How Well Can You Bounce Back?

Strong Resilience Can Delay or Defeat Dementia

Photo by Mariah Solomon on Unsplash

In her late 70s, my mother was showing some memory loss and other mild signs of dementia, but she was comfortable in the house in Baton Rouge, La., where she had lived for nearly 30 years. Then catastrophe struck in the form of Hurricane Katrina. Trees fell, electric service shut down, streets flooded. My brother moved her across town to his house for several months.

Eventually the area recovered, but my mother did not. The disruption of leaving her familiar surroundings and daily routines started her mental state on a sharp and rapid decline. The last decade of her life was a horror show as Alzheimer’s Disease eroded her memory, her personality, and her ability to cope with the simplest tasks.

What my mother lacked was resilience. Or more likely, her store of resiliency had been depleted by a half century on the roller coaster with a bipolar husband. Once she was torn away from the familiar and comfortable, she couldn’t regain her equilibrium, and Alzheimer’s progressively overwhelmed her brain.

When life delivers a sucker punch, resilience is what allows you to get back up, dust yourself off, and say, “Okay, what’s next?”

Research is beginning to identify resiliency as a key factor in resisting – or possibly even preventing – the symptoms of Alzheimer’s.

Resistance versus Resilience

A major study in The Netherlands looked at hundreds of people who had reached the age of 100 and self-identified themselves as cognitively healthy. Many maintained their mental capacities for up to four years beyond 100. What was their secret? The researchers performed autopsies on 44 of the centenarians who had given their consent. You might expect that these lucky individuals had won the genetic lottery, reaching an advanced age with no signs of Alzheimer’s. In some cases, that was true.  But what is more surprising is that many brains had the same buildup of plaques and tangles typical of Alzheimer’s patients - yet somehow exhibited no Alzheimer’s symptoms during their lifetimes.

The group with no evidence of Alzheimer’s in their brains were Alzheimer’s resistant, says Dr. Thomas T. Perls, a Boston University geriatrician who is an international leader in the study of exceptional longevity. Their protection likely was a combination of good genes and a healthy lifestyle. Those whose brains looked like Alzheimer’s patients but had maintained good cognitive health, he says, were resilient. Their brains had sustained damage, yet they were able to get around it by forging new pathways to replace the ones blocked by the disease.

You’re Not Too Late

What do we need to make our brains more resilient? Some factors are outside our control, like genes. Higher socioeconomic status, good pre-natal and post-natal care, education beyond high school, and a stimulating environment also help.  

But the evidence is strong that other steps we can take, even in midlife, can build resiliency and reduce the risk of Alzheimer’s. Here are the most significant ones:

·         Continue your education. Take on the mental challenges of learning a new language or another subject you always wanted to learn but never had time to pursue. Just as muscles need exercise to stay strong, brains need stimulation to stay sharp. If you’re still working at something you love and find exciting, good for you - keep it up. Activities that challenge and engage the mind can delay the onset of Alzheimer’s symptoms by eight to nine years.

·         Develop a mindfulness practice. In mindfulness meditation, the idea is to focus your attention on the present moment and gently steer your attention back to the present each time the mind drifts, as it will, into thoughts and worries. A daily meditation practice helps build mental reserves for handling anxiety and frustration – in other words, resilience. It may also reduce high blood pressure and cholesterol, lifestyle risk factors for Alzheimer’s. Other mindfulness practices include making art, listening to music, walking in a garden, or watching birds.

·         Engage with your community. People who engage with other people consistently fare better with Alzheimer’s than elders who remain alone and isolated. (See Barbra Was Right!)

·         Adopt a healthier diet. What’s good for the heart is also good for the brain. According to one major study, “a heathy Nordic diet” had a positive impact. Not surprisingly, that study was conducted in Finland. Healthy Nordic means lots of fish, fruits and vegetables, and oils. It actually resembles the currently popular Mediterranean Diet – vegetables, fruits, whole grains, healthy fats, poultry, beans, eggs, easy on the dairy and red meat – plus more fish.

Some people consider Keith Richards as an exemplar of resilience, but my own personal role model is the comedian George Burns. After losing Gracie Allen, his comedy partner and the love of his life, he rebounded in his 80s to become a box office smash, even winning an Academy Award. On his 100th birthday, he remarked, “I can’t die now – I’m booked!” And he stayed booked right to the end.

We should all be so lucky.

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