How to Stay Mentally Sharp -- for Life, Part II

Alzheimers prevention

• Eat more fruits and vegetables. Take antioxidants. We humans need oxygen to live, but oxygen also has a downside. In the body, some oxygen molecules become so highly chemically reactive that they disrupt other body processes. These troublemaker molecules are called "free radicals," and many scientists believe that the damage they inflict (oxidative damage) is at the root of cancer, heart disease, and stroke. (Smoking and a high-fat diet greatly increase the number of free radicals in the blood.)
  
  
  
  Free radicals also contribute to the development of Alzheimer's disease.
  
  
  
  Fortunately, certain nutrients  -- antioxidants  -- can prevent the oxidative damage free radicals cause. Antioxidant nutrients include: vitamin A, vitamin C, vitamin E, the mineral selenium, and vitamin A's close chemical relatives, the carotenoids, among them beta-carotene. These nutrients are abundant in plant foods, and many studies show that as fruit and vegetable consumption increases, risk of every cancer decreases.
  
  
  
  Czech researchers gave the antioxidant drug selegiline to 173 people with mild to moderate Alzheimer's disease. After six months, their memory improved significantly. In another study, selegiline enhanced the benefits of Cognex (tacrine), one of the two drugs currently approved for Alzheimer's treatment.
  
  
  
  Finally, a recent Dutch report shows that eating foods high in the antioxidant beta-carotene helps protect against memory loss. The scientists surveyed the diets of 5,100 people aged 55 to 95. Compared with those whose diet supplied 2.1 mg a day or more of beta-carotene, those who consumed 0.9 mg or less showed twice the risk of cognitive impairment and disorientation.
  
  
  
  


• Drink tea. A recent Dutch study shows that drinking black tea helps prevent stroke and the cognitive impairment it often causes. Tea is high in antioxidants and other compounds (flavonoids) that help prevent the formation of stroke-triggering blood clots in the brain.
  
  
  
  


• Take a multivitamin. Over the years, several studies have shown that vitamin supplements improve memory and mental functioning. Recently, David Benton, Ph.D., a professor of psychology at the University College of Swansea in Wales, asked 127 college students to take either a placebo or a multivitamin twice a day for a year. The supplement contained vitamins A, C, E, B-12, thiamin, riboflavin, pyridoxine, folic acid, biotin, and niacin. In tests of reaction time, both the men and women in the vitamin group initially outperformed the placebo-takers. The women continued to do so for the whole year, but the men who took the placebo eventually caught up with the men on the vitamins. Still, it appears that vitamins play some role in mental acuity.
  
  
  
  Another study showed that vitamin B-6, also known as pyridoxine, helps memory. The Dutch researchers at the University of Amsterdam focused on B-6 because it is key to the synthesis of several neurotransmitters. In the three-month study, they divided 76 healthy elderly men, aged 70 to 79, into two groups. One group took a placebo, the other, 20 mg of pyridoxine daily. Pre- and post-tests of memory showed that "vitamin B-6 supplementation improves storage of information modestly but significantly."
  
  
  
  


• Beware of stress. Emotional stress has been linked to all sorts of ills -- from heart attack to sex problems. Recently, a Stanford researcher added memory loss to the list. Robert M. Sapolsky, Ph.D., a professor of biological sciences, says that prolonged stress produces hormones -- among them, adrenaline and glucocorticoid hormone -- that can damage the hippocampus, a part of the brain involved in memory and learning. Studies of Vietnam veterans suffering from post-traumatic stress syndrome have shown that many have unusually small hippocampuses. Stress management is important not only for mental sharpness but also for general well-being and quality of life. Effective stress management programs include meditation, biofeedback, and exercise -- everything from dancing to gardening, cycling to yoga.
  
