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The Dose Transcript for May 16, 2024

Host: Brian Goldman

BRIAN GOLDMAN: Hi, I'm Dr. Brian Goldman. Welcome to The Dose. People of all ages are obsessed these days with trying to keep their brains in shape, but especially people who are older and feel as if they are slipping a bit cognitively. I exercise regularly not just for physical fitness, but to keep my mind sharp. Global Market Insights says that in 2023, the US market for brain exercise software was $8 billion, and it is rising. But does any of that plus Wordle and learning a new language and all that other stuff make a difference? So this week, we are asking, how can I keep my brain sharp as I age? Hi, Steven. Welcome to The Dose.

STEVEN LAUREYS: Hi, Brian. Great to be here.

BRIAN GOLDMAN: Great to have you here. And, you know, I'm not sure if you need it. I've told you what I do. Do you do anything to keep your mind sharp like on a regular basis?

STEVEN LAUREYS: I do research, work in the hospital.

BRIAN GOLDMAN: You do research.

STEVEN LAUREYS: I write books. And my wife who’s a psychologist often reminds me, you know, you should read your books again and, you know, walk the talk. But no, I really try to, of course, lead by example. And there's many things we can do. It's not rocket science. And maybe the most important of all is having good quality sleep.

BRIAN GOLDMAN: Yeah. Yeah. I'm still working on that. I've been working on that for several decades. I'm really looking forward to our conversation. But before we begin, can you give us a hi, my name is? Tell us what you do, all of those illustrious qualifications that our loyal subscribers love to hear.

STEVEN LAUREYS: Well, my name is Steven, Steven Laureys. I'm a neurologist and a brain scientist, a dad of five. That's also a reason to meditate. And I'm from Belgium, but now Canadian by adoption because I was awarded the Canada Excellence Research chair in neuroplasticity. And I think, Brian, that's what you're going to be talking about today. So I'm a professor at Laval University and setting up a team at the wonderful Cerveau Brain Research Centre in Quebec City. I'm also invited professor at Harvard Medical School at Beth Israel in Boston, and still affiliated as a research director at the National Fund for Scientific Research at Liège University in Belgium. So that's quite a number of challenges where indeed, I better keep my brain sharp.

BRIAN GOLDMAN: Wow. Indeed, you must if you keep up with that list of illustrious credentials. So let's begin our conversation. What happens to our brain cognition naturally as we age?

STEVEN LAUREYS: Well, we age, of course. It's some kind of challenge to accept that we're not going to win the Olympics age 70. So our body changes, our brain changes. And we know that some cognitive abilities like memory, processing speed, what we call executive function can decline with age, but there's a lot we can do. And of course, we don't all experience that decline at the same rate. There is a genetic factor. But most importantly, there's the impact of our lifestyle and overall health. So the message here is that there's a lot we can do to have a positive impact on our brain health and the fact that, yes, when we age, there is this natural process of decline.

BRIAN GOLDMAN: You off the top, when you were talking about your eminent qualifications, you talked about neuroplasticity or neuronal plasticity. What do we mean by that? And what has that got to do with cognition as we age?

STEVEN LAUREYS: So when I was in med school in the 80s, we thought, you know, we only lose neurons when we get older. Now we know that isn't true. You know, it was a dogma. And some scientists observed that we actually make new brain cells, especially in the hippocampus, which is part of the brain, important for memory. And of course, we have not just these billions of neurons of brain cells. Their real power and what makes them different from any other cell in our body is that they connect. They talk to other cells. So that makes them so powerful. They have thousands or tens of thousands of connections. We call them synapsis, and these change basically all the time. So we have now way more dynamic view on the brain, and that's fascinating. That's called brain plasticity, how the brain changes its structure, those thousands of billions of bridges. And that, of course, is terribly important when, you know, you're born and you learn a bunch of things. But it is important throughout our lives. And that's, well, the topic of our Chair of Excellence, trying to understand that process by means of brain scanners and the impact of what we do, even what we think each and every day, meditation, the quality of our sleep and the things you want to talk about.

BRIAN GOLDMAN: So what types of cognitive exercises are best, you know, based on the evidence that we have thus far, you know, to keep our brain sharp?

