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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Memory Loss—Meditation to the Rescue

by Ram

Yellow Leaves by Melina Meza

Alzheimer's disease (AD) is an irreversible, progressive neuro-degenerative disease that is characterized by severe memory loss, unusual behavior, personality changes and a decline in thinking abilities. Death of neurons in key parts of the brain harms memory, thinking, and behavior. Neuronal death in the hippocampus 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 areas of the cerebral cortex responsible for functions such as language and reasoning. Thus AD patients gradually lose language skills and judgment. Personality changes, emotional outbursts and disturbing behavior, such as wandering and agitation, appear and can happen more and more often as the disease runs its course. People with AD eventually require comprehensive care, so the disease presents a considerable problem in patient management. It is believed that therapeutic intervention that could postpone the onset or progression of Alzheimer’s disease would dramatically reduce the number of cases over the next 50 years.

While mutated genes may contribute to the development of Alzheimer's, scientific evidence shows that genes are neither necessary nor sufficient to cause the disease. Environmental as well as life-style practices may also contribute to the disease progression. There is growing evidence that an epidemic of AD may be around the corner and people are rightly concerned, since it threatens to spike in prevalence as the population steadily ages. The significant growth in the population over age 85 that is estimated to occur between 2010 and 2030 (from 5 million to 9 million) suggests a substantial increase in the number of people with Alzheimer's. AD affects over 5 million Americans--there is neither a cure, nor treatment to halt the progression of symptoms. The drugs currently available to treat the disease address only its symptoms and with very limited effectiveness.

Most of us can avoid the mind ravaging effects of AD by making healthy changes in lifestyle, remaining active, achieving ideal weight, reducing stress, and in some cases, supplementing with a diet, vitamins, herbs and/or nutraceuticals that are recommended to you by a physician or licensed practitioner. The brain, like muscles in the body, requires exercise to remain strong in function. Stimulation of the brain increases the branching of brain cells that support cognitive function, and these beneficial effects can be seen in people of all ages. Thus, it is important to pursue intellectually challenging activity throughout life. Maintaining mental agility and learning new tasks as we age is will also contribute to our own well-being and independence. This was clearly articulated by Baxter in his post The Importance of Independence and Nina in her post What is Healthy Aging, Anyway? as they defined healthy aging.

Meanwhile here’s some good news for us yogis with regard to AD. A new pilot study led by researchers at Beth Israel Deaconess Medical Center suggests that the brain changes associated with meditation and stress reduction may play an important role in slowing the progression of age-related cognitive disorders including Alzheimer's disease. The authors of a new research article demonstrated that stress reduction through meditation also improves cognitive reserve.

Approximately 50 percent of people diagnosed with mild cognitive impairment—the intermediate stage between the expected declines of normal aging and the more serious cognitive deterioration associated with dementia—may develop dementia within five years. Additionally, as people with mild cognitive impairment age, there's a high correlation between perceived stress and AD. The authors wished to know if meditation reversed this process. They evaluated adults between the ages of 55 and 90 and included 14 adults diagnosed with mild cognitive impairment in the study. All participants were randomized to two groups: one group that participated in Mindfulness-Based Stress Reduction (MBSR) using meditation and yoga, and a second control group that received normal care. The study group met for two hours each week for eight weeks. They also participated in a day-long mindfulness retreat and were encouraged to continue their home-practice for 15 to 30 minutes per day. All participants underwent a functional MRI (fMRI) before the onset of the study and then again after eight weeks to determine if there were any changes in the structures of the brain or in brain activity.

The results of MRI imaging showed that the group that engaged in MBSR had significantly improved functional connectivity in the hippocampal areas of the brain that is responsible for emotions, learning and memory. Furthermore, those who practiced MBSR experienced less degeneration of the hippocampus. In addition, the data also suggested a trend toward improvement for measures of cognition and well-being.

What a cheap but effective method to reduce hippocampal degeneration and improve functional connectivity in the same areas of the brain that is affected by Alzheimer's disease! Meditation and yoga are some of the simplest intervention modalities with very little downside that may provide real promise for AD individuals that have very few treatment options. In addition to beneficial changes in the brain, yoga and meditation will stimulate the three aspects of healthy aging namely: decreased morbidity, independence and mental equilibrium (equanimity). Indeed, a very good deal!!

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