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Experts Find Keys to Healthy Brains for Aging
Americans
National Institutes of Health moves forward on
"healthy brain" project
 Feb.
21, 2006 – A panel of experts seeking ways aging Americans can keep
their brains healthy, has zeroed in on education, cardiovascular health,
physical activity, psychosocial factors and genetics as key factors
associated with brain health as people age. In their report to the
National Institutes of Health, they said research aimed at directly
testing the effectiveness of interventions in several of these areas
deserves further attention.
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The NIH is intensifying the search for strategies
to preserve brain health as people grow older and the effort moved an
important step forward today with a report by the expert panel.
The report is published online today in Alzheimer's
and Dementia: The Journal of the Alzheimer's Association.
It is a product of the Critical Evaluation Study
Committee, a panel of experts appointed by NIH and led by Hugh Hendrie,
M.B., Ch.B., D.Sc., of Indiana University, Indianapolis. The committee
evaluated several large on-going studies of older adults for current
scientific knowledge on brain health.
"Three NIH institutes--the National Institute on
Aging (NIA), the National Institute of Mental Health (NIMH) and the
National Institute of Neurological Disorders and Stroke
(NINDS)--established the NIH Cognitive and Emotional Health Project to
coordinate and accelerate research leading to interventions for
neurological health," says NIH Director Elias A. Zerhouni, M.D.
"This report suggests a future direction of
research and is a terrific example of what we can learn when scientists
of diverse specialties work together on a complex health issue."
Hendrie and colleagues cited demographic pressures
to find ways to maintain cognitive and emotional health with age.
Approximately 4.5 million Americans have Alzheimer's disease, and
additional numbers of older people experience less severe, but still
problematic cognitive impairment with the risk of such cognitive decline
increasing with age. In one area of emotional health – depression – the
everyday function of an estimated two million older adults is also
threatened, according to NIMH.
"With more Americans living well into their 70s,
80s and 90s, developing strategies to preserve cognitive and emotional
health as we grow older is a major public health goal," says Richard J.
Hodes, M.D., Director of the NIA. "This report analyzes research
identifying factors that are associated with cognitive and emotional
health and most importantly describes several directions for testing
interventions to determine their effectiveness in improving cognition
and emotional health."
The panel broadly discussed a change in the focus
of brain research. In addition to studying specific causes of brain
disease and dysfunction, research also should approach cognition and
emotion from the opposite direction--looking at what works to preserve
brain health. "We set up the Cognitive and Emotional Health Project in
recognition of changed thinking. In this report, the committee
specifically articulates a new paradigm for research focused on health
rather than dysfunction," says NINDS Director Story C. Landis, Ph.D.
Another major theme emphasized the
interconnectedness between cognitive and emotional health. Cognitive
health and emotional well-being are "inextricably linked," the report
concludes, and efforts should be made to examine them simultaneously.
"Cognitive decline and emotional stress in older
people involve a number of physiological and psychological processes
going on at the same time," says Thomas Insel, M.D., Director of NIMH.
"This report highlights the need to better
understand this interrelatedness if we are going to devise effective
ways to maintain brain health."
The evaluation committee reviewed scientific data
from 36 large, ongoing studies of aging and identified more than 40
separate factors that may play a role in cognitive and emotional health.
Those highlighted in the report are summarized
below, including those in which possible interventions might be
explored:
● Education – Higher levels of education
correlate with both good cognitive and emotional function in the
scientific literature. But there is no consensus as to why this may be
so. Researchers continue to explore such explanations as education
providing cognitive "reserve" or the socioeconomic factors such as
quality of education that may affect the relationship between higher
education and better cognition.
● Cardiovascular--A growing body of observational
research links cognitive decline with several traditional risk factors
for cardiovascular disease, including hypertension, greater body mass
index, heart disease, diabetes and smoking. Understanding the impact of
these influences is critically important because they can be modified
though lifestyle and medical interventions. NIH currently funds clinical
trials to test whether interventions for high blood pressure, diabetes
and high cholesterol reduce the risk of cognitive decline.
● Psychosocial--A number of psychosocial
factors--emotional and social support networks, high socio-economic
status and low stress levels--correlate with cognitive and emotional
health later in life. Stress, for example, has been linked to cognitive
decline, while social engagement, social support and higher
socio-economic status are associated with better cognitive and emotional
health.
● Depression and anxiety --Some studies associate
a history of depression or anxiety with poor cognitive and emotional
health later in life. Researchers only recently have recognized a
possible connection between mood disorders and future cognitive decline.
This could be an important area for testing interventions.
● Physical activity--Finding out if physical
activity can protect against cognitive deterioration "would be of great
public health importance because physical activity is relatively
inexpensive, has few negative consequences, and is accessible," the
report says. A number of studies suggest a protective effect, and
clinical trials are underway to test exercise as an intervention against
cognitive decline. The panel said a large clinical trial should be
considered.
● Chronic illness--Chronic illnesses, such as
arthritis, cancer, lung disease, heart disease and diabetes, are linked
to poor emotional outcomes, specifically depression, in older people.
Further study could examine the important questions of cause and effect,
whether illness causes depression or whether depression can make people
more vulnerable to illness.
● Genetics--There is a poor understanding of
genetic influences on cognitive and emotional health. While risk for
late-onset Alzheimer's disease increases with inheriting one form of the
apolipoproteinE (APOE) gene, little is known about its specific role in
Alzheimer's or its effects on emotional health. Genetic factors cannot
be modified, but greater knowledge of the genetics of cognitive and
emotional health could help identify people at higher risk.
Details of the research papers evaluated by the
panel are available online –
click here. The Cognitive and Emotional Health Project's searchable
database of a large number of studies on age and cognitive and emotional
function can be found on the NIH website –
click here.
About information source:
The NIH, a component of the U. S. Department of
Health and Human Services, is the primary federal agency for conducting
and supporting basic, clinical and translational medical research. For
more information about research and health, visit the
NIH Website or the websites of the three institutes involved in the
Cognitive and Emotional Health Project:
>
National Institute on Aging
>
National Institute of Mental Health
>
National Institute of Neurological Disorders and Stroke
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