Salmon and Sardines for Stress Reduction

Benefits attributed to eating oily fish are mounting. Eating fish is now credited  with combating depression, reducing the symptoms of arthritis, reducing the risk of heart disease, protecting vision, and most recently with reducing stress and  improving working memory. Of course, this is due to oily fish, like salmon and  mackerel, being very rich in omega-3 poly-unsaturated fatty acids and protein.  White fish have fatty acids too but not as much.

A study published in the American Journal of Physiology – Regulatory, Integrative,  and Comparative Physiology shows that fatty fish oils can “counteract the  detrimental effects of mental stress (read that: the fight or flight reaction) on your  heart.” The study, led by Jason Carter of Michigan Technological University,  revealed that people who took 9 grams of fish oil supplements a day for over a  month experienced less mental stress in measurements of cardiovascular health,  including heart rate and muscle sympathetic nerve activity (MSNA) compared to  those who took 9 grams a day of olive oil instead.

Oily fish are species of fish that contain significant amounts of oil throughout their body tissues and in their belly cavity. In contrast, whitefish only contain oil in their liver – and much less of it than oily fish. Other examples of oily fish include trout,  sardines, kipper, eel, and herring.

The American Heart Association recommends that people eat at least two servings of fish every week. The National Health Service of the United Kingdom also advises people to eat at least two portions of fish a week, including one of oily fish.

It has been known since the famous Avon, England study of all the pregnant  women in that city during one year in the 90’s that women who do not eat fish  during pregnancy are more likely to experience high levels of anxiety at that time.  The University of Bristol longitudinal study suggested that eating fish during pregnancy could help reduce stress levels, which – in turn – has the effect of  reducing behavioral and attention problems in the offspring of oily fish eating mums.

My favorite study involved London cabbies, a stressed group who can always use  some working memory improvement. The BBC reported on a small group of 10  cabbies who agreed to eat 4 portions of oily fish a week for 12 weeks. They were  tested before and after the 12 weeks to see what affect the increased intake of  oily fish had on their stress levels and memory.

At the end of the 12 weeks it was found that cabbies were better able to deal with  stressful situations and their visualization-based memory had also improved significantly, something Omega 3 is believed to help with. As a group, their stress  hormone as a whole was down by 22% and their anti-stress hormone up by 12%.

Since the study included only ten participants and had no control group, the  results are only suggestive. However, the cabbies could be heard to exclaim: “So long and thanks for all the fish…”

The relationship between stress and dementia is actually a fairly new  research topic and one that is important the longer people live and  the more complex, demanding, and chaotic our lives are becoming.  Most of us find it difficult to avoid the chaos and conflicting demands  on our time and resources. Given the circumstances, it is only natural to ask if stress can cause dementia. The short answer is: Yes! Early studies are at least linking stress with an increased risk of dementia.  Here are some of the recent findings.

1. A longitudinal study of 2 ½ years, involving 62 participants, with an  average age of 78 years, who were diagnosed as either mild cognitive  impairment or cognitively normal, were followed for cortisol levels, ratings of the amount of stress of lifetime events, and changes in  independent psychiatric diagnoses. The authors concluded that  prolonged highly stressful experiences can accelerate cognitive  decline in people with aging, already susceptible brains. However,  cortisol measures were not associated with decline or change in diagnosis. (Peavy, Jacobson, et al. 2012.)

2. In another study with mice, it was found that high levels of stress  hormones are linked to higher levels of tau and amyloid precursor  protein, which is linked to Alzheimer’s.

3. The importance of highly stressful experiences and prolonged  highly stressful experiences seem to be a repeating finding. One thing is well known: highly stressful experiences can age the brain more  quickly than is typical in the passage of the same amount of time.  Defining a “highly stressful experience” are things such as being fired after age 50 when it is much harder to find another job. Another  experience that rates as highly stressful would be a financial crisis.  One study of over a thousand participants found that each stressful  experience aged the brain by 4 years. One implication from this  finding is that there is most likely a cumulative effect of stress and each stressful event could increase the risk of dementia. The study’s  authors argued that this cumulative hypothesis may help explain why  African-Americans, who tend to face higher rates of stress, have  higher rates of dementia.

