The Six Pillars of Brain Health with Dylan Wint, MD

Podcast Transcript

John Horton:

Hey there and welcome to another Health Essentials podcast. I'm John Horton, your host. Your brain controls everything you do and the thoughts that come out of that squishy mass in your skull make you uniquely you. Without it, you're just a collection of bones and tissue with no real direction. That's why a healthy brain is key to living life to the fullest. So, how can you keep your noodle in tip-top shape and reduce your risk of neurodegenerative disorders like Alzheimer's disease or Parkinson's disease? Well, we're going to get a plan in place today based on the six pillars of brain health. Leading us on this mental exercise will be psychiatrist Dylan Wint, director of Cleveland Clinic's, Lou Ruvo Center for Brain Health. Dr. Wint is one of the many experts at Cleveland Clinic who pop into our weekly podcast to give us insight as to how our bodies work best. So, with that in mind, let's find out how we can improve what's happening upstairs. Welcome to the podcast Dr. Wint. Thanks for joining us today to talk about what's going on in our noggins.

Dylan Wint:

Thanks a lot for having me, and I'm looking forward to the conversation.

John Horton:

So, ahead of your visit, I was listening to an interview that you did and you shared a concept that really just got my mind worrying, and basically it was that our brain creates the world we experience. That's just kind of some mind-bending, almost sci-fi stuff to wrap your head around.

Dylan Wint:

Yeah. And it was pretty shocking to me as I went through college and medical school understanding how much of what we think we are experiencing we are actually simply perceiving. So, everything that we interact with, whether it's through touch, scent, sound, sight, our sensory organs are collecting pieces of information that actually you wouldn't recognize as having anything to do with the world around you. They're neural impulses and these neural impulses travel through your nervous system to the brain where they are then interpreted into the experience that we have of the world around us. So, when we "see" something, what we're actually doing is understanding the interpretation that our brain has made of neural signals representing light and dark and color that are coming to our brain and similarly with sounds and with textures. So, if there's a distortion in the way that our nervous system is transmitting or processing this information, we can have a very skewed understanding of the world around us.

John Horton:

I love that whole concept and it really was one of those things when I heard it and you just started thinking about it and it's really like it makes you think it made me use the brain that we're here to talk about. Sometimes I think we overlook just how much our brain does. It's a workhorse with just a lot on its plate. Basically it's running everything in our bodies. I love this quote from Thomas Edison who had a pretty impressive mind and he said, "The chief function of the body is just to carry the brain around."

Dylan Wint:

I hadn't heard that quote. I thought just neurologists thought that. In a way it's true. The brain actually holds what makes us us, our memories of our experiences, our personality, our plans, and the rest of the body does provide a carrying case and support system for the brain. That's not to diminish the importance of the rest of the body. In fact, a key component of brain health is the health of the body because let's face it, without the body and what it provides, oxygen, blood, nutrients, transportation for the brain, the brain doesn't serve much of a purpose.

John Horton:

Well, and while the brain is an incredibly powerful tool as you just kind of laid out for us, we also know that it's not indestructible. And I know that's a reality that you see quite a bit in your work here focused on neurodegenerative conditions. So, it seems like there are quite a few ways where we can lose some of the computing power that we have in our heads.

Dylan Wint:

There are, unfortunately. On the fortunate side, for most of us, we might experience changes in the way this computer, this supercomputer works.

John Horton:

I'm already feeling that. Everything seems to be slowing up a little bit.

Dylan Wint:

We do transition from sort of information gathering and storing machines to more information processing. And that kind of goes along with some of the responsibilities as we get older. When we're children our job is to learn how to be people, learn how to communicate, to get around and so forth. And so there's a very rapid acquisition of knowledge. We're very good at storing information in our heads, and as we transition to older ages, what's less important than how quickly we can attain knowledge is how we use that knowledge to make judgments, to make conclusions, to make decisions, and to sort of structure our lives around those and to help the younger ones that now we are imparting knowledge to, to learn how to use that knowledge themselves. And so there are natural transitions that occur as we age, but unfortunately our brains also, much like other organs within our body or even other machines as we age, they do become more vulnerable and more susceptible to diseases, to trauma, to the effects of malnutrition and other negative impacts on our body systems.

