How patients over 50 can reduce risk for cognitive decline and increase lifespan and healthspan

You’ve heard it before: ”Time waits for no one.” For as long as they’re alive, our patients will continue to age. Unfortunately, this aging is frequently coupled with a decline in energy and vitality and an increase in chronic disease. Fortunately, however, this doesn’t necessarily have to be the case. A growing body of research is demonstrating that there are specific recommendations that we can make to our patients who are 50 and older to help them preserve their cognitive capacity, decrease their risk for disease, and increase both their lifespan and their healthspan.


Laying the foundation for health early on

Irrespective of the wonderful advances we’ve made and continue to make in the field of medicine, the fact remains that the foundation of good health lies in our diet and lifestyle practices, as well as in our daily habits. Medication and supplements work wonders, but the truth is that these therapeutics can never fully undo the negative effects of poor dietary, lifestyle, and mindset habits. This is why the earlier we start educating and empowering our patients to make health-producing choices, the better it will be for their overall health and well-being.


Which foods should adults age 50+ avoid to promote mental and physical well-being? What should they eat instead?

Chronic, low-grade inflammation significantly contributes to the development of cardiovascular disease [1] and leads to increased risk for multiple other age-related health conditions, including cognitive decline and dementia, [2] depression [3], and diabetes. [4-5] In order to help our patients decrease their risk for these conditions, we need to help them avoid foods that can contribute to inflammation. This includes added sugar (e.g. sugar-sweetened drinks, cereal that sugar is added to, etc.), [6] fried foods, [7] and red and processed meats. [8] We should encourage our patients to replace these foods with a wide variety of fruits and vegetables, whole grains, moderate amounts of protein, and healthy fats. [9]


The results of a large prospective cohort study and meta-analysis involving over 15,000 adults aged 45-64 years demonstrated that both high- and low-carbohydrate diets were associated with increased mortality, whereas moderate carbohydrate-containing diets were associated with increased longevity. [9] Based on the results of this study, the optimal percentage of energy from carbohydrates (if our goal is increased lifespan and healthspan) appears to be about 50-55%. Researchers further noted that of the participants who consumed low-carbohydrate diets, those who ate large amounts of animal-derived proteins had greater mortality compared to those who replaced carbohydrates with more proteins derived from plant-based sources.


To sum it up, if our goal for our patients is longevity and increased healthspan, our recommendations to our patients should reflect this common saying: “eat real food, not too much, and mostly plants.”


What are some nutrients that people over 50 may be deficient in?

If they don’t consistently eat foods that are fortified with these important nutrients, people over 50 may be at an increased risk of being deficient in vitamins B12 and folate. [10-11] Low B12 and folate can manifest as fatigue, changes in cognition, paresthesias, vision disturbances, mood changes, and other symptoms. We should especially encourage our patients who are 50 and older to prioritize consuming foods that contain B12 and folate. In cases of deficiency, oral supplementation, intramuscular injections, or even intravenous nutrient therapy combined with other beneficial nutrients are of value.


[Click here to learn more about offering intravenous nutrient therapy in your practice.]


Which lifestyle interventions and supplements can slow aging and age-related cognitive decline?

A NHANES-based study suggests that high levels of physical activity may lead to decreased telomere shortening (up to 8.8 years worth), which is essentially how we quantify aging at the cellular level. [12] Additionally, food-based antioxidants, such as blueberries and other anthocyanin-containing fruits, [13] and herbal nootropes such as Bacopa monnieri [14] have been demonstrated to be beneficial in preventing and slowing age-related cognitive decline. As a result of its anti-oxidant and anti-inflammatory properties, N-acetylcysteine (NAC) may be beneficial as well. [15]


What are some mindset habits that can promote longevity and support increased healthspan?

Positive affect, or habitually being cheerful, attentive, and even enthusiastic, has been associated with decreased risk for age-related memory decline. [16] This includes both immediate and delayed recall. Positive affect was related with a decline in memory loss, even when researchers controlled for age, gender, education, depression, negative affect, and extraversion.


Positive affect has also been associated with lower mortality, likely because positive affect buffers the health-destroying effects of stress and reduces risk for stress-related chronic physical and mental health concerns. [17] Research suggests that the more challenging our patients’ circumstances are, the more beneficial positive affect will be to them.


We should emphasize intentional positivity with our patients in order to help them experience optimal lifespan and healthspan.


Summary

To summarize, there are specific recommendations that we can make to our patients who are 50 and older to help them experience optimal well-being for the duration of their years. The foundation of these recommendations lies in healthy habits, specifically in the areas of diet, lifestyle, and mindset.


Our 50+ patients may be at increased risk for nutrient deficiencies. To help them feel and be their best, we should consider checking for nutrient deficiencies and correcting them via oral, intramuscular, or intravenous nutrient therapy.


Positive affect has beneficial effects on cognition and memory, as well as on lifespan and healthspan. Promoting intentional positivity to our patients can be instrumental in helping them live their best lives, in their 50s and beyond!




