Infection: Possible Cause of Alzheimer's Disease?

by Ram

Roads and Fences by Marie Lossky

Alzheimer’s disease was first described in 1906 by a German physician Alois Alzheimer and the disease that got its name from this physician continues to baffle neuroscientists to date about the exact cause, cure, or treatment. Alzheimer’s disease (AD) is a progressive brain disorder that damages specific cells in the region of the brain called hippocampus. Death of neurons in the hippocampal area of the brain triggers short-term memory failure, and often the person's ability to do familiar tasks begins to decline as well. Alzheimer's disease also attacks other areas of the brain responsible for functions such as language and reasoning, resulting in the loss of language skills and judgment. As the disease progresses, patients often exhibit personality changes, emotional outbursts, and disturbing behavior, such as wandering and agitation. People with AD eventually require comprehensive care, thus the disease presents a considerable problem in patient management as well. It may sound strange that despite a century having elapsed since the disease was first described, there is still no cure or proper treatment for this disease.

According to recent statistical data, an estimated 5.4 million Americans of all ages have Alzheimer's disease. By 2050, the number of people with Alzheimer's disease may nearly triple, to a projected 13.8 million. In the last 10 years of the 244 compounds that went to clinical trials only one was approved. And that one approved drug works with limited efficacy only when given to patients during the early stage of the disease. Finding drugs for AD is especially difficult because: 

1. The exact cause of AD is not yet known.
2. The brain is relatively inaccessible, and harder to test and deliver compounds to.
3. No proper animal models exist that recapitulate? exactly the disease in humans.
4. Less is known about the biology of the condition.

 While the exact cause of the disease is still unclear, most of the attention has been driven towards a protein called beta amyloid, which forms toxic aggregates or plaques in the brain of AD patients. When not properly cleared, the toxic beta amyloid blocked transport of essential nutrients and disrupted communication between neurons that ultimately resulted in death of nerve cells, cognitive decline, and memory loss. Evidence suggests that amyloid is deposited early during the course of the disease, even before clinical symptoms appear. Thus, this protein became a major drug target in the search for a cure to Alzheimer’s, with pharmaceutical companies spending billions of dollars designing drugs that bind to and trigger clearance of the toxic beta amyloid. In all these trials, not only were these drugs ineffective in reversing the AD symptoms, in several cases, patients exhibited severe side effects very early on and the trials had to be abandoned prematurely. So targeting beta amyloid in patients with AD may not be the correct approach to stop the disease, and several researchers continued to debate passionately about the amyloid hypothesis while looking into other theories. 

Now a team of researchers is proposing a very different story. In a study published last week, the collaborative team from Harvard and MIT report that beta amyloid may actually have a critical neuroprotective role in the brain: protecting the brain from infections (bacterial or viral). The neuroscientists suggest that beta amyloid acts as a foot soldier by trapping potentially invading harmful bugs and alerting the other defense teams in the brain to their presence. By forming a mesh like structure, beta amyloid traps the microbes and prevents them from traveling deeper into the brain. The researchers also pointed out that animals that overproduced beta amyloid were more resistant to infections and had longer survival rates compared to animals that did not produce the protein. The higher the expression of beta amyloid, the greater was the protective effect from the infection, suggesting that beta amyloid acted as a natural antibiotic. This meant that getting rid of amyloid, as most drug trials tried in the past, could actually be dangerous, especially when the patient contracted any infection. 

So if beta amyloid is actually a protective protein, what eventually triggers Alzheimer’s disease? According to the researchers, the disease could be inadvertently triggered by an infection that causes the formation of excessive beta amyloid. As people get older and their immune system becomes increasingly compromised, it paves the way for microbes to sneak into the brain, resulting in an overabundance of the beta amyloid protein that exceeds the normal protective threshold. An excessive buildup of the protein may trigger the body’s own defense system to go awry that which we know as inflammation (see Chronic Inflammation and Yoga: Combating the Fiery Killer). Thus, what may be a neuroprotector, over time changes its face into a neurotoxic molecule. It is like the soldiers who stage a coup instead of defending their country. 