John Horton:

And some of those are just, they're scary to even think about when you start thinking about Alzheimer's and dementia and Parkinson's and those are all things that I think most of us, you fear coming across them, whether it's you or whether it's somebody that you love and it's way more common than what you would want.

Dylan Wint:

It's a lot more common than we would want. Unfortunately, 10 to 15% of people over the age of 70 will experience Alzheimer's disease, and that's just one of the many diseases that can affect the brain. Parkinson's disease, which has been maybe about one-fifth as common as Alzheimer's disease for reasons that we don't fully understand, is now the most rapidly growing in incidence and prevalence, neurodegenerative disease. So, we're starting to see rates of Parkinson's disease going up, and then there are numerous other conditions that affect the brain such as stroke, other degenerative diseases like Alzheimer's or Parkinson's where cells in the brain are slowly dying off, where our brains become more susceptible to head trauma as we get older. And so there are a number of things that can affect us, but we have a number of ways of making our brains healthier, more resilient, and more capable of fighting back against the effects of aging, including neurodegenerative disease.

John Horton:

Well, and that's what we're here to talk about as you were going through that list. I'm thinking those are all things that all of us want to avoid, and it sounds like we can improve our odds of maintaining high-level cognitive function through how we live our lives. And this all seems to be summed up very nicely in what's called the six pillars of brain health. Can you give us a little bit of an introduction to that?

Dylan Wint:

Yeah, absolutely. So, the six pillars of brain health are scientifically demonstrated ways of reducing risk of getting Alzheimer's disease and other cognitive disorders. So, the six pillars, I would put three of them in a category that I would label as increasing activity. I think our bodies and our brains are made for exploring our environment for encountering and learning new things. And so three of the pillars are increased physical activity or exercise, increased mental activity, cognitive stimulation and increased social activity, interacting with other individuals. And then the other three pillars, maintaining good physical health. So, taking care of chronic conditions like blood pressure, diabetes, that's one of the pillars. Another one of the pillars is proper amounts of rest and relaxation, and that includes sleep in the appropriate quantities and at an adequate quality of sleep. And of course, the fuel that our bodies and brains need is very crucial. And so maintaining a good diet and we have specific recommendations about that.

John Horton:

Well, and let's get into some of that now. I'd like to kind of drill down a little bit on some of these pillars and explore them a little bit. So, let's start right at the top of the list, which I guess you had mentioned exercise, one of the big things. And I think everyone thinks that exercise is being for your body, you're going to be a little more fit. You're going to get some muscles that look good. How is that going to help your brain?

Dylan Wint:

Yeah, well, speaking about how exercise helps the body, exercise helps us to maintain regular blood pressure, regular blood sugar. Exercise keeps our hearts and our blood vessels healthier, and all of these things are good for the brain, but exercise also appears to have direct impacts on the brain in increasing hormones that are important for nerve cell health. Also in increasing the activity of neurotransmitters that are important for well-being, for cognition and for sleep and other body functions. Exercise has been demonstrated to reduce the risk of developing cognitive trouble. Exercising people who have the earliest signs of cognitive trouble, which we call mild cognitive impairment, exercise reduces the likelihood and the rate of progression to later stages of cognitive dysfunction. So, even if one is worried about their brain or if you have a demonstrated brain problem already, exercise can help. It's never too early and it's never too late to apply exercise and the other pillars of brain health.

John Horton:

Is some of that just I know anyone, if you exercise, you get that high out of doing it and you feel better and you feel better mentally. I know I run and you can work so much out running and your head kind clears and all that. I know it's similar if you're biking, if you're lifting weights, if you're doing anything like that, you do get that boost. And is that just kind of a sign that our brains are just eating all that up and just really getting healthier?

Dylan Wint:

I think it serves two purposes. One is, or that feeling comes from two sources. One is that yes, when we exercise, there is an immediate on neurotransmitters in our brain and our brain does signal that it's loving this. Another purpose is that when we get these flows of neurotransmitters, it increases the likelihood that whatever activity we're engaged in, that we will engage in the future. If you liked it, if it felt good-

John Horton:

True.

