AARP report: 6 Pillars of Brain Health – lifestyle changes and community policies

Published in RINewstoday on April 4, 2022

The Washington, DC-based AARP releases its latest Global Council on Brain Health (GCBH) report citing strong scientific evidence that behavior changes and lifestyle habits can positively impact one’s brain health – yet many adults struggle to implement such simple changes.

In a new report released last month, “How to Sustain Brain Healthy Behaviors: Applying Lessons of Public Health and Science to Drive Change,” GCBH outlines how individuals age 50 and over, communities, and policymakers can all take steps to support brain health.

The World Health Organization predicts that the number of people living with dementia is expected to grow to 82 million by 2030 and skyrocketing to 152 million by 2050. The GCBH report notes to lower this expected trajectory it will take “effective behavior and cultural changes, initiated and driven by all the pertinent actors working in concert at all levels of society.”

The 38-page report and its recommendations are based on a review of the current state of science and the consensus of 20 experts from across the world in an array of disciplines, notes the report. GCBH is an independent collaboration of scientists, health professionals, scholars and policy experts from all over the world who are working in the area of brain health related to human cognition to promote brain health.

GCBH’s 38-page report, released March 15, 2022, provides tips to support brain-healthy behavior. Over the past six years, the GCBH has issued reports on broad topics taking a look at whether adults’ behavior and lifestyle style habits could affect their brain health as they grow older.

“While we encourage people to make good decisions, the GCBH recognizes that an effective strategy to enhance brain health must be framed broadly, and that individual choices are made in a larger social and environmental context… Simply putting research findings forward and expecting people to change their behaviors and sustain healthy lifestyles accordingly is unrealistic,” say the report’s authors. 

Calls for Supporting Positive Brain Health

In the latest GCBH report, the authors share what they have learned about how to persuade and motivate people to maintain brain-healthy lifestyles, and how community policies can be shaped to promote this vital goal. 

“We know what works to support brain health – this report focuses on how to make that happen,” says Sarah Lenz Lock, GCBH’s Executive Director. “Our experts have identified specific, practical tips to help older adults, communities and policymakers support the habits that are good for brain health. We show that change is possible, and why supporting brain health for an aging population makes good health and economic sense for communities and society as well as individuals,” Lock says.

“We describe why implementing programs designed to promote brain health for older adults makes good health and economic sense for communities and societies as well as individuals. GCBH experts advise individuals to set specific goals, be realistic about what they choose, and approach their goals step by step,” says the report’s authors. 

“We encourage community-based organizations to create opportunities for peer-to-peer coaching. And we urge policymakers to raise public awareness that people can take steps to help themselves. These and many other recommendations along with a framework for achieving change for individuals, community organizations and policymakers are provided in the final report approved by the GCBH Governance Committee,” they add. 

The GCBH report also calls for addressing the disparities in health and access to care that undermine the cognitive well-being of underserved communities including many African Americans and Hispanics.

Hearing loss, high blood pressure, obesity, and depression are among the health issues that may be linked to cognitive decline and should be properly managed with access to health care.

The Six Pillars of Brain Health

After a careful analysis of scientific findings, GCBH’s report notes that “evidence continues to mount” that people may be able to lower their risks for cognitive decline by engaging in healthy lifestyle behaviors, referred to as the six pillars of brain health.

Specifically put:

“Be social” and continue to maintain and expand your social network.  Keep tabs on family and friends and don’t isolate yourself from others. 

  • Find new interests and hobbies to “engage your brain” and to stimulate your thinking. 
  • Meditate, relax, and maintain a consistent schedule to “manage stress.”
  • Don’t forget the importance of “ongoing” exercise” and schedule at least 2.5 hours of moderate to vigorous exercise a week.  
  • Achieve “restorative sleep” by at least getting 7-8 ours of restful sleep daily.
  • Finally, “eat right” by choosing a nutritious, heart healthy diet to limit high blood pressure, of fish, poultry, nuts, low-fat dairy, vegetables, whole grains, fruits, and vegetable oils. 

