There's an integral connection between mental health and brain health, as poor mental well-being can wreak havoc on cognitive function and increase the risk of Alzheimer's and dementia, nearly 9 years ahead of diagnosis.⁴  Our mental health is influenced by interconnected psychosocial and biological factors, where psychosocial triggers can lead to biological responses.  This understanding is crucial in addressing anxiety, depression, and their connection to Alzheimer's disease.  Psychosocial factors encompass social, psychological, and environmental aspects that impact mental health and can contribute to various conditions. 

 Key factors include: 

• Changes in lifestyles, roles, and responsibilities can be overwhelming and disrupt our sense of stability which can trigger anxiety and depression. 
• Loss of self-sufficiency and independence can lead to feelings of helplessness, frustration, and a diminished sense of self-worth and can negatively impact mental health. 
• Adaptation difficulties arise when individuals struggle to cope with new environments, major life events, or social changes and increase stress and affect mental well-being. 
• The psychological early reaction to Alzheimer's disease or witnessing the cognitive decline of a loved one can evoke intense emotional responses and lead to anxiety and depression. 

Psychosocial factors can trigger biological responses, such as dysregulation of the HPA axis, which can worsen mental health conditions.

Other biological factors that can be triggered including⁵:  

• Higher levels of T-Tau and P-Tau proteins have been observed in individuals with Alzheimer's disease and have been linked to cognitive decline. 
• Neuritic plaques, primarily composed of beta-amyloid protein, are another hallmark of Alzheimer's disease. 
• Individuals with depression may exhibit a selective reduction in NMDA receptor density in certain brain regions, such as the prefrontal cortex and hippocampus. 
• In conditions such as Alzheimer's disease, neuronal damage and atrophy are commonly observed in the temporal cortex, which is involved in various cognitive processes, including memory, emotion regulation, and language. 

The impact of caregiving on mental health cannot be overlooked, as caregivers often find themselves at an increased risk for poor mental health, potentially leading them down the same paths as those they care for.  This is where the noble act of providing care comes at a cost.

Some of the main stressors that caregivers deal with are their patients characteristics, include⁶: 

• Cognitive impairments in care recipients require caregivers to constantly adapt and respond to changing needs, leading to increased emotional and mental strain. 
• Functional disability in care recipients, where they rely on caregivers for assistance with daily activities, can lead to physical and emotional exhaustion for the caregiver.  
• Problem behavior exhibited by care recipients, such as aggression, agitation, or resistance to care, can be challenging for caregivers to manage.

In addition to patient characteristics, several aspects of the caregiving situation itself can contribute to the poor mental health including⁶:  

• Caregivers who are in a care situation where they have limited social support or who feel isolated in their caregiving role may experience increased stress and feelings of being overwhelmed. 
• A prolonged duration of caregiving can lead to chronic stress, fatigue, and a higher risk of mental health issues. 
• Caregivers who spend many hours of their day or night attending to the needs of their loved ones may face challenges in maintaining their own self-care routines, social connections, and personal interests. 
• The multitude of caregiving tasks, ranging from medication management to personal hygiene assistance, can be overwhelming and contribute to heightened stress levels and decreased mental well-being for caregivers. 

Secondary stressors, not directly related to caregiving, can significantly impact caregivers' lives including⁶: 

• Work interference arises when the demands of caregiving conflict with employment responsibilities, leading to potential job strain and reduced performance.  
• Financial strain is a common concern, as the costs associated with caregiving can burden caregivers and contribute to anxiety and decreased financial security.  
• Social isolation may occur as caregivers often have limited time and energy to engage in social activities, leading to feelings of loneliness and disconnection.  
•  Reduced relationship quality can result from the strains of caregiving, leading to increased conflicts and decreased satisfaction in personal relationships.  
• Caregivers often have limited time for leisure activities, reducing opportunities for relaxation, self-care, and enjoyment. 

Listen below to the insights of Elizabeth Humphreys, the founder of Mind What Matters nonprofit, as she shares practical suggestions for relieving the stress that caregivers face and promoting better mental health. 

Amidst the challenges caregivers face, it is crucial to recognize that even a few hours dedicated to self-care can have a profound impact on their mental health.  Organizations like Mind What Matters, a nonprofit dedicated to supporting caregivers, provide care grants to caregivers across the United States, allowing them to access those precious extra hours.  To support this cause and help caregivers in their journey, we encourage you to consider donating to Mind What Matters and following their work by visiting here.  

