We spoke to Giuseppe Fernando Colloca, lecturer in Geriatrics at UniCamillus University
As life expectancy increases, so does the number of older people. This also leads to an increase in the rate of cognitive decline, which is a natural age-related process and consists of a gradual slowing down of memory, attention and thinking speed.
These physiological changes do not necessarily lead to dementia: in the case of this disease (the most common of which is Alzheimer‘s), the deterioration is more rapid and significant, affecting the person’s autonomy and quality of life and requiring medical treatment.
However, to avoid these extreme consequences, it is important to ‘train’ the brain so that it does not lose its elasticity.
How can we delay the brain’s retirement age as long as possible? We asked Giuseppe Ferdinando Colloca, lecturer in Geriatrics at UniCamillus University.
What are the most common age-related changes in the brain? And how do they differ from the different forms of dementia?
“If we think of ageing as a continuous process from birth, we can better understand how brain function can also vary from childhood to adulthood and then to old age.
During childhood there is a steady increase in the ability to think and reason, allowing the child to acquire increasingly complex skills, whereas in adulthood brain performance is relatively stable.
As part of this physiological ageing process, the brain begins to decline at a certain point, with the volume of certain areas decreasing by up to 1% per year in some people, albeit without any loss of ability.
Very interesting is the Nun Study, a study of a community of Catholic nuns followed since 1986, who donated their brains to science to study the ageing processes and those that could lead to Alzheimer’s disease and other forms of dementia. The study showed that the pathological changes associated with Alzheimer’s disease do not always translate into cognitive deficits or pathological behaviour. It demonstrated that many people who appeared to be cognitively healthy had brain changes consistent with advanced Alzheimer’s disease. This is a sign of the plasticity and adaptability of our brains.
The most common changes are initially short-term memory and the ability to acquire new knowledge, which tend to be impaired. Verbal abilities are then affected, while information processing tends to remain intact in the absence of concomitant neurological or vascular disorders.
Redundancy, the formation of new connections and nerve cells, can compensate for these losses.
If family members or the person themselves are in any doubt, they should consult an expert (geriatrician or neurologist in a memory clinic) and avoid self-medication”.
What are the first symptoms of neurodegenerative diseases to look out for? Is there a way to intervene early?
The biggest concern for both patients and practitioners is that memory loss is a precursor to dementia. Classically, the most common symptoms are difficulty remembering names or where one’s car or house keys are. But memory loss is not the beginning of dementia! In most cases, this symptom is related to other causes. Other signs to look out for include depression, confusion, personality changes and difficulty with everyday activities. As memory loss becomes more severe, people may not remember how to pay bills or find their way home, and may get into dangerous situations, such as forgetting to turn off a cooker.
In all these cases, it should be considered, through your GP, whether you should be referred to a specialist for a multidimensional assessment and possibly neuropsychological testing to identify and treat possible causes”.
What kind of activities do you recommend to keep the brain fit?
“Take regular exercise, eat a healthy diet with plenty of fruit and vegetables, get enough sleep, don’t smoke, reduce or eliminate any alcohol or other substances and take part in socially and intellectually stimulating activities.
Reading, learning new things (for instance, a new language or playing a musical instrument), doing mental exercises (jigsaw puzzles, word puzzles, chess or other games involving strategy) are all activities that seem to stimulate brain plasticity and slow down cognitive decline”.
Let’s turn to nutrition: what food should we favour to improve brain health?
“Food is not just a source of energy, but it is also a healing and preventive force: a good diet is a recipe for longevity. Fruit, vegetables and foods rich in antioxidants help prevent inflammatory processes and those that accelerate ageing. Omega-3 fatty acids, found in nuts—walnuts, almonds, flaxseeds—and oily fish, play an important role in neuronal plasticity”.
How important is our lifestyle?
“An unhealthy lifestyle, substance or drug abuse and poor diet are all associated with multiple risk factors and therefore the possibility of developing some form of dementia. Our lifestyle at any age has an impact on our future”.
Social life: how important is it and what do you recommend?
“This question brings me to the Blue Zones, so let’s broaden the field to longevity. The Blue Zones are the areas of the world where people live longer while maintaining good physical and cognitive performance. Together with Italia Longeva—the national association for ageing and active longevity—we went to visit and study these zones a few years ago: the secret of longevity lies in a combination of lifestyle, sociality and simplicity. Living in a community, interacting with others, being active and participating prevents the development of cognitive impairment and allows you to stay healthy. An example of a blue zone in Italy is Ogliastra in Sardinia”.