#13: We Can Lower Our Risk Of Cognitive Decline

08/12/24 • 42 min

Live Long and Well with Dr. Bobby

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Approximately 40% of the risk for cognitive decline is preventable through lifestyle changes and proactive measures.
Nearly 7 million Americans are affected by Alzheimer's, with numbers expected to double in the coming decades. It's the sixth leading cause of death, costing the US around $800 billion annually.
Not Inevitable: Cognitive decline is not an inevitable part of aging, as demonstrated by figures like Barbara Walters and Henry Kissinger, who remained mentally sharp well into their later years.

Part 2: Strategies That Work

Exercise: Regular physical activity is associated with a 28% reduction in the likelihood of Alzheimer's. Dancing, in particular, has shown benefits due to its combination of physical and mental engagement.
Sleep: Adequate sleep (around seven hours per night) is crucial, with poor sleep increasing the risk of Alzheimer's by 68%.
Smoking: Smoking cessation is critical, as smoking is linked to 5% of dementia cases.
Blood Pressure Control: Managing hypertension can greatly reduce the risk of cognitive decline
Obesity and Diabetes: Both conditions are associated with an increased risk of dementia.
Sauna Use: Regular sauna use correlates with a reduced risk of dementia, with benefits increasing with frequency of use and time/session.
Hearing Loss: Treating hearing loss may lower the risk of cognitive decline by maintaining cognitive stimulation.
Alcohol Consumption: Reducing alcohol intake can decrease the risk of cognitive impairment.
Social Engagement: Maintaining strong social connections is associated with a reduced risk of dementia.

Part 3: Strategies That Don't Work

Omega-3 Supplements: No substantial evidence supports their role in preventing cognitive decline.
Brain-Focused Diets: Diets like the MIND diet have not shown significant benefits in reducing cognitive decline in clinical trials.

Part 4: Unclear or Emerging Strategies

Probiotics, Viagra, and Multivitamins may have benefits.
Brain Training Games: While they may improve specific skills, there is limited evidence that they prevent general cognitive decline. Newer approaches have some promising results

Send us a text

Approximately 40% of the risk for cognitive decline is preventable through lifestyle changes and proactive measures.
Nearly 7 million Americans are affected by Alzheimer's, with numbers expected to double in the coming decades. It's the sixth leading cause of death, costing the US around $800 billion annually.
Not Inevitable: Cognitive decline is not an inevitable part of aging, as demonstrated by figures like Barbara Walters and Henry Kissinger, who remained mentally sharp well into their later years.

Part 2: Strategies That Work

Exercise: Regular physical activity is associated with a 28% reduction in the likelihood of Alzheimer's. Dancing, in particular, has shown benefits due to its combination of physical and mental engagement.
Sleep: Adequate sleep (around seven hours per night) is crucial, with poor sleep increasing the risk of Alzheimer's by 68%.
Smoking: Smoking cessation is critical, as smoking is linked to 5% of dementia cases.
Blood Pressure Control: Managing hypertension can greatly reduce the risk of cognitive decline
Obesity and Diabetes: Both conditions are associated with an increased risk of dementia.
Sauna Use: Regular sauna use correlates with a reduced risk of dementia, with benefits increasing with frequency of use and time/session.
Hearing Loss: Treating hearing loss may lower the risk of cognitive decline by maintaining cognitive stimulation.
Alcohol Consumption: Reducing alcohol intake can decrease the risk of cognitive impairment.
Social Engagement: Maintaining strong social connections is associated with a reduced risk of dementia.

Part 3: Strategies That Don't Work

Omega-3 Supplements: No substantial evidence supports their role in preventing cognitive decline.
Brain-Focused Diets: Diets like the MIND diet have not shown significant benefits in reducing cognitive decline in clinical trials.

Part 4: Unclear or Emerging Strategies

Probiotics, Viagra, and Multivitamins may have benefits.
Brain Training Games: While they may improve specific skills, there is limited evidence that they prevent general cognitive decline. Newer approaches have some promising results

Previous Episode

#12: To Test or Not To Test?

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We’re bombarded with advertisements for all sorts of tests these days: comprehensive blood panels for a few hundred dollars, total body MRI scans for cancer detection, heart calcium scans, and even tests to rule out multiple cancers. But are these tests worth it if you are asymptomatic and don’t have an important family history?

A few years ago, I experienced fainting episodes while running. After a series of tests, including seeing a cardiologist, I was told that my blood pressure dropped upon standing—a condition that required no treatment, just caution. During these tests, they found that my heart was larger than usual. This discovery led to a lot of anxiety over the years, despite it likely being a false positive. This case illustrates how even with legitimate symptoms, testing can sometimes lead to more questions than answers. And, large panels of tests compound the problem.

The Issues with Testing

It’s tempting to think that more testing is better, but the reality is that tests are imperfect. They’re often based on statistical averages, and results can be misleading. For example, if you undergo multiple tests, you’re likely to get some abnormal results just by chance. This can lead to further testing, expense, time, potential medical complications, and unnecessary worry.

Medical Expert Recommendations

Organizations like the US Preventive Services Task Force and the American College of Radiology provide guidance on screening tests. They recommend specific tests like pap smears, mammograms, and colonoscopies, but not routine total body MRIs or large blood panels. Even well-regarded screening tests can result in false positives, as shown by studies and practices in countries like South Korea.

Real-Life Examples

I’ve seen friends go through the stress of false positives from MRIs or calcium scores, leading to further tests and anxiety. It’s essential to weigh the potential impact of these findings on your life, including how they might affect insurance and your mental well-being.

Conclusion

To sum up, while early detection of health issues sounds appealing, the reality is that many screening tests can lead to false positives and unnecessary complications. If you’re asymptomatic and don’t have a concerning family history, it’s often best to save your money and avoid these tests. Always consult with your doctor to make informed decisions based on your specific health needs.

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#14: Eight Glasses Of Water A Day: Important Guidance Or Urban Myth?

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Our bodies are 60% water and water is really important. But, It is not clear the origin of drinking 8 glasses of water per day. There were no studies that scientifically show that this number is the correct amount. I vote that it is an "urban myth." Good report summarizes important information about how our body uses water
But, water is crucial for us, just not that mythical amount. Our body uses water in the following ways:

urine to excrete byproducts of what we eat (perhaps 2-3 glasses of water per day needed)
respiratory loss (perhaps 1 cup/day)
"insensible loss"-sweating to maintain body temperature (wide range depending upon temperature--2 glasses of water/day up to 1 gallon or more)
stool perhaps 1/2 cup of water per day

My take on the scientific evidence:

1. The body is amazing at controlling our water balance. Trust it! There is no evidence based reason to focus on getting 8 glasses of water each day. And, we get substantial fluids from our food/morning coffee/milk or sodas at meals...

2. If you are thirsty, drink. If your urine has gotten much darker, then perhaps drink. Otherwise trust your body
3. these observations don't apply if you have kidney disease or are elderly. Ask your doctor.

Tasty water "tidbits": drinking extra water each day...

does not seem to make our skin look young and full (might hydrate it a little but not clear if it looks better)
does not seem to affect our joints/cartilage (no evidence found here...)
does not reduce dry eyes
probably doesn't help us eat less
DOES reduce the risk of recurrent urinary tract infections