Have you ever walked into a room and forgotten why you were there? Diminished cognitive health—from this type of mild decline to more serious dementia—can have profound implications for overall health and well-being. Sustained brain health and enhanced lifelong learning are vital parts of aging and improve quality of life. Cognition, which includes mental processes such as intuition, judgment, language, remembering and the ability to learn new things, has a key role in wellness. Many neuroscientists are now convinced that the brain is capable of superior performance even into the 10th decade and beyond. If the brain remains healthy and free from disease, it can continue to function normally for as long as we live. According to Mahoney and Restak (1998), nerve cells should remain alive and able to maintain and form new connections and networks throughout life.
Aging and brain health is a topic of great interest as the older-adult population in the United States continues to grow. It is estimated that the number of Americans aged 55 and older will almost double between now and 2030—from 60 million (which is 21% of the total U.S. population) to 107.6 million (31% of the total population). Women who reach age 65 today have an average life expectancy of 83, while men who make it to 65 can anticipate living another 16 years, for an average life expectancy of 81 years (Experience Corps 2009).
Longer life expectancy brings with it the need for a healthy body and a healthy brain, to allow people to live full and productive lives. This article examines brain anatomy, function and disorders and suggests strategies and ideas that fitness professionals can use to help older-adult clients thrive in body and mind.
About the Brain
Approximately 90% of scientists’ knowledge of the brain comes from the past decade of research and study (Summerford 2009). Although the brain weighs only about 3 pounds and is approximately the size of your two fists joined together, it is responsible for approximately 20% of the body’s energy consumption. It uses about 8 gallons of blood per hour and needs about eight glasses of water per day. The major sources of energy for the brain are oxygen and glucose (Wolfe 2001). The brain is made up of about 78% water, 10% fat and 8% protein (Hardiman 2003).
This amazing and complex organ comprises specialized
regions that work closely together to make sense of the world. Taylor (2006) identifies the four regions and their functions:
- The frontal region is responsible for self-motivation and appropriateness of behavior. The frontal lobe is the brain’s “library,” where we store information. It is the brain’s “chief executive officer” (Madigan 2004) and is considered the home of our working memory.
- The parietal region integrates all sensory information. It is where our higher senses are processed, and it is responsible for auditory processing, meaning and language functions.
- The temporal region takes care of hearing, learning and memory.
- The occipital region is responsible for vision. It serves as the “movie screen” of the brain.
The prefrontal cortex is the conductor of the brain’s orchestra and our decision maker. It works closely with the brain’s “chief operating officer,” the cerebellum—which means “little brain” (Wolfe 2001)—where we store motor patterns, maintain body posture, coordinate muscle function and develop balance abilities. It is the birthplace of all learning. Ratey (2008) refers to the cerebellum as the “rhythm and blues center,” as it is involved in maintaining rhythm and continuity for many functions, such as emotions, memory, language and social interactions. The brain stem functions as the survival mechanism and coordinates automatic processes like heartbeat, respiration and blinking.
The hemispheres of the brain are separated by the corpus callosum. The brain is divided front to back by the motor cortex. All four quadrants need to communicate for optimum learning to occur. Cross-lateral movements (crossing the midline of the body) stimulate the four quadrants to communicate and organize brain processes (Madigan 2004). The hippocampus is part of the brain’s limbic system just above the brain stem. This is where new nerve cell growth occurs throughout life; it is the “campus” for new memory (Hannaford 1995). The hippocampus stores memories and creates meaning by comparing them to experiences stored in long-term memory. The information stored by the hippocampus is often moved to long-term memory in the brain’s cortex (LeDoux 1998).
Nussbaum (2006) identifies five critical domains in a brain-healthy lifestyle: physical activity; mental stimulation; diet; spirituality; and socialization. Small (2006) identifies four critical domains that improve brain health: physical activity; mental activity; healthy diet; and stress management. Both Nussbaum and Small emphasize three common critical domains: physical activity, mental stimulation and a healthy diet.
Stress and Lifelong Brain Health
Managing stress effectively is essential for overall health of the body and brain. Jensen (2006) provides a simplified look at how stress affects the body. Cells are either in a threat-distress mode, in which they are protecting themselves from danger, or in a growth mode. Cells cannot be under the attack of distress (think of running from a dog or fighting with a spouse) and at the same time grow and reproduce. Neurons will not communicate properly with other cells in distress. Stress damages neuronal networks just as a cut damages skin.