Brain Health Pillar #3: Cognitive Training

When you think of hobbies, do you ever consider the impact they may have on your brain health?  Engaging in activities that stimulate and challenge our minds is not only enjoyable but can also have long-lasting benefits for our cognitive health and function.  One such activity is cognitive training, which involves exercises and tasks designed to enhance cognitive abilities.  It is considered one of the easiest and most accessible ways to start building our cognitive reserve and protect our brain for years to come. 

The U.S. POINTER study: Also known as the "Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk," is a groundbreaking research initiative dedicated to investigating the potential of cognitive training and other lifestyle interventions in reducing the risk of cognitive decline and Alzheimer's disease.  While the specific findings of the POINTER study are yet to be announced, its comprehensive nature and large participant cohort make it an important milestone in the field of cognitive health research.  By focusing on cognitive training as a central component of a multifaceted approach, the study highlights the significance of proactive measures in promoting brain resilience and potentially reducing the risk of cognitive decline.⁷  

Looking for actionable steps to begin cognitive training and safeguard against cognitive decline?  Recently published in the Alzheimer's and Dementia journal are primary prevention recommendations aimed at reducing the risk of cognitive decline, with the role of cognitive training being one of the 6 highlighted amongst: neurovascular risk management, physical activity, sleep, nutrition, and social isolation.⁸  

Among the suggestion for cognitive training are: 

• Nonfiction reading (included in our Summer Special Bundle linked in bio)  
• Exploring crafts and skills (cooking, hobbies, gardening, etc.)  
• Practicing mindfulness and meditation 
• Exposure to nature 
• Nurturing relationships (pets, friends, etc.) 
• Expressing yourself through arts (visual, music, dance)  

While there are countless ways to participate in cognitive training, one of the most exciting and latest methods involves harnessing the power of technology.  In a recent study, researchers conducted a comprehensive review of 12 randomized controlled trials to evaluate the effectiveness of computerized cognitive training (CCT) in individuals experiencing subjective cognitive decline (SCD) and mild cognitive impairment (MCI).  The results of this study revealed that CCT had a significant and positive influence on cognitive function, with a specific focus on memory improvement.  This meta-analysis underscores the promising potential of computerized cognitive training as an intervention for cognitive impairment, offering valuable benefits to those looking to enhance their cognitive abilities.⁹  

Watch how Tom Holland, M.D., esteemed Rush University Medical Center researcher and medical advisor to NeuroReserve, as he shares practical strategies for initiating cognitive training and effectively achieving and pushing our goals.

Brain Health Pillar #4: Diet and Nutrition

Recent studies have provided compelling evidence including the findings from the UK Biobank study.  The UK Biobank involves over 500,000 participants, where in this study 60,000 were followed over a 9-year span and has highlighted the influential role of diet in preserving cognitive function and preventing Alzheimer's disease.  Notably, a strong adherence to the Mediterranean diet was associated with a significant 23% lower risk of all-cause dementia. Importantly, this risk reduction applies even to individuals with a high genetic risk for Alzheimer's.  It is worth exploring the concept of a "polygenic risk score" to better understand how the MeDi overcomes genetic factors.  This score reflects various aspects of an individual's genetics (like carriers of the APoE4 gene) and illustrates that, for 95% of cases, the influence of genetics can be mitigated by following a Mediterranean-style diet.¹⁰  

Another significant study on the horizon is the MIND Diet Randomized Controlled Trial.  This meticulously designed three-year, multicenter trial involves 604 individuals between the ages of 65 and 84 who are at risk for Alzheimer's disease (AD).  The study aims to investigate the effects of the MIND diet, a comprehensive dietary pattern, on cognitive function among this vulnerable population.  Unlike previous studies that focused on single nutrients or specific foods, the MIND study examines a comprehensive dietary pattern in an at-risk population.  Additionally, the MIND study goes beyond dietary recommendations by providing participants with key components of the MIND diet.  Moreover, the MIND study incorporates advanced MRI scans of participants' brain structure and volume.  This innovative approach holds the potential to provide mechanistic evidence, offering insights into how the MIND diet affects the brain at a structural level.¹¹  While the results of the MIND Diet Randomized Controlled Trial are yet to be announced, the anticipation surrounding this study is immense.  Researchers and individuals alike eagerly await the findings in the coming months, as they hold the potential to revolutionize our understanding of the role of MIND-MeDi diets in preserving cognitive function and preventing Alzheimer's disease.  

