Memory: 5 Ways to Protect Your Brain Health

Dr. Majid Fotuhi, MD, PhD

Memory: 5 Ways to Protect Your Brain Health | Johns Hopkins Medicine

Dr. Fotuhi received his MD degree (cum laude) from Harvard Medical School, as a member of the Harvard-MIT Division of Health Sciences and Technology (HST), and his doctoral PhD degree in Neuroscience from Johns Hopkins University. He is currently the medical director of the NeuroGrow Brain Fitness Center.

He also serves as an affiliate staff at Johns Hopkins, Howard County General Hospital, and a lecturer at Harvard Medical School.

In the past he served as an assistant professor of neurology at Johns Hopkins, a director of the Center for Memory and Brain Health at Sinai hospital, and as the chief medical officer at NeurExpand Brain Center.

Dr. Fotuhi’s initial clinical research at Johns Hopkins focused on basic brain neurochemistry and on finding effective ways to prevent dementia.

More specifically, he worked on longitudinal studies to determine the beneficial role of a combination of vitamins and natural supplements along with non-steroidal anti-inflammatory drugs (NSAID) in maintaining cognitive function and brain health.

His current research focuses on designing multi-disciplinary treatment programs for patients with memory loss and/or post-concussive syndrome, and on clinical trials on the role of natural supplements for enhancing memory. He has published his research in Brain Research, Journal of Neuroscience, the Lancet, Nature, Neurology, Neuron, and Proceedings of National Academy of Science.

Dr. Fotuhi has dedicated much of his time to educating the public about memory, aging, and concussion. In his book, The Memory Cure: How to Protect Your Brain Against Memory Loss and Alzheimer’s Disease, he provides clear and concise information about how to prevent dementia.

His second book, entitled The New York Times Puzzles to Keep Your Brain Young: The 6 Step Age Defying Program, was released in January 2008. His most recent book, Boost Your Brain, teaches people how they can grow the size of their hippocampus.

He has had two PBS programs, entitled “Conquering Memory Loss” and “Fight Alzheimer’s Early.” He has been interviewed by more than 50 media outlets including ABC News, CTV, CBS, TODAY show, Montel show, Fox News, Dr.

Oz show, Discovery Channel, The Boston Globe, USA Today, Health magazine, Ladies’ Home Journal, Forbes, BusinessWeek,The Chicago Tribune, The Washington Post, The Wall Street Journal, The Montreal Gazette, and The Times (London).

Dr. Fotuhi has taken a leadership role in medical education as well. He has received numerous awards for his innovative and dynamic teaching style. He is one of the most popular instructors at Harvard Medical School, where he designed and helped to build two 5-foot-tall brain models for his students in neuroanatomy classes.

He won the distinguished teaching award from the American Academy of Neurology in 2001.

He has presented academic lectures as the honorary visiting professor in Canada, Egypt, China, Israel, and Japan; he also had the honor of presenting a lecture at a United Nations meeting in New York in September 2010, and at the legislative briefings for the house and senate in Maryland in February 2015.

He lives with his wife and two daughters in Virginia. His hobbies include ballroom dancing, tennis, and traveling.

Source: https://www.neurogrow.com/dr-majid-fotuhi-md-phd/

Can Hearing Aids Prevent Memory Problems?

Memory: 5 Ways to Protect Your Brain Health | Johns Hopkins Medicine

For people with hearing loss, using a hearing aid is associated with a reduced risk of three common health problems of aging—dementia, depression, and falls—according to a new study in the Journal of the American Geriatrics Society. 

This study adds to the growing body of research that links hearing loss to memory issues and dementia. “Cognitive decline is much higher among people with hearing loss,” says study author Elham Mahmoudi, Ph.D., an assistant professor in the department of family medicine at the University of Michigan.

The new study also suggests using hearing aids might help delay the onset of dementia in some people, and it's the largest study to date to look at this possible connection, according to Mahmoudi.

Here, what this and other research has shown about hearing loss and the brain, and what it all means for you.

The new study found that people who received hearing aids in the three years after being diagnosed with hearing loss had lower rates of dementia, depression, and falls than those who didn’t get the devices.

To get these findings, University of Michigan researchers examined managed care insurance claims from 114,862 adults with hearing loss between 2008 and 2016. All were age 66 or older.

The researchers looked at the study subjects’ insurance claims for three years after their hearing loss diagnosis.

They did this to determine which people with hearing loss had been prescribed a hearing aid, which had not, and which study subjects in both groups were later diagnosed with dementia, depression, or a fall-related injury. Then they compared the difference between the hearing aid group and the non-hearing aid group.

