Joey Wahler (Host): It's something people wonder if struggling with recollection, so we're discussing whether your memory can be improved. Our guest is Dr. Sanjiv Sahoo. He is a neurologist with BayCare. This is BayCare HealthChat. Thanks for joining us. I'm Joey Wahler. Hi there, Dr. Sahoo. Welcome.

Dr. Sanjiv Sahoo: Hi. How are you?

Host: Good, thanks. Great to have you aboard. So first, what are some effective lifestyle changes that can naturally enhance brain function and cognitive performance?

Dr. Sanjiv Sahoo: You know, that's an excellent question. So to help, Massachusetts General Hospital just came out with a very excellent resource that should be available online. It's called a Brain Care Form. And essentially, it's a checklist that tells us all the things that we can do to improve our brain health. And I would say lifestyle changes are probably a big part of the recommendations. And if I was to summarize, I would say exercising and maintaining physical activity at least 150 minutes a week, maintaining your blood pressure less than 120/80. If you're diabetic, keeping your hemoglobin A1c less than 5.7; keeping your cholesterol less than 190; keeping a good body weight, less than body mass index of 25; keeping an alcoholic drink to less than once a week; not smoking; and maybe adopting a healthy diet. These are just some of the changes that make a huge difference.

Host: Absolutely. So, let's dive into a few of those in a little more detail. How does regular physical exercise contribute to a brain boost, if you will? And what types of exercise are most effective?

Dr. Sanjiv Sahoo: You know, this has been studied rigorously and what they found is that if you do at least 150 minutes of moderate aerobic exercise a week, which kind of equates to about 30 minutes a day, five days a week, or 75 minutes of high intensity exercise weekly, that can help boost blood supply to the brain, it can help you maintain a healthy weight, a good heart function, and  that all helps avoid strokes and heart conditions which can indirectly lead to dementia.

Host: How about specific brain foods or dietary supplements that can aid in cognitive improvement and what are their key nutrients that make that possible?

Dr. Sanjiv Sahoo: So, that's also being looked at closely. And I think there's a number of studies out there and they've shown that a healthy diet can help stave off dementia and strokes. Specifically, a Mediterranean diet, which is fish, fruits, and vegetables, and a DASH diet. The acronym stands for Dietary Approach to Stopping Hypertension. The combination of that is also used, and that's known as a MIND diet, Mediterranean-DASH Intervention for Neurodegenerative Delay, and both of these diets can help prevent dementia and strokes. And really, these diets are just essentially a healthy serving of fish, fruits, vegetables, whole grains, avoidance of sugars, processed foods, and avoiding oily fast foods.

So, dietary supplements have also been studied, but they haven't shown consistent results in keeping dementia away. Therefore, I would just recommend a regular multivitamin with minerals, and that would be a great start. However, if you have been tested and your B12 levels are low or your vitamin B1 level or vitamin E levels are low, then supplementing those, that would be very meaningful.

Now, if you really wanted to try some supplements, then folic acid and even magnesium threonate, which is known to cross the blood-brain barrier that might have a small role in memory boosting, and it's been shown in a few small human studies to make a difference. So, I would recommend only those two supplements in addition to a multivitamin.

Host: Okay. But multivitamin too, yeah?

Dr. Sanjiv Sahoo: Yes.

Host: Okay. How does chronic stress impact cognitive abilities and how can mindfulness and meditation practices contribute to cognitive enhancement and really overall emotional well being, right?

Dr. Sanjiv Sahoo: So, you know, stress can impact our lives in many negative ways, and it really increases the risk of stroke, dementia, and heart conditions. And one direct way is when you are stressed, you have a flight or fight response, your adrenaline levels are high. You can throw your heart into abnormal cardiac rhythms or arrhythmias.

And one of the most dreaded arrhythmias is atrial fibrillation. And that definitely leads to clots, which can go to your heart, cause a heart attack, can go to your brain, cause a stroke. And those will eventually lead to dementia if they're not taken care of. So, it's worth mentioning that trying to maintain a manageable level of stress that does not impact our day-to-day functioning. That's probably an achievable and a desirable target. Now, a secondary effect of stress is sleep quality. So, trying to get at least seven to eight hours of undisturbed sleep is a key to a healthy brain. And if you have to use meditation or other methods to achieve that, then absolutely.

Host: Okay. How about the potential cognitive benefits of learning new skills or languages, and how exactly does that promote neural plasticity, if you will?

Dr. Sanjiv Sahoo: You know, with our aging population and changing demographics, I think it's interesting that several large scale studies have actually shown that maintaining a working schedule and staying employed longer actually helps prevent memory decline and early dementia. And we see that in clinical practice, you know, people retire early and then all of a sudden they have some degree of cognitive decline. So if you stay socially active, if you engage with others outside from your family, other than your spouse and your children, that's an important way of keeping your mind active as well as maintaining lower stress levels. So, learning new skills, languages, keeping our brains mentally challenged always forces the brain to keep synapses active, as well as help create new connections or neuroplasticity. Now, if you want to stay young, we have to think young. So, engaging in activities that give your life a meaning or a purpose, that might actually help in keeping our brain healthy.

Host: So, stay young by thinking young, or as they say, "Use it or lose it," right, doc?

Dr. Sanjiv Sahoo: Absolutely.

Host: Is there an age, by the way, from your experience at which memory starts to decline in many people, maybe even just slightly, where they can be more mindful of doing the things you've laid out? When does this become more important?

Dr. Sanjiv Sahoo: So, this Brain Care Form that came out was actually validated in studies. It's a 21-point score. And if you try to achieve the highest score, you do better. So if you even improve your score by five points, you can decrease your chances of developing dementia by about 30-50% and the higher percentage happens if you start earlier.

Now, dementia is definitely age-related and a percentage of people who are above the age of 65 will start having symptoms of cognition decline and that increases quite a bit above the age of 85. It's almost affecting one-third of the population above age 85. So, it's definitely age dependent. So above 65, we'll start seeing changes.

Host: So, the older you get, the more mindful, no pun intended, you need to be about doing some of these things. In summary, generally speaking, doctor, by following some of these approaches that you've discussed, what would you say the chances are of someone's memory, in fact, improving from that?

Dr. Sanjiv Sahoo: So, if we do all of the recommendations and we follow that checklist, I think we have at least a 30-50% chance of slowing or preventing dementia. And if you're already in that phase, then doing the above can definitely slow the decline and will help improve memory.

Now, there are medications that you can also take that will help boost your memory and you'll have to see a neurologist for that. And some very interesting trials are ongoing and new medications are out there that are hopefully going to make a difference and eventually lead to a cure. But until then, I think we have to follow the above.

Host: So, help is indeed available. Well, folks, we trust you're now more familiar with whether memory can be improved. Dr. Sanjiv Sahoo, thanks so much again.

Dr. Sanjiv Sahoo: Thank you for having me.

Host: Absolutely. And for more information or to connect with a provider, please visit BayCare.org. Please remember to subscribe, rate, and review this podcast and all the other BayCare podcasts as well.

If you found this one informative, please do share it on your social media and be sure as well to check out all the other interesting podcasts in BayCare's library. For more health tips and updates, follow BayCare on your social channels. I'm Joey Wahler. And thanks again for being part of BayCare HealthChat.