Avoiding Falls By Keeping Your Brain Fit

As a person gets older, changes occur in all parts of the body, including the brain:

• Certain parts of the brain shrink (such as the prefrontal cortex and hippocampus); both areas are important to learning, memory, planning, and other complex mental activities.
• Changes in neurons and neurotransmitters. Neurons are the basic working unit of the brain; they're specialized cells that send information to other nerve cells, muscle, or gland cells.
• Changes in the brain's blood vessels occur. Blood flow is reduced because arteries narrow.
• In some people, structures called plaques and tangles develop outside of and inside neurons, which in much larger amounts, can result in Alzheimer's disease.
• Damage by free radicals. Free radicals are a normal by-product of the body's metabolism. Normally, free radicals serve important functions, such as helping the immune system fight off disease. Free radical damage may contribute to memory loss.
• Neurodegenerative disease such as Parkinson's disease, Alzheimers, or other dementias can affect a person's mental capacity (their ability to perform complex tasks of attention, learning, and memory).

Aside from memory problems, changes in brain activity influences one's chances of falling. The ability to keep balance and avoid falling depends not only on leg strength, but also on complex and simple reaction times, known as ‘brain speed'. In a new study, elders with good reaction times were able to balance on one leg for a longer period of time than those whose brains worked more slowly. The faster one's brain can move between events (identifying a loss of balance and executing a safe alternative to maintain balance), the better off people are in avoiding falls. In other words, when some elders fall, their brains may not be keeping up with what is happening and unable to quickly recover from a loss of balance.

Another study found that people whose brains work hard when trying to complete complex activities (such as walking and talking at the same time) may have a higher risk of falling than those individuals who do both tasks with ease. When elders perform any cognitively demanding task, their brains become more active to handle the challenge. Walking and talking at the same time requires greater attention. Thus, more brain effort is expended, which in some individuals can lead to falling.

Brain Boosters

It's not clear whether underlying diseases may be alerting brain activity and placing elders at fall risk. But the good news is that older brains are capable of compensating for any difficulties that certain regions may be having. For example, the brain may recruit alternate brain networks to perform a task. Growing evidence of the adaptive capabilities of the older brain (what scientists call ‘plasticity') provides optimism that people may be able to do things to sustain good brain function as they age.

There are a variety of activities that people can do to keep their brains healthy and help counter normal brain changes:

Get a Check-Up

• Take care of your health. Certain conditions can affect brain health including diabetes, stroke, vitamin deficiency, thyroid disease and high blood pressure. Controlling risk factors for chronic disease (such keeping blood cholesterol, blood pressure at healthy levels and maintaining a healthy weight) is good for brain health.
• Certain medicines, such as sleep and anxiety drugs can also affect mental ability. Ask your doctor to review all your medications on a regular basis.

Eat Healthy

• Eating a healthy diet can help maintain brain health. For example, eating fruits and vegetables (that have high levels of disease-fighting antioxidants) helps counteract disease-causing free radicals throughout the body, including the brain.

Stay Active

• Enjoy regular exercise and physical activity. Exercise helps counter normal cognitive decline; it can also assist in managing and preventing conditions like high blood pressure and depression that are associated with poor brain health.
• Exercise pumps blood to the brain and encourages the growth of new brain cells.
• Regular aerobic exercise (such as walking, cycling and swimming) for 30 minutes a day reduces brain cell loss.
• Exercise changes how the brain processes movement, resulting in improved mobility.

Engage Your Brain

• Just like physical exercise, mental exercise is good for you. Mentally stimulating activities help preserve brain function. Keeping your mind engaged increases the brain's vitality and helps build its reserves of brain cells and connections.
• Do stimulating activities that you enjoy; read, write, put together a jigsaw puzzle, work on crosswords, etc. Any mentally challenging activity will keep your mind sharp.

Stay Social

• Connect with family, friends and your community. Isolation can be a threat to brain health. Staying engaged with family and being active in your community can keep your brain active. The more social connections someone has, the better they are at preserving mental function and memory.
• Social interaction engages areas of the brain that are involved in memory and attention, the same mental processes that are used in many cognitive tasks.
• Activities that combine social interaction with physical and mental activity may help prevent dementia.

Get a Good Night's Sleep

• Getting seven to eight hours a night is good for the brain. Attention and concentration are threatened with restless sleep.

Drink in Moderation

• Drinking alcohol may be beneficial to your brain. Low -dose alcohol consumption (a drink a day for women, two for men) can reduce the risk of dementia. However, heavy alcohol use can lead to brain damage and cognitive decline.

Rein Tideiksaar Ph.D., PA-C is the president of FallPrevent, LLC, Blackwood, N.J., a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr. Tideiksaar is a gerontologist (healthcare professional who specializes in working with elderly patients) and a geriatric physician's assistant