The risk of chronic stress increasing one’s risk of dementia becomes a greater concern for people for whom dementia runs in their family. It  is important for all of us to help pass the message that stress is  something you can have significant control over. If people will wake  up to the importance of reducing stress on a regular basis and become more aware of their states of mind, they should be able to  reduce the risk of dementia by regularly reducing their stress.

That is what Dr. Peta Stapleton on Bond University in Australia found1 when she replicated  Dawson Church’s 2012 cortisol study.1 In the original study, Church et al examined salivary  cortisol levels in 83 subjects who were randomly assigned to either an emotional freedom  technique (EFT) group, a psychotherapy group (SL for Sympathetic Listening) or a no  treatment group (NT). The EFT group had a 50-minute session of tapping with a certified EFT coach. The NT group waited 50 minutes in the waiting room and the SL group had a 50-minute session with a licensed therapist. Cortisol was assayed just before and 30 minutes after an intervention. Emotional distress was assessed using the Symptom Assessment-45 to measure  the subject’s level of anxiety and depression. The EFT group measured a significant decrease  (p<0.03) in mean cortisol level (-24.39%) compared to a decrease of -14.25% in the SI group and  -14.44% in the NT group.

Dr. Stapleton replicated the original Church study almost exactly. However, her results were  even more dramatic. The EFT group reduced cortisol after 1 hour of EFT by 43%. There were 53  subjects in this study randomly assigned to one of the three groups. The Symptom Assessment-45 was again used to assess psychological distress. Salivary cortisol assessment  was performed 30 minutes before the intervention and 30 minutes after.

Cortisol is considered to be an important biological marker of stress. EFT or acupoint  stimulation is shown to be an effective method to reduce stressrelated cortisol in a person. In  an experimental situation, this is “interesting” and often that is all that happens with a reader  who has an interest in stress reduction. In a real life situation, however, where someone has a  history of not dealing well with stress, finding a short, easy to apply method that reliably  reduces the amount of cortisol circulating in their body, the importance cannot be over-stated.

Creating a list of people who have a history of “not dealing well with stress” is an important  first step. These are people who for some reason tend to hold the stress producing situation in their minds and continue to think about it, such as people who are more likely to have anxiety  disorders like GAD or PTSD. The list should also include people who because of their physical  condition, such as being pregnant, do not want to maintain high levels of cortisol in their  blood.

An important second step as clinicians is for us to introduce them to various techniques to  help them reduce their stress related cortisol. The Tapping Solution is possibly NOT the best  technique. That remains to be seen. However, it is surely experimentally proven to reliably reduce cortisol and it is easy to do.

It might make a good tool for your therapy box if you see and treat people with anxiety.

_______
1. Stapleton, P., Crighton, G., Sabot, D., and O’Neill, H.M. (2020). Reexamining the effect of   motional freedom techniques on stress biochemistry: A randomized controlled trial. Psychol  Trauma.doi: 10.1037/tra0000563 (epub ahead of print.)
2. Church, Dawson, Yount, G., and Brooks, A.J. (2012). The effect of emotional freedom  techniques on stress biochemistry: A randomized controlled trial. J Nerv Ment Dis., 10, 891-6.

How Wild Animals Cope with Stress

Humans are not the only animals that suffer from an overload of stress. Animals from our pets to lizards and songbirds to wild beasts can experience stressful and challenging situations that actually can have long-lasting impacts of them. Just as young children can have lifelong consequences from Early Life Stress (ELS), so can a rare Colorado checkered whiptail lizard stress eat in response to noise. In fact, the similarities to humans includes passing on  trauma to the next generation. Just as pregnant mothers who are super- stressed and anxious during pregnancy can affect the performance of their offspring (generational trauma), the same passing of the trauma has been identified in some species, like small fresh water fish.

