Protecting the Aging Brain

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

Ashes to ashes…Dust to dust…Oil those brains…Before they rust.

—Children’s poet Jack Prelutsky, from A. Nonny Mouse Writes Again!

Your brain is a 3-pound mass of water, fat, and 100 billion neurons. That’s about 2 percent of total body weight—but we all know that it plays a much heftier role in the overall scheme of things. The brain is the CEO of your body. As such, it deserves a good deal of attention, especially as you start getting up in years.

All of the activity carried on by the brain that we call “thinking” is accomplished through electricity and chemicals. To help protect these vital processes and maintain optimum mental function for as long as possible, medical science has given us some con­crete ideas—many of which I’ve shared with you over the years. After attending a great lecture on protecting the brain while at an anti-aging confer­ence in Las Vegas, I thought it would be a good time to revisit the subject. So let this article serve as a brief refresher course on the brain. It’s a subject you really can’t know enough about.

Physical Changes Are Predictable

As we age, the brain—like the rest of the body—changes in ways that make it less efficient. For instance, beginning in our 60s or 70s, brain mass may shrink a bit. Certain areas downsize more than others. One of them is the frontal lobe, which con­tains the prefrontal cortex—the primary thinking area of the brain—and another is the hippocampus, which is where new memories are formed. At the same time, the outer surface of the brain thins slightly due to a reduction in synaptic connections, the communication avenues between brain cells.

The amount of white matter also decreases. This fatty tissue serves both as electrical insulation and as the passageway for messages traveling between different areas of grey matter that belong to the nervous system. Aging white matter is linked with changes in the speed of memory, attention, action, problem solving, and decision-making abilities. Aging brains also produce fewer neurotransmit­ters—chemicals like serotonin—to transport mes­sages between brain cells. There is also a loss of receptor sites on cells for these chemicals, which can affect memory.

It’s Not Always Alzheimer’s

When confronted with a loss of mental function in an aging patient, it’s difficult for doctors to pin­point the precise cause. Many things can contribute to a decline, either by themselves or in combina­tion: Alzheimer’s disease, vascular dementia from impaired blood flow to parts of the brain, long-standing hypertension, mini-strokes, a lifetime of drinking too much alcohol, and even lack of exercise.

People commonly refer to dementia as Alzheimer’s, but that may not necessarily be the case. Alzheim­er’s disease is a specific condition that destroys brain cells and causes problems with memory, thinking, and behavior that, even in its early stag­es, are severe enough to affect work, lifelong hob­bies, and one’s social life. It is, however, the most common of dementia-related conditions, it worsens over time, and it can be fatal.

There is a great deal that medical science does not yet know when it comes to the aging brain. For that reason, the right diagnosis is often elusive. It’s also worth noting that your ability to quickly remember what you did with your keys or glasses, or to remember peoples’ names, is often affected by much lesser problems than dementia (drug side effects are one cause). And remember, there is a natural slowing down in the speed of recall with age.

Anti-aging medicine is about protecting the body (and the brain) as we get older. It’s not about simply prolonging life, especially if that means you must live in a minimally functional state. Instead, it focuses on preserving physical and mental faculties and slow­ing the pace of decline that naturally accompanies time—so the quality of your life remains high.

Ways to Support Your Brain

There are a number of natural ways to stay men­tally sharp. Here are some of my favorites:

  • Keep the lid on your stress level. Scientists have discovered that stress—in the form of emo­tional, mental, or physical tension—can physi­cally reshape and shrink the brain and cause long-lasting harm to humans and animals. Stress may aggravate or lead to Parkinson’s, Alzheimer’s, and other neurodegenerative dis­eases. Find ways to manage your stress, such as meditation, prayer, yoga, T’ai Chi, or the pursuit of some engaging or relaxing hobby.
  • Keep your blood pressure under control. Hypertensive patients have a greater propensity for ischemia in the brain—in other words, the brain doesn’t get enough oxygen. As I’ve dis­cussed in the past, high blood pressure exerts constant damaging force inside the arteries. Although your body can repair this damage, the cholesterol it uses to do so can build up over time and form plaque. Significant plaque buildup will narrow the arteries and reduce blood flow, resulting in oxygen deficiency in the brain and other organs. Keeping stress under control is one of the best ways to naturally reduce blood pres­sure, as is my next recommendation: exercise.
  • Exercise regularly. Walk. Dance. Do T’ai Chi. Use a rebounder. Exercise increases blood flow to the brain, which in turn delivers more oxygen and nutrients to cells. This not only helps keep cells in top shape, but also supports the removal of waste. Additionally, aerobic exercise produces a hormone called brain-derived neurotrophic factor (BDNF), which helps preserve existing neurons and create new ones. This hormone is active in the hippocampus and prefrontal cor­tex—areas that are vital to learning, memory, and higher thinking, and, as I explained earlier, are especially vulnerable to aging. Exercise also increases levels of the neurotransmitters sero­tonin and dopamine. Serotonin is a mood eleva­tor while dopamine is important for being able to maintain focus.

