Courtesy of 145 Thinking Quotes To Make You More Thoughtful
Hi friends, Dr Dennis here; nice to e-meet you here and thanks for reading this series of four on all things Dementia, particularly Alzheimer’s disease. Please read from the start, as it will make more sense.
In this blog, we will continue to explore the rest of the Bredesen 7 protocols: exercise, stress management, sleep regulation, and brain stimulation exercises. You may think, here we go again, go old topics, haven’t we heard enough? Let’s start with a famous quote by a renowned artist who needs no introduction! “I am always doing that which I cannot do so that I may learn how to do it”. Perhaps we can apply to re-learn how to exercise probably, the different types of exercise that are beneficial to failing memory, why are sleep essential and how to fall asleep without the need to take sleeping pills, what type of brain-stimulating games or programs that are proven to be beneficial and new ways of reducing stress. I hope you see my points here and will stick around with me a little longer so I can share my knowledge with you.
D. EXERCISE
First thing first, exercise is NOT doing housework! Of all the seven protocols, exercise has the most scientific evidence! To be more specific, cardio exercises (1). One of the many scientific pieces of evidence of cardio exercise is that it increases hippocampal volume! What is a Hippocampus? Please refer to blog 3, series one. Another review (2) suggests that physical exercise benefits all stages of the lifespan; it may enhance cognition and other neurodegenerative disease such as Alzheimer’s and Parkinson’s disease. Aerobic exercise improves cerebral blood flow, increases Brain-derived growth factor (BDNF), preserves cortical (outer layer) thickness, improves the lymphatic (glymphatic) drainage system of the brain, etc. Be innovative and look for ways to stay active! Sitting is a type of new smoking! Thirty minutes of walking is all required. What’s the procrastination? Get up! Just do it (not advocating for the Nike brand 😊)!
E. SLEEP REGULATION
Friends, it is indisputable that sleep (sustainable, seven hours) is good for our health, including brain health (3). It helps directly by allowing the lymphatic system (glymphatic) (4) to clear the byproducts of metabolism, including beta-amyloid fragments, consolidate memory through the REM (rapid eye movement) period, improve memory, etc. Inadequate sleep has been linked to most vascular diseases, diabetes (in general, metabolic health), and heightened inflammatory response, which lead to poor brain health. Obstructive Sleep Apnoea (? one of the potential risk factors for divorce! I have just made that up!) has emerged (not conclusively) as one of the risk factors for developing Alzheimer’s (5). Sleep problems are a global epidemic. One international survey in 2008 estimated that the prevalence of sleeping problems was 56% in the United States, 31% in Western Europe, and 23% in Japan (6). These are reported diagnoses. The real extent of sleep disorders is not known. We will undoubtedly hone in on this topic in our later series.
F. STRESS MANAGEMENT
Friends, I am sure you have heard the term “fight-or-flight.” It turns out that this is a vital survival mechanism, enabling people and other mammals to react quickly to life-threatening situations. The carefully orchestrated yet near-instantaneous sequence of hormonal changes and physiological responses helps someone fight the threat or flee to safety (direct quote, LeWine, HE., 2024) (7). However, relentless or long-term stimulation from triggers will lead to ill health effects from exposure to elevated stress hormones. Unresolved stress will lead to ill health effects, just like those with deprived sleep. One of the potential solutions is to practice mindfulness. Mindfulness is a practice technique to retrain and tame our sometimes “wondering” and “wilful” minds to refocus on the now. This technique can be practised during walking, cooking and other daily activities. Meditation is also another technique we can call upon in times of stress. Friends, we will explore this in more detail in future blogs.
G. STIMULATION – COGNITIVE STIMULATION THERAPY (CST)
CST has been advocated in the management of early Alzheimer’s disease as a routine therapy for more than two decades ago (World Alzheimer’s Report, 2011). Systemic reviews and meta-analysis (8)
Also found, combining cholinesterase inhibitors with CST may work in reducing neuropsychiatric symptoms. Unlike exercise, which has a definitive impact on neuroplasticity, how CST works on cognition is unknown. So, the jury is still out (for now)!
What are the main take-home messages?
- The positive effect of exercise has been most extensively documented, and both cardio and lower limb strengthening have edged out compared to other exercises.
- A seven-hour sleep, preferably sustainable and uninterrupted, will help our brain process and store information and excrete toxic byproducts and beta-amyloids.
- Stress management through meditation and mindfulness practice will help to reduce the unwanted effect of chronically elevated hormones, like noradrenaline and inflammatory molecules, which are toxic to the neurons.
- CST does have a role in improving and promoting a healthy brain, but the jury is still out as there are many confounding factors.
Friends, there is much more emerging evidence about the potential reversibility of Alzheimer’s in some and prevention in ALL! This is the end of series four, and if you have followed my blogs from week one, thank you for your support.
References
- Exercise and the Brain: The Neuroscience of Fitness Explored – Neuroscience News
- A Life-Long Approach to Physical Activity for Brain Health – PMC
- The effects of insufficient sleep and adequate sleep on cognitive function in healthy adults – Sleep Health: Journal of the National Sleep Foundation
- The Sleeping Brain: Harnessing the Power of the Glymphatic System through Lifestyle Choices – PMC
- Association Between Obstructive Sleep Apnea, Its Treatment, and Alzheimer’s Disease: Systematic Mini-Review – PMC
- Sleep disorders are an overlooked risk factor for non-communicable diseases | The BMJ
- Understanding the stress response – Harvard Health
- Different durations of cognitive stimulation therapy for Alzheimer’s disease: a systematic review and meta-analysis – PMC