So what does this mean for pharmaceutical companies? Well, instead of attempting to completely eliminate the beta amyloid protein from the brain, drugs need to be engineered such that they dampen the beta amyloid levels to a stage where they continue to elicit the protective anti-infective properties. And what does it mean for people who have early stages of the disease? Or what does it mean for people who do not have the disease yet but who have a family history of AD? For now, some of us maybe able to avoid the chronic mind-ravaging effects of AD by making healthy changes to our lifestyle, remaining active, achieving ideal weight, reducing stress, and in some cases, taking vitamins, herbs and/or nutraceuticals that are recommended by a physician or licensed practitioner. The brain, like muscles in the body, requires exercise to remain functionally strong and resist infections. Stimulation of the brain increases the branching of brain cells that provide resilience to the brain and also support cognitive function. Thus, it is important to pursue intellectually challenging activity throughout life (see The Power of Mental Exercise, Part 1). 

Maintaining mental agility and learning new tasks as we age will also contribute to our own well-being and independence (see What is Healthy Aging, Anyway) Additionally, brain changes associated with meditation and stress reduction play an important role in slowing the progression of age-related cognitive disorders including AD. Furthermore, maintaining good sleep and sleep habits helps to clear out harmful toxins, a process that may reduce the risk of AD (see Sleep, Alzheimer's Disease and Yoga). If you’re having trouble sleeping, yoga’s stress management techniques can help quiet your nervous system so you fall asleep more quickly and more soundly (see Five Tips for Better Sleep). And if you'd like to add any additional practices to encourage brain health, start meditating on a regular basis (see Memory Loss—Meditation to the Rescue) and keep practicing your yoga asanas (see More on Yoga and Brain Strength: Neuroprotection). It’s not too late to start all these techniques and practices to keep a healthy brain and a strong mind, so better start today! 

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6 Ways to Foster Brain Health with Yoga

by Nina and Ram

Mademoiselle Ferrand Meditating on Newton by de La Tour

In his post Mental Exercise, Yoga, and the Perfect Brain, Ram mentioned six basic ways you can help prevent age-associated memory loss and foster brain health. Today I thought we'd look a bit closer at each of those ways, so if brain health is a concern of yours (and, really, who isn’t concerned about this?), you can target your yoga practice to help support your brain health as well as your overall health in general. 

1. Engaging in Physical Activity. Engaging in regular aerobic activity leads to structural changes in the brain that result in improved cognition. Physical exercise increases nerve branching and in some cases triggers regeneration of new nerve cells, especially in the memory centers of the brain. Physical exercises help you learn new things, and to be more alert and attentive owing to the structural changes. Scientists believe that physical exercise triggers increased blood flow to the brain. The greater the blood flow is, the more oxygen and other important nutrients that reach the brain, which may explain the cognitive improvements associated with exercise. Physical exercises will also help maintain optimal blood pressure, control diabetes and lower cholesterol levels, all of which are potential mental risk factors.

A regular, well-rounded asana practice provides an excellent form of exercise, fostering strength, flexibility, balance, and agility. But targeting cardiovascular health with your practice could be especially helpful for brain health (see About Yoga for Heart Health And Circulation). As Ram says, “What is good for the heart is good for the brain.” After all, your brain is one of the important organs of your body, just as your heart is.

2. Staying Mentally Active. Just as exercise and physical activity prompt muscles to grow stronger, mental exercise tones thinking skills and memory. Mental exercises maintain, build, and remodel neural network connectivity, trigger production of nerve growth factors that increase neuronal branching, and stimulate new synthesis of neural cells. The brain actively grows and rewires itself in response to stimulation and learning. Our brain grows stronger from use and from being challenged. This is called brain plasticity. Plasticity is the reason why stroke patients can relearn skills after a brain damage and also explains how a healthy part of the brain might assume the job of a damaged part. The brain is continually morphing/re-sculpting itself in response to new experience and learning. The greater the neural density, stronger and more resilient is the brain and mind that keeps the physical body strong, in turn promotes healthy aging.