Many of us overeat to  stress. Or, we drink too much coffee. Or, maybe we drink too much of other substances that are bad for our health. Some of us have developed life threatening habits, like smoking, and the response to increase stress is to light up.

A new study involving the rare Colorado checkered whiptail lizard discovered that part of their habitat is an army base. Low flying aircraft regularly fly in and out of the base producing sounds that are much louder than the lizards experience naturally and the result is almost continuing stress for the species.  The study took blood from some of the lizards and found that during flyovers they released more cortisol – yes, our old friend, Cortisol – and they ate more and moved less.

Sleep is important for all animals, human and non-human. Sleep deprivation is a definite form of stress. The effects of sleep deprivation on animals is actually studied even in fruit flies and bees. Fruit flies, for instance, sleep less and eat more when subjected to social isolation. Sleep deprived mice eat more.  Butterflies who don’t get enough rest/sleep have been known to even lay their eggs on the wrong types of plants. And, some bee species who are sleep deprived perform their waggle dances with less precision. The “waggle dance” of a bee is their equivalent of a GPS. So a sleep deprived bee who is supposed to be communicating with the rest of the hive as to the direction of food could be off in the directions they are giving the others.

It is not just sleep deprivation or too much noise or too much heat or rain that can cause stress in animals. The presence of predators obviously makes animals nervous. And, that goes for most humans, too.

10 Stress-Free Minutes a Day Keeps the Doctor Away

It is true that most of us cannot avoid stress, especially if we want to continue to be an active participant in the world. Stress goes with the territory of juggling a career, a family, and a social life. Most of us understand only too well the dangers of continuing to schedule full days, of adding new projects to an already overlong list, and still trying to find some time for ourselves at the end of the day. We routinely overbook ourselves. Some of us have the grace to promise to do better next week and might even believe that we can make it up later. But, can we?

Chronic stress is now linked to so many problems related to illness, chronic health problems, anxiety, loss of memory, and reduced longevity that it would take the rest of this column to simply list all the ways it affects our lives.

We know, for example, that the things we think about and dwell on can have a direct effect on how much cortisol, or stress hormone, is produced in our body. Keeping the cortisol down has become a new goal for the health conscious. Researchers from the University of California, Davis have published findings from a long-term study, called the Shamatha Project, that studied how meditation influences the brain and mental health. The article, published in the journal Health Psychology, reports that meditation, and particularly mindfulness training, helps lower stress and cortisol levels, which in turn can help you lose excess weight and avoid developing “cortisol belly.”

It’s time to draw a line in the sand and start reducing stress and cortisol. What I am proposing is not perfect, but it is a start that you can build on. If you keep waiting until you have the time, or until you can do it “right,” it could be too late. Stop letting your calendar manage you. Don’t try” to do better. As Yoda says, “Do or Do Not!”

Begin Your 10 Stress-Free Minutes Today

You might think that 10 minutes a day is not much help. But it is. A few minutes goes a long way toward recharging your energy and breaking up your resistance to taking breaks. You can gradually add more mental “down time” and physical relaxation to each day.

Get started by making yourself push away from your desk or daily routine for 10 minutes. Take this break with the intention of taking a brief mental holiday; give your mind a rest. Why not begin with 10 minutes of Mindfulness? Or, spend 10 minutes in focused breathing (with longer  exhale). Add some music or put your feet up, close your eyes and direct your favorite piece of music.

Remind yourself to do this daily by putting the reminder into your smart phone.

And, by the way, those of you who work with stressed-out clients, I have found that many seriously stressed patients are so overwhelmed that they cannot even begin to think about how they can reduce their stress.

The above suggestion that they start with just 10 minutes a day has helped many people start adding relief to their day. Once they begin, the time can be gradually increased.

Psychology tells us that making a conscious choice with commitment is a powerful tool.

Do as I say AND as I do.

