Your attitude towards ageing matters

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Increasing the amount of physical activity that you do cuts the risk of dementia by as much as 60%, when combined with a healthy lifestyle which includes cutting out nicotine and and cutting down on alcohol.

Recent research now explains that exercise is the key to ageing successfully because physical activity keeps your brain healthy. A 2015 study reveals that older adults (their participants were Japanese men aged 60 to 74 years) are more likely to use the same part of the brain for tasks requiring cognitive control (such as the Stroop test — you can try it here) as young adults if they are physically fitter; those with less fitness use more parts of their brain to perform the same task. Another 2015 study also finds that brain atrophy can be reversed among healthy older adults and those with mild cognitive impairment (MCI) through moderate intensity exercise.

But exercise is only half the equation. It’s also important to give your brain opportunities to grow new neural connections. The notion that healthy ageing involves giving yourself cognitively demanding tasks (see our earlier blog post) gets more support from a 2016 study. Building on earlier findings, this study demonstrates that mentally challenging activities – such as learning digital photography or quilting or learning both – produces greater improvements in memory than low hanging fruit, like travel and cooking activities for which participants are not required to learn something new.

It doesn’t do any harm to also increase healthy foods, specifically green vegetables, walnuts, curries, and omega-3 foods like eggs, bananas, dark chocolate, avocado, and blueberries, which have been found to reduce the risk of cognitive decline with age.

But it might surprise you to find out that social connections also have a powerful effect on your health. A 2016 study finds that having a larger social network is crucial for health during late, as well as early, adulthood. Seniors not in social isolation achieve better scores on health markers which include blood pressure, body mass index, and a measure of systemic inflammation.

And that your beliefs about ageing can also be impactful. A 2015 study finds that people who hold negative beliefs (e.g., “elderly people are decrepit”) are more likely to subsequently experience brain changes associated with Alzheimer’s dementia.

Just something to think about as the planets line up on this full moon.

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Ageing successfully

Couple on Beach

According to the World Health Organization (WHO), life expectancy and medical advances has lengthened lifespans in most countries, and the number of people aged 60 years and older has doubled since 1980. Living longer is easy, with the advances we’re making in the domain of science and medicine. But we’re probably more interested in answering the question of how we can age successfully. That and avoiding dementia.

On this International Day of Older Persons, let’s review what’s been known for a while:

1. Eat your veggies!

There’s no getting away from it. Studies show that those who live a long independent life in Okinawa eat lots of fruits and vegetables, as well as fish and whole-grains. Their habit of eating until they feel 80% full is also likely a major contributor to the reason for their disability-free longevity.

2. Stay active!

Research indicates that cardiovascular disease risk is a major contributor to Alzheimer’s and vascular dementia (Fratiglioni et al., 2004). Lowering this risk through regular, weekly moderate-to-vigorous exercise is one strategy. And also a reason why Sardinians, who herd sheep over steep hills, are reputed to age successfully (see this TED video about the blue zones).

3. Engage your social brain!

A review of the literature shows that adults who are socially active are also likely to have better psychological wellbeing in their later years; being engaged in social activities and having stronger social networks is a protective factor against dementia (Fratiglioni et al., 2004). Various studies show that religious attendance, community involvement, and being employed are associated with better mental wellbeing among older adults. These activities are also shown to be helpful for local residents too…

So to sum, it’s the same thing that us active younger (a little bit younger) adults need to start doing. But we just need to keep doing them!

Caregiving: It’s a thankful job

World Elder Abuse Day

The World Health Organization defines dementia as a syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities. It is not considered part of normal ageing, but affects a substantial number of older adults. The Statistical Appendix from the local Alzheimer’s Disease Association put the number of locals with dementia at 22 for every 1000 persons in the year of 2005.

The multidimensional response to the negative appraisal and perceived stress resulting from taking care of an ill individual (Kim et al., 2011) does however negatively affect those tasked with looking after the care recipient. This caregiver burden puts strain and stress particularly on those in full or part-time employment.

And caregivers aren’t necessarily only those who do this job fulltime. There are more caregivers out there than you think. A 2011 Singstat Singapore Newsletter article reports that almost 75% of respondents providing regular assistance to friends or family in 2010 were also working adults who juggle work with caregiving responsibilities.

Given that research has shown that caregiver stress increases with the physical dependency of the care receipient, it’s all the more important that caregivers are equipped with the right knowledge. Kua and Tan in a 1997 study (see also Mehta, 2005) found that those who looked after care receipients with dementia tended to experience a high level of stress. And according to WHO, this is a pattern observed in other communities as well.

But the mental health of caregivers is often overlooked. Although various organisations like the US Family Caregiver AllianceTouch Caregivers, Singapore Caregiving Welfare Association, Women’s Initiative for Ageing Successfully, Council for the Third Age, Asian Women’s Welfare Association, Tsao Foundation and Singapore Family Caregivers, have useful self-care tips, caregivers typically do not seek help for themselves.

So we may need to play our part and help someone we know and care about. The American Psychological Association (APA) suggests a self-assessment instrument which was designed by the American Medical Association.

So on this World Elder Abuse Awareness Day, help that person you know take a step in the right direction. Get him or her to assess his or her stress levels, which will ultimately protect himself or herself from being burnt out as a caregiver!

Majong is good for you

That majong is good for us is music to our ears (well, at least for some of us who actually play majong). The claim is based on recent research findings, which has led to reports that “tai chi, majong offer hope for dementia patients” (South China Morning Post, 22 April 2013; see also a similar report in www.majongnews.com).

The evidence is based on two studies. The first showed that a 3-times-a-week programme of either tai chi or majong for 12 weeks was significantly more effective in reducing depression scores among older adults with mild dementia and moderate depression in nursing homes than a handicraft control condition (Cheng et al., 2011). The second showed that the same programme was effective in improving cognitive task performance for a sample of 110 participants with the same population characteristics (Cheng et al., 2012); the first study sampled 12 participants for each condition. It’s not the case that the findings are limited to only nursing residents because these results replicate an earlier finding by Cheng and colleagues. Their 2006 study found that playing majong twice or four times a week for a duration of 16 weeks improved the cognitive performance of 62 older adults living in the community.

Although it would appear that playing majong is helpful in protecting against dementia, it would be wise to also observe that the participants in the 2006 study had not played (although they knew how to play) the game for at least 6 months prior to the study. Similarly, nursing residents were also not regularly practising tai chi or playing majong on a regular basis before the intervention programme was implemented. That is to say, there may be some benefit initially of engaging in mentally challenging activities, but at some point the cognitive demand of these activities may not be sustained over the longer term.

So the advice is to provide your brain with opportunities to grow new neural connections. Giving yourself cognitively demanding tasks like mastering a new language, musical instrument, skill, dance, game, or exercise form, serves this purpose. Learning to play a mentally challenging game like Chinese or international chess, weiqi, taboo, scattergories, and majong for the first time will definitely put us out of our comfort zone. But with a little practice (or a lot for strategy games), it likely loses its edge in its ability to build cognitive reserves and its protective cloak against Alzheimer’s disease. If you’re feeling comfortable, whatever you’re doing is not likely to be of extra benefit. If you’re feeling the strain on your brain, you should keep doing it (at least for a while).

Learning is important. But what’s crucial is that we keep levelling up.