According to Baxter’s post How Yoga Sequences are Brain Aerobics, to be a “brain aerobic” an activity: needs to engage your attention, must break a routine activity in an unexpected, nontrivial way, and must involve more than one of the senses. So practicing yoga asana mindfully, which not only engages your attention but involves more than one of your senses, can meet all three of these requirements if you intentionally keep your practice varied (see Practicing Yoga Mindfully and Stuck in a Rut?). Meditation and pranayama can also meet these three requirements, again, if you vary the practices. See How Yoga Sequences Are Brain Aerobics for more ideas. And, of course, simply learning new yoga poses and practices, and studying the scriptures (see The Power of Svadhyaya, Part 2) provide excellent learning opportunities.

3. Being Socially Active. Social engagement reduces the risk of isolation and depression. Remaining socially active also supports brain health and delays the onset of dementia. Because being socially active requires that you plan, participate, engage, and be attentive and alert, it qualifies as mental exercise. Social engagement is also a learning exercise for the brain and mind. As with other mentally stimulating activities, social activities help build up healthy brain cells and the connections between them.

Attending yoga classes and participating in your local yoga community is a good way to stay socially active as well as to keep your practice going strong. See 8 Ways to Join the Yoga Community for more ideas. You can even practice yoga with one or more friends (see Practicing Yoga with a Friend).

4. Eating a Healthy Diet. High blood pressure, obesity, diabetes and high cholesterol are potential mental risk factors and increase the risk of dementia. A healthy diet helps to keep these factors at optimal levels. Some of the consequences of chronological aging are increased oxidative stress, free radical production, and uncontrolled inflammation that not only hasten aging but also trigger rapid brain aging. A healthy diet soaks up free radicals and brings down inflammation, thus preventing brain decay. Eating a healthy diet promotes good blood flow to the organ system, which includes the brain.

Practicing yoga stress management techniques improves digestion, prevents stress eating, and reduces cortisol levels. Cultivating mindfulness with meditation and asana practiced mindfully can help make you more aware of what your body really needs (and what it doesn’t). And using your meditation practice to strengthen you will power will help support you in changing your eating habits. See Yoga for Healthy Eating: An Overview for further information. 

5. Managing Chronic Stress. Chronic stress (see About Stress: Acute vs. Chronic) causes havoc not just to the body but also to the brain. Chronic stress brings with it several health issues, including constant fear, worry, anxiety, depression, and memory deficits. 

While stress hormones do sharpen attention and spur us to take needed action, we are not designed to handle high levels of stress hormones day after day, year after year. In the brain these stress hormones weaken blood vessels, kill off neurons, and shrink the hippocampus, resulting in memory loss. Chronic stress also speeds up the normal aging of other cells that in turn affects normal structure and function of the brain.

Using yoga’s stress management techniques help you dial down stress levels when you are suffering from chronic stress (see The Relaxation Response and Yoga). Cultivating equanimity in the face of life’s difficulties will help you from getting stressed out in the first place (see 7 Ways to Cultivate Equanimity with Yoga). 

6. Sleeping Well. Lack of sleep or sleep deprivation triggers accelerated mental decline. Sleep appears necessary for our nervous systems to work properly. Too little sleep leaves us drowsy and unable to concentrate, and leads to impaired memory and physical performance. If sleep deprivation continues, hallucinations and mood swings may develop. Just as sleep gives the body time to heal itself, sleep allows neurons to lower down their neurochemical activity and repair themselves.

Without sleep, neurons become “fatigued” and begin to malfunction. Sleep helps to clear out toxins from the brain as well as from the body (see Sleep, Alzheimer's Disease, and Yoga). Finally, the brain gets exposed to thousands of stimuli through the five senses, and sleep helps to reduce chaos and bring order to the information flow, helping to put an order to these information inputs and archive them as memories. 

Yoga can be really helpful for improving sleep because you can use it to manage your stress levels and reduce anxiety, both of which are frequent causes of insomnia (see The Relaxation Response and Yoga and 10 Ways to Soothe Anxiety with Yoga). If pain or physical discomfort is keeping you awake, you can use yoga pain management techniques (see Yoga for Pain Management). And soothing practices, such as restorative yoga and simple, calming forms of pranayama, can help you if you wake in the middle of the night. See Yoga for Insomnia, Part 1, Day to Night: Yoga for Better Sleep, and Five Tips for Better Sleep for further information.