Early Life Stress Can Affect Brain Development and Mental Health

Early Life Stress (ELS) is defined as the exposure to a single or to multiple events during childhood that exceed the child’s coping mechanisms and leads to extended periods of stress,  such that the child’s innate ability to recover from the body’s response to the stress is  overwhelmed. Childhood stressors include abuses of all kinds, neglect, hunger, witnessing  violence and other household dysfunction. Unfortunately, poverty, parent divorce, illness,  death, and substance abuse are counted as ELS and so many children are subjected to those. A clear estimate of how many children experience ELS has been hard to gather. One study in 2007 estimated that 3.5 million or 22.5% of all children in this country came to the attention of  child protection services. And we all know how low the true rate of disclosure is.

ELS is a devastating fact of life and one that can have long-term consequences. Little has been  done to fashion early intervention programs that can be helpful in preventing and treating ELS.  One of the most helpful ways to begin to develop such treatments is to more fully understand  what Early Life Stress can do to children as they grow into adults.

Cognitive or brain-related consequence of such stress need to be better known. One report  indicated that nearly 32 percent of adult psychiatric disorders are due to Early Life Stress.  Various forms of early adversity account for about 67 percent of risk for suicide. Exposure to  multiple episodes of ESs can significantly increase the risk of mental illness and disease. Sexual abuse between the ages of 9 and 14 has been linked to smaller hippocampal volumes and  prefrontal cortex dysfunction.

Since the early 1990s, a large body of work has focused on the impact of chronic stress in  pregnant women on the developing child’s brain. A strong relationship has been identified  showing that chronic stress during pregnancy can lead to an inability for the child and later  adult to cope with even normal stressors. Many children come into the world at risk of learning  disabilities, attention problems and high levels of anxiety because their mothers were super-stressed and did not recognize how their stress levels might change the way their baby’s brain developed. Exactly how chronic stress during pregnancy affects cognitive functioning and  emotional well-being in the developing child through specific neurobiological pathways is still poorly understood.

However, the importance of the connection between ELS and chronic stress in pregnant women and the subsequent impact on their children in the form of a life-long impact on their  intelligence, memory, executive function, and emotional IQ needs to be broadly disseminated in the hope of future prevention through education.

 How to Be Happier and Live Longer

After nearly 80 years of longitudinal study, the Harvard-Grant Study has proved that embracing one’s community helps us live longer with less stress and be happier. This study began in 1938 tracking the health and long-term success and happiness of 268 Harvard sophomores (all white males at the start, in the classes of 1942, 1943, & 1944). The study was funded to answer the question of what makes us happy and to identify predictors of healthy aging. Recognizing the limitations of the initial cohort, a second cohort of 456 disadvantaged, non-delinquent, inner-city male youths in Boston was started and termed, the Glueck Study. Today, the men continue to be evaluated every two years using questionnaires, information from their physicians, and personal interviews. Several books have been written with the findings. Among the most notable Grant Study participants is former President John F. Kennedy.

The main conclusion of this 80-year study is that the warmth of relationships throughout life has the greatest impact on life satisfaction. The team psychiatrist of the study was Dr.  George Vaillant. Dr. Vaillant framed the main conclusion this way: “Happiness is love. Full stop.” He pointed out that when the study began in 1938 no one cared about empathy or attachment. Now, “the key to healthy aging and life happiness is relationships, relationships, relationships.” Good relationships protect our bodies and our brains. The current principal investigator, Robert Waldinger, said, “Loneliness kills. It’s as powerful as smoking or alcoholism.” Good marital partners help each other reduce stress. Good relationships, the data indicate, are what keep people happy throughout their lives and are correlated with longevity.

Along the same point of the power of relationships is the finding that financial success also depends on the warmth of a person’s relationships – not on intelligence or hard work.  People who are able to generate good relationships are people with strong emotional intelligence. It turns out that emotional intelligence is much more highly correlated with personal and professional success than IQ. Further, emotional intelligence skills are learnable and measurable. Empathy, self-awareness, and impulse control are relationship skills, and the people who have them tend to form strong bonds with others.