Dylan Wint:

You do it again. So, there's a reward component to it that increases the potential for you doing it in the future and actually lowers the threshold for you engaging in that activity. We're always balancing consciously or not whether the next thing we're going to do is worth the effort that it takes, and that worth side is driven by the amount of reward that we perceive we're going to get from it. And so for those who are struggling to get an exercise program going, recognize that the more that you're able to even get some component of that going, the easier it will be over time to continue to engage in it. So, starting a good habit means starting with small steps.

John Horton:

And as far as what you need to exercise to help your brain, we're not talking you need to go out and do an Ironman competition or start flipping those tractor tires. I mean, this is just basic physical activity we're talking about, right?

Dylan Wint:

That's right. For those who are looking to reduce their risk or those who have mild cognitive impairment or looking to slow down cognitive decline, we're talking about an average of 150 minutes per week. So, 30 minutes, five times per week or one hour, three times per week. There are different ways to get there, but 150 minutes per week seems to be the threshold for producing those brain protective and mental health enhancing effects. And it's a level of exercise that's moderate meaning one way to look at it is the level of exercise that would make it hard for you to sing a song. You're too out of breath to sing a song, but you could still hold a normal conversation. So, brisk walk, slow jog, a bike ride, a hike. These are all kind of in that moderate level. If you want to do a more intense level of exercise, of course there's no negative to that, and in fact, it might require even less time, maybe more like 120 minutes per week of intense exercise.

John Horton:

Well, that sounds like a good and achievable goal for people. Just get out, stroll around, hike at your nearby park, just find something and your body should feel better. And it sounds like your mind should feel a little better.

Dylan Wint:

That's absolutely right.

John Horton:

All right, well let's move on. We have six pillars to get to here. So, what do you want to hit next?

Dylan Wint:

Why don't we go with social activity and social interaction?

John Horton:

I always love talking about friends. So, it's just hanging out with people, how is that going to help our brain just be the best it can be throughout life?

Dylan Wint:

Well, we don't understand all the reasons that social activity and social engagement help, but we know that social withdrawal is damaging to the brain and increasing levels of social activity can improve cognitive performance and protect against cognitive decline. In fact, at older ages, the presence or absence of social activity may actually impact your brain health more than the presence or absence of amyloid protein, which is the key protein that's involved in Alzheimer's disease. So, the effects of social activity and social engagement on brain health are truly profound.

John Horton:

Wow. So, is it just the stimulation of, I guess, conversing with somebody else or it forces you to kind of process a lot of information as you're having discussions and just analyze and everything that you do when you're hanging out with people?

Dylan Wint:

I think both of those are reasonable thoughts. I don't know that anyone's identified the key factors, but absolutely, if you think about it, a conversation is really good brain exercise. There's of course the language component of it both producing and interpreting language, but they're also interpreting vocal inflections, facial expressions, thinking about the overall plan for the conversation. But we think that there is an independent effect of just that engagement with another person because there have also been studies demonstrating that the depth of one's engagement with their social contacts influences the impact of social interaction on brain health.

John Horton:

Just makes you realize how important developing these relationships are and then continuing them throughout your life. You always hear about isolation being really a big danger as people age, and this seems to be a clear reason why.

Dylan Wint:

It is truly dangerous to be socially isolated as you age, dangerous to your cognitive health, dangerous to your mental health in terms of emotional and psychological well-being, and increasing evidence suggests that it's dangerous to your physical health as well.

John Horton:

Now when we were talking about kind these relationships, you kind of touched on the whole concept of keeping your mind engaged in doing things, which leads us nicely into one of those other pillars, which is mental fitness. This kind of sounds like one of those use it or lose it sort of concepts.

Dylan Wint:

Well, I think it might go along with that, and it starts pretty early in life. So, even factors like someone's access to quality education in elementary school influences their risk of getting Alzheimer's disease and other forms of dementia later on in life.

John Horton:

Wow.

Dylan Wint:

So, very early age onward. Our level of intellectual or cognitive engagement has a lot to do with where our cognitive status ends up towards the end of life. We generally recommend that people don't sort of just find a specific activity and continue doing that. There's a lot of questions that I get about, "Oh, should I do crossword puzzles every day?" Or even more so people who say, "Well, I can't have dementia because I do crossword puzzles every day." That is great to do crossword puzzles every day, but remember that whole idea of our brains and bodies being meant to explore. So, doing new things that are mentally challenging is probably better for your brain than even getting very good at doing a singular thing like a crossword ... Excuse me. Doing new things that are challenging for your brain is probably even better than getting very good at doing the same old thing like a crossword puzzle or something like that. I'm not saying give up the crossword puzzle. I'm saying-

John Horton:

Yeah, that makes so much sense. Whenever you do take on something new, it's a different level of mental activity I always feel like. When you're trying to get these new concepts and just that stumbling around a little bit and you always feel a little off, but it really forces you to use your head, use your mind to figure things out.