Neuronal dendrites, the branch-like extensions that carry information into the cell body of the neuron, can be reduced by 18%–32% when exposed to toxic stress. Consistent stress leads to the death of neurons. Cortisol, a stress hormone, damages the cells of the hippocampus, crippling the ability to learn and remember. The bottom line is that while stress responses play an essential role in protecting us under intense conditions, chronic stress can speed up disease and cause damage to the brain (LeDoux 2002). Acute stress may boost cardiovascular performance to enable someone to lift a car off a child, but under long-term stress, adrenaline stops regulating surges in blood pressure. Unregulated surges create rough spots and tears inside blood vessels. The spots turn into scars, and sticky substances build up there, clogging arteries. This is why people with chronic stress have an elevated risk of heart attack, stroke and dementia (Medina 2008).
Mahoney and Restak (1998) remind us that one of the greatest protections against the harmful effects of stress is a strong
social support system. These authors suggest that people with supportive friends and family members are less likely to rely on alcohol, tobacco or drugs. They also encourage lowering stress by letting go of things beyond our control, taking frequent movement breaks, volunteering for others, practicing focused breathing and eating a healthy diet.
Cardiovascular exercise is a key factor in effectively managing stress. It stimulates brain-derived neurotrophic factor (BDNF), a protein that helps brain cells multiply and function effectively (Ratey 2008). At least 30 minutes of cardiovascular exercise in the training heart rate zone can improve mood, elevate our stress threshold, speed delivery of oxygen to the brain, and help to balance brain chemicals and hormones for more effective stress management (Madigan 2004). Regular exercise also helps the body sleep better, which aids in dealing with little and big stressors. Falling asleep is easiest when the body and mind are relaxed and more difficult when the body is alert and tense (Michaud & Wild 1991).
Neurogenative Disorders Linked to lack of Physical Activity
What affects the body affects the brain. What is bad for the body is bad for the brain, and what is good for the body is good for the brain (Medina 2008). Exercising, eating healthy foods, refraining from smoking and limiting alcohol consumption reduce the risk for cardiovascular disease and diabetes and also the risk for age-related neurogenative disorders. The mental and physical diseases that occur in old age are directly tied to the cardiovascular and metabolic systems. People who have diabetes have a 65% higher risk of developing dementia. Those with heart disease are at far greater risk of developing Alzheimer’s, the most common form of dementia. High cholesterol increases the risk of developing dementia by 43% (Ratey 2008).
Alzheimer’s attacks areas of the brain that process information and store memory, thereby affecting a person’s ability to carry out daily activities. The disease usually begins after age 60, and the risk increases significantly with age. About 5% of men and women aged 65–74 have Alzheimer’s, and nearly half of those 85 and older may have the disease. An estimated 5 million Americans currently have Alzheimer’s. This number has doubled since 1980 and is expected to be as high as 13.4 million by 2050. Scientists do not yet fully understand what causes Alzheimer’s, but there is research to support the theory that high blood pressure, high cholesterol, a sedentary lifestyle, obesity and family history are all risk factors for the disease.
The average 75-year-old suffers from three chronic medical conditions and takes five prescription medicines. Among those over 65, most suffer from hypertension; more than two-thirds are overweight; and nearly 20% have diabetes, which triples the chance of developing heart disease (Ratey 2008). It has become essential that people make purposeful choices in order to live through their golden years with a healthy body and mind.
Physical Activity and the Brain
It seems logical that if scientists have been able to connect lifestyle choices with brain health, physical exercise would be a positive option. Neuroscientists (Nussbaum 2006; Abbott et al. 2004; Verghese et al. 2003) recommend swimming, dancing, gardening, knitting, more frequent use of the nondominant hand and leg, and walking 10,000 steps on a daily basis. Small (2006)
encourages regular physical activity that includes an adequate cardiovascular workout. Medina (2008) suggests that aerobic exercise is the key to lowering the odds of getting Alzheimer’s by 60%. A daily 20-minute walk can cut the risk of having a stroke, one of the leading causes of mental disability in the elderly, by 57%. Medina (2008) notes that our evolutionary ancestors were used to walking up to 12 miles per day, which strengthened the cardiovascular system and built a network of vessels that
enhanced blood flow to the brain.
Regular cardiovascular exercise gets blood to the brain, bringing much-needed oxygen and glucose for energy, while stimulating BDNF to grow dendrites, thereby enhancing neuronal connections. Thirty minutes of aerobic exercise stimulates the production of BDNF, which also stimulates the growth of new cells in the hippocampus. Ratey (2008) calls aerobic exercise Miracle-Gro® food for the brain, “fertilizing” cells to keep them functioning and growing.