Understanding the profound impact of nutrition on memory, cognitive performance, and the risk of Alzheimer's and dementia, Dr. Annie Fenn emerges as a leading figure in the realm of brain-healthy eating.  

As the founder of Brain Health Kitchen, Annie imparts her knowledge through international speaking engagements and instructional sessions, where she shares innovative techniques for creating delicious, brain-healthy recipes.  In her debut cookbook, titled "The Brain Health Kitchen: Preventing Alzheimer's Through Food," Annie presents 100 delectable and straightforward recipes brimming with brain-nourishing ingredients.  

Dive into brain-boosting habits with our Brain Healthy Nutrition Starter Pack, a perfect way to start (or reinforce) your lifelong brain health journey. Featuring the new cookbook by renowned brain health chef and physician, Annie Fenn, M.D., this bundle offers an inviting gateway to delicious, practical, and innovative brain-strengthening recipes and nutritional support. Learn more about this offer by visiting here. 

Brain Health Pillar #5: Staying Connected and Managing Stress

There is one crucial pillar that completes the framework of cognitive well-being: our relationships.  These connections not only bring us joy and fulfillment but also play a pivotal role in curbing cognitive decline.  In addition, effectively managing stress, whether through nurturing relationships or adopting stress-relieving techniques, is an integral part of maintaining optimal brain function.  Caregivers, in particular, face unique stressors from daily life to caregiving factors, that can significantly impact their cognitive health.  

Social Networks and Alzheimer's Disease (SNAD) 

Social connections refer to the relationships and interactions we have with other individuals.  The term "density" involves the number of relationships we have and the level of engagement and support within those relationships.  Research suggests that individuals with a higher density of social connections tend to experience various benefits cognitive health.  Both social bridging and bonding pathways contribute to the protective factors against Alzheimer's disease.  By expanding social networks and establishing meaningful connections, individuals can access social resources, engage in cognitively stimulating activities, and maintain an active lifestyle.¹² 

Harnessing the Power of Breath and Yoga 

Recent studies have also shown promising results in improving cognition, mood, and balance among individuals at risk for cognitive decline by harnessing the power of breathwork and yoga.  Breathwork, a practice involving controlled slowed breathing techniques, has shown potential for improving amyloid beta levels.  Amyloid beta is a protein linked to cognitive decline in conditions like Alzheimer's disease.  Breathwork may reduce stress, enhance the glymphatic system's waste clearance, and increase heart rate variability, potentially helping maintain healthy amyloid beta levels.¹³   Yoga, a holistic practice that combines physical postures, breathing exercises, and meditation, has also demonstrated positive effects on the following various cognitive functions¹⁴:  

• Executive function, which involves skills such as planning, problem-solving, and decision-making. 
• Visual memory, the ability to recall and recognize visual information.  
• Semantic memory, which involves the retrieval of general knowledge and concepts.  
• Attention, a fundamental cognitive function for staying focused and processing information efficiently.  
• Verbal fluency, the ability to generate and express words or ideas.  

Caregivers, who shoulder the responsibility of caring for individuals with cognitive impairment or dementia, are often the ones most likely to experience poor relationships and struggle with stress management.  As presented above in Brain Health Pillar #2, caregivers deal with a long list of both life and caregiving stressors.  Chronic exposure to these stressors activates the body's stress response, and can contribute to oxidative stress, neuronal atrophy, and impaired cognition.  In the end, these stressors lead to abnormal cognitive decline and increase the risk of late-life dementia.¹⁵

Drawing from her personal experience as a caregiver, Elizabeth Humphreys, the compassionate founder of Mind What Matters nonprofit, understands the profound impact of caregiving on individuals and families.  

Through her own journey of caring for her mother, Elizabeth has firsthand knowledge of the challenges faced by caregivers and the importance of providing support. Inspired by her own experiences, Elizabeth established Mind What Matters to offer care grants and assistance to caregivers across the United States, ensuring they receive the vital respite they need.   

Join us in supporting Mind What Matters and making a difference in the lives of caregivers across the United States. Your contribution, big or small, directly supports their efforts to provide care grants and assistance, ensuring caregivers have the respite they deserve. Donate today or subscribe to their newsletter by visiting here.