STEVEN LAUREYS: Brian, I think the best ones are the ones you like. I truly believe in motivation. So my first mission here is to share the scientific knowledge as a neurologist also seeing patients, challenging your brain, getting out of your comfort zone a little bit, not overstretching will really have an impact and just diversify. It can be something you find on the internet or an app. And of course, there's a whole business around that. But also, just go out, meet people, enjoy a walk in the park, you know, try to find what's happening around you, learn a new music instrument or dancing class or whatever. So I think there is not just one magic bullet. It depends on your needs and your passions. So to me, motivation and finding what you enjoy is the key.

BRIAN GOLDMAN: What's happening in our brains when we're, you know, slaking our thirst for new knowledge, when we're indulging our curiosity?

STEVEN LAUREYS: Well, that's neuroplasticity in action. So you're challenged, right? Let's say you decide I'm going to, I don't know, learn something new, whatever it is. Well, it's a learning process, so you will need your attention. You will work on it. So you're challenging what you know today. And what you will be able to do tomorrow is basically permitting the brain to grow. Don't put the bar too high. Sometimes we, you know, we expect too much too quickly. Just enjoy the ride. And we're social animals. So if there is a way you can also do things together, that's really great. That's kind of challenging your brain to, you know, interact with other brains, basically. And then we see really with the brain scans, already after a couple of weeks, actually, that there are these structural changes in the grey matter, the brain cells in the connections, that's the white matter, and in the way the brain functions and deals with these new challenges and getting better and better at this.

BRIAN GOLDMAN: Wow, just two weeks. That's incredible.

STEVEN LAUREYS: A couple of weeks. It depends, of course, what you do, but yeah, now we are also, with these better and better machines, able to capture that neuroplasticity in action.

BRIAN GOLDMAN: In addition to doing things that you already enjoy doing and building upon them and learning more about them, there are these stereotypic brain games, which are, of course, a whole industry. I do Wordle every day, and there are many variations of Wordle. You know, is that good?

STEVEN LAUREYS: No, great. You like Wordle? You know, it can be beneficial for language, problem solving skills. But again, I would not just do that. Complement it with other activities. The more diverse, the better for your brain.

BRIAN GOLDMAN: And is that because it's the same stereotypic game every day so that you're not really challenging yourself? Is that what's going on?

STEVEN LAUREYS: Well, no. They’re really good. There's a number of them. Some of them have really been validated by scientific studies. And they, of course, adapt towards your learning process and make it more and more challenging and can be diversifying, yet you're still behind the screen, right? We spend already a lot of time behind screens. So don't just do that. Also do other things like these podcasts are great. You challenge every time you interact with another human being. And then, as you said, just enjoy going out. I don't think, and maybe there I disagree a bit with, you know, the Silicon Valley gurus that it's just technology that's going to save us here. It's also reconnecting with our humanity, our emotional needs, our body. So it's all of that, really, not just an app.

BRIAN GOLDMAN: And we'll get into some of those other things. I think you're making the point, though, very clear, and it's an important point. But just sticking with the, you know, the technology, or let's talk about doing puzzles. When you do puzzles, do they work on one part of the brain or are they working on multiple parts of the brain?

STEVEN LAUREYS: No, they are working on multiple parts. So you're of course focusing your attention, recognizing patterns, stimulating your vocabulary. You can also do crosswords. They will challenge your general knowledge. So it's helping you in problem solving in different dimensions, and we see that in terms of the brain networks involved. So attention network, language network, working memory and long term memory. All of that has been documented by functional MRI, you know, these machines that make pictures of the brain, but also how it is changing its activity when you're doing these tasks and documenting the learning process.

BRIAN GOLDMAN: You off the top talked about some of the lifestyle interventions that you do, things like sleep and exercise. And of course, there's diet. How important are all these? Let's try to take these one at a time.

STEVEN LAUREYS: Let me start with meditation then, Brian.

BRIAN GOLDMAN: Okay.

STEVEN LAUREYS: That's currently my favourite. And I wrote a whole book about it where I share my story when I was struggling, not able to keep, you know, my focus. I was giving a TEDx in Paris 2013. There was a monk there. His name is Matthew Ritard. He talked about meditation and invited me there to go with him on a retreat because he saw I was in a struggling moment in life. I was going through a separation, taking care of the three kids, and that to me was an eye opener in such a way that I invited him to be a guinea pig and many others followed. And then we documented what meditation does to your brain. And he’s 70 plus. His brain, Brian, looks like 10, 15 years younger. When we measure it up, you know, voxel based morphometric, we can actually really document that there's parts of the brain that are just bigger compared to other people his age. And that made me convinced that my job as a neurologist was more than just making a diagnosis and prescribing pills. So now I prescribe meditation. Meditation is a good place to start. It's gymnastics for the brain, and it also might have a negative connotation. You know, we think this is esoteric.