The GCBH recommendations urge people to avoid smoking and not drink alcohol.  But if you drink, limit alcohol to more than one drink a day for women and two drinks a day for men.

The Brain-Heart Connection is examined in GCBH’s report.  Hypertension is a serious risk to brain health that can lead to stroke, mild cognitive impairment, or dementia. With knowledge of this, the report notes that people can lower blood pressure by increasing physical activity and reduce overeating, excess drinking, smoking and even reducing sodium (salt) intake.

The GCBH report provides simple, easily obtainable steps to make successful behavioral changes to improve brain health.  Specifically, people can:

Set a goal, identify a specific action you want to take on.

Be thoughtful and realistic about the goals you choose.

Find something that is fun and choose what is enjoyable for you.

Re-purpose some of your free time.

Rethink your environment to reduce the temptations and encourage better choices.

Celebrate the wins.

Learn from the setbacks.

Involve friends and family with common goals to reinforce healthy choices; and

Pick a good start time. 

While brain health behavior changes can be achieved by individuals, these changes require the support health care providers, employers, and community organizations.  Health care providers can help their patients improve their lifestyle habits and make healthy choices to reduce risks and alleviate the symptoms of disease. Employers can promote healthy behaviors too by creating healthier work environments, offering wellness initiatives, health screenings, immunizations, supporting healthy sleep by minimizing shift work, not requiring employees to respond to emails 24/7 and respecting vacations and breaktimes.  These all can promote better brain and mental health, says the GCBH report.

Mission-driven organizations, like AARP, the Arthritis Foundation, and the Heart Association, can also provide individuals with needed information and tools to access their own wellness and motivate a person to make positive behavior changes.

Finally, policymakers can set goals to improve the public’s brain health with a focus on building equity, fighting the sigma of dementia, and implementing best practice to improve brain health from around the world. They can also become aware of how public policies in other areas, such as the built environment, nutrition, and education, can have a lifelong impact on brain health. Some specific examples of successful public health policies include seat-belt laws and smoking cessation requirements.

“A chasm remains between what researchers are discovering about brain health and how little this knowledge has been applied for the public good. Progress will require the combined actions of individuals and communities, reinforced by public policies that facilitate healthy lifestyles,” says the report’s authors. “By applying lessons of public health and science, we can improve brain health for the benefit of individuals, communities and countries around the world,” they say, noting that this report lays out the steps needed to achieve this goal.

The full report on “How to Sustain Brain Healthy Behaviors” is available by going to https://www.aarp.org/content/dam/aarp/health/brain_health/2022-03/gcbh-behavior-change-report-english.doi.10.26419-2Fpia.00106.001.pdf.

To obtain all of the GCBH’s past reports on brain health, go to https://www.aarp.org/health/brain-health/global-council-on-brain-health/resource-library/.

To see how staying socially active impacts brain health, go to https://thriveglobal.com/stories/spumoni-s-where-everybody-knows-your-name-study-says-being-socially-active-may-improve-cognitive-functioning-2/

Taking a Look at Physical Activity and Cardiac Health

Published in Woonsocket Call on March 8, 2020

Spring time is coming. Get out your walking shoes…

Physical exercise (that doesn’t have to be strenuous to be effective) can lead to longer, healthier lives, according to two preliminary research study findings presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic P Scientific Sessions 2020. The EPI Scientific Sessions, held March 3-6 in Phoenix, is considered to be the premier global exchange of the latest advances in population-based cardiovascular science for researchers and clinicians.

“Finding a way to physically move more in an activity that suits your capabilities and is pleasurable is extremely important for all people, and especially for older people who may have risk factors for cardiovascular diseases. Physical activities such as brisk walking can help manage high blood pressure and high cholesterol, improve glucose control among many benefits,” said Barry A. Franklin, Ph.D., past chair of both the American Heart Association’s Council on Physical Activity and Metabolism and the National Advocacy Committee, director of preventive cardiology and cardiac rehabilitation at Beaumont Health in Royal Oak, Michigan, and professor of internal medicine at Oakland University William Beaumont School of Medicine in Rochester, Michigan.

