Dear Wellness Seeker,

You sit nervously in the doctor’s office, fidgeting a bit as you wonder how to explain your concerns. After all, should you really be worrying that you keep forgetting where your keys were or that you take a while to remember your university roommate’s name? Is it that big of a deal that you can’t keep a telephone number in your memory, but have to write it down? Is this ageing or is it early-stage dementia?

One common concern many physicians hear in their offices is some variation of “my memory is getting worse “brain fog,” and “normal ageing.” The mind that was previously sharp and focused on each individual task has been dusted with cobwebs. It takes longer to remember names, dates, and numbers or to recall locations. One struggles to find the right word to communicate one’s intended meaning. And of course, one wonders if these are warning signs for something far more ominous.

Current medical research has shed new opinions on the topic of strengthening the mind and preventing cognitive decline. Alzheimer’s disease and Parkinson’s disease are two of the most fear-inducing medical conditions and devastating for caregivers to witness in their previously strong and mentally astute loved ones. Naturally, we wonder how we can optimize our mental health, whether to stave off scary diseases or to simply maintain mental acuity and memory that seems to fog with every passing decade. How can we awaken our minds from its current hibernation? Reassuringly, all of us can develop a set of skills that can be utilized to maintain wellness.

The market has been inundated with video games, computer games, and interactive apps with the promise of reducing “cognitive decline.” Even games like crossword puzzles, Suduko, and chess have become more popular as the elder generation seems to keep their minds sharp and the younger generations doggedly pursue them in order to reduce their chances of degenerative brain disease. While the medical literature lacks any guidelines on these topics, it is clear that these games and exercise do not seem to delay or prevent dementia. However, these games can help to exercise brain functions that can slow with age (such as processing speed, reaction time, decision making, and short-term memory). They can also help to build up what scientists refer to as “cognitive reserve,” basically the brain’s innate ability to store “brain power” in times where quick thinking is needed, much like a mental emergency savings account.

So, what is the medicine that our brain desperately requires to lift itself from grogginess and lack of use? The answer lies not in quick and fancy games and apps, but rather in ways that improve neuroplasticity, the remarkable ability for the brain to repair itself. Neuroplasticity is the reason why patients who have suffered devastating strokes can re-learn lost functions like movement and speech. In other words, it is the self-rehabilitation of the mind.

When neuroscientists, neurologists, and directors of anti-ageing clinics are interviewed about neuroplasticity and what they would recommend improving brain function, the verdict is clear… it involves the constant mental exercise that accompanies the challenge of learning something new. If one uses the same app or mindlessly and automatically plays a game of chess, there is no value in increasing neuroplasticity for the brain’s neurons are in “default” mode. To achieve a state of neuroplasticity and mental clarity, these neurons must change from “default” mode to “active mode” much like how we use physical exercise to engage new muscles. It is the mental equivalent of staying in one’s comfort zone all the time versus continually raising the level of difficulty and pushing our minds to be continually stimulated.

While there is no harm in doing crosswords and Suduko and brain-training apps, medical researchers and clinicians are much more likely to recommend focusing one’s attention and efforts on four domains from the American Association of Retired Persons. These domains may sound simplistic, but they hold the key to maintaining optimal brain wellness:

1. – physical activity,
2. – discovery,
3. – relaxation,
4. – nutrition,
5. – and social interaction.

For physical activity, it may please people to know that not only their waistlines will benefit from some exercise. Research has shown that 150 minutes of moderate-intensity aerobic exercise per week can increase blood flow to the hippocampus (the brain’s memory storage region) and optimizes existing neural connections.

Discovery can be thought of as the ability to learn a new skill and this is what the medical community strives to communicate amidst the focus on brain-training. The new skill does not have to be expensive or technologically advanced…. Ideas range from learning a language or instrument, creative endeavours like painting or sculpting, or reading different books that offer a level of mental engagement rather than “tuning out” with each page. We must fight against the temptation to relax in front of endless Netflix shows or video games, effectively sedating ourselves amidst the tensions of everyday life.

We also cannot discount the effect of relaxation, which includes proper sleep hygiene. Mindfulness, meditation, journaling, prayer, and ensuring a full and deeply restful sleep are all essential in maintaining mental clarity. It is paramount to continue to go to sleep at the same time and wake up at the same time every day, and we should also limit the amount of news we consume and try not to do it right before bedtime as constant negative stimuli can adversely affect the quality of sleep.

Nutrition can also be a challenge. Some people depend on the convenience of delivery and restaurants, and it does take considerable effort to shop and think of nutritious and delicious recipes. It can even be comforting to indulge in comfort food in stressful times or to snack on little meals during the whole day, mindlessly eating even in the absence of hunger. By continuing to plan our meals and snacks in advance and organize our recipes to contain mostly wholesome fresh ingredients, we can avoid the temptation to succumb to impulsive eating and mindless snacking throughout the day.

And finally, social interaction. No matter if one is an introvert or an extrovert, everyone benefits from a little bit of social engagement. The options are endless: group fitness classes, a walk with a neighbour, book clubs and dinner parties, or a simple phone call to check in on friends and family.

The prescription is simple: Engage yourself, engage your mind.

To your Best Life,

Shirin Karimi Hund, M.D. – internal medicine

Your Chenot Wellness Team