A lot of prior research has found that hearing loss is connected with an increased risk of memory problems.

In a 2018 analysis published in JAMA Otolaryngology–Head & Neck Surgery, researchers pooled the results of 36 studies and found that age-related hearing loss was linked to an increased risk of dementia and cognitive decline and impairment. 

(Other previous research has also linked hearing loss to depression and falling.)

Fewer studies have been conducted on whether the use of a hearing aid might delay or prevent the onset of dementia, says Jennifer Deal, Ph.D., an assistant scientist in the department of epidemiology at the Johns Hopkins Bloomberg School of Public Health, who wasn’t involved in the new study.

But the new research, several small studies that have addressed the question in recent years have found that the use of hearing aids is linked with a lower risk of dementia.

Scientists don't have definitive answers about the effects of hearing loss on brain health. One theory, according to Deal, is that when your hearing is damaged, the brain must expend more effort to decode the sound signals it takes in, possibly at the expense of other brain functions.

Another hypothesis is that hearing loss changes the physical structure of the brain in a way that could harm memory—and some evidence from brain imaging studies supports this theory.

Hearing loss can also increase a person’s feeling of social isolation, because the condition makes it harder to communicate. And social isolation is linked to a number of health problems, from heart disease to Alzheimer’s disease.  

Neither prior studies nor the new one offer firm proof that hearing loss is a cause of dementia. In fact, it’s not clear yet what actually causes Alzheimer’s disease or some other types of dementia. 

The new study was observational—meaning it looked only at data on existing health outcomes, rather than testing the effects of a hearing aid. So, while it found a pattern, it couldn't establish that hearing problems actually cause dementia. 

And, say researchers, a number of other factors could have influenced the outcome of the study. For instance, the researchers weren’t able to factor in socioeconomic status in their analysis. That's important because people with more education and economic resources have been found to be less ly to experience cognitive decline as they age.

For scientists to be able to say definitively that hearing loss is a cause of dementia, a randomized controlled trial is needed, comparing similar groups of people, some of whom have their hearing loss treated with a hearing aid, and some who don’t.

Deal and her research team are currently conducting one such trial, so she hopes to be able to answer this question within a few years. 

While the new study found that for people with hearing loss, using hearing aids was associated with a lower risk of dementia, that doesn't mean aids can prevent dementia or even reduce risks.

It’s just too early to say, without the results of a randomized controlled trial.

Still, the upside of using these devices for hearing loss can be substantial. “If someone is considering a hearing aid, we do know that it should help improve the quality of life, help with communication,” Deal says. “We do know there are benefits, we just don’t know if cognition is one of them.”

If you notice you’re having difficulty hearing—frequently turning the TV up, asking people to repeat themselves, or missing parts of in-person or over-the-phone conversations—see your doctor.

Hearing loss may be reversible, if it’s caused by a problem such as earwax clogging your ear canal, an infection, or a damaged ear drum. A doctor can evaluate your ears for potential physical problems that could be interfering. 

And have your hearing tested. If the problem with your hearing isn’t fixable, you can find out how extensive the damage is. A hearing professional can tell you whether you might benefit from a hearing aid.

And if your healthcare providers think a hearing aid will help you, it’s best to start using the device sooner rather than later. “Research suggests that the earlier you adopt [a hearing aid], the better the outcome,” Deal says.

Source: https://www.consumerreports.org/hearing-aids/can-hearing-aids-prevent-memory-problems/

More Than Just Jaundice: Bilirubin May Protect The Brain

Memory: 5 Ways to Protect Your Brain Health | Johns Hopkins Medicine

Summary: Bilirubin, a bile pigment most commonly associated with jaundice in newborns, appears to have neuroprotective properties. A new study in mice reveals bilirubin may protect the brain against oxidative stress.

Source: Johns Hopkins University

In studies in mice, Johns Hopkins Medicine researchers report they have found that bilirubin, a bile pigment most commonly known for yellowing the skin of people with jaundice, may play an unexpected role in protecting brain cells from damage from oxidative stress.

Bilirubin is commonly measured in lab tests as a marker for liver or blood health, and high levels may indicate disease. However, whether it has a role in healthy people has remained unclear.

The Johns Hopkins Medicine team says its interest in the compound’s function in the brain arose from testing which tissues in the mouse body produced bilirubin. Surprisingly, the researchers found “exceptional levels” of the stuff in mouse brains — five to 10 times higher production than in rodents’ livers.

