What to Expect in Concierge Choice Physicians' Special Brain Brawn Edition of Motivated Mondays

Originally posted January 29, 2024

Happy Monday and welcome to our first week of Motivated Mondays 2024!

Four years ago, we launched the program Motivated Mondays with the intention of helping members implement small monthly lifestyle changes to yield lasting behaviors toward improved wellness. Last year, we pivoted and the program became focused on modifiable lifestyle factors impacting brain health and cognitive decline. The program was so well received, we decided to make our 2024 Motivated Mondays program about brain health once again. But don’t worry if you participated last year—you won’t be bored! We will refresh the content with new information, tips and tools, as it is always and forever evolving.
 
As in the past, we won’t just provide you with “the what” to do and “the how” to implement it, but also “the why” each resolution is impactful for the health of your brain.
 
We're so glad you decided to join us in 2024. Let’s begin!

 
Can we really prevent cognitive decline?
 
Research has shown that cognitive decline is a top fear of aging adults. Since not all of us are genetically endowed to be cognitive “super-agers,” we can pursue modifiable lifestyle factors that are within our control to fend off cognitive decline.
 
Why learn about and implement these healthy behaviors? Well, despite the staggering amount of money invested in brain health research, we are no closer to a magic treatment. This is likely because cognitive decline and its associated neurodegenerative conditions are multi-factorial in origin. A combination of genetics, environment and modifiable lifestyle factors are at play for the onset and progression of these conditions. However, observational and interventional studies have shown how our behavioral choices can have a positive influence on brain health.
 
While most people attribute cognitive decline with neurogenerative conditions such as Parkinson’s disease and Alzheimer’s, there are non-neurodegenerative conditions which also impact cognitive function such as cardiovascular disease and diabetes. This should come as no surprise since these non-neurodegenerative conditions are also strongly associated with and influenced by modifiable lifestyle factors/behaviors.
 
Keep in mind, cognitive impairment can be temporal, as with exposure to certain medications, surgical anesthesia, traumatic brain injury or stroke. Even mental health conditions such as depression and anxiety are known to impact cognitive function.
 
Let us not forget that normal aging may impact cognitive function, but impaired cognitive function is not inevitable!

6 Cognitive Function Domains

Cognitive impairment can occur in any of the six cognitive function domains:
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Learning and memory are probably the most well-known aspects of cognitive function. They are characterized by the ability to record information and retrieve them when needed. There are several types of memory.	Language is our ability to communicate, either through writing, reading, or speaking. Language skills includes tasks such as naming objects, finding the right words, the fluidity and flow of our speech patterns, grammar and syntax.
Executive functions refer to high-level cognitive abilities required to control and coordinate other cognitive abilities and behaviors. In other words, these are the functions we need to plan, prioritize, make decisions, respond to our environments, and toggle between tasks. This includes sequencing, planning, and organization tasks.	Social cognition is how we process, recall and use information in social contexts. This includes our ability to control our desires to act on impulses, express empathy, recognize social cues, read facial expressions, and motivate ourselves.
Complex attention is our ability to focus on multiple things at once and our ability to choose what to pay attention to and what to ignore.	​Perceptual motor control is our ability to coordinate our body’s movements in response to what is happening around us.

The clinical manifestation (i.e., which domain affected) of the impairment is determined by the area of the brain affected. In most cases, the changes occur as result of perturbations in neuronal communication at the synapse. In other words, regardless of the domain or the cause of the injury, the end result is that neurons (brain cells) are not effectively communicating with one another.

 
Here are a few terms we will revisit throughout 2024:

• Brain Plasticity – the ability of the brain to rewire itself or change in response to external or internal stimuli, a measure of neurological resilience
  
  
• Brain Derived Neurotrophic Factor (BDNF) – a protein secreted in the nervous system which promotes survival of neurons, a mediator of plasticity. Facetiously known as Miracle Grow for the brain!
  
  
• Subjective Cognitive Decline – patient reported experience of memory loss or confusion but not apparent yet on neurophysiological testing.
  
  
• Mild Cognitive Impairment – a clinical diagnosis by a healthcare provider in which the patient experiences the early stages of cognitive ability/memory loss but in which activities of daily living (ADLs) are not impacted. Some patients progress to neurodegenerative disease, others do not.
  
  
• Dementia – a clinical diagnosis in which the patient experiences loss of cognitive function in one or more of the cognitive domains which are severe enough to impact ADLs. Alzheimer’s disease is a type of dementia.
  
  
• Mitochondria is the structure found in all cells in the body—except in red blood cells—that is responsible for creating energy for the cell. You might recall your science teacher saying, "The mitochondria is the powerhouse of the cell."

We’ll begin our 2024 program next week with our first mini resolution to remove added sugar from the diet, which we’ll pursue for the next several weeks. Fear not, we won’t tell you to skip the Valentine’s Day chocolate truffles, but will encourage you to remove the unnecessary, hidden, added sugar in your ketchup, bacon, yogurt, marinara, sausage, nut butters and so on.

Feel free to email your Motivated Mondays Coach Michele at [email protected] with your individual questions.