Dylan Wint:

And the threshold for doing something new is I think a lot lower than it's been in the past. There are lots of ways that you can find, let's say self-teach an instrument and the instruments are cheaper than they ever have been, and it doesn't have to be any kind of, it doesn't have to be a concert instrument. You could get a recorder or a kazoo or a harmonica and learn how to play one of those. We now have apps that can teach us new languages sometimes for free, and there are lots of universities that offer courses for folks who are retired where they can essentially go and audit a course at a very low cost with other retirees and get that social engagement in there as well.

John Horton:

Yeah. Now, what does gaining this new information do? Is this just that you're making more connections in your brain that are keeping things together? How does that keep it healthier?

Dylan Wint:

Well, another thing that we're not sure about, and I hate to keep repeating this, but human brains are substantially different from the brains of any other organisms. And so although we have animal models and we have Petri dish models for human brain processes, we know that there's a lot more going on in very complex ways that we can understand from animal models and Petri dishes. So, what I would say in terms of how does gathering new information or learning new things help the brain to stay healthy, I think it may have something to do with we have a growth mindset that's kind of a psychological status where we are open to new ideas. I think there may also be a growth or learning brain set where biologically our brain stays more capable of accepting, adapting to new ideas, and that stultification the avoiding new ideas, avoiding exploration actually puts your brain into a mindset where it is no longer as easily capable of learning, of adapting. And that's again where that danger comes in because if you cannot learn and adapt, pretty soon that leads to retraction.

John Horton:

Now, you had mentioned that a lot of this is set even from an early age, like what you do in elementary school or preschool kind of sets you up as you age, what your abilities are or what you can do if you fell behind early. I mean, this doesn't mean that you should just give up, right? I mean, you can always gain something later in life if you kind of pursue this new learning.

Dylan Wint:

That's right. Early life has significant influences, but it is not destiny. And in fact, if early life was somewhat deprived intellectually, that may be considered even more motivation to pursue learning opportunities if they arise later in life.

John Horton:

Well, this is fun. I think we're halfway through our six pillars. I guess spin the wheel and what do you want to hit next?

Dylan Wint:

Well, let's talk about food and nutrition.

John Horton:

Oh, we love talking about food and nutrition here. We have a Nutrition Essentials podcast where we're constantly talking about food and all the incredible things that it does for our bodies. So, I'm glad to see it. I figured it would also hit the brain.

Dylan Wint:

Well, if you think about it, and it doesn't take very deep thinking about it, our bodies and brains are actually made up of the food we eat, the air we breathe, the fluids we drink. The healthier those components, the healthier the scaffolding, the materials that are used to construct our brain and our bodies, the stronger our brains and bodies will be. And we recommend the mind diet. This was developed at Rush University in Chicago, and it's a combination of the Mediterranean diet that many people have heard about and the DASH diet, which was developed specifically for vascular health in people who have high blood pressure.

The mind diet doesn't contain anything I think that will be a surprise to people, but I like it's relatively simple format. There are 10 types of foods that they recommend getting lots of, five types of foods that they recommend getting little of or minimizing, and they give you the actual number of servings per week or per day that you want to aim for. And I think that's what a lot of people are looking for. We tell them, oh, eat a Mediterranean style diet. Well, people have an idea of what that means, but how many servings? How much? Eat more green vegetables. Well, more, what's enough? When do I get to enough? What if I don't like green vegetables? I don't want keep eating more and more. What's the threshold for me to do well? And I think the mind diet helps to give us quantities and give good examples of the types of foods that they're talking about.

John Horton:

And I'm sure we can do a whole episode just on those diets. But in a nutshell, it sounds like a lot of that it's based on fruits and vegetables, lean proteins, whole grains, legumes. I'm sure I'm missing a bunch of them there too, but those are kind of what you want to hit, right?

