1. How to Maintain Brain Health in Old Age
S. Duke Han, PhD, ABPP-CN
Director of Neuropsychology in Family Medicine
Associate Professor of Family Medicine,
Neurology, Psychology, and Gerontology
Keck School of Medicine of USC
University of Southern California
@sdukehan
Interprofessional Health Care Symposium
March 1, 2019

2. Brain Structure Changes As We Age

3. Raz et al., 2005

5. What can we do to maintain our brain health as we get older?
What information can we rely on about how we can do this?

6. Global Council on Brain Health
The Global Council on Brain Health (GCBH) is an independent collaborative of scientists, health professionals, scholars and policy experts from around the world working in areas of brain health related to human cognition.
The GCBH is convened by AARP with support from AgeUK to offer the best possible advice about what older adults can do to maintain their brain health.
GCBH members come together to discuss specific lifestyle issue areas that may impact peoples’ brain health as they age with the goal of providing evidence-based recommendations for people to consider incorporating into their lives.

10. Physical Activity Consensus
Physical activity has a positive impact on brain health
People can change their behavior to become more physically active at any age.
Based on randomized control trials, people who participate in purposeful exercise show beneficial changes in brain structure and function.
Based on epidemiological evidence, people who lead a physically active lifestyle have lower risk of cognitive decline.

12. Some Physical Activity Recommendations

14. Sleep Consensus
Sleep is essential to overall mental and physical health and well-being.
There are changes to sleep as people age.
People, at any change, can change their behavior to improve sleep.
Persistent, excessive sleepiness is not a normal part of aging.
People with chronic inadequate sleep are at higher risk for dementia, depression, heart disease, [and other medical conditions].

15. Some Sleep Recommendations

17. Social Engagement Consensus
Social engagement is interacting with others, feeling connected to other people, doing purposeful activities with others and/or maintaining meaningful social relationships.
Social connections vary by their structure, function and qualit), and these differences affect the outcomes of social engagement on brain health
The weight of evidence suggests that social engagement helps maintain thinking skills and slows cognitive decline in later life.

18. Some Social Engagement Recommendations

20. Cognitive Activity Consensus
Cognitively stimulating activities over the life course, such as engaging in formal or self-initiated informal educational activities, continuing to engage in work experiences, learning a new skill, or engaging in leisure activities that are mentally challenging, provide benefits for adults’ brain health.
Most commercial products marketed as “brain games” are not what the GCBH means when discussing the benefits of cognitive training. If people play a “brain game,” they may get better at that game, but improvements in game performance have not yet been shown to convincingly result in improvements in people’s daily cognitive abilities. There is insufficient evidence that improvements in game performance will improve people’s overall functioning in everyday life.

21. Some Cognitive Activity Recommendations

23. Diet Consensus
Long-term healthy eating habits promote good brain health.
The typical, contemporary Western diet (high in salt, sugar, excess calories, and saturated fats) is not good for the brain. See a discussion of healthy diets including the Mediterranean diet, the DASH diet, the MIND diet and the Nordic diet [in the statement].
No single food acts as a silver bullet for improving or maintaining brain health. The combination of different types of food and nutrients together in our diets likely determines health benefits.

24. Some Diet Recommendations

26. Mental Well-Being Consensus
Experiencing the full range of emotions is part of the human experience, but too much negative emotion and stress (e.g., situations which exceed your capabilities and are not within your control) is bad for both mental well-being and cognitive health.
Greater mental well-being is associated with reduced dementia risks.
Regardless of how old you are, you can take steps to improve your mental well-being such as engaging in a purposeful activity (e.g., volunteering) and living a healthy lifestyle (e.g, regular exercise, eating a balanced diet).

27. Some Mental Well-Being Recommendations

28. [So what’s next for the GCBH?]
Conclusion
Many different factors impact brain health as we grow older.
There are proactive steps we can take to maintain our brain health as we age.
There is reliable information available about how to maintain brain health into old age.
[So what’s next for the GCBH?]

30. Acknowledgements UNIVERSITY OF SOUTHERN CALIFORNIA Laura Mosqueda, MD
Jehni Robinson, MD
Gali Weissberger, PhD
Caroline Nguyen, BS
Emanuil Parunakian
Jacqueline Chen
Morgan Goodman
CURRENT RESEARCH
FUNDING
NIA R01AG055430
National Institute for Justice
Elder Justice Foundation
Cathay Bank Foundation
USC Department of Family Medicine