Women's Bodies, Women's Wisdom (128 page)

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Dementia is not inevitable. Most women have a very good chance of preserving our memories as we grow older—and in fact may even improve them. Neuropsychological testing has shown that brain function in healthy older people remains normal throughout the eighth decade (which is as far along as it has currently been studied).

There is no question, however, that hormones have an effect on brain function, which is why those who’ve had their ovaries removed before the age of forty have a much higher risk of neurologic problems later in life, including dementia. Millions of women have taken hormone therapy in part to ward off dementia because estrogen was originally thought to be protective, yet data from the Women’s Health Initiative Memory Study showed that the risk of dementia in the estrogen-only HT group, which was taking Premarin, was 49 percent higher than in women not taking hormones.
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While the individual risk is small (among 10,000 women using hormones, 37 could be expected to develop dementia, compared to 25 in the no-hormone group—a mere 12 extra cases) and the risk was not deemed statistically significant, the data are still cause for some concern. As I’ve already said, I believe Premarin to be the most problematic of all the choices out there. (In contrast, a 2009 study done at Emory University School of Medicine in Atlanta showed that transdermal estradiol may confer at least modest protection against Alzheimer’s, especially if it’s begun soon after menopause.)
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In contrast to Premarin, bioidentical estrogen has been shown to encourage dendritic and axonal branching between brain cells—a process associated with enhanced memory.
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This is one of the reasons why some women on estrogen report better mood and even memory. (DHEA and pregnenolone—a steroid hormone related to progesterone—also aid the proliferation of connections between brain cells.)
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To date, there have been a few studies of women with mild to moderate Alzheimer’s whose memory has improved initially on estrogen. And, in fact, estradiol (one type of natural estrogen) binds to the areas in the brain that are associated with memory and are affected by Alzheimer’s disease: the cortex, the hippocampus, and the basal forebrain.

Brain function and memory preservation—and the acetylcholine lev els associated with these functions—are also affected by a wide variety of factors other than hormones.

A Brain Preservation Program

Update your knowledge and attitude about memory and age.
Our society currently operates under the mistaken notion that it is normal to become senile, lose memory, and have a change of personality with age—and all of us have been around relatives and friends with Alzheimer’s or other de- mentias and know what a toll this illness can take on everyone concerned. But no one loses neurologic function simply because of age. There are always other factors such as cellular inflammation, suboptimal nutrition, and so on. So the first thing you must do to enhance your brain function is to stop buying in to the self-fulfilling prophecy about memory decline with age. Start by banishing the phrase “senior moment” from your vocabulary.

Here are the facts: When you are born, you have a full complement of nerve cells in your brain, which reaches its peak size at about age twenty, after which there is a gradual decline in size throughout the rest of your life. If bigger is better, that would mean that we reach peak wisdom and intelligence by age twenty, which is a completely ridiculous notion (this will immediately become obvious to you if you watch much MTV).

The key to appreciating and enhancing your brain function is to realize that normal loss of brain cells over time is not necessarily associated with loss of function. In fact, studies have shown that throughout our lifetime, as we move from naiveté to wisdom, our brain function becomes molded along the lines of wisdom. Think of your brain as a tree that requires regular pruning if it is to acquire its optimal shape and function. Brain cell loss with aging is akin to pruning the nonessen tial branches that may actually be interfering with optimal function by clouding consciousness and mental clarity. Complementing this proc ess, the dendritic and axonal branching among brain cells actually increases with age as our capacity to make complex associations increases. What this means is that the older and more experienced you become, the more likely you are to lose inessential connections and cells in your brain but develop new connections that help you synthesize your experiences. This is how wisdom gets wired!
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Protect yourself with antioxidants.
Adequate antioxidant and vitamin intake helps prevent Alzheimer’s since it reduces the amount of free-radical damage to brain tissue.
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Free radicals are unstable molecules that are formed in our cell tissue by culprits such as radiation, trans fatty acids, and even oxygen. These free radicals combine with normal, healthy tissue and cause microscopic scarring and damage, which over time sets the stage for loss of tissue function and disease. Antioxidant vitamins, such as vitamin E, help quench these free radicals as soon as they are produced, thus helping to spare our brains, hearts, blood vessels, and other tissues from their ill effects.

Make sure your diet is rich in vitamins C and E, selenium, and the B vitamins, including folic acid. In fact, vitamin E has been shown to slow the progression of already-diagnosed Alzheimer’s, but why wait? Another class of powerful antioxidants are the proanthocyanidins found in pine bark and grape pips. Since a great deal of brain health depends on minimizing free-radical damage, women should include a good antioxidant formula in their daily supplementation program.

Avoid smoking and excessive alcohol intake.
Alcohol affects the basal forebrain—an area associated with memory. And cigarettes are well-known factors in causing cardiovascular disease and small blood vessel changes that decrease oxygen to your brain tissue.

Protect your brain acetylcholine levels.
Avoid drugs that are known to decrease acetylcholine levels. Decreased acetylcholine is associated with memory loss and confusion. You’d be amazed at how many of these there are and how few doctors realize their adverse effect on brain function. Check the label of any medication used for sleep, colds, or allergies to see if it contains diphenhydramine (which is commonly sold under the name Benadryl). Examples are Tylenol PM and Excedrin PM.

Consume omega-3 fats.
All of the cells of the central nervous system (the brain and spinal cord) are made from specific types of fat. The omega-3 class of fats is particularly important for healthy brain function. I recommend 1,000 to 5,000 mg of omega-3 fats daily. (See
chapter 17
.)

Engage in regular exercise.
Studies have shown that exercise improves memory even in those who are already showing signs of dementia. Imagine what it does to prevent the problem!