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Brain Health: An Interview with Ram Rao

by Nina and Ram

New Growth by Melina Meza

I’m trying to learn more about brain health so I can write a brief overview about how you can use yoga to foster brain health. And since we just happen to have a handy expert on the topic—Dr. Ram Rao—I thought I’d interview him as a way of doing my research. You lucky people get to see my interview in its complete form today. —Nina

Nina: What are the types of dementia? And what is the probability for developing one of these forms of dementia as you age?

Ram: Memory loss can be a simple age-associated phenomenon or due to a pathological condition. Age is one of the known risks for memory loss or forgetfulness. Age-associated memory loss is not the same as dementia. If a person experiences forgetfulness without having any underlying pathological condition, then the memory loss is solely due to age. Age-associated memory loss is not disabling and does not impact or interfere with daily performance.

Dementia is a pathological term to indicate loss of memory and other mental abilities including thinking and reasoning. The condition can be severe so as to interfere with daily life. Any damage to the memory centers can trigger the onset of dementia. Although many diseases trigger dementia, some forms of dementia may improve greatly when the underlying cause is treated. Dementia can arise due to:

• NeuroDegenerative diseases, including Alzheimer's disease, Parkinson's disease, Huntington's disease (a rare inherited disorder), and multiple sclerosis
• Vascular disorders that results from multiple strokes in the brain
• Traumatic brain injury due to accidents, severe injuries to the brain, hits to the brain
• Infections, including meningitis, HIV
• Chronic alcohol or drug use
• Depression
• Developmental abnormalities

Nina: Can yoga help us reduce our probabilities of developing memory loss? If so, how?

Ram: According to the Mayo Clinic, memory loss can be prevented by: 1) physical activity/exercise, 2) staying mentally active, 3) being socially active, 4) eating a healthy diet, 5) leading a stress-free life and 6) sleeping well.

There are so many scientific studies that indicate benefits of yoga (asanas, meditation and pranayama) in combating stress, keeping the individual physically and mentally stable and active, improving the digestive capacity and also helping in the sleeping process, all of which will result in combating age-associated memory loss. Yoga does this through multiple cellular mechanisms.

Nina: How can yoga help prevent strokes?

Ram: Yoga (asanas, meditation and pranayama) has been shown to improve the health of the heart and blood vessels, reduce blood pressure, reduce arrhythmia, reduce anxiety and depression, and improve metabolic parameters including blood lipid profiles all of which help in keeping stroke at bay

Nina: How can yoga help reduce chances of getting Alzheimer’s Disease?

Ram: In a recent study involving patients with early signs of Alzheimer’s disease (AD), it was shown that Yoga and Meditation increased functional connectivity in the areas involved in memory and also decreased the early degenerative changes that are typically seen in these regions, suggesting that Yoga and meditation have a positive impact on the regions of the brain related to AD. According to one Harvard researcher, yoga and meditation need to be included as part of the treatment regiment for dementia and Alzheimer’s patients. All the above-mentioned risk factors for stroke including hypertension, atherosclerosis, abnormal lipid profile, and stroke can trigger (AD).  Since Yoga has been proven to improve all these conditions, in turn it can also reduce the onset and/or severity of AD.

Nina: How about general mental acuity? Can yoga help us stay mentally sharp as we age?

Ram: Yes, there are numerous studies that show that practice of yoga (asanas, meditation and pranayama) has beneficial effects on the emotional well-being and general mental acuity without any of the side effects. It’s no wonder that a recent article in Yoga Journal on yoga’s effects on mental acuity was aptly entitled Yoga-Better than Prozac. That in itself sums up the power of yoga. Yoga increases brain chemicals such as endorphins and enkephalins that contribute to a feel-good response and ward off mental stress. It is akin to stimulating the brain in a positive way, which results in optimal brain function all of which can keep an individual alert and sharp.

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Sleep, Alzheimer's Disease and Yoga

by Nina

Sun Behind Clouds by Melina Meza

One of the worst fears I think we all share about getting older is of developing dementia. Just recently I had a long phone conversation with a woman who is trying to deal with a mother in the early stages of Alzheimer’s Disease, and it was just so sad. I had some advice for her, but no solutions, of course. Then I heard a news piece on NPR “Brains Sweep Themselves Clean of Toxins During Sleep”  that gave me  glimmer of hope.

