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The Livelong Newsletter: Feature Edition

Hi everyone,

Thinking about the aging brain can be overwhelming. Dementia and Alzheimer’s disease are daunting conditions that we all want to prevent but can’t (yet!), and even facing ‘normal’ age-related cognitive decline can be unpleasant.

The good news is that you’re probably already doing things to promote better brain health, according to Mark D’Esposito, MD, a neurologist and professor of neuroscience and psychology at the University of California, Berkeley.

D’Esposito—an expert on cognition, prefrontal cortex function, and aging who was featured on the Huberman Lab podcast—joins Livelong for a discussion on aging and brain health.

He offers a grounded, optimistic, and realistic approach to a better brain that you do not want to miss.

In today’s newsletter, you will learn:

• Basic brain biology (I swear, you’ll get it).

• The cost of memory.

• How to tell if your brain is actually getting better.

• Brain health optimization strategies.

• And so much more…

BRAIN HEALTH

Building a better brain

Erin: Could you deconstruct the main functions of the frontal lobe region?

Mark D’Esposito: There are 4 lobes in the brain. The frontal lobes are the largest and the most important. We actually can divide the frontal lobes into 3 parts as well. 

• The medial section: This is very important for our motivation and our drive. 

• The orbital part: That's important for emotion and social behavior. 

• The lateral part: Probably the most important part of the frontal lobes. 

The lateral part is important for executive function—this includes higher-level skills like working memory, cognitive flexibility, and behavior control. It is the “CEO of the brain” [and] allows us to translate our thoughts into actions based on rules, intentions, and goals. 

Erin: How does aging impact the structure and function of the brain?

Mark D’Esposito: There seem to be two parts of the brain that are most affected by normal aging: the frontal lobes (especially lateral part), and the hippocampus (important for memory). These 2 regions are very biologically costly—they're the ones that are working the hardest in the brain. They need more:

• Energy

• Glucose

• Oxygen

It's not surprising that they're undergoing the most wear and tear as we age. You can think of them [the lateral part of the frontal lobes and hippocampus] as hubs…important hubs in the brain that are keeping the engine going. 

Erin: What are normal signs of cognitive decline, and how does it impact executive function?

Mark D’Esposito: With healthy aging, there are changes in both the frontal lobes and the hippocampus.

What we mostly see is that the brain not only shows decreased function, but a kind of compensatory function.

• For example, if a young brain is used to just using its left frontal lobe to perform a task, an older individual will use both frontal lobes to perform the task.

• The brain is plastic [and] it's trying to rewire itself [to] compensate for changes.

Not all cognitive abilities are going to decline with age. Wisdom, for example, will presumably improve with age🦉.

But executive function—how fast we process information, switch back and forth, inhibit irrelevant information, and remember esoteric things (i.e., names)—does change and decline. 

Erin: Do these compensatory actions contribute to long-term brain health?

Mark D’Esposito: Absolutely. The brain is organized by these networks. What changes is not that we get new neurons, but the way neurons interact with each other so new networks form.

• We see that compensation is just a reflection of the brain's plasticity, and it's the way that it reorganizes. 

Erin: What is cognitive therapy and how could it be beneficial to the aging brain?

Mark D’Esposito: Older individuals…have trouble with not suppressing what's irrelevant—dampening out distracting information. Cognitive therapy tries to build exercises that enhance that very specific ability. 

There's a group of exercises that have been built by a group from U.C. San Francisco. It's called Brain HQ (brainhq.com), and they have a series of brain exercises that are based on very specific mechanisms of how the brain works. You can target very specific cognitive abilities.

Erin: With cognitive training, is there a barometer to know when your brain and executive function are improving?

Mark D’Esposito: That's a great question [and] that’s the problem we've had—we've never had a brain health index.

‘How would you know if you're healthier after you do brain exercises?’

There's something called the Brain Health Project, which has been developed by the University of Texas at Dallas, [and] they've developed a brain health index, a very comprehensive tool that assesses all aspects of brain health. 

If you participate in the study, you will take the brain health index and get a real number. Then they have interventions (i.e., cognitive therapy). What's exciting is that, [with] the interventions they offer, brain health does go up.

Erin: What are some common myths about brain health and cognitive function?

Mark D’Esposito: I think the biggest myth that's starting to be overturned is the idea that our brains don't change as we get older; that the brain is not plastic.

• 📖 Any intervention on the brain—reading a book or learning a new skill or having new relationships—will change networks in the brain. 

• 💪 Everyone seems to believe that we can get physically better if we exercise, so there really should be no reason to think that if we exercise our brain, we can't improve as well. 

But people need feedback that their brain health is getting better, otherwise it'll be very hard to sustain all of these things we're talking about.

Erin: What are strategies to optimize long term brain health?

Mark D’Esposito: There's not some magic bullet that's going to optimize brain health and prevent dementia.

I think we should be focusing on the holistic approach that there are many different things that we can do that will make our brain healthier.

Everything we do probably does improve brain health.

• Improving sleep, nutrition, exercise, decreasing stress, seeking social connections, and maintaining cognitive gains will all lead to better brain health. 

Erin: It seems to me like consistently making changes in your life coincides with good changes in your brain. 

Mark D’Esposito: I think that's a great message. 

As we get older—having trouble processing information as fast or having trouble filtering out distracting information—there are very specific things that you can do with brain exercises (just like if you wanted to build certain muscles) to target specific areas.

But in general, if you're just trying to get networks to integrate and form and change, just lead an engaging, meaningful life—it will do the same thing.

What does D’Esposito do for his own brain health?

The researcher has an active professional and family life and he is always doing new things. These are the core things that can help to build and sustain new networks in the brain. 

Every time we do things that are meaningful and engaging and aren't just rote (just doing the same thing every day), we're:

• Taking on new problems

• Being creative or curious

• Engaging in lots of things

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🔔 Catch up on last week’s newsletter

We all know about the Paris Olympics, but do you know about the Rejuvenation Olympics?

We can’t wait to cover more trending topics in longevity in our next newsletter. Stay tuned.

-Erin

Longevity Media LLC

Be your own expert. Optimize your health. Look beyond conventional.

Always seek the advice of a physician or other qualified health care professional before starting any exercise, wellness, or health program. Nothing in our content, products or services should be considered, or used as a substitute for, medical advice, diagnosis, or treatment. Livelong is a media company and not a medical provid