While I’m on the topic of exercise, I’d also like to emphasize the importance of wearing a helmet if you participate in an activity like cycling. An unexpected fall could cause an injury that may permanently damage the brain. We’re especially vulnerable to this as we age because our blood vessels become more prone to bleeding.

  • Challenge yourself to think. Now, I’m not suggesting that you go back to school, but ten­nis great Jimmy Connor’s famous words cer­tainly apply here: “Use it or lose it.” That is, your brain is like a muscle—it will atrophy if it’s not regularly exercised. That’s why it’s important to involve yourself in activities that challenge and stimulate the brain. Some examples include puzzles, riddles, games (chess and card games are excellent), taking a class, or teaching your­self a new skill. I’ve even heard of people teach­ing themselves a new language! It really doesn’t matter what you choose so long as it forces you to think creatively, and you do it regularly.
  • Nutritional Support
  • Eat less sugar. I consider sugar to be the num­ber one cardiovascular enemy because it causes inflammation in the body. Sugar combines with proteins in the blood to form advanced glycation end products (AGEs). These substances can damage the highly sensitive endothelium—the inner lining of the arteries—whether they lead to your heart or your brain.
  • Drink less alcohol. Alcohol is damaging to the liver and it contributes to premature aging of the brain. Alcohol interferes with normal digestion, absorption, use of nutrients, and excretion of waste, and it creates nutritional deficiencies. Chronic heavy drinking can affect many vital nutrients, including glucose, pro­teins, and vitamins A, B-complex, C, D, E, and K, as well as the minerals magnesium, iron, calcium, and zinc. Over time, excessive drink­ing can cause effects ranging from simple “slips” in memory to permanent, debilitating conditions that require ongoing custodial care.Eat organic blueberries on a regular basis. Blueberries contain a powerful array of brain-friendly antioxidants and pigments. According to animal studies, these natural compounds lower oxidative stress and inflammation, as well as enhance communication pathways between neurons and neurotransmitters. An excellent source for high-quality blueberries is
  • Consider genetic testing. If you have a fam­ily history of Alzheimer’s or dementia, you should be tested to see if you have a gene that predisposes you to the condition. Check with your doctor or insurance carrier to find out where the test is available. Specifically, the test will look for the APO E4 allele. APO refers to a blood protein involved in fat metabolism. Alleles are combinations of genes. The presence of two alleles identified as E4 in these proteins sug­gests that you need to be especially mindful about protecting yourself—not just for the risk of dementia, but also heart disease. For more about APO E4, visit

Finally, remember that we live in an increasingly toxic environment. Along with pesticides, insecti­cides, and chemical pollutants, we are constantly exposed to new wireless technologies that can have disruptive effects on the body. These factors threat­en our faculties, in the young and old alike, and we have to protect ourselves as much as possible.


  • DHA (Docosahexaenoic Acid), an Omega-3 Fatty Acid, in Slowing the Progression of Alzheimer’s Disease. Web site: Accessed February 2, 2009.
  • Dukic-Stefanovic S, et al. AGES in brain aging: AGE-inhibitors as neuroprotec­tive and anti-dementia drugs? Biogerontology. 2001;2(1):19–34.
  • Shukitt-Hale B, Lau FC, Joseph JA. Berry fruit supplementation and the aging brain. J Agric Food Chem. 2008 Feb 13;56(3):636–641.

This article originally appeared in the March 2009 issue of Dr. Sinatra’s monthly written newsletter,  Heart, Health & Nutrition. HMDI has reprinted this article with permission from Healthy Directions, LLC (© 2009 Healthy Directions, LLC).

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