Scientists have been trying to figure out the purpose of sleep for a very long time. A recent study “Sleep Drives Metabolite Clearance from the Adult Brain”  published in Science Magazine, proposed a fascinating new theory. The team of researchers from the University of Rochester discovered that while the brain sleeps it clears out harmful toxins, a process that may reduce the risk of Alzheimer's. According to the NPR interview, during sleep, the flow of cerebrospinal fluid in the brain increases dramatically, washing away harmful waste proteins that build up between brain cells during waking hours. Professor of Neurosurgery and an author of the study, Dr. Maiken Nedergaard, said, "It's like a dishwasher."

The waste proteins getting washed away during sleep are toxic to brain cells, which could explain why we don't think clearly after a sleepless night and why a prolonged lack of sleep can actually kill an animal or a person. The results appear to offer the best explanation yet of why animals and people need sleep.

“Thus, the restorative function of sleep may be a consequence of the enhanced removal of potentially neurotoxic waste products that accumulate in the awake central nervous system.” Lulu Xie, et al.

Alzheimer's Disease researchers say this research could help explain a number of recent findings related to sleep and AD. Dr. Randall Bateman, Professor of Neurology  at Washington University said this about beta amyloid, which is the main component of certain deposits found in the brains of patients with Alzheimer's Disease.

"Beta amyloid concentrations continue to increase while a person is awake. And then after people go to sleep that concentration of beta amyloid decreases. This report provides a beautiful mechanism by which this may be happening.”

The team of scientists discovered the cleaning process while studying the brains of sleeping mice. Dr. Nedergaard said that during sleep the system that circulates cerebrospinal fluid through the brain and nervous system was "pumping fluid into the brain and removing fluid from the brain in a very rapid pace.” When the mice went to sleep, their brain cells actually shrank, making it easier for the fluid to circulate. But when the mice woke up, their brain cells enlarged again and the flow between cells slowed dramatically.

The researchers speculated that the reason the brain doesn’t do this cleaning all the time is because the cleaning uses a lot of energy, and it’s probably not possible for the brain both to clean itself and at the same time be aware of its surroundings, talk, move, and so on. So getting enough sleep—which we already know is vital for our physical and mental health—may be one key to preventing Alzheimer’s Disease as you age.

But what does all this have to do with yoga? Well, if you’re having trouble sleeping, yoga can help with that. Because insomnia is so often related to stress, yoga’s stress management techniques can help you quiet your nervous system so you fall asleep more quickly and sleep more soundly. For  information on how yoga can help you sleep better, see Yoga for Insomnia, Part 1, Day to Night: Yoga for Better Sleep, and Five Tips for Better Sleep. The Supported Inverted poses I wrote about recently (see All About Supported Inversions) are poses that I've found particularly helpful.

We’re so careful here at YFHA not to make any false promises and of course as this research is new, we can’t promise that getting enough sleep will definitely make a difference for you. But encouraging you to get a good night’s sleep can’t be harmful in any way, and if this gives you more motivation to practice stress management techniques, which are helpful for preventing a whole host of health problems, we’re doing you a favor. And if you'd like to add an additional practices to encourage brain health, start meditating on a regular basis (see Meditation and Brain Strength) and keep practicing your yoga asanas (see Yoga for Brain Health?). 

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Yoga and Dementia: Welcome News

by Nina

A Rainbow at the Dam by Melina Meza

"Dementia Rate Is Found to Drop Sharply, as Forecast”

Now that’s the kind of headline I like to see! Yes, an article in the New York Times this week Dementia Rate Is Found to Drop Sharply, as Forecast announced the results of two different studies that showed that the incidence of dementia—in one case in England and Wales and in the other case in Denmark—was declining. And the reasons for this are very exciting to us here at Yoga for Healthy Aging.

“Yet experts on aging said the studies also confirmed something they had suspected but had had difficulty proving: that dementia rates would fall and mental acuity improve as the population grew healthier and better educated. The incidence of dementia is lower among those better educated, as well as among those who control their blood pressure and cholesterol, possibly because some dementia is caused by ministrokes and other vascular damage. So as populations controlled cardiovascular risk factors better and had more years of schooling, it made sense that the risk of dementia might decrease.”

