The More You Read and Learn, The Less You Will Forget Names at Weddings and Parties

As I had mentioned in the piece titled “Not Forgetting Names at Weddings and Parties”, one of the major worries of healthful ageing is cognitive decline, defined as the reduction in one or more cognitive abilities, such as memory, awareness, judgement and mental acuity.

Physical activity, a predominantly plant based food habit and good sleep, including daytime naps, are the three legs that help us reduce the rate of cognitive decline or perhaps prevent it from occurring in the first place.

Two recent papers have further addressed the importance of food and cognitive decline,  one showing a positive correlation between cognitive function and the MIND diet (a hybrid of the Mediterranean diet and the Dietary Approach to stop Hypertension - DASH) [1], the other showing an inverse correlation between dietary fibre intake and the risk of dementia [2], meaning the higher the intake of fibre, the lower the risk of dementia.

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Not all factors causing cognition loss are under our control. Another study published just a month ago showed a linear relationship between air pollution exposure and semantic fluency [3]. Semantic fluency is the ability to name in one minute, items belonging to a specific category like fruits or vegetables or animals, and is a sensitive marker of cognitive function. The more the air pollution, the lower was the semantic fluency in this study.

Clearly, while it is our hands to be physically active, eat sensibly and sleep well, it is often not possible to mitigate air pollution risk on our own.

One recurring question that keeps bothering me is whether cognition loss is reversible or does it stay put and/or worsen once it occurs. If the latter were to be true, that would mean that all the measures we take to mitigate the risk of cognition loss can perhaps only stabilize the loss or reduce the rate of further loss but not reverse or prevent loss. Fortunately that is not true.

A recent study in Neurology headed by Iraniparast M and colleagues [4] looked at religious sisters (the NUN study), who were over 75 years of age. One third experienced at least one reverse transition and 86% of them never developed dementia. This means that even if you experience cognitive decline of either memory or judgment, it is not only spontaneously reversible, it may not necessarily progress to full blown dementia. More importantly, those who had higher levels of education had a lower rate of progression to dementia.

Higher levels of education and by extension, life long learning are linked to “cognitive reserve”, defined as the resilience developed by some people in staving off the effects of dementia, even if their brains at autopsy or on MRI show the same degeneration as those who have functional dementia. Those who have higher cognitive reserve somehow develop alternate functional pathways in those parts of the brain that are damaged by dementia producing disease. The main factor that influences the extent of cognitive reserve is the extent of education. “Individuals with increased cognitive reserve tend to be more highly educated, possess higher IQs, reach higher occupational attainment, and are involved in a diverse range of leisurely activities.” [5].

As I mentioned in “The Healthy 7 is also the Happy 7”, life-long learning is an integral component of healthful ageing and happiness, along with developing healthy coping mechanisms and cultivating long-term, stable relationships. Life-long learning increases cognitive reserve and staves off cognitive decline, which helps us be healthy and happy.

This then brings us to the last question. Should we test for minimal cognitive impairment (MCI), so that we can perhaps double-down on our efforts to reduce or control the decline, if we test positive? If you have no symptoms, or if you just tend to forget names and car-keys, but are otherwise fine, it probably does not help to get tested, especially now that we know that MCI can spontaneously reverse, unless there is a visible decline noticed by you or more importantly those around you.

In summary, physical activity, a sensible food plan preferably plant-based and containing fibre and good sleep including daytime naps, go a long way in preventing cognitive decline. Even if your brain is affected by pathologic processes that cause dementia and cognitive loss, a high level of education coupled with life-long learning will allow you to build significant cognitive reserve to help prevent the occurrence of clinical dementia and/or reduce the amount of significant cognitive loss if it does occur. Irrespective of your education level, it is a good idea therefore to start structured learning and to cultivate a wide range of leisure activities and hobbies that involve reading and learning and then try and implement that knowledge gained, in the best possible way.

Footnotes

1. Dhana K et al. J Alzheimer’s Dis. 2021;83:683

2. Yamagish K et al. Nutritional Neurosci. Online first. 06 Feb 2022

3. Sakhvidi MJZ et al. Lancet Planet Health 2022;6:3-219

4. Iraniparast M et al. Neurology. 2022 Mar 15;98(11):e1114-e1123. Medaglia JD et al. Neurosci Biobehav Rev 2017;75:53

5. Medaglia JD et al. Neurosci Biobehavior Rev 2017:75:53

6. Canadian Task Force on Preventive Health Care, Pottie K et al. CMAJ. 2016 Jan 5;188(1):37-46.