BRIAN GOLDMAN: Yeah.

STEVEN LAUREYS: I'm not Buddhist. I can think of nothing. But it's really training your attention. And we're actually now looking in multicentric studies how programs like mindfulness based stress reduction can help people who are at risk for cognitive decline.

BRIAN GOLDMAN: Can you give some suggestions on how to do it, how to start meditating, where to look for for ways to do it?

STEVEN LAUREYS: A lot of possibilities. You can go on the internet. A lot of stuff is offered for free. There's great apps worldwide. Headspace is number one. I think it's well presented with videos, guided meditation. What I prescribe is mindfulness based stress reduction. That's an eight week program. You're in good hands. It's a psychologist, and that has been the most scientifically validated. And that's offered basically everywhere, both in hospitals and in private centres. There's books, of course. There are so many ways to practice meditation. A little bit like sport. Very probably, Canadians should spend less time behind their screens and sitting. We should exercise more. But whether it's going biking or running or swimming, do what you like. And the same for meditation. There is a number of practices, but the key is paying attention to what's happening in your heart. You spend a lot of time there and learning to observe what you are experiencing, and then training to decide what you focus on. And it's basically attention training.

BRIAN GOLDMAN: That is very helpful. Now I want to turn to something else. So there's a couple of things I want to talk about. You know, I mentioned sleep, and I can't sleep. Well, I can sleep, but, you know, I wake up in the middle of the night and I have trouble getting back to sleep. It's been almost a lifelong affliction of mine. And yes, I do practice some mindfulness. I practice breathing. It does help. You mentioned that it's important to get a good night's sleep, and that's something that I have not been able to fix. But what is the connection between poor sleep and poor cognition?

STEVEN LAUREYS: Sleep is vital. I see it in my consultation now, a lot of video consultation when people come to me because they have, you know, whatever problem, basically, from headache to chronic pain to depression, anxiety. Very often, they would share, if I ask about the quality of their sleep, that they struggle. And actually, many take sleeping pills or, you know, tranquillizers or whatever. Way too many Canadians still do, and we know that's not good for your brain. I think it's important to stress that sleep is really not a waste of time. A lot is happening when you sleep. We actually studied and published, again, brain plasticity, when we use these brain scans to see what's going on. When you sleep, we show that it's important for memory, but it's also important for your emotional stability. And what often happens is that you have this vicious circle like I don't sleep well for whatever reason. You know, I'm stressed, professional, private. I feel more irritable. I can become more anxious, and then I sleep even less good, and there it goes.

BRIAN GOLDMAN: You're describing me.

STEVEN LAUREYS: Well, so the good news, Brian, is that we can really increase our efforts to understand why is that and what can I do. So working around your sleep ritual. And there are specific psychologists that can help you with cognitive behavioural therapy. And there's one system that's actually discovered not so long ago, and that's the glymphatic system. Glymphatic system. What is that? Well, we have brain cells neurons, but next to them are glial cells. And they help to get rid of toxic waste products that accumulate during the day. It's really mechanical. It's a natural, efficient detox happening during deep sleep. And studies show that if we don't have good quality sleep, you know, we are at risk for a number of brain diseases, degenerative dementia, neuropsychiatric diseases. And again, the good news, if we identify the cause and we treat it, people age better.

BRIAN GOLDMAN: I know exercise is important, and I know that there's actually a lot of evidence to show that regular exercise is not only good for your physical health, but good for your cognitive health.

STEVEN LAUREYS: Absolutely. And again, everything holds together. My mission now is to defend more integrative medicine, a holistic build bridge between hyper specialized, hyper technological medicine and pharma with a more central active role for citizens, patients. So of course, when I work out, it will have an impact on the quality of my sleep. And the studies show that if we can get three times a week, 20 minutes aerobic exercise, it really changes the neurochemistry of my brain. It's not rocket science. We can again go towards a more healthy life and don't need to run a marathon three times a week, 20 minutes sweating. That's what I prescribe to the patients I see.

BRIAN GOLDMAN: What about diet and supplements? What do we know about that and how they can help our cognition and memory?

