Here’s a harrowing statistic, and a cause for hope: According to the World Health Organization, 50 million people worldwide are suffering from dementia, a number projected to triple by 2050. Fortunately, experts say there are lots of measures we can take—many of them pleasurable, or at least, not particularly onerous—to fortify our cognitive functioning. Increasingly, studies point to the deeply intertwined nature of physical, emotional and cognitive health.
“The science is pretty clear: As you exercise, neurotrophic growth factors are released that actually help to make new neural networks that preserve and enhance cognitive ability,” says Richard Carmona (pictured right), a trauma surgeon who served as surgeon general under president George W. Bush and is the author of Canyon Ranch: 30 Days to a Better Brain. Carmona, enviably trim at 69, practices what he preaches and urges all of his patients to follow his lead by engaging in daily cardiovascular and strength-building exercises, eating sensibly and maintaining strong social connections.
Happily, research has also established that the healthy diet and physical activity recommended for brain health benefits the heart as well.
“We’re seeing more and more evidence that heart and brain health are closely linked, and that’s because of blood flow,” says Monique Tello (pictured left), a practicing physician at Massachusetts General Hospital, clinical instructor at Harvard Medical School and author of Healthy Habits for Your Heart. “The research goes back to the 1970s, and now it’s widely accepted that anything that improves blood flow to the brain—which is the same as blood flow to the heart—can help prevent some forms of dementia. What’s fascinating about [the World Health Organization’s] dementia prevention guidelinesis how similar they are to those for heart disease prevention.”
In addition to physical activity, investing the time to exercise the brain itself—challenging the mind with exercises like learning to speak a new language or studying a new instrument—plays a key role in healthy aging.
“You can change your brain and its health by systematically exercising it—just as you can improve your physical body and health,” says Michael Merzenich (pictured right), emeritus professor of otolaryngology at University of California, San Francisco, where he was codirector of the Keck Center for Integrative Neuroscience.
Carmona cites experiments he’s run, challenging right-handed patients lucky enough to stay for a month at one of Canyon Ranch’s medical spas, where he’s chief of health innovation. “I say to them: ‘While you’re here, I want you only to write with your left hand. I’ll make sure you’re sleeping well, that you’re doing some exercise, that you’re de-stressing, that you’re engaged in meaningful social relationships with your peers. I’ll get a handwriting coach to help you. What would your writing look like after a week, after two weeks, after three weeks? In the beginning it’s going to be kind of gross, at the macro level, but when you leave, your left and right will be indistinguishable.’”
That experiment, Carmona says, demonstrates neuroplasticity, the science establishing the brain’s ability to continue making new connections and encode new neural pathways.
It’s an area pioneered by UCSF’s Merzenich, who founded the company BrainHQ, which offers subscription-based brain training exercises. “In our studies, we defined specific brain exercise strategies that are most beneficial for sustaining your neurological vitality. Those exercises are embodied in the brain gym provided by BrainHQ. In that gym, you can calibrate yourself—for example, by defining your brain speed and accuracy relative to others of your age—and if you’re not near the top of the heap, get serious about exercising in the ‘gym’ until you more than catch up.”
While Merzenich, author of Soft-Wired: How the New Science of Brain Plasticity Can Change Your Life, has built a business selling online strategies for brain health, he is quick to emphasize the many ways that free, offline activities contribute to cerebral wellness.
Among them: sleeping soundly, spending quality time with loved ones and perhaps the most challenging in our super wired society—embracing daily, technology-free spontaneity.
“Get away from those electronic devices for a substantial length of time every day,” Merzenich says. “Engage with that world outside, where most of the surprises in life will be found, in a mindful way. Look for joyful things out there. Surprises are brain food. They engage the machinery in your brain that directly controls your liveliness. They’re a key to sustaining a happy, positive spirit in life.”
Merzenich’s point, that external factors directly influence cognitive vitality, and that positive emotional experiences positively impact cellular health and growth, has led even traditional, Western-based medical researchers to embrace East Asian practices like Ayurveda, yoga, acupuncture and reiki, once marginalized as “alternative” medicine.
“This is not a foo-foo idea from crazy people or hippies, this is real science, and some of this stuff is 3,000 years old. We have an understanding now, and we’re smart enough not to dismiss it, not to embrace what I call the arrogance of Western medicine,” says Carmona, who as surgeon general participated in the planning for what became the NIH’s National Center for Complementary and Integrative Health.
“You get a massage, and if you like it, neurotransmitters like dopamine and the endocannabinoid system in your brain respond and say, ‘I want to come back and do that again.’ So you’re getting a neuroplastic benefit from it that you’re feeling physically well, and that’s helping your brain as well,” he says.
Those positive sensations, Carmona explains, are epigenetic inputs, environmental stimuli that influence health on a cellular level by effecting gene expression, and they’re so important that he urged me to try reiki, a Japanese form of energy healing, at Canyon Ranch’s Lenox, Mass. campus.
“Essentially, the gene is a software package, and you get to code it for most of your life,” Carmona explains. “Who you are is determined 25 or 30 percent by the genes you inherit from your parents, but the other 70 to 75 percent is determined by the daily decisions you make.”
With Carmona’s encouragement, I was ushered into a quiet treatment room by my therapist Becky, unsure of what to expect, and not at all certain I would enjoy the procedure. Lying down on the massage bed, I closed my eyes and the session began. Unlike massage, for reiki one remains dressed, but the experience was in some ways more intimate, as Becky held positions, whether cupping my face or touching my shoulder, for several minutes. I was battling a bad sore throat, and Becky hovered over my neck for an extended period as well, encouraging me to breathe slowly and deeply, as in a yoga class. I do not practice yoga, but the session quickly and easily took on a sort of meditative state, filling me with warmth and a drowsy sense of stillness and tranquility.
Merzenich says this kind of quiet, when practiced regularly, can provide profoundly beneficial results.
“The values of meditation have been particularly strongly validated through intensive neurological studies [which] have documented enduring plastic changes that contribute to sharpening your attentional focus and reducing the noisiness that can degrade it,” he says. “These brain activity-quieting strategies can induce changes in gene expression that facilitate a transition to a positive brain growth mode.”
Carmona, a member of many boards and frequent conference speaker, attributes his own keen mind to the steady stream of information he reads on neuroscience, physical science, pharmacology and the food industry, and to his work as a University of Arizona professor.
“If nothing else, my ego prevents me from embarrassing myself if I can’t answer my students’ questions, so I have to stay abreast of all the things that are coming my way,” he says, adding that he enhances the perks of learning new information with a good diet, exercise, sleep and social connections.
“You need all of those things put in the proper order, otherwise you don’t get the maximum benefit of the neural plastic ability, which is laying down those neural tracks or enhancing the old ones. It’s not only about new stuff, it’s about making sure the stuff you already have doesn’t deteriorate. If you don’t use it, you lose it.”