by Majid Fotuhi, M.D., Ph.D
Director, Center for Memory and Brain Health
Sandra and Malcolm Berman Brain & Spine Institute
Most recent studies show that elderly people over the age of 80 often have mixed pathologies in their brains that account for their memory loss and confusion. Very few senior citizens have “pure Alzheimer disease,” and therefore, this diagnostic terminology should be used with caution. It now appears that vascular problems such as high blood pressure and diabetes can shrink the parts of the brain that control memory and can significantly affect at what age elderly people become demented. Those with better health (good diet, optimal fitness, low stress) may be able to postpone the cognitive decline that occurs late in life.
In a recent publication in Nature Review Neurology, my colleagues and I discuss our formulation of a new framework, called the dynamic polygon hypothesis, by which to think about memory loss and dementia with aging. They believe that a balance of positive and negative factors affect the brain throughout early life and midlife to determine the degree of cognitive agility and impairment in late life. These factors increase or decrease cerebral blood flow, inflammation, insulin-signaling components, size and frequency of strokes, and concentrations of growth factors, cortisol, and other hormones.
The realization that the size of our brains can be modulated throughout adult life brings hope to millions of baby boomers concerned about losing their memories with aging.
A full discussion of this topic was published in the December 2009 issue of Nature Reviews Neurology article, Changing perspectives regarding late-life dementia.
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