  
  
  


• Try ginkgo. Ginkgo bilboa, a living vestige of the dinosaur age, is the oldest surviving species of tree on earth. Poetically, it helps preserve the oldest people. An extract of ginkgo leaves opens the blood vessels in the brain and aids circulation through it. In Europe, ginkgo extract is widely prescribed for stroke recovery and the memory lapses of old age. Dutch scientists recently reviewed 40 studies of ginkgo's effects on the mind. Their conclusion: The herb improves memory and concentration, and reduces absent-mindedness.
  
  
  
  But you don't have to be elderly to benefit from ginkgo. In a British study, researchers gave eight women, average age 32, 600 mg of ginkgo extract. An hour later, the women took a battery of cognitive function tests. The ginkgo "significantly improved" their memory.
  
  
  
  


• Try carnitine. Carnitine is a nutrient composed of two amino acids, lysine and methionine. Two recent studies show that it helps treat Alzheimer's disease. Italian researchers divided 130 people with Alzheimer's into two groups. Half received 2 daily grams of acetyl-L-carnitine, while half took a placebo. After one year, both groups showed diminished cognitive abilities, but compared with those who took the placebo, those who took acetyl-L-carnitine showed significantly less mental deterioration. A similar study at the University of Pittsburgh School of Medicine using 3 grams of carnitine a day showed the same results.
  
  
  
  


• Enjoy complex music. Music nourishes the soul. It may do the same for the brain. A controversial 1993 experiment by Frances H. Rauscher, Ph.D., a research fellow at the Center for the Neurobiology of Learning and Memory at the University of California-Irvine, showed that a 10-minute dose of Mozart temporarily boosts intelligence. Dr. Rauscher had 36 college students take a standard intelligence test before and after listening to either silence, a tape of relaxing Muzak, or Mozart's Sonata for Two Pianos in D Major (K. 448). After the period of silence, the students' average score was 110. After the Muzak, it was 111. But after listening to Mozart, it jumped to 119. Even students who said they didn't like Mozart's music experienced the boost in intelligence-test score. "Listening to complex music like Mozart may stimulate neural pathways that are important in thinking," Dr. Rauscher says. If that's so, other complex musical forms, for example, jazz, should have a similar effect, but simpler, more repetitive forms -- folk, country, and most rock -- might not.
  
  
  
  


• Watch out for depression. Depression typically causes profound sadness, helplessness, hopelessness, weeping, and serious lethargy. But it may also be present differently -- especially in elderly people -- with confusion, distraction, and irritable outbursts, symptoms that may be mistaken for Alzheimer's disease. If you're concerned about cognitive problems, get evaluated for depression. Antidepressant medication may help.
  
  
  
  


• Have your hearing checked. If you don't remember what people tell you, perhaps your mind is going -- or maybe it's your hearing. Researchers at the Memory Disorders Clinic at the University of South Florida at Tampa examined 52 elderly people, of whom half had a diagnosis of probable Alzheimer's disease, and half had other memory problems. Just about all of them (49 of the 52, or 94%) also had severe hearing problems. Only about one-third of healthy elderly people have such hearing problems. It's not clear, the researchers say, whether hearing problems are a cause or effect of memory loss, or whether these findings are coincidental. However, undiagnosed hearing loss interferes with learning, and makes people seem distracted, confused, disoriented, and unresponsive, traits that might suggest Alzheimer's disease.
  
  
  
  


• Beware of indoor air pollutants. Many physicians overlook indoor air pollution as a cause of cognitive problems. Consider the case of a 79-year-old widow who suffered progressive cognitive deterioration during the six months after her husband's death. She was diagnosed with Alzheimer's disease, and her family made arrangements to place her in a nursing home.
  
  
  
  But by chance, a family friend was a physician well-informed about environmental medicine. He asked a few questions about her deterioration, and suggested that her Alzheimer's diagnosis might be a mistake. Despite the woman's grief over losing her husband, she remained mentally sharp for four months after his death. She sold their home and moved into a new condominium. Her symptoms appeared after living there for two months, and progressed more quickly than Alzheimer's disease usually does.
  
