Mental decline is one of the greatest fears of older adults. In fact, a 2010 survey asking what disease Americans most feared found that 31% of respondents answered Alzheimer’s. This was second only to cancer, which got 43% of votes and far outpaced heart disease, stroke, and diabetes.

Dementia is feared for good reason. According to the National Alzheimer’s Association, the number of Americans living with dementia exceeds five million and that statistic could rise as high as 16 million by 2050.

Alzheimer’s disease is the sixth leading cause of death. In fact, one in three older adults will qualify for a diagnosis of Alzheimer’s or another dementia at some point in their lifetime. “Although this is reason for concern, it’s important to keep these statistics in perspective,” says Daniel J. Ackerman, MD, Medical Director of the St. Luke’s University Health Network Stroke Program. “The incidence of dementia is increasing largely due to the fact that people are living longer, which is a very positive trend. Years ago, people died of other causes before dementia appeared.” In 1970, for example, the average life expectancy in this country was about 71. Today it’s about 79.

On the positive side, many people remain cognitively sharp well into their 90s and beyond, he says. Also, every day new medications are being developed to better treat dementia-related conditions and slowing the progression of the disease. Certain types of mental decline begin in early adulthood. For example, a University of Virginia study indicated that some cognitive skills – the ability to make rapid comparisons, remembering unrelated information and detecting relationships – begin a slow decline beginning around age 27. On the positive side, accumulated knowledge skills, such as improved vocabulary and general knowledge, continue to increase into advanced years.

Dr. Ackerman adds that the brain is capable of changing and developing new connections throughout our lifetimes. “Years ago, it was believed that it loss of mental functioning was inevitable,” he says. “Today, we know that nerve cells within the brain continue to develop. This is known as neurogenesis or brain plasticity.” To illustrate, a study compared the brains of London taxi drivers who were learning 25,000 streets with bus drivers who had a set route. Post mortem exam revealed that the taxi drivers’ brains showed changes related to map learning with more cells growing in that area. “If you want to remain as mentally sharp as possible, constantly challenge your brain,” Dr. Ackerman suggests. “Learn a language, take up an instrument, audit a college course – whatever interests and challenges you mentally.”

And, exercise your body too. Exercise improves your mental health by helping to prevent “vascular dementia”, the second most common form of dementia. The result of clogged or damaged blood vessels in the brain, vascular dementia causes a decline in cognitive function, memory loss and an inability to think, plan and make decisions. It also affects mobility and balance.

“Physical exercise reduces the risk of vascular dementia by modulating blood pressure and having positive effects on blood glucose and brain oxygenation.” Dr. Ackerman says. “Therefore, find an activity you enjoy and get moving, but be sure to protect your brain in the process. If you’re riding a bike, wear your helmet. If you’re driving to the park for a walk, fasten your seatbelt. Organize your home environment to prevent falls.”

“Mental exercise is just as important as the physical,” he adds. “Social interactions, games, puzzles, and reading help to build your “brain muscles” and maintain mental focus and sharpness. Take good care of your brain and it will take care of you.”

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