So what they are saying here is that, along with being better educated, controlling blood pressure and cholesterol can help prevent dementia. And that means yoga can help. Foremost, yoga’s stress management tools can help you keep your blood pressure low. As I discussed in Chronic Stress: An Introduction, living with chronic stress can cause high blood pressure. So practicing stress management (see The Relaxation Response and Yoga and Stress, Your Health and Yoga will help you keep your blood pressure in check as it benefits your health in many other ways. Stress management can also help you maintain a low cholesterol diet by reducing stress eating and giving you more willpower to stay away from high cholesterol foods (see Yoga, Stress and Weight Management and Healthy Eating, Stress and Self Control). Healthy eating is also fostered by mindfulness (see Meditation and Healthy Eating) so if staying away from high-cholesterol foods is a problem for you, a meditation practice may be helpful.

For me, yoga even provides an ongoing education. Yoga philosophy is food for my intellect as well as providing inspiration for living my life with greater equanimity. Why, just this week I learned a lot from Ram’s post Hindu, Hundism and Yoga, and the week before I learned from writing my own post Modern Yoga and Hinduism. So if yoga philosophy and history are of interest to you, a whole world of new knowledge and intellectual stimulation awaits you.

The New York Times quoted Dr. Anderson, of the National Institute on Aging, saying:

“With these two studies, we are beginning to see that more and more of us will have a chance to reach old age cognitively intact, postponing dementia or avoiding it altogether. That is a happy prospect.”

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The Effect of Yoga Poses on Your Mood

by Nina

“To sit in Lotus Pose and gaze at one’s nose is said to be a spiritual practice; to do Lotus Pose and concentrate on the coccyx or elsewhere is said to be a physical practice. Where is the difference? How can Hatha Yoga be only physical and Raja Yoga only spiritual?” —BKS Iyengar

Iyengar sounds a bit cranky in that quote, doesn’t he? I think that’s because back in the 60s he was getting tired of explaining his somewhat radical point of view that doing yoga poses was a form of meditation. Traditionally yoga poses were seen as physical exercises to purify and strength the body for meditation and other spiritual practices. But Iyengar argued that the poses themselves were a spiritual practice.

“A posture can be considered as much a mantra or as much as meditation.” —BKS Iyengar

I thought of this recently when I read an interesting article about a study about the affects of meditation on moods (see Meditation Induces Positive Structural Brain Changes). When I first heard about the article, I thought it was going to be about a study of traditional seated meditation, and I was excited about the possibility that there was proof that traditional meditation helped improve our moods. Instead, I found the study was done using a special form of Chinese meditation called Integrative Body-Mind Training (IBMT) that “differs from other forms of meditation because it depends heavily on the inducement of a high degree of awareness and balance of the body, mind, and environment. And the study found:

“Building on results from a study they published in 2010, investigators found that healthy college-aged volunteers who practiced IBMT for 4 weeks showed significantly improved mood changes compared with those who did not practice the meditation technique.

The researchers note that these mood changes coincided with improved axonal density and expansion of myelin in the anterior cingulate part of the brain, a region that is implicated in self-regulation. Previous research has linked deficits in this brain area with attention deficit disorder, depression, schizophrenia, dementia, and addiction.”

Orchids in the Mist by Michele Macartney-Filgate

Exciting results, certainly. But doesn’t IBMT sound like Iyengar yoga? I mean, isn’t the practice of yoga poses with a mindful focus on alignment and physical sensations the same as “awareness and balance of the body, mind, and environment”? So it’s pretty easy to extrapolate from this study that Iyengar yoga would have similar effects as this Chinese meditation technique.

Of course I don’t really need a study to tell me what I know from personal experience. My asana practice definitely affects my moods. I usually feel better after practicing almost any sequence, and when I’m feeling depressed or discouraged or stressed, I can intentionally design a practice that can improve my mood. But it’s always nice to find out about studies that back up what I know intuitively because, well, it seems I’m on a mission: I want you, whoever you are, to start practicing, too. Your moods will improve and your stress levels will be reduced, and your overall health will benefit as a result. And now there is the intriguing possibility the practice could also help with dementia (as well as attention deficit disorder, schizophrenia and addiction)!

“Yoga is the harmony of the body, senses, mind, and intellect. That’s why there is no difference between physical and spiritual yoga.” —BKS Iyengar

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