STEVEN LAUREYS: Of course, what we eat is important, and we can read a lot about what we should and should not eat. I prefer just common sense, Mediterranean diet, lots of fruits, vegetables, nuts, olive oil. And if you have such a healthy diet, diverse, you don't need any supplements. We also didn't stress how the brain that is using a lot of energy needs a lot of blood supply. So what is good for your heart is good for your brain. So we don't want to have atherosclerosis, you know, clutter our arteries. So not too much sugar, fat, watch your cholesterol, check for hypertension, diabetes. That is also very, very important if we want to age healthy, to keep a healthy heart and healthy arteries.

BRIAN GOLDMAN: So we've been talking about brain function as we age. And I think I've been speaking mostly or asking mostly about healthy ageing. But then again, there's dementia and, you know, Alzheimer's type dementia and other kinds of dementia. So what I'm trying to do is is find the connection between all the things that you're suggesting and maybe slowing down the progress of dementia. Do the strategies that you've talked about work to at least slow down the progress of dementia for people who are at risk?

STEVEN LAUREYS: Yeah. So as you mentioned, there's a number of diseases that can cause dementia. There's vascular dementia, degenerative and a number of types, and there's genetic components. But again, there is this big impact of the environment of what we do throughout our whole lives. So you better start thinking about this when you're young. But any age is good to, you know, live more healthy, quit smoking, avoid alcohol, all the things we said. It's not a vaccine, right? You can still get sick. It's not necessarily going to cure you. It's not a magic stick, but definitely can help. So you build up your cognitive reserve, as we call it. When you have an exciting job and a lot of social interactions and live healthy, you will have a more healthy brain. And so if it turns out you develop such a brain disease, of course, you start from higher, and it will take more time and you will be able to enjoy longer good quality of life.

BRIAN GOLDMAN: So lots of things that we can do in the here and now, especially meditation, which I'm going to put on my list, better sleep, but also lots of promising research now and in the years to come. Dr. Steven Laureys, thank you so much for sharing your knowledge and wisdom with us on The Dose.

STEVEN LAUREYS: Wonderful. And I wish you a sweet night and a good restorative sleep, Brian. It was great talking.

BRIAN GOLDMAN: Well, amen to that. From your lips to God's ear. Thank you very, very much for speaking with us on The Dose.

STEVEN LAUREYS: Pleasure.

BRIAN GOLDMAN: Dr. Steven Laureys is a neurologist and brain scientist and the Canada Excellence Research Chair in Neuroplasticity at Laval University. Here's your dose of smart advice. As we age, there is a gradual decline in reasoning ability, memory and processing speed. That's normal. But at all ages, the brain also makes new connections and even new brain cells. Scientists call that neuroplasticity. There are many ways to enhance neuroplasticity. One way is through meditation and other forms of mindfulness. Meditation helps sharpen your mental focus. It helps manage stress, and stress has an adverse effect on thinking and memory. Regular meditation makes your hippocampus get bigger. That's the part of the brain where memories are stored. Exercise is another brain booster. Aerobic exercise for 20 minutes three times a week improves reasoning and memory, especially working memory, which refers to the bits of information your mind can hold at any one time. Exercise also helps executive function. Sleep is critical to thinking and memory. That's because sleep is necessary for neuroplasticity and to detox the brain. Diet is also important. Foods that help with cognition include green leafy vegetables like kale and spinach, fatty fish, berries and walnuts. Your morning hit of caffeine provides a short term boost in concentration and may help solidify new memories. But too much coffee increases heart rate and the stress response, which in turn have an adverse effect on cognition. Brain games, puzzles and other forms of mental exercise help us get better at doing those exercises. But it's hard to generalize the benefits because the methods used to train research subjects aren't consistent. If you enjoy doing brain exercises, they will probably help you think better. Don't rely exclusively on screens and other technology to keep your brain sharp. Challenge yourself. Get out of your comfort zone. Try doing new things. High blood pressure, diabetes, elevated cholesterol and triglycerides affect brain health by causing atherosclerosis, which reduces the blood supply to the brain. Controlling these risk factors can help preserve brain function. One last thing. Your brain thrives on social connections. Staying in touch with family and friends is an important way to keep your mind sharp in the long run. If you have topics you'd like discussed or questions answered, our email address is thedose@cbc.ca. If you liked this episode, please give us a rating and review wherever you listen. This edition of The Dose was produced by Isabelle Gallant. Our senior producer is Colleen Ross. The Dose wants you to be better informed about your health. If you're looking for medical advice, see your health care provider. I'm Dr. Brian Goldman. Until your next dose.

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How can I keep my brain sharp as I age? - Transcript

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