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The Heart of a Healthy Brain

Updated: Nov 24, 2023

A young woman in her twenties shows an elderly woman something on her cell phone.  They are sitting outside on a wooden park bench on a spring day.

Is your heart health the key to preventing Alzheimer's and other forms of dementia? Although it may seem like an unlikely pairing, research strongly suggests a link between heart health and brain health.

We recently had a chat with Emily Wong, MD, an internist, integrative medicine specialist, and executive director of Integrity Healing. We talked about what women can do to prevent heart disease, dementia and Alzheimer's, and vascular dementia by taking the best care of their hearts and brains.

What Causes Alzheimer's Disease and Dementia?

Did you know that women have a higher risk of developing Alzheimer's disease than men do? That means we may have to work a little bit harder to stave off Alzheimer's and other forms of dementia.

In addition to being a woman, other common risk factors of dementia include:

  • Age. After the age of 65, the risk of developing dementia spikes.

  • Family history. If you have a parent or sibling with Alzheimer's, you're more likely to get it.

  • Head injury. There's a link between head injuries and increased risk of future dementia.

  • Heart health. Your cardiovascular habits and heart health impact your brain, including cholesterol, hypertension, blood pressure, diabetes, smoking, activity levels, weight, etc.

The Heart-Head Connection

There's an overwhelming amount of evidence linking brain health to heart health. Although it may sound unlikely, when you think about how the body's richest network of blood vessels nourishes the brain, and how the heart is responsible for pumping blood through these vessels to the brain, it starts to make more sense.

As such, many conditions that damage the heart and blood vessels also increase the risk of developing Alzheimer's or vascular dementia. Some of these conditions include:

  • Heart disease

  • High cholesterol

  • High blood pressure

  • Diabetes

  • Stroke

Further studies of brain tissue have found more evidence of the connection between the heart and the brain. These studies suggest that plaques and tangles are more likely to cause symptoms of Alzheimer's if you have a history of strokes or damage to the brain's blood vessels.

The vast majority of the time, Alzheimer's co-exists with other conditions in women's health.

"We know that Alzheimer's does not exist by itself very often," Dr. Wong said. "In fact, if brain scientists and pathologists see a brain that only has Alzheimer's changes in it, meaning the beta-amyloid plaques and the tau neurofibrillary tangles, they actually call that a unicorn. Because it's very rare that Alzheimer's changes exist alone in the brain."

The most common condition Alzheimer's co-exists with is changes in the blood vessels, known as vascular changes.

"So there may be large blood vessel plaques clogging the arteries, there may be tiny arteries that are being clogged," Dr. Wong said. "So what they're finding is that there may be multiple mechanisms where these two conditions actually co-exist with each other and probably make each other worse."

What Is Vascular Dementia?

When impaired blood flow to the brain results in brain damage, and the person experiences problems — either immediately or more likely, in the future — with thought processes, such as judgement, reasoning, planning, and memory, they will likely be diagnosed with vascular dementia.

Vascular dementia refers to the judgment, reasoning, planning, memory, and any other thought process issues caused by brain damage from impaired blood flow to the brain.

Vascular dementia can develop after a stroke blocks an artery in the brain and other conditions that damage blood vessels and reduce circulation, which deprives the brain of critical oxygen and nutrients.

Preventing Vascular Dementia

Lifestyle and behavioral changes are key to preventing vascular dementia. The earlier you can start making these changes, the better.

"What we're finding is that we can improve the odds of getting dementia if we can intervene with these lifestyle choices up to two or three decades before the symptoms begin," Dr. Wong said. "So what we're now finding with early detection is that many of the changes that occur in the brain can occur up to two or three decades before the onset of the disease."

Dr. Wong said this is similar to heart disease because it begins long before someone has a heart attack or starts experiencing any chest pain.

"We know that if we look in the arteries in the heart, there's already some buildup of plaque, it may start out as something reversible like a fatty streak, but then it becomes like a hardened artery, like concrete in a pipe," she explained. "And so what we want to do is intervene at an earlier stage before that heart attack happens or a stroke, which we call a 'brain attack.'"

To prevent or limit your risk of vascular dementia, you should:

  • Get to and/or maintain a healthy body weight, especially if you carry your fat in your stomach. Women with "apple" shaped bodies are more prone to dementia.

  • Maintain a healthy blood pressure. A normal blood pressure range can help prevent vascular dementia and Alzheimer's.

  • Quit smoking. Smoking tobacco causes damage to blood vessels all over the body.

  • Prevent or control diabetes.

  • Get moving. Regular exercise is great for your overall health and mental well-being. It also may help prevent vascular dementia.

  • Optimize your cholesterol levels. Eating a low-fat diet and taking cholesterol-lowering medications can help reduce your risk of stroke and heart attack that can cause vascular dementia.

What one action will you take to protect your brain health?

We hope this article and Dr. Wong's insights have empowered you to make smart and healthy choices to protect your brain and heart in order to keep them functioning optimally. You don't have to make all of these changes at once. Start with what you can. Ask yourself what one action you can start today to protect your brain health? And then, start doing it!

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