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Key points
- Health and lifestyle factors are major causes of cognitive decline.
- Exercise is crucial for heart and brain health.
- Sleeping less than five hours a night and sleep interruptions increase the risk of dementia.
America deserves to have a mentally intact president—someone who can make sound decisions, think logically, work through tough problems, objectively weigh alternatives, and manage complex domestic and international policy. So, our next president of the United States (POTUS) needs to be of sound mind.
Regardless of who you plan to vote for in November, one truth is self-evident: whoever wins will be old. That is not a value statement, just a fact. And with advanced age comes an increased risk of cognitive decline and dementia. Whether Alzheimer’s disease, vascular dementia, frontotemporal dementia, or another neurological disorder, living longer brings greater risks of losing mental abilities. With Joe Biden already over 80 and Donald Trump at 78, the next guy has a more than 25% chance of brain decline during his term in office.
Fortunately, dementia risk is modifiable in half of all people if you know what you are doing and are motivated to act. That is why I am offering both candidates some dementia prevention advice.
I realize that nobody asked for my opinion, and it may sound egotistical, but dementia prevention is what I do for a living. As a Ph.D., board-certified clinical neuropsychologist, I have spent 45 years evaluating more than 20,000 older adults for dementia and then crafting interventions to help them preserve their thinking skills. My advice is based on scientific facts and extensive clinical experience, not fads or fly-by-night ideas. I also co-authored a book on dementia prevention. So, I think I know a thing or two about this subject.
Here are eight “no-brainers” for the next POTUS.
1. Recognize that health and lifestyle factors are the major causes of cognitive decline. You cannot change your genetics, prior health conditions, or earlier life experience. But you can identify and improve your physical and cognitive health even at your present age. Consider it like the golf axiom, “You play it where it lays.” But, here, you cannot move the ball or take a Mulligan.
2. Get a good doctor. You need someone who is thorough, can tell you like it is, and can be persuasive. You may need a team of specialists. But no sycophants to tell say you are wonderful. You need brutally honest medical advice from someone you respect and who can nudge you to become better.
3. Exercise, exercise, exercise. This is crucial for your heart and brain. Mr. Biden, if peripheral neuropathy interferes with your feet feeling the ground, use a recumbent stationary bicycle, swim laps, or find another form of cardiovascular exercise. Mr. Trump, golf only qualifies as exercise if you are walking the course. Start with every other hole and work your way up. A goal of 6,000 to 10,000 steps per day is usually enough to preserve grain function and temperament.
4. Sleep better. Sleeping less than five hours per night, sleep interruptions, and irregular sleep hours increase your dementia risk and can make you cranky and impatient. Your brain needs to go through each of the four sleep stages at night, and its glymphatic system needs time to flush out the toxins that build up each day while you think. Try turning off your digital device to avoid its stimulating effects. For both candidates, it is important to wind down about an hour before going to bed and aim for at least six hours. While difficult to do, reducing irregularity of sleep hours is desirable.
5. Breathe while you sleep. We know that Mr. Biden has sleep apnea and uses a CPAP machine. Kudos to him. He is avoiding the loss of energy, attention, and thinking clarity caused by sleep-disordered breathing. What’s a couple of mask lines on your face to keep your brain healthy? For those with sleep apnea, when not enough air gets to the lungs, not enough oxygen gets to the brain. This will impact word finding and linearity of thinking while speaking in the evening because our brain is taking micro-naps at those times. For many of my patients, CPAP use is like a facelift for their brain.
6. Check your hearing. Seventy percent of people over age 70 have enough hearing loss to benefit from hearing aids. Hearing loss increases cognitive problems and depression. While both of you get asked a lot of questions you would rather not hear, our country is better off if you are just ignoring those questions.
7. Watch your step. Order an escalator or elevator for Air Force One to replace those outside steps. Recent research finds that falls with concussions are common in people over 65 and are most likely for active, better-educated, and wealthy individuals. Walking downstairs projects a more youthful and vital image, but nothing ruins a youthful image as much as facial bruising. Anyway, who among us still deplanes this way in 2024? Order an escalator or portable glass-enclosed elevator.
8. Develop and maintain a positive attitude. Optimism, as a personality trait, has been shown to reduce your risk for dementia, while pessimism and negativity can accelerate mental decline. A positive, uplifting mental attitude is good for you and for our country. Light some candles, and don't curse the darkness.