It was also found by analyzing the masses of data collected over the years that alcoholism is a disorder of great destructive power and it is the main cause of divorce between the Grant Study men and their wives. Further, it is possible to say that alcoholism plus cigarette smoking is the single greatest contributor to early death of the study participants.

Waldinger says that these findings have changed his own behavior: “it’s easy to get isolated, to get caught up in work and not remembering, ‘Oh, I haven’t seen these friends in a long time.’” So, Waldinger said, “I try to pay more attention to my relationships than I used to.”

Stress Can Increase Your Risk of Mortality

Researchers at King’s College London examined data on the effects of stress on mortality  (Hotopf, Henderson, & Kuh, 2008). The subjects self-reported their stress levels. The chilling finding was a strong association between higher levels of self-reported stress and all causes of  death. Stress can affect the body in so many different ways that finding the means by which  stress leads to death at earlier ages is complicated.

Nonetheless, one important connection needs to be examined. Research on telomeres may  hold an answer. Telomeres are distinctive structures at the ends of our chromosomes. They are  sections of DNA. The form like a cap, much like a plastic tip on shoelaces, that works to protect  the chromosome. The telomeres allow the chromosomes to be replicated in cell division. Every  time a cell carries out DNA replication, the telomeres are shortened. As we age, telomeres get  shorter. They play a major role in cancer as well as in aging.

Oxidative stress, such as diet, smoking, and stress, make telomeres shorter, too. Many studies  have now demonstrated links between chronic stress and higher oxidative stress. In addition,  the chronic stress is associated with lower telomerase activity and shorter telomere length.  Shorter telomere length is associated with advanced aging of the body. When a telomere gets  too short, after many replications and possibly increased oxidative stress, it reaches a ‘critical  length’ and can no longer be replicated, triggering the cell to die.

Newborn babies usually have long telomeres. Telomeres get shorter as we age. There are ways  that have been found to increase the length of existing telomeres or reduce the shortening  effects of stress. Obviously, avoiding chronic stress is one way to reduce or slow down the  shortening of the telomeres. However, one of the ways that many people choose to deal with  stress has been shown to be highly effective at actually lengthening telomeres. Aerobic exercise  lengthens telomeres and reduces stress according to several studies (Puterman et al,  2018). In the Puterman study, high stress caregivers completed 40 minutes of aerobic exercise  3-5 times a week for 24 weeks.

Aerobic exercise is an excellent way to reduce built-up muscle stiffness from sitting at your  computer all day working. “Working” may not seem like stress to some, but if working means  thinking, then it is definitely stress. At the end of each day, the built up stress should be reduced and aerobic exercise is a good way to do it. Apparently, there is an added benefit of  increasing your chances of living a longer, happier, and more productive life.

Healing the Healers: Stress Among Psychotherapists

Surely, there is no real argument that mental health providers have job stress. This topic has been explored in numerous countries, including Great Britain, India, Spain, and Japan, to name a few. The Japanese Occupational Health department even developed a Brief Job Stress Questionnaire. Unfortunately, it is only available in Japanese.

The British studies by the British Psychological Society (BPS) did a study by survey in 2015. The findings were that 46 percent of psychologists surveyed reported that they experienced a depressed mood and 70 percent said that they found their jobs stressful. Many listed over-work as a primary factor in their burnout.

A study from a state in midwestern USA published by Deutsch, CJ in Professional Psychology: Research and Practice (1984) surveyed 264 therapists about the amount and sources of their stress. The therapists completed a questionnaire on background
information, their beliefs, and a 36-item stress scale. What they found was that irrational beliefs and attitudes held by mental health providers lie at the center of their reported job stress.

The irrational beliefs uncovered are very interesting and can provide a basis for all psychologists and/or mental health providers to explore their own systems of beliefs. So, to that end, I list a few irrational beliefs for further contemplation.