  
  
  Further investigation revealed that she had high blood levels of toluene, a toxic chemical used in construction materials. The release of toluene can contaminate the indoor air of new buildings, even those that appear to be adequately ventilated. On the advice of the environmental physician, the woman moved out of her condo, and into her daughter's older home. Within three weeks, she was back to her old self.
  
  
  
  This story is by no means unique. Older people spend about 80% of their time indoors, and as a result, suffer greater-than-average exposure to indoor air pollutants, among them: carbon monoxide from gas appliances; volatile organic compounds from paints and polishes; and formaldehyde from new carpets, drapes, paneling, and furnishings. In addition, compared with most adults in the prime of life, the elderly are more sensitive to low-level toxic exposures.
  
  
  
  If you suspect a loss of cognitive function, be sure to assess possible toxic exposures. Red flags include: a newly constructed residence, new carpeting, new drapes, new furniture, new paint, or newly refinished floors.
  
  
  
  


• Beware of lead. Mention lead poisoning, and most people think of the toxic metal's effects on children, in whom it causes learning disabilities, and in severe cases, mental retardation. But lead poisoning -- and the cognitive problems it causes -- are also problems for the elderly, especially elderly women.
  
  
  
  Lead was once a common ingredient in paints and gasoline. Lead was banned in these products more than 20 years ago, but today's elderly and middle-aged populations spent decades exposed to it. In addition, lead can still be found in much of the nation's air and water because of its persistence in the environment, and in the calcium supplements many older women take to prevent bone-thinning osteoporosis, notably bone meal and dolomite.
  
  
  
  The body accumulates lead in bone tissue. After age 50, bone begins to break down. Osteoporosis affects both sexes, but it proceeds more quickly in women. Its best-known symptoms include: loss of height, stooped posture, and increased risk of fractures. But in addition, as bone deteriorates, the lead stored in it gets released into the bloodstream, giving many elderly women surprisingly high blood levels -- even if they live in a lead-free environment. Unfortunately, public health efforts to control lead exposure have neglected older people, focusing almost entirely on children.
  
  
  
  If you're a postmenopausal woman, ask your doctor to test your blood for lead periodically.
  
  
  
  Estrogen helps prevent osteoporosis. In addition to its role in preventing Alzheimer's disease, it also helps keep lead stored in bone out of the bloodstream, which helps prevent lead-related cognitive problems.
  
  
  
  


• Watch the aluminum (possibly). Aluminum is unusually abundant in the tangled brain tissue of people with Alzheimer's disease. For years, rumors have circulated that aluminum cookware contributed to the disease. Most scientists scoff at this notion because aluminum is one of the most abundant elements on earth and everyone is exposed to a great deal of it. The role of aluminum pots and pans in mental impairment, if any, is anyone's guess. But at least one study published in the prestigious medical journal Lancet linked an increased risk of Alzheimer's disease to drinking water with more than 11 micrograms of aluminum per liter.
  
  
  
  


• On the horizon, the possible promise of nicotine. Physicians view nicotine, the addictive compound in tobacco smoke, as a public health villain. But its dark cloud appears to have a silver lining. Nicotine boosts mental functioning in people with Alzheimer's disease, and some version of the compound -- nonaddictive one would hope -- might one day help preserve cognitive functioning of older people in general.
  
  
  
  Researchers at the Veterans Affairs Medical Center in Albany, New York, placed nicotine patches, the kind used to help people quit smoking, on seven nonsmoking men with Alzheimer's disease. The men wore the patches for 16 hours a day for two weeks. Based on pre- and post-patch evaluations using the Alzheimer's Disease Assessment Scale, the nicotine improved their cognition, though the results did not quite reach statistical significance.
  
  
  
  Nicotine enhances brain cell release of the neurotransmitter acetylcholine. People with Alzheimer's are deficient in acetylcholine. Previous studies have shown that nicotine also improves mental competence of people with normal brain function.