Memory Maintenance Program

10 recommendations to help defer the onset of brain decline

It is important to lead a brain healthy lifestyle to help defer the onset of brain decline, dementia and Alzheimer’s disease. These top 10 recommendations as developed by Dr. Ashford and his colleagues at the Stanford / Veterans Affairs Aging Clinical Research Center.

  1. Maximize and continue your education and mental exercise:
    • Learn about your brain and how to care for it.
    • Develop habits to maintain your brain.
    • Take classes in subjects that interest you; education is associated with decreased Alzheimer’s risk, learning a new language may be very good.
    • Do mentally stimulating activities, including puzzles (like crossword puzzles, sudoku, and most importantly also learn new things).
    • Engage in a personalized brain training program.
  2. Maximize and continue your physical exercise:
    • Have a regular exercise program.
    • Physical exercise is best 10-30 minutes after each meal for 10-30 minutes, 3 times per day.
    • Do both aerobic and strengthening exercises.
    • Stretching improves flexibility.
  3. Maximize your social network and spiritual interactions:
    • Stay active with your friends.
    • Get involved with your community.
  4. Continually monitor and improve your diet:
    • Take your vitamins daily.
    • Take at the morning meals: Vitamin E 200 iu; Vitamin C 250 mg; Multi-vitamin (with folate 400 mcg and no iron). For discussion, see: Willet WC, Stampfer MJ, “What vitamins should I be taking, Doctor?” New England Journal of Medicine, 345, 1819 (2001).
    • Check with your clinician yearly to be sure your homocysteine levels are not high and you have no signs of or risk factors for B12 deficiency.
    • Ask your doctor to make sure your B12 level is above 400. If diet doesn't help, take oral supplement. If oral supplement doesn't work, get monthly B12 shots additionally.
    • Maximize your vegetables.
    • Increase your dietary intake of omega-3-fatty acids.
    • OPTIMIZE Plant products and fish: Fruits - citrus, blue berries; Vegetables - green, leafy; Fish - deep sea, finned, oily, at least 3x/week; Nuts - especially almonds, and also dark chocolate.
    • MINIMIZE other animal products: Red meat (no more than once per week); Dairy (limit to low-fat); Poultry (limit eggs to 7 or fewer per week).
  5. Keep your Body Mass Index (BMI) in the optimal range (19-25):
    • If you don’t know your BMI, make a point of finding out.
    • To optimize your BMI, control your food intake and exercise.
  6. Physically protect your brain:
    • Wear your car seat belt.
    • Wear a helmet when you are riding a bicycle or participating in any activity where you might hit your head.
    • Decrease your fall risk through physical exercise; improve your balance.
    • Make your environment safe.
  7. Visit your clinician on a regular basis. Know your body and your health risks:
    • Decrease your risk of type II diabetes. Monitor your fasting blood sugar yearly. If you have diabetes, make sure that your blood sugar is optimally controlled.
    • Consult your clinician about your joint and muscle pains (treat arthritis with ibuprofen or indomethacin).
    • Keep your hormones stable. Check with your clinician about your thyroid hormone. Discuss sex-hormone replacement therapy with your clinician (such therapy is not currently recommended for Alzheimer prevention, but may help memory and mood).
  8. Optimize your cardiovascular health:
    • Take your blood pressure regularly; be sure that the systolic pressure is always less than 130, diastolic blood pressure is less than 85.
    • Watch your cholesterol; if your cholesterol is elevated (above 200), talk to your clinician about appropriate treatment. Consider “statin” medications and be sure your cholesterol is fully controlled.
    • If approved by your clinician: 1 enteric coated baby aspirin each day.
  9. Optimize your mental health:
    • If you have difficulty getting to sleep, consider trying 3 - 6 milligrams of melatonin at bedtime (consider different brands if not helpful at first).
    • If you snore, consult your clinician about sleep apnea.
    • Get treatment for depression if needed.
    • Keep your stress level under control. While some stress is needed to maintain motivation, severe stress is bad for health.
    • Avoid excess alcohol use.
  10. Optimize your cognitive health:
    • Have your memory screened regularly after 60 year of age.
    • Be sure the people around you are not concerned about your memory.
    • If you think that you have significant difficulty with your memory, talk to your clinician about further evaluation and therapy.
    • Engage in a variety of cognitive stimulation activities .