How to Improve Your Brain Health as You Age - Dr Rangan Chatterjee with Dr Tommy Wood
Shift Your Mindset About Cognitive Decline
Cognitive decline is not an inevitable part of aging; while it does occur on average, you can significantly change its trajectory.
The brain, much like muscles, can adapt, make new connections, and even generate new cells in certain areas (like the hippocampus) if challenged.
Stop telling yourself the story that your brain's function is beyond your control because of age, as this is "not true".
Understand that age-related dementia, which is what most people fear, is influenced by environment, genetics, lifestyle, and general health, and is different from early-onset Alzheimer's.
Cognitive decline often starts much earlier in life, possibly in your 20s or 30s, driven by a lack of continuous mental challenge rather than an uncontrollable biological process.
View the brain's capacity like physical "headroom"; as function declines, your maximum capacity approaches what you do daily, leading to cognitive frailty where there is "no extra capacity".
Actively Challenge Your Brain
Consistently introduce new, difficult tasks to stimulate your brain; its structure and function are directly proportional to the demands you place on it.
Engage in lifelong learning, such as learning a new language, which can improve cognitive function and protect specific brain regions.
Incorporate physical activities with a coordination component like Tai Chi, yoga, or dancing, as these offer greater cognitive benefits than purely repetitive exercises and can even increase hippocampus size.
Embrace activities that involve complex learning and problem-solving, similar to intense professional training or learning "the knowledge" for London taxi drivers.
Consider activities that offer a multifaceted stimulus, combining movement, social interaction, and music, which can provide a more comprehensive brain challenge.
While technology can offload certain tasks (like navigation), use it strategically to free up cognitive reserve for other demanding activities, or engage in new forms of challenge, such as video games that involve reactions and problem-solving. Overall brain training through digitised games can also translate to better working memory and executive function in real life.
Regularly engage in tasks where you are not yet proficient, as the process of learning and overcoming difficulty offers greater benefits than simply repeating what you are already good at; amateur musicians, for example, show greater brain benefits than professionals.
Dedicate 20-30 minute focused chunks to cognitively challenging activities, as this aligns with human attentional capacity and maximises skill development, followed by rest and recovery.
Choose activities you enjoy to ensure sustained engagement and long-term adherence to cognitive stimulation.
Be aware that while crosswords and Sudoku might offer some benefit, they are likely less impactful than more complex, skill-developing activities, especially once mastery is achieved.
If retired, replace the cognitive stimulus provided by work with new challenging activities to prevent a faster decline in cognitive function; early retirement, especially from cognitively stimulating jobs, is linked to earlier cognitive decline.
A lack of stimulus to the brain may be causative of age-related decline in brain function.
Prioritise Key Nutrients and a Healthy Diet
Ensure adequate intake of B vitamins (B12, folate, B2, B6), which are crucial for brain health; B12 is mainly from animal foods, and supplements may be needed for plant-based diets.
Optimise your long-chain Omega-3 fatty acid levels (especially DHA), which are vital for brain development and function, primarily found in seafood. Plant-based individuals can use algal sources and should consider testing their omega-3 index.
Focus on a diet rich in whole, minimally processed foods that is accessible, enjoyable, and sustainable for you personally, considering ancestral and seasonal eating patterns.
Understand that the gut is metabolically flexible and can thrive on a variety of dietary approaches; while fibre can be beneficial, the necessity of a very high diversity of plant foods (e.g., 30 per week) may not be universally applicable or historically consistent.
Acknowledge that systemic health significantly impacts gut health, meaning overall lifestyle choices influence the gut microbiome, not just fibre intake.
If your model of human health doesn't account for individuals thriving on radically different diets (e.g., low-fibre or carnivore), then your "model is wrong" and needs to incorporate such outliers.
Engage in Consistent Physical Activity and Build Muscle
Recognise that physical activity is the only intervention known to reverse all biochemical hallmarks of aging at a cellular level.
Understand that muscle mass is vital for brain health and overall well-being, as it is the largest glucose sink in the body (75% of blood sugar is taken up by muscles) and a secretory organ that releases brain-supporting factors.
Implement resistance training as strength declines from your 30s and muscle mass from your 60s, with strength being a strong predictor of mortality and cognitive decline.
Aim for a minimum effective dose of 2-3 sets per muscle group per week, pushing to voluntary muscular failure; this can be achieved with bodyweight, resistance bands, or household items, not necessarily a gym.
For greater benefits, consider 8-12 sets per muscle group per week, split over 2-3 sessions (e.g., three times a week, three sets of 6-8 exercises), which has been shown to improve brain function and structure even in individuals in their 70s.
Remember that any increase in physical activity is beneficial, regardless of intensity or duration; even a 20-minute brisk walk or light resistance training makes a significant difference.
Prioritise Rest, Recovery, and Stress Management
Ensure adequate sleep and recovery, as these periods are critical for the brain to consolidate learning, build new connections, and perform repair processes like autophagy.
Actively manage and minimise chronic stress, which can prevent the brain from adapting and recovering, contributing to cognitive decline.
Avoid social isolation, which is a significant stressor and detrimental to cognitive health, comparable to unethical animal experimental conditions.
Be aware of and mitigate exposure to chronic societal stresses (e.g., discrimination, financial strain, racial stress), as these profoundly impact biology, physiology, and cognitive function.
Be Mindful of Environmental Toxins
Minimize exposure to environmental toxins such as air pollution (e.g., car exhaust, leaded petrol residue), cigarette smoke, and heavy metals (e.g., lead in water supplies), which can directly damage brain cells and inhibit their ability to adapt.
Monitor Key Health Markers
Regularly check for the components of metabolic syndrome (waist circumference/waist-to-height ratio, HDL cholesterol, triglycerides, blood pressure, blood sugar) as they are foundational indicators of overall health linked to dementia risk.
Monitor your blood sugar levels (fasting glucose and HbA1c); aim for optimal ranges (e.g., fasting glucose around 4.5-just over 5 mmol/L; HbA1c between 5-5.5%) for the lowest risk of mortality and cognitive decline.
Understand that while individual blood tests are helpful, it is crucial to interpret them in combination to build a comprehensive picture of your health and avoid hyper-focusing on single numbers in isolation.
If your blood sugar control is poor (high levels or significant spikes), know that this is associated with faster cognitive decline, but it is reversible through lifestyle changes.
Consider testing your B12 and folate levels, especially if signs of cognitive impairment are present or if you follow a plant-based diet, and aim for levels in the upper end of normal (e.g., serum B12 above 600, depending on lab and context).
Use blood tests like the Omega-3 Index to objectively assess your long-chain omega-3 status and consider supplementation if levels are low.
Be aware that "normal" ranges for blood tests are often based on an "unhealthy" average population and may not reflect optimal health.
Broad Societal Considerations
Recognise the impact of social determinants of health (e.g., financial status, access to healthy food, safe living environments) on an individual's ability to implement lifestyle changes.
Provide accessible, high-quality health information to everyone, acknowledging that while some may face more barriers, it is "condescending and disempowering" to withhold advice based on assumptions about their ability to act on it.
Support for behaviour change strategies is needed, particularly highlighting low-cost or free ways to incorporate stimulating and challenging activities into daily life.