Dylan Wint:

Yeah. You've got a pretty good coverage of them there, particularly the fresh fruits and vegetables and lean meats, whole grains also. And then trying to stay away from processed sugar, staying away from fatty foods and really trying to, sometimes I tell patients who are still having some struggles getting it, the closer a food is to the way it came from nature, the more likely it is to be good for you.

John Horton:

Well, that makes a lot of sense. And it seems like a lot of this is with what you eat, it's linked to oxidative stress, and I feel like that's one of those terms that come up with eating a lot and people have a hard time wrapping their heads around it. I saw one explanation and they compared it to rust on your bike handles, which I kind of liked. And is it really that simple? We're all, if you eat a really poor diet, you're just, you're rusting out your brain inside?

Dylan Wint:

Well, yeah, I think that's not bad. The rust that develops on bike handles is literal oxidation of the metal in the bike handles, but it's kind of a passive process. I think the oxidative stress that we have to be even more concerned about is that as we process, in this case we're talking about foods, but in general, body processes are associated with byproducts of those processes and digesting food, processing food is associated with byproducts, some of which are oxidizing entities. And so that is the oxidative stress.

And with rust on a bike handle, it's pretty hard to control that. I mean, you can keep the bike inside and keep it away from moisture and dry it off if it gets wet, but still, it's kind of a passive process. I think it's really important for people to understand that the oxidative stress, that's a result of eating highly processed foods that your body then has to unprocess to make it useful to the body. This is what generates a lot of the oxidative stress that the modern person is exposed to. So, you're actually putting things into your body that increase those stresses on your system.

John Horton:

And it sounds like as we do that, then your risk of some of those diseases you were talking about earlier just become a little more pronounced.

Dylan Wint:

Yes. Chronic oxidative stress is not good for a whole host of diseases of the body and the brain. And it does appear that oxidative stress is an important player in both the initiation of Alzheimer's disease as well as its rate of progression, and that's likely true for other degenerative conditions as well.

John Horton:

Okay. Well, after you eat, as we all know, sometimes you'll feel sleepy. Which kind of leads us into one of the other pillars that we haven't touched on yet, which is sleep and relaxation. Is this just a matter of giving our brains a break so they can kind of catch up with everything?

Dylan Wint:

I would say yes in terms of catching up with everything, but not so much in terms of giving our brains a break. Our brains are quite active actually during sleep. In fact, in some stages of sleep, the brain is more active than it is when we are sitting there thinking about a math problem or some other problem. So, it's not so much that our brains are resting, but that there's a different mode that our brains go into where they're performing other activities during rest that can't be performed while we're awake. And those have a lot to do with maintenance. Sometimes I use the analogy, think about Disney World at 9:00 PM, let's say, they get all the guests to the park out, and what do you think happened? What do you think you would see if you went there at 10:00 PM? You wouldn't see an empty park with the lights all off.

You'd see all the maintenance workers cleaning out the garbage cans, checking the rides to make sure they're functioning properly, maintaining the other equipment, replacing the change in the cash registers so that when the park opens again at 9:00 the next morning, it doesn't look like it did when you left the 9:00 PM the night before. And if Disney World never closed, I'm sure the kids would be happy, but it would be a pretty nasty looking place after a few days. And this is what sleep is important for, making sure that our Disney World is ready to go the next day and the day after that and the day after that.

John Horton:

That is such a great way to explain that. And I love the idea that when you sleep, your brain is basically just cleaning everything up and kind of freshening things so you can start the next day and really be ready to go.

Dylan Wint:

But it's doing a lot of work. And that work has to, it's not just the amount of time you give for the work, but the work has to be sequenced and staged in a certain way. In the same way that you can imagine at an amusement park. You don't want to put the new garbage bags in the trash bins until the old one's taken out. If you did it in the wrong order or if you didn't give enough time for each stage, then it wouldn't come out right. And similarly with sleep, there's a way that our brain is set to go through stages of sleep through the night.