“Bilirubin is normally considered a waste product, but this level of production takes a lot of metabolic energy, and it seemed bizarre for bilirubin to not have a function,” says Bindu Paul, Ph.D., faculty research instructor at the Johns Hopkins University School of Medicine’s Solomon H. Snyder Department of Neuroscience, and a member of the research team.

The new study, described in a report published July 25 in Cell Chemical Biology, set out to find the purpose for harboring so much bilirubin in the brain.

The team noted that past studies proposed that bilirubin might be an important antioxidant.

Since the brain is so metabolically active and vulnerable to oxidative damage, the research group considered the possibility that bilirubin might be particularly important to protecting the brain against oxidative stress.

For their experiments, the team used mouse neurons grown in the laboratory that were genetically engineered to not produce bilirubin. As the cells grew, the researchers exposed them to various sources of oxidative stress by introducing reactive molecules to their environment.

When compared with normal mouse brain cells, the researchers found that the genetically modified mouse neurons were far more vulnerable to these stressors — particularly at the hand of a harmful form of oxygen called superoxide.

Chirag Vasavda, an M.D./Ph.D. student in Solomon Snyder’s laboratory and first author on the study, notes that superoxide is an important chemical cell messenger linked to learning, memory and development in the brain.

However, excessive brain cell activity can lead to uncontrolled superoxide levels, which can trigger oxidative stress and initiate a series of harmful reactions that cause damage to the brain. “Our initial experiments hinted to us that bilirubin might play an important role in controlling the levels of superoxide in the brain,” says Vasavda.

Collage of neuron cells used in this study. Neurons here are expressing a protein that fluoresces upon binding bilirubin. The image is credited to Chirag Vasavda.

The research team suspected that bilirubin’s ability to regulate superoxide originated in its chemical structure, which allows it to grab on to and neutralize the harmful molecule in a way that other antioxidants, such as glutathione and cysteine, cannot.

To test this, the researchers stimulated excessive brain cell activity in normal brains and brains engineered to lack bilirubin. They found that brains lacking the bilirubin-production gene accumulated excessive superoxide. Then they stimulated brain activity in normal mice and mice lacking bilirubin to test whether removing bilirubin worsens brain damage or cell death.

The researchers found that mice that lacked bilirubin had about two to three times more brain damage as their normal counterparts, suggesting that bilirubin protected normal brains against harmful superoxide reactions.

This discovery, the investigators say, advances scientific understanding of bilirubin’s role in the brain and elsewhere and could lead to novel treatments for neurodegenerative diseases such as Huntington’s and Parkinson’s that are marked by excessive superoxide levels and oxidative stress.

Other researchers involved in this study include Ruchita Kothari, Adarsha Malla, Ming Ji, Cristina Ricco, Risheng Xu, Harry Saavedra, Juan Sbodio, Adele Snowman, Lauren Albacarys, Lynda Hester, Thomas Sedlak and Solomon H. Snyder of the Johns Hopkins University School of Medicine; Robert Tokhunts of Dartmouth College; and Anthony Lin of the Duke University School of Medicine.

Funding: This work was supported by the National Institute of Mental Health (MH18510), the National Institute of General Medical Sciences (T32 GM73009) and the National Institutes of Health Office of the Director (S1D016374, S1OD016374).

The authors declare no competing financial interests.

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[divider]About this neuroscience research article[/divider]

Source:
Johns Hopkins University
Media Contacts: Rachel Butch – Johns Hopkins University

Image Source:

The image is credited to Chirag Vasavda.

Original Research: Closed access
“Bilirubin Links Heme Metabolism to Neuroprotection by Scavenging Superoxide”. Chirag Vasavda et al.
Cell Chemical Biology. doi:10.1016/j.chembiol.2019.07.006

Abstract

Bilirubin Links Heme Metabolism to Neuroprotection by Scavenging Superoxide

Highlights• Eliminating endogenous bilirubin renders cells vulnerable to oxidative stress• Bilirubin exhibits distinct redox activity among endogenous small molecules• Bilirubin scavenges O 2 ⋅−

• Neural bilirubin prevents NMDA receptor excitotoxicity by scavenging O 2 ⋅−

Summary
Bilirubin is one of the most frequently measured metabolites in medicine, yet its physiologic roles remain unclear. Bilirubin can act as an antioxidant in vitro, but whether its redox activity is physiologically relevant is unclear because many other antioxidants are far more abundant in vivo.

Here, we report that depleting endogenous bilirubin renders mice hypersensitive to oxidative stress. We find that mice lacking bilirubin are particularly vulnerable to superoxide (O 2 ⋅−) over other tested reactive oxidants and electrophiles.

