I am in the same boat as everyone else who is aging.   I am trying to plan for the best outcome.   My profession does not protect me from either the physical or mental changes that come with getting older.  During my last physical, my physician, Kathleen Wilson, gently reminded me that I am not being aggressive enough with my personal wellness program.  I have been managing hypertension since I was 35.   I have Type II diabetes in my family and mildly elevated blood sugars.  These factors and age increase my risk for cognitive decline (I hope that if I decline it will not be severe enough that I become demented) as I grow older.

As part of my wellness, I take an aspirin each day, exercise, and stay engaged in professional and leisure activities.  A couple of recent studies encourage me that I am on the right track.  First, what about taking the aspirin, acetylsalicylic acid (ASA, for short)?  There is clear evidence that taking aspirin reduces my risk of stroke and heart disease.  But does taking aspirin reduce my risk for dementia?

Until now there have been no studies for guidance.  Four hundred eighty nine women (I hope the same findings apply to men) ranging in age from 70-92 (British Medical Journal, October 2012) completed assessment of social, physical, and cognitive health.  Those who took low dose aspirin, 75-160 mg, at the beginning of the study declined less than those who did not take aspirin.  This benefit remained regardless of age, Mini Mental State Score, APOE genotype, cardiovascular risk score, and use of other NSAIDS.

Interestingly, taking aspirin did not reduce the risk of becoming demented despite helping reduce cognitive decline.  This finding goes to the point I often make.  Some memory loss is not the same as dementia and not everyone with cognitive decline becomes demented and disabled.  I will keep taking my aspirin each day.

What about exercising?  With hypertension (and if I progress to diabetes), I am at greater risk of increased brain atrophy and increased white matter damage.  Does my exercise plan help?  How much time do I need to put into exercise?  A study (Neurology, 2012, 79, 1802-1808) of about 700 with a mean age of about 70 (close to my age) higher levels of physical activity were associated with both less atrophy and less white matter damage.  Interestingly, there was no association between leisure activity and stimulation and brain volume or white matter disease.  It may be that those who are willing to be in these studies are those who already seek stimulation and engagement.

Another study (Preventative Medicine 2012, September 7) does not directly address the issue of cognitive function.  There is evidence that about 150 minutes of exercise per week (about 2.5 hours) improves cardiovascular health and reduces the risk for diabetes.  The new study of 7,674 adults adds that 2.5 to 7.5 hours of exercise per week reduces stress, anxiety, and depression.  Those who exercised less than 2.5 hours or more than 7.5 hours report greater stress, anxiety and depression.  I aim at a minimum of 40 minutes at least 4 days a week (160 minutes).  I am a long way from overdoing it but I will persist.