In one session, Dr. Andrea Z. LaCroix, Ph.D., of the University of California San Diego (UCSD), presented her study’s findings that showed the importance of walking, stressing that every step counts in reducing cardiovascular disease deaths among older women.

USCD’s study was supported by The National Heart, Lung, and Blood Institute of the National Institutes of Health.

According to the UCSD study’s findings, women who walked 2,100 to 4,500 steps daily reduced their risk of dying from cardiovascular diseases (including heart attacks, heart failure, and stroke) by up to 38 percent, compared to women who walked less than 2,100 daily steps. The women who walked more than 4,500 steps per day reduced their risk by 48 percent, in this study of over 6,000 women with an average age of 79.

LaCroix says that the UCSD study’s findings also indicated that the cardio-protective effect of more steps taken per day was present even after the researchers took into consideration heart disease risk factors, including obesity, elevated cholesterol, blood pressure, triglycerides and/or blood sugar levels, and was not dependent on how fast the women walked.

“Despite popular beliefs, there is little evidence that people need to aim for 10,000 steps daily to get cardiovascular benefits from walking. Our study showed that getting just over 4,500 steps per day is strongly associated with reduced risk of dying from cardiovascular disease in older women,” said LaCroix, the lead study author who serves as distinguished professor and chief of epidemiology at the UCSD. Co-authors of the study are John Bellettiere, Ph.D., mph; Chongzhi Di, Ph.D.; Michael J. Lamonte, Ph.D., M.P.H.

“Taking more steps per day, even just a few more, is achievable, and step counts are an easy-to-understand way to measure how much we are moving. There are many inexpensive wearable devices to choose from. Our research shows that older women reduce their risk of heart disease by moving more in their daily life, including light activity and taking more steps. Being up and about, instead of sitting, is good for your heart,” said LaCroix.

LaCroix’s study included more than 6,000 women enrolled in the Women’s Health Initiative with an average age of 79 who wore an accelerometer on their waist to measure their physical activity for seven days in a row; these participants were followed for up to seven years for heart disease death.

This study was prospective, and half of the participants were African-American or Hispanic, stated LaCroix, noting that the use of an accelerometer to measure movement is a strength of the study. However, the study did not include men or people younger than 60, she said, calling for future research to examine step counts and other measures of daily activity across the adult age range among both men and women.

In another session, Joowon Lee, Ph.D., a researcher at Boston University (BU) in Boston, noted that higher levels of light physical activity are associated with lower risk of death from any cause.

According to the findings of BU’s study, older adults were 67 percent less likely to die of any cause if they were moderately or vigorously physically active for at least 150 minutes per week, (a goal recommended by the American Heart Association) compared to people who exercised less.

However, the researchers observed that, among the participants with an average age of 69, physical activity doesn’t have to be strenuous to be effective. Each 30-minute interval of light-intensity physical activities – such as doing household chores or casual walking – was associated with a 20 percent lower risk of dying from any cause, they said, noting that on the other hand, every additional 30-minutes of being sedentary was related to a 32 percent higher risk of dying from any cause.

“Promoting light-intensity physical activity and reducing sedentary time may be a more practical alternative among older adults,” said Joowon.

The BU research study, supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health, evaluated physical activity levels of 1,262 participants from the ongoing Framingham Offspring Study. These participants were an average age of 69 (54 percent women), and they were instructed to wear a device that objectively measured physical activity for at least 10 hours a day, for at least four days a week between 2011 and 2014.

The researchers say that the strengths of this study include its large sample size and the use of a wearable device to objectively measure physical activity. However, the participants of the Framingham Offspring Study are white, so it is unclear if these findings would be consistent for other racial groups, they note.

Co-authors of the study are Nicole L. Spartano, Ph.D.; Ramachandran S. Vasan, M.D. and Vanessa Xanthakis Ph.D.