And so it's not just the amount or the quantity, but it's also the quality and sequencing of sleep and ensuring that we're going through the right stages. Anyone who is consistently feeling tired or still sleepy when it's time for them to wake up in the morning should get their sleep evaluated. Whether it's just evaluating yourself and saying, you know what? Maybe I don't need to watch all five episodes of Law and Order before I go to sleep. Maybe I need to go to sleep a little earlier. Or it may be, you know what? I go to sleep and I'm in bed for eight hours and I wake up still feeling crummy. That tells me that the quality of sleep that you're getting may not be right, and perhaps there's even a medical sleep disturbance that needs to be addressed.

John Horton:

Well, if somebody is having those problems, they can go back and look at our podcast. We have covered this several times with Dr. Foldvary-Schaefer and sleep hygiene and just how to get good sleep habits. So, there's a wealth of information there if somebody is struggling with that and they want some information.

Dylan Wint:

I have read so many of her commentaries in articles and so forth, so glad to hear you say that.

John Horton:

She's fabulous. We love having her on. And just every time I feel like I sleep better that night after I talk to her, because you just start building good habits. Doing this podcast is going to turn me into one of the healthiest people on earth. I'm convinced of it.

Dylan Wint:

Well put.

John Horton:

Which then nicely leads us into our final thing, which is just overall health, which it seems like a rather large tent, but it seems like everything in our body, your heart, your lungs, whatever, it eventually affects your brain, right?

Dylan Wint:

Absolutely. So, chronic health conditions, chronic unwellness is not good for the brain, probably both on a physical level. So, if you're not getting enough oxygen to your brain, your brain's not going to do well. But also the feeling of not feeling well is not good for the brain either. Some of the particularly important effects that have been found are for high blood pressure, diabetes, depression, or what's formally called major depressive disorder, and then chronic health impairing habits such as a sedentary lifestyle. So, not getting that exercise, that social interaction, smoking and heavy alcohol use.

John Horton:

Yeah, it's amazing. All of these pillars, I mean, they're all their own things, but they all seem like they interconnect too.

Dylan Wint:

It's very hard to separate the brain from the body, and it is hard to separate these pillars from one another. It's unusual to find someone, for example, who is exercising 30 minutes a day, yet never goes to their primary care doctor. And it's strange to find someone who is really paying close attention to their sleep, the quality and quantity, and yet is eating a poor diet. I'm not sure whether some people are just predisposed toward healthful habits. I suspect though that it's more that once you start getting one of these areas under better control, you start looking for other ways to optimize your health because you do actually feel better, and it is actually rewarding. And once you get into the habit, it becomes much less of a workload, much less of a burden to continue that habit. And so you look for something else that might be helpful for you.

John Horton:

And that's what I love about all these pillars and everything that we just kind of went over. They all seem very attainable. I mean, this isn't something where you need to climb to the top of Mount Everest to find the secret. These are all things that we can work into our daily lives and just how we go about just spending our days.

Dylan Wint:

Yeah. Another thing, I probably say this too many times, but another thing that I've told patients and their families, what I'm telling you is no different from what our grandparents and parents told us, right? Go to school.

John Horton:

They're always right. The older I get, the more I realize they were always right.

Dylan Wint:

Because there are some fundamental things that are good for the human organism, and we now have scientific data that backs this up, and we're starting to understand some of the mechanisms. But fundamentally, it's not that these are new discoveries, rather we're discovering more about where the thresholds are. We're discovering in more detail, what does eat a good diet mean? Well, we have a very description of that now. Exercise more or get enough exercise. Well, what's enough? Well, we actually have a very precise amount now, 150 minutes per week. So, really, if you are doing something that your grandmother probably would disapprove of, it's likely that it's not so good for your health.

John Horton:

So, let me ask you this, if people make these changes, if you kind of embrace this good lifestyle, do you see those sort of changes in brain health then? Do you see it pay off?

Dylan Wint:

Yes. So, there are two ways in which I see this payoff. One is that people come to me asking for an assessment of how their brain is doing. They're not noticing any specific cognitive problems, or maybe they're noticing that they're not as fast or they can't multitask the way that they used to. And I explain that these may be normal changes of brain aging, but people who come to me and have maintained these lifestyle habits, when we take a picture of their brain, we typically don't see damage from vascular problems that we might see. We don't see as much diffuse shrinkage of the brain as we usually would. The second category is people that come to me who do have a memory problem, who have developed mild cognitive impairment or dementia, and folks who have been maintaining a healthy lifestyle, they tend to have better outcomes.

