Healthy Aging: Building a Better Brain

Building a Better Brain

Karen Koffler, M.D. Director of Functional Medicine, Rezilir Health

Team Rezilir

1 Help you appreciate your brain

2 Help you understand conundrum of demen5a

3 Help you to appreciate that we can improve brain func5on

What I hope to accomplish

Understanding our most complex organ

As a fetus, a trillion neurons are produced 100 billion neurons remain 100 trillion connections As we age, we lose 7 milliseconds per decade from age 20 We become slower Misjudge distances

“Mild cognitive impairment� is loss of brain speed and we all experience it Many of us see this showing up in our 40s

A single neuron can have 100,000 dendrites

A Quick Tour: Baby’s Brain

Ages 1-3: baby’s brain has 2x number of neurons, connections vs. adults • Faster loss if not touched • Cortisol plays a major role Neglect/abuse has the same effect in dropping IQ Memory storage starts as early as 2

Adolescent Brain “All anybody expects of an adolescent is that he acts like an adult and be satisfied to be treated like a child.”

Burst of connections between ages 6-12: learning is accelerated Between puberty and 25, neurons are pruned The more we learn, the less neuronal loss The more we practice, the thicker the white matter

Adolescent Brain

Growth begins in the rear of the brain nd moves forward • Sensory cortex is first to develop • Prefrontal cortex is last to develop (executive center) nformation tends to be processed more in the amygdala (emotional enter) vs frontal lobe in adults rationality)

Brain changes with age:

% volume loss over time • Men lose more mass than women • Especially left hemisphere (language) • 2 oz drop brain weight in women at menopause

eaction time doubles from age 20 to 60

e get less efficient at retrieval

3 of those over 70 will have memory issues that impair day-to-

y life (without being diagnosed with Alzheimer’s)

Brain Changes With Age (the upside)

Brain keeps growing in the temporal lobe and frontal

lobe • emotional development and wisdom • moral decision-making • regulation of emotions • reading social situations • We also are better at remembering positive images vs. negative ones

Is there a difference between men’s and women’s brains?

• Corpus callosum is bigger in women • Men have 6x more gray matter (nerve cells) • Women have 10x more white matter (connections) • Men have larger parietal lobes: space & perception • Women have larger limbic system: regulation of emotions

Is there a difference between men’s and women’s brains?

Men and women access different parts of brain while performing tasks • Listening to a story activates left hemiphere in men; both hemispheres in women • Navigation involves cerebral cortex in women, hippocampus in men Women are faster and more accurate in identifying emotions

Is there a difference between men’s and women’s brains?

• Women diagnosed more often with anxiety and depression • Men diagnosed more often with autism, Tourette’s, dyslexia and schizophrenia • Girls diagnosed with ADHD show more inattention; boys show reduced impulse control

Differences between male and female brains: plasticity

Men store more information in visual-spatial dimension • Pilots, architects, engineers

However, environmental input for women can drive the same capacity

Is there a difference between men’s and women’s brains?

• IQs are the same • Rates of development of different areas are different: • Boys are superior in math and geometry; these areas matu about 4 years prior to girls • girls may get frustrated and give up • Studies of male and female soccer players show similar spati abilities Brain is influenced by biology and environment Differences may be complementary, support survival of the specie

“I am having a senior moment”

• When we forget something at a certain age, we become concerned • Memories may be there, decreased speed of retrieval • The issue of attention

30 million with Alzheimer’s

By 2050, there will be 160,000,000

Currently, 1 in 9 adults over 65 has Alzheimer’s

Not all forgetting is Alzheimer’s: Types of Dementia

What you might notice

Forgetfulness Inability to recognize common objects. May get lost in a familiar place. Store things in unusual locations Comprehension: Challenged by following a conversation Coordination: Reach for an item and miss it. Difficulty navigating.

Inability to perform complex routine tasks

Ways to differentiate…

More than just memory is perturbed New learning is impaired Must be a clear decline from previous level of functioning

Rudy Tanzi, PhD. Dale Bredesen, M.D.

Dale Bredesen, M.D., Buck Institute “Most of the causes of Alzheimer’s Disease are related to lifestyle factors”

Drugs to treat Alzheimer’s has been abysmal 243/244 drug trials have failed

My approach to improving brain health

hat we explore when optimizing brain alth:

ne6cs: ApoE4, MTHFR xins uma ec6ons amma6on ood

• Nutrients • Hormones • Exercise • Stress • Sleep

at are we doing to contribute to the s of brain function?

cohol: up to 60,000/d urons lost in heavy drinkers • Inac6vity • Hypertension edica6ons

ronary Artery Disease

ec6ons

sence of a s6mula6ng rtner or environment

flexible personality style

• Malnutri6on • Depression • Diabetes • Smoking • Stress

Food and your Brain

Diet • Cornerstone of Prevention: Antiinflammatory Diet • Plant-based • Minimize carbohydrates • No gluten • No processed food

Cut Out The Sugar!!!!

