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

Happy Monday and welcome to our first week of Motivated Mondays 2025!

In 2020, we launched the program Motivated Mondays with the intention of helping members implement small monthly lifestyle changes to yield lasting behaviors toward improved wellness. In 2023, we pivoted and the program became focused on modifiable lifestyle factors impacting cognitive decline and neurodegeneration. The program continues to be well received and since the science is ever evolving, in 2025 we continue with our brain health focused Motivated Mondays.  Don’t worry if you previously participated—you won’t be bored! We will refresh the content with updated science, new tips and tools and a few new special editions.
 
As always, we commit to providing you with “the what” to do, “the how” to implement it, and also “the why” each resolution is impactful for the health of your brain.
 
We're so glad you decided to join us in 2025. Let’s begin!

​Can we really prevent cognitive decline?
 
Captain Kirk may have proclaimed space as the “final frontier” but scientists have barely scratched the surface of what there is to know about the brain, thus we argue the brain is both the first and final frontier in science and medicine. Consider the brain functions tirelessly 24/7 to execute the biological and chemical functions of the 30 trillion cells a human possesses! We are not even aware of most of the brain’s activity because it happens in the autonomic nervous system- without our conscious thought.
 
A combination of genetics, environment and modifiable lifestyle factors are at play for the onset and progression of cognitive decline and neurodegeneration. While 2024 was a landmark year for testing and treatment options, evidence continues to mount that each of us can choose behaviors which protect or harm our brains and its function. This year we will address behaviors to engage in which are protective and behaviors to avoid which are detrimental. Yes, plural! There is no one magic behavior; cognitive decline and its associated neurodegenerative conditions are multi-factorial in origin offering multiple opportunities to intervene! As the year draws to a close it will become evident how these behaviors are interrelated towards preventing cognitive decline and neurodegeneration.
 
While most people attribute cognitive decline with neurodegenerative 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 the same modifiable lifestyle factors/behaviors we will be discussing.
 
It is also important to note, some cognitive decline can be temporal, as with exposure to certain medications, surgical anesthesia, traumatic brain injury or stroke.
 

6 Cognitive Function Domains
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Cognitive impairment can occur in any of the six cognitive function domains and is determined by the part of the brain affected by genetics, environment or lifestyle behaviors/factors.

​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. It involves 1) organization- to collect information and modify it to be evaluated and 2) regulation - which conducts the evaluation of the information and adjusts ones response to it. 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. 

​Perceptual motor control is our ability to coordinate our body’s movements in response to what is happening around us. 

​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.  

​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.

Glossary
 
Here are a few terms we will revisit throughout 2025:

• 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." 
  
  
• Neurotransmitter- chemical messengers released by neurons to communicate with other cells.
  
  
• Amyloid beta and tau-aggregations of proteins interfering with neuronal communication

​We’ll begin our 2025 program next week with our first mini resolution to remove added sugar from the diet. 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, etc.

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