1. One should operate at peak efficiency and peak competence with all clients and at all times.
2. If a client does not get better or terminates prematurely, it is the therapist’s fault for not doing a better job of engaging the client.
3. A good psychotherapist is not likely to get “burnout” because a good therapist is emotionally well-balanced and can manage their own emotions and stress. So, if the therapist becomes “burned out,” it must mean that that person is not a good therapist and is not well adjusted after all.
4. It is an embarrassment for a therapist to seek therapy for themselves.

Just How Stressed Are We Really About Covid?

There seems to be a lot of talk about the “stress” of this 14 to 15-month long pandemic. And, yes, it has caused a lot of inconvenience. It has forced us to stop doing many of the things that make life fun, like visiting with friends and travelling to see family. And, most of us are bored by having to continue to observe all the safety precautions. However, inconvenience and boredom are not really the same as “stress” that has measurable and observable physiological and emotional effects on our bodies and minds.

One way to describe stress could be that state in which our worries, fears, anxieties or simply thinking (targeted mental activity) causes our bodies to produce cortisol and other stress hormones, which can cause physical damage if that state becomes chronic. In other words, true stress comes from the type of mental activity that activates our Sympathetic Nervous System, in particular the “fight or flight” mechanism. It becomes “stress” when our Autonomic Nervous System’s Parasympathetic Nervous System loses its ability to balance or cancel the Sympathetic Nervous System and put the ANS into a state of rest. That occurs when a person is chronically worrying and/or thinking and rarely engages the Parasympathetic Nervous System to rest or unwind. 

Is that happening to most of us because of Covid? Yes, it is for some but perhaps not for all of the humans in the world. Some people who have lost loved ones or friends are likely experiencing bereavement and grief, maybe even deepening into a depression. Others are experiencing isolation, particularly if they live alone and are trying to remain apart from others for fear of catching the disease. The loneliness and inability to talk about our anxieties and fears with others can mushroom into a true physiological stress reaction. Others may have lost their jobs or found their income cut. Fear for personal safety and worry about finances are definite causes of stress.

The CDC has posted information on the ways that the stress of the pandemic is affecting people’s lives. CDC is recommending that people learn to cope with stress in healthy ways, like taking breaks from watching TV news and iPhone information about the pandemic, much of which is anxiety producing. They recommend reaching out by phone and other means, like Zoom, to talk to friends, family and others. And, most of all, take time to unwind, doing things that work for you, like exercising, meditating, listening to music.

Learning to cope with stress in a healthy way will make you and those around you become more resilient.

Healing the Healers: Stress Among Psychotherapists

Surely, there is no real argument that mental health providers have job stress. This topic has been explored in numerous countries, including Great Britain, India, Spain, and Japan, to name a few. The Japanese Occupational Health department even developed a Brief Job Stress Questionnaire. Unfortunately, it is only available in Japanese.

The British studies by the British Psychological Society (BPS) did a study by survey in 2015. The findings were that 46 percent of psychologists surveyed reported that they experienced a depressed mood and 70 percent said that they found their jobs stressful. Many listed over-work as a primary factor in their burnout.

A study from a state in midwestern USA published by Deutsch, CJ in Professional Psychology: Research and Practice (1984) surveyed 264 therapists about the amount and sources of their stress. The therapists completed a questionnaire on background
information, their beliefs, and a 36-item stress scale. What they found was that irrational beliefs and attitudes held by mental health providers lie at the center of their reported job stress.

The irrational beliefs uncovered are very interesting and can provide a basis for all psychologists and/or mental health providers to explore their own systems of beliefs. So, to that end, I list a few irrational beliefs for further contemplation.

1. One should operate at peak efficiency and peak competence with all clients and at all times.
2. If a client does not get better or terminates prematurely, it is the therapist’s fault for not doing a better job of engaging the client.
3. A good psychotherapist is not likely to get “burnout” because a good therapist is emotionally well-balanced and can manage their own emotions and stress. So, if the therapist becomes “burned out,” it must mean that that person is not a good therapist and is not well adjusted after all.
4. It is an embarrassment for a therapist to seek therapy for themselves.

