking at circuits, cells, and molecules. He and his team are developing a means of early identification for Alzheimer’s disease, and potential treatments for dementia.
Associate Professor Liana Machado is a researcher in the University of Otago Psychology department. Her lab examines cognitive functioning: how it works normally, how it changes with age, and how exercise and nutrition can improve cognitive function.
The basics of dementia
Question 1: What is the difference between Alzheimer’s, dementia, and cognitive decline?
“Dementia is an umbrella term,” Ngaire says, “and Alzheimer’s disease is the largest subgroup within that ‘dementia’ group.” Liana goes on to explain that there is a normal amount of cognitive decline that happens as you age, anything beyond that is termed ‘mild cognitive impairment’, and beyond that is dementia.
“This is one of the big reasons we need biomarkers,” Cliff says, “so that we can tell the difference between a person who is going to age normally and someone who is going to develop dementia.” A biomarker is a test that can be performed to diagnose a condition, and for those with dementia early diagnosis may mean the difference between stopping or slowing the progression of the illness and developing full dementia.
Question 2: What is the difference between MCI and normal ageing?
MCI, or ‘mild cognitive impairment’, is anything beyond the normal decline we’d expect with ageing. “Basically, you’re a little bit worse off,” Liana says, “this is more than just having an ‘off day’ or forgetting where you put your keys, it’s a really persistent long-term problem.” One of the difficulties with MCI is that it’s not as definite as a dementia diagnosis. People can shift from MCI and back to normal, or vice versa, and it can be very difficult to know what to expect as MCI progresses. “What we do know is that people with MCI will have a greater rate of decline over time,” Cliff says.
Question 3: What are some examples of normal ageing?
“firstly, I just want to clarify that ageing isn’t all downhill,” Liana says, “that idea of getting older and wiser really is true. People become real experts as they age, and they collect a lot of knowledge that you can only get with practice and over time.” With that being said, there are a few key things that get a bit worse as we get older. “The ability to focus on one stimulus at a time can be really affected, so something like trying to read while the TV is on can become very difficult,” Liana says, “also, your working memory, or the ability to manipulate information in your mind, can deteriorate. We also tend to find that older people have difficulty with cognitive flexibility, so if for example you throw a ball in their direction and tell them not to try and catch it they find it really difficult to follow that instruction.” So, in general, we gain a lot in terms of expertise but lose some finer skills.
What can we do to help our brains?
Question 4: What advice would you give us to live to 100 with all our marbles?
“Stay active, stay engaged, and keep learning,” Ngaire says, “the worst thing you can do is give up on things, so just keep pushing yourself.” The general idea is to keep using and keep practicing all those abilities you want to keep. Staying engaged, and keeping up with meaningful activities and interactions are the best way to tell your brain ‘I’m using this!’ “Keep working your memory. Go to museums, meet new people, put yourself in situations where you’re having to reminisce and attach those old memories to new situations.”
It’s not just about thinking, however, being physically engaged is also incredibly important. “As a general rule,” Cliff says, “what’s good for your heart is good for your brain.”
Question 5: How does sleep impact us, and are sedatives harmful?
Sleep takes up a large portion of our lives, and for good reason. While we’re sleeping our brains are laying down memories, and performing general maintenance so that they can function well when we wake up. As we age, however, some people do find it more difficult to get enough sleep.
“I wouldn’t recommend sedatives, because they increase the risk of falls,” Ngaire says, “instead, I’d suggest trying to develop good sleep hygiene.” Sleep hygiene isn’t about having clean sheets; it’s a pattern of behaviour that you follow to make it easier to sleep when you’re meant to. This includes: not having a nap during the day, limiting coffee intake, not using electronic devices in bed, and generally not being in bed unless you’re trying to sleep.
“If you are finding it hard to get to sleep,” Ngaire says, “just try not to worry about it. Get up, read a bit of a book, listen to the radio, and then try again."
Question 6: Does food and diet have an effect? Are there bad foods that we should avoid?
For the past few years Liana has been looking into the potential benefits of beetroot for improving cognitive abilities in older individuals, but for now the jury is still out. “A Mediterranean diet, with lots of fresh fruits and vegetables, low sodium, less processed food,” Liana says, “that seems to be a good way to go.”
“There’s no magic way to go about this, unfortunately,” Cliff says, “a balanced diet, and exercise are your best bet.”
The issues of ageing are a relatively new problem for science. Until more recently these problems were hidden away and not spoken about, but as our ageing population grows so too does our need to understand how age affects us. There is still a long way to go, but progress is being made. “If I can impress anything upon you tonight, I hope it’s this,” Ngaire says near the end of the session, “don’t give up on things, go out and try something new. Why not? It can’t hurt.”