In other words, they stay for a longer time in those milder stages of dementia than folks who have not been able to maintain a healthy lifestyle. So, it's important to point out that there's no absolute a hundred percent way to prevent degenerative brain disease. You can reduce your risk substantially of getting degenerative brain disease with these lifestyle habits. However, even if you are destined to get a brain disease despite a healthy lifestyle, the healthy lifestyle will enable you to feel and function better for longer with that brain disease than you would if you weren't maintaining that lifestyle.

John Horton:

Can you turn things around if you do start having these cognitive declines? Or is it just a matter if you start embracing healthier habits, maybe you stop the decline?

Dylan Wint:

You can sometimes turn around the decline. It depends on what amount of your decline is related to these habits or not. So, was it yesterday or the day before? I saw a patient who was drinking, not what we would all consider an excessive amount, but she had been drinking more than she did earlier in life. Between the first appointment and the most recent appointment, which is about six months, she stopped drinking. And just with that, her performance on our cognitive screening test, which is a 30 point test, went up by five points.

John Horton:

Wow.

Dylan Wint:

And she reported feeling much better, thinking much better. So, for her, clearly the drinking was a large component. That's not the case for everyone. But what we try and do is optimize brain health. So, that means anywhere that we see a vulnerability, anywhere we see a habit that may increase your risk. Anywhere we see where you're not engaged in a habit that might decrease your risk, we try and adjust those because in some, you will end up with a better outcome than you would. In some people that is really reversing a prior trajectory of decline. In other folks, it is stabilizing or slowing down decline. And other folks, it's going to be preventing decline from occurring at all.

John Horton:

And I know we talk about this often on this podcast that a lot of times with these changes, people can get overwhelmed thinking about what you need to do, but it often just comes down to just making small, manageable changes and slowly adjusting to embrace these healthier habits. And if you do it a little bit at a time, pretty soon you're doing it, everything seems a little bit better.

Dylan Wint:

Yes, that's a really important point that it can be easy to become overwhelmed. And I give you this list of six pillars of brain health, and I can't do all of this, and you can take it slow. This is a marathon, not a sprint. We're not tumbling towards cognitive decline, but each day we make decisions that can contribute to or detract from brain health. Try and make more decisions each day that contribute to your overall brain health. So, today, you may eat a salad instead of a hamburger. Tomorrow you might eat that hamburger again. But see if you can make another decision maybe to walk for 30 minutes that contributes to brain health, right? And eventually you start naturally making decisions that contribute to brain health, but it's really important to start and to persist.

John Horton:

Well, my mind is feeling pretty full after absorbing all of this information, Dr. Wint. So, I'm pretty sure, first of all, that I've checked my metal fitness box on the six pillars list for today with learning new things. But before we end the chat though, what's the one thing you want our listeners to take away from this podcast when it comes to things they can do to improve their brain health?

Dylan Wint:

I think that very thing that there are things you can do to improve your brain health now and to improve your brain health in the future. And that those things are not exotic. They are things that you have control over. And so for those who are out there feeling like brain disease is something that's inevitable, let's say it's in my family or I'm already noticing some effects, you can have influence over this. And for some of you who are out there, that influence will be to stop brain disease in its tracks.

John Horton:

Dr. Wint, thank you so much for, I guess, showing us the power that we have to kind of help our own minds so we can, I guess, live our best life as we age.

Dylan Wint:

Well, thank you so much for the opportunity and I'm happy to come back again anytime there are questions or you want more detail.

John Horton:

We'll definitely have you back. Thanks a lot, Dr. Wint. Have a great day.

Dylan Wint:

Thank you. You too.

John Horton:

You need your brain to function and your brain needs you to function at its best. What you eat and drink, how much you exercise, how well you sleep, and manage stress, and even friendships and efforts to continue learning can keep your brain humming along deep into your golden years. Consider it something to think about. If you liked what you heard today, please hit the subscribe button and leave a comment to share your thoughts. Till next time, be well.

Speaker 3:

Thank you for listening to Health Essentials, brought to you by Cleveland Clinic and Cleveland Clinic Children's. To make sure you never miss an episode, subscribe wherever you get your podcasts or visit clevelandclinic.org/hepodcast. This podcast is for informational purposes only and is not intended to replace the advice of your own physician.