Medina (2008) also reports on the growing body of research that points to exercise as a key factor in preventing and treating depression and anxiety. Exercise releases three neurotransmitters that are directly associated with the maintenance of mental health: serotonin, dopamine and norepinephrine. These neurotransmitters have a positive impact on mood and overall feeling of well-being.
Exercise optimizes learning in three ways (Wolfe 2001):
- 1. It heightens the ability of systems to function more efficiently and effectively.
- 2. It enhances the ability of cells to connect.
- 3. It promotes new cell growth.
Arthur Kramer, PhD, of the University of Illinois, tested the cognitive functioning of 124 men and women, aged 60–75. Subjects were divided into two groups; one walked briskly for an hour three times per week, while the other did yoga-type stretching. After 6 months of activity, they were given a memory test, and the walkers scored 25% higher than those who stretched (Ratey 2008).
According to Verghese and colleagues (2003), elderly people who dance regularly decrease their risk of dementia by 76%. One of the women in my “Prime Time” fitness classes was very active in square dancing and often commented that it kept her brain and body healthy. When I began teaching at Minot State University, her square-dance group came to teach our students. The students and I observed firsthand the quick responses these older adults had to complex square-dance calls. The students were even more impressed when they joined in, learning just a few of the basic moves. Any time we challenge our brains with something new and complex, we strengthen neuronal connections (Jensen 2006).
Mental Activity and Socialization
The “use it or lose it” principle that applies to muscle and cardiovascular fitness of the body applies to the brain as well. Nussbaum recommends activities like playing board games, doing crossword puzzles, learning a second language, taking a class, increasing
exposure to classical music and learning new skills. Small (2006) reports that participating in such leisure activities as playing board games, reading books or doing crossword puzzles cuts the risk of developing Alzheimer’s disease by nearly a third.
Following directions during a group fitness class is healthy for the body and the brain. Add new challenges to those classes by playing “Name That Tune” and “Name That Artist.” Another simple way to boost brain health and enrich positive thinking is to begin or end each class with a “thought for the day” or a “fit fact.” Many older adults come to class up to a half-hour early in
order to socialize. Offer simple activities to stimulate discussion and interest (see the sidebar “Activities for Mental Brain Health and Connection” for more ideas).
Integrating socialization into group fitness and club programming will benefit clients in both body and mind. It creates camaraderie, which also builds club loyalty and can be an excellent marketing tool. Word-of-mouth marketing from clients is priceless. An active social life also has a significant impact on brain health. Nussbaum (2006) suggests that older adults remain integrated in the community by contributing time and energy in meaningful things. He encourages involvement in groups, clubs and volunteer activities. Spending recreation time with others and maintaining a network of friends are essential throughout our lives and seem to be especially so in the golden years.
A Healthy Diet Makes a Difference
Balanced nutrition is essential for body and brain health. A well-balanced diet includes carbohydrates, proteins and fats. The Dietary Guidelines for Americans (U.S. Department of Health and Human Services and U.S. Department of Agriculture 2005) provides science-based advice on food choices for good health. The guidelines recommend a diet that emphasizes fruits, vegetables, whole grains and fat-free or low-fat milk; includes lean meats, poultry, fish, beans, eggs and nuts; and is low in saturated fat, trans fat, cholesterol, salt and added sugar. Educate yourself on the unique needs of the aging body and brain, and consider developing an affiliation with a registered dietitian in your area.
Water is essential for the electrical transmissions within the nervous system that make us sensing, learning, thinking and acting organisms. Water makes up 50%–60% of our body weight (Kravitz 2008) and comprises up to 80% of the brain. Ideally, a person should drink one-third of an ounce of water per pound of body weight each day (a quart per 100 pounds) and should double that amount when under stress. Coffee, tea, caffeinated soda and alcohol are diuretics and inhibit reabsorption of water in the kidneys, causing more water loss in the urine. A drop of just 2% in the body’s water level can trigger fuzzy short-term memory, low energy, grogginess and trouble with processing information (Hannaford 2005). The take-home message: water is essential for improving brain health and enhancing lifelong learning.
True Mind-Body Health
The critical domains of a brain-healthy lifestyle are key points to consider for optimal aging of the brain and the body. Educate clients on lifestyle choices they can make for better brain health. When designing your programs and classes, incorporate opportunities that facilitate the practice of physical and mental activity, healthy diet advice, stress management and socialization. A well-rounded approach to wellness can make a difference in boosting lifelong learning and brain health.