Grain Brain

• Concern for gluten and gut inflammation • Gut inflammation has a negative impact on brain function

Role of Omega 3 Fats

Principal brain fatty acid is DHA We know that low blood levels of DHA is a risk factor for dementia • Studies show lower level of DHA in demented and impaired patients vs. controls (Lipids 2000 Dec;35(12):1305-12.)

Let thy food be thy medicine‌

Other Foods Rich in Omega 3

Walnuts, pumpkin seeds, hazelnuts, almonds Venison, buffalo Green leafy vegetables Chia seeds

Energy Prevent plaque

Calorie Restriction

Takeaways on food and brain health

Plant-based diet Organic No sugar; fruit is ok Healthy fats and plenty of them Timing is important Cease overeating

Supplements: specific to improve cellular function

Use of Vitamin E By Patients With Mild to Moderate Alzheimer Disease Slows Decline

Food sources of vitamin E

•  400iu mixed tocopherols

Many nutrients have been studied and found to be helpful:

cetyl-l-carnitine -acety-cysteine tocholine RF2 Activators vitamins agnesium

• Ashwaganda • Cat’s Claw • Bacopa • Vinpocetine • Huperizine • Maca • Tumeric

Hormone Replacement Therapy

Estradiol Pregnenolone Thyroid Testosterone Cortisol Dhea

OPTIMIZED

Exercise

Physical activity maintained throughout life is associated with lower incidence and of chronic diseases: cancer, diabetes and cardiovascular and coronary heart diseases Recent studies suggest that physical exercise also protects against dementia Non-negotiable Do not over train!

Exercise and he Brain

Exercise stimulates release of brainderived neurotropic factor BDNF stimulates the growth of new nerves and preserves existing ones

Why I Try to avoid surgery…

• “Post-operative cognitive dysfunction”: cognitive decline associated with anesthesia • Affects the elderly most • Worsened by mechanically-circulated blood (“bypass”) • Not sufficiently studied…

Toxic Exposures and the Brain

• In essence, we are all “fat heads” • Brain is composed of 60% fat!

• Worrisome considering at any one time, we are carrying more than 700 toxins (EPA)

Some of our more concerning toxic xposures: Plasticizers BPA and Phthlates

Mercury: effects on human health

• Depression • Difficulty concentrating • Fatigue • Fearfulness • Indecisiveness • Irritable • Memory changes

Tooth loss linked to mental decline • 3166 adults > 60 years old • Memory and walking speed evaluated • 10% decline in both if no longer possessed their own teeth

Medications can be helpful…and harmfu

Tylenol Sleep and anxiety medications Antidepressants Statins Beta blockers Narcotics Incontinence medications Antihistamines

Sleep • Deep sleep consolidates all your memories from the day • Deep sleep clears out the debris

Perception of stress activates hypothalamus Adrenals release cortisol: fight or flight Cortisol at persistently elevated levels damages the hippocampus New memory formation is mpaired

Anxiety and Brain Health

  Anxiety medications are associated with increased risk of dementia

How the Mind Affects the Body Which Affects the Mind Impact of cortisol: acute and chronic • Raises blood sugar, mobilizes fatty acids, protein breakdown from muscle • Antagonizes insulin • Increases blood pressure • Thickens blood to prevent loss • Inhibits immune function • Steals progesterone • Causes injury to hippocampus and pre-frontal cortex • Augments the amygdala

The good news: we can manipulate the brain

What neuroplasticity teaches us:

The brain changes its structure with every different activity performed If certain “parts” fail, other “parts” can take over And that thinking, learning, acting can turn on and off different genes!

What meditators teach us: • Increased grey matter (nerve cells) • Increase hippocampus (memory) • Increase prefrontal cortex (reasoning) • Reduce cortical thinning (age-related atrophy) • Improve attention • Improves mood • Strengthen immune function • Improve sleep

Why meditation is an essential part of our program:

Stress makes it harder to remember things Stress leads to anxiety, depression, and insomnia Meditation lowers stress and improves brain function and memory Meditation reduces anxiety and depression, both risk factors for Alzheimer’s Most studied meditation techniques include: a. The Relaxation Response – 20 min/ twice a day b. TM – 20 min/twice a day c. Mindfulness – 47 min average d. Kirtan Kriya (KK) – 12 min

What about Brain Gyms?

  No compelling evidence to date that computer-based brain gyms make a difference in reducing or reversing cognitive decline

Learning Something New is the Key

coming Expansive as We Age

se who explore, take on new challenges,

ment, retain greater brain capacity is a challenge for those of us “set in our ways�

the degree of brain usage as we age that determines our mental

acity

e demanding tasks recruit more tissue

The healing benefits of music‌..

How to protect your brain

member the basics: eat well, sleep well, move, relax propriate supplementation nimize unnecessary exposures estion your medications a life-long learner

karen.koffler@rezilirhealth.org