Whereas major antioxidants such as glutathione and cysteine exhibit little to no reactivity toward O 2 ⋅−, bilirubin readily scavenges O 2 ⋅−. We find that bilirubin’s redox activity is particularly important in the brain, where it prevents excitotoxicity and neuronal death by scavenging O 2 ⋅− during NMDA neurotransmission.

Bilirubin’s unique redox activity toward O 2 ⋅− may underlie a prominent physiologic role despite being significantly less abundant than other endogenous and exogenous antioxidants.

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Source: https://neurosciencenews.com/bilirubin-neuroprotection-14730/

For Better Brain Health, Preserve Your Hearing

Memory: 5 Ways to Protect Your Brain Health | Johns Hopkins Medicine
Continue reading the main story

Every now and then I write a column as much to push myself to act as to inform and motivate my readers. What follows is a prime example.

Last year in a column entitled “Hearing Loss Threatens Mind, Life and Limb,” I summarized the current state of knowledge about the myriad health-damaging effects linked to untreated hearing loss, a problem that afflicts nearly 38 million Americans and, according to two huge recent studies, increases the risk of dementia, depression, falls and even cardiovascular diseases.

Knowing that my own hearing leaves something to be desired, the research I did for that column motivated me to get a proper audiology exam.

The results indicated that a well-fitted hearing aid could help me hear significantly better in the movies, theater, restaurants, social gatherings, lecture halls, even in the locker room where the noise of hair dryers, hand dryers and swimsuit wringers often challenges my ability to converse with my soft-spoken friends.

That was six months ago, and I’ve yet to go back to get that recommended hearing aid. Now, though, I have a new source of motivation. A large study has documented that even among people with so-called normal hearing, those with only slightly poorer hearing than perfect can experience cognitive deficits.

That means a diminished ability to get top scores on standardized tests of brain function, matching numbers with symbols within a specified time period. But while you may never need or want to do that, you most ly do want to maximize and maintain cognitive function: your ability to think clearly, plan rationally and remember accurately, especially as you get older.

While under normal circumstances, cognitive losses occur gradually as people age, the wisest course may well be to minimize and delay them as long as possible and in doing so, reduce the risk of dementia.

Hearing loss is now known to be the largest modifiable risk factor for developing dementia, exceeding that of smoking, high blood pressure, lack of exercise and social isolation, according to an international analysis published in The Lancet in 2017.

The analysis indicated that preventing or treating hearing loss in midlife has the potential to diminish the incidence of dementia by 9 percent.

Difficulty hearing can impair brain function by keeping people socially isolated and inadequately stimulated by aural input.

The harder it is for the brain to process sound, the more it has to work to understand what it hears, depleting its ability to perform other cognitive tasks. Memory is adversely affected as well.

Information that is not heard clearly impairs the brain’s ability to remember it. An inadequately stimulated brain tends to atrophy.

The National Institute on Aging is currently sponsoring a trial of 997 people aged 70 to 84 with mild to moderate hearing loss to determine how effective hearing aids can be in diminishing the risk of dementia. Results of the trial, called Aging and Cognitive Health Evaluation in Elders, are expected in 2022.

Currently, the sound level of 25 decibels — the ability to hear a whisper — is used to define the border between normal hearing and mild hearing loss in adults.

But this threshold is really arbitrary. The lead author of the study, Dr. Justin S.

Golub, otolaryngologist and researcher at Columbia University Irving Medical Center, and his colleagues found that hearing loss is on a continuum that starts with “perfect” hearing at zero decibels (the sound level of a pin drop), with measurable cognitive deficits occurring with every additional loss above zero.

In fact, the researchers demonstrated that the biggest drop in cognitive ability occurs at the slightest level of hearing loss — a decline from zero to the “normal” level of 25 decibels, with smaller cognitive losses occurring when hearing deficits rise from 25 to 50 decibels.

“This doesn’t mean we should be fitting people with hearing aids when the softest sound they can hear is 25 decibels,” Dr. Golub said in an interview.

After all, getting people with far more advanced hearing loss to use hearing aids is already an enormous challenge. As Dr.

Golub noted, “Currently only 25 percent of people over 80 wear hearing aids, yet 80 percent of them have significant hearing loss” that might be greatly improved with aids.

The new findings linking cognitive decline to even minimal hearing loss suggest that we could do a lot to protect our brains if we protect our hearing. The fact that measurable cognitive losses occur at hearing levels below 25 decibels, and that cognition gradually worsens as hearing declines, suggests that protecting against hearing loss should start in childhood.

