你好，朋友们，我是Dennis医生。
很高兴在这里与大家相遇，感谢你阅读这一系列关于痴呆症，特别是阿尔茨海默病的博客。 请从第一篇开始阅读，这样会更有逻辑性。
在本篇博客中，我们将继续探讨Bredesen 7方法论的其余部分：运动、压力管理、睡眠调节和大脑刺激训练。你可能会想，又来了，又是这些老生常谈的话题，我们不是已经听够了吗？让我们先引用一位不需要介绍的著名艺术家的名言！
“我总是在做那些我不会做的事情，这样我就能学会如何去做。” 或许，我们可以应用这个思维方式，重新学习如何正确地运动，了解哪些运动对记忆衰退有益，为什么睡眠如此重要，以及如何不依赖安眠药入睡，了解哪种大脑刺激训练或相关项目经过科学验证确实有益，以及有哪些新的减压方式。 我希望你能理解我的观点，并愿意继续阅读，让我与大家分享我的知识。
图片 B 提供
D. 锻炼
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