2020: A Year of Stress (Solutions) in Review

How to Reduce Your Risk of Alzheimer’s Dementia

Stress and anxiety have been linked to possible risk of dementia for a number of
years now. Animal and some human studies have examined brain areas affected
by chronic anxiety, fear and stress, using neuroimaging and stress and fear
conditioning with animals. We now know that there is a “see-saw” relationship
between the amygdala and the prefrontal cortex (PFC) in which an overactive
amygdala (due to fear, anxiety and chronic stress), is associated with an
underactive PFC (thinking areas of the brain that regulate emotional responses).
Further, chronic stress can cause the hippocampus to atrophy. Since that brain
area is important to long-term memory there is an obvious relationship with
dementia and chronic stress.

While this relationship has been known, clinical practice has not placed much
focus on preventing chronic stress in order to reduce the risk of dementia. An
October 2020 presentation by Dr. David Bennett at the National Academy of
Neuropsychology (NAN) may change that. Dr. Bennett is the Director of Rush
Alzheimer’s Disease Center at Rusk University Medical Center in Chicago. Dr.
Bennett spoke about early results of 2 very important longitudinal studies
involving participants of religious orders, called the Religious Orders Study and
the Rush Memory and Aging Project. The Religious Orders Study participants are
1500 older nuns, priests, and brothers without known dementia from across the
US who have agreed to annual clinical evaluation and to brain donation. The
project began in 1993; approximately 375 have developed dementia. Over 600
have developed MCI and over 825 brain autopsies have been performed to date.
The Rush Memory and Aging Project began in 1997 and include 2,200 residents
from the Chicago area who agreed to annual clinical evaluation and to donate
their bodies on death. Of that group to date, 375 developed dementia, 625 have
MCI and 925 autopsies have been performed.

Findings from 2 such large studies are immense and will be coming forward for
many years; however, Dr. Bennett’s talk provided a glimpse into prevention that
neatly fits the subject matter of this column. There is a continuum of cognitive
aging from cognitive decline to MCI to dementia. The brain pathology that relates
to changes in cognition are increasingly clear as the research continues around
the world. However, the Rush studies have made a discovery that will allow
people to better maintain cognitive health in old age.

Much of late life cognitive decline is not due to common neurodegenerative
pathologies (brain atrophy, infarctions, NP, NFT, NIA-Reagan, PHFtau temp, and
amyloid, etc.); only 41 % of the variance is explained. In other words, most brains
of elderly people show common neurodegenerative pathologies even though they
do not always have the same degree of cognitive decline (MCI to dementia). The
question became what else contributes to cognitive decline? All participants
were adjusted for age at baseline and for sex. The following variables were
studied: education, early life instruction in foreign language and music, emotional
neglect in childhood, depression, purpose in life, social isolation, social activity,
social networks (number of children, relatives, friends they saw each month and
felt close enough to talk about private matters or call upon for help), tendency to
avoid harm, avoid new situations, chronic distress, anxiety, size of one’s life
space (from 1 bedroom to travel outside of town), and diet. Those that stood out
as lowering the risk of dementia are well summed up in Dr. Bennett’s final
recommendations on how to build a better brain as we age. (Bennett DA.
Scientific American. Special Collector’s Edition. 2017; Summer: 85-91.)

1. Pick your parents well! Make sure you get good genes, a good education, a
   second language and music lessons. Avoid emotional neglect.
2. Engage in regular cognitive and physical activity.
3. Strengthen and maintain social ties.
4. Get out and explore new things.
5. Chillax and be happy.
6. Avoid people who are downers, especially close family members!
7. Be conscientious and diligent.
8. Spend time engaged in activities that are meaningful and goal-directed.
9. Be heart-healthy: what’s good for the heart is good for the brain.
10. Eat a MIND diet, (Mediterranean-DASH Intervention for Neurodegenerative
    Delay diet) with fresh fruit and vegetables and fish.
11. Be lucky!