[1] Hotamisligil G. S. (2006). Inflammation and metabolic disorders. Nature, 444(7121), 860–867. https://doi.org/10.1038/nature05485

[2] Xu, G., Zhou, Z., Zhu, W., Fan, X., & Liu, X. (2009). Plasma C-reactive protein is related to cognitive deterioration and dementia in patients with mild cognitive impairment. Journal of the neurological sciences, 284(1-2), 77–80. https://doi.org/10.1016/j.jns.2009.04.018

[3] Howren, M. B., Lamkin, D. M., & Suls, J. (2009). Associations of depression with C-reactive protein, IL-1, and IL-6: a meta-analysis. Psychosomatic medicine, 71(2), 171–186. https://doi.org/10.1097/PSY.0b013e3181907c1b

[4] Donath, M. Y., & Shoelson, S. E. (2011). Type 2 diabetes as an inflammatory disease. Nature reviews. Immunology, 11(2), 98–107. https://doi.org/10.1038/nri2925

[5] Shoelson, S. E., Lee, J., & Goldfine, A. B. (2006). Inflammation and insulin resistance. The Journal of clinical investigation, 116(7), 1793–1801. https://doi.org/10.1172/JCI29069

[6] O'Connor, L., Imamura, F., Brage, S., Griffin, S. J., Wareham, N. J., & Forouhi, N. G. (2018). Intakes and sources of dietary sugars and their association with metabolic and inflammatory markers. Clinical nutrition (Edinburgh, Scotland), 37(4), 1313–1322. https://doi.org/10.1016/j.clnu.2017.05.030

[7] Keewan, E., Narasimhulu, C. A., Rohr, M., Hamid, S., & Parthasarathy, S. (2020). Are Fried Foods Unhealthy? The Dietary Peroxidized Fatty Acid, 13-HPODE, Induces Intestinal Inflammation In Vitro and In Vivo. Antioxidants (Basel, Switzerland), 9(10), 926. https://doi.org/10.3390/antiox9100926

[8] Chai, W., Morimoto, Y., Cooney, R. V., Franke, A. A., Shvetsov, Y. B., Le Marchand, L., Haiman, C. A., Kolonel, L. N., Goodman, M. T., & Maskarinec, G. (2017). Dietary Red and Processed Meat Intake and Markers of Adiposity and Inflammation: The Multiethnic Cohort Study. Journal of the American College of Nutrition, 36(5), 378–385. https://doi.org/10.1080/07315724.2017.1318317

[9] Seidelmann, S. B., Claggett, B., Cheng, S., Henglin, M., Shah, A., Steffen, L. M., Folsom, A. R., Rimm, E. B., Willett, W. C., & Solomon, S. D. (2018). Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. The Lancet. Public health, 3(9), e419–e428. https://doi.org/10.1016/S2468-2667(18)30135-X

[10] Laird, E. J., O'Halloran, A. M., Carey, D., O'Connor, D., Kenny, R. A., & Molloy, A. M. (2018). Voluntary fortification is ineffective to maintain the vitamin B12 and folate status of older Irish adults: evidence from the Irish Longitudinal Study on Ageing (TILDA). The British journal of nutrition, 120(1), 111–120. https://doi.org/10.1017/S0007114518001356

[11] Tucker, K. L., Rich, S., Rosenberg, I., Jacques, P., Dallal, G., Wilson, P. W., & Selhub, J. (2000). Plasma vitamin B-12 concentrations relate to intake source in the Framingham Offspring study. The American journal of clinical nutrition, 71(2), 514–522. https://doi.org/10.1093/ajcn/71.2.514

[12] Tucker L. A. (2017). Physical activity and telomere length in U.S. men and women: An NHANES investigation. Preventive medicine, 100, 145–151. https://doi.org/10.1016/j.ypmed.2017.04.027

[13] Krikorian, R., Shidler, M. D., Nash, T. A., Kalt, W., Vinqvist-Tymchuk, M. R., Shukitt-Hale, B., & Joseph, J. A. (2010). Blueberry supplementation improves memory in older adults. Journal of agricultural and food chemistry, 58(7), 3996–4000. https://doi.org/10.1021/jf9029332

[14] Aguiar, S., & Borowski, T. (2013). Neuropharmacological review of the nootropic herb Bacopa monnieri. Rejuvenation research, 16(4), 313–326. https://doi.org/10.1089/rej.2013.1431

[15] Tardiolo, G., Bramanti, P., & Mazzon, E. (2018). Overview on the Effects of N-Acetylcysteine in Neurodegenerative Diseases. Molecules (Basel, Switzerland), 23(12), 3305. https://doi.org/10.3390/molecules23123305

[16] Hittner, E. F., Stephens, J. E., Turiano, N. A., Gerstorf, D., Lachman, M. E., & Haase, C. M. (2020). Positive Affect Is Associated With Less Memory Decline: Evidence From a 9-Year Longitudinal Study. Psychological Science. https://doi.org/10.1177/0956797620953883

[17] Okely, J. A., Weiss, A., & Gale, C. R. (2017). The interaction between stress and positive affect in predicting mortality. Journal of psychosomatic research, 100, 53–60. https://doi.org/10.1016/j.jpsychores.2017.07.005


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