“In people with very good hearing, we need to be aware of how early changes in hearing affect the brain,” said Dr. Frank Lin, director of the Cochlear Center for Hearing and Public Health at the Johns Hopkins Bloomberg School of Public Health. “Without a doubt, the most important measure to preserve hearing is protection against noise.”

The two characteristics of noise associated with the greatest damage to hearing are intensity — that is, loudness — and duration, or how long unprotected ears are exposed to very loud sound, Dr. Lin explained in an interview.

“The damaging effect of noise exposure is cumulative,” he said. While he is less concerned about ear protection during the relatively brief time someone uses a hair dryer or stands on a New York City platform as a train screeches into the station, people who work all day in the subway or listen to loud music for hours need to protect their hearing.

“We can see a hearing deficit the next day after someone has attended a very loud concert,” Dr. Lin said.

He urges people who listen to music through headphones or earbuds to invest in ones with a noise-canceling feature that blocks ambient sound.

This enables people to listen to their preferred music or programs at a lower volume that is less damaging to hearing. Apple, for example, now markets AirPods Pro earbuds that have a noise cancellation feature.

At $249 a pair, they are a lot cheaper than currently available hearing aids.

That said, by 2021 a selection of much less expensive over-the-counter hearing aids is expected to be on the market. And if Congress manages to pass the Medicare Hearing Act of 2019, the cost of audiology services needed to maximize the benefits derived from hearing aids will be covered for recipients.

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Source: https://www.nytimes.com/2019/12/30/well/live/brain-health-hearing-dementia-alzheimers.html

Majid Fotuhi, MD, PhD

Memory: 5 Ways to Protect Your Brain Health | Johns Hopkins Medicine

Majid Fotuhi, MD, PhD, received his MD (cum laude) from Harvard Medical School, as a member of the Harvard-MIT Division of Health Sciences and Technology (HST), and his PhD in neuroscience from Johns Hopkins University School of Medicine.

He is the medical director of NeuroGrow Brain Fitness Center and an affiliate staff at Johns Hopkins Hospital.

He also lectures on topics related to neuroscience, cognition, brain health, and concussion to medical students at Harvard Medical School and at local, national, and international conferences.

Fotuhi’s initial clinical research at Johns Hopkins focused on the basic brain neurochemistry and on finding effective ways to prevent dementia.

More specifically, he worked on longitudinal studies to determine the beneficial role of a combination of vitamins and natural supplements along with nonsteroidal anti-inflammatory drugs and omega-3 fatty acids in maintaining cognitive function and brain vitality.

His current research has focused on issues related to intensive treatment of patients with memory loss and/or post-concussive syndrome. He has published his research findings in Brain Research, Journal of Neuroscience, The Lancet, Nature, Neurology, Neuron, and Proceedings of National Academy of Sciences.

He has developed a multi-disciplinary treatment protocol for helping patients boost their cognitive function called the Brain Fitness Program, and the results of this work have been published in the Journal of Prevention of Alzheimer’s Disease.

Fotuhi has dedicated much of his career to educating the public about memory, aging, and concussion. In his book The Memory Cure: How to Protect Your Brain Against Memory Loss and Alzheimer's Disease, he provides clear and concise information about how to prevent dementia.

His second book, The New York Times Crosswords to Keep Your Brain Young: The 6-Step Age-Defying Program, was released in January 2008 and was the basis for his PBS program, Fight Alzheimer’s Early.

His most recent book, Boost Your Brain, teaches people how they can grow the size of the memory parts of their brain.

Fotuhi has been interviewed by more than 50 national media outlets including ABC News, CTV, CNN, CBS, the TODAY Show, the Montel Williams Show, Fox News, the Dr. Oz Show, Discovery Channel, The Boston Globe, USA Today, Health magazine, Ladies’ Home Journal, Forbes,BusinessWeek,The Chicago Tribune,The Washington Post, The Wall Street Journal, The Montreal Gazette, and The Times (London).

Fotuhi has taken a leadership role in the field of medical education. He has received numerous awards for his innovative and dynamic teaching style.

He is a popular instructor at Harvard Medical School, where he designed and helped to build two 5-foot-tall brain models for his students in neuroanatomy classes. He won the distinguished teaching award from the American Academy of Neurology in 2001.

He has presented academic lectures as an honorary visiting professor in Canada, Egypt, China, Israel, and Japan.

Fotuhi lives with his wife and two daughters in McLean, VA.  His hobbies include ballroom dancing, tennis, scuba diving, traveling, cooking, and spending time with his family.

© 2019 WebMD, LLC. All rights reserved.

Source: https://www.webmd.com/majid-fotuhi