Welcome to this talk about stress management for dementia prevention.
Stress management is one of the four pillars of Alzheimer's prevention that I am sharing in this series about brain longevity based on what I learned and continue to learn from the Alzheimer's Research and Prevention Foundation.
The other three pillars are nutrition,
Physical and mental exercise,
And what ARPF calls spiritual fitness.
It is difficult for me to totally separate stress management from spiritual fitness,
So I will introduce you to that concept later in this session.
The final talk in this series will be devoted to a powerful meditation technique called kirtan kriya and how it might prevent or delay Alzheimer's disease.
There is a short prayer that follows the Lord's Prayer as part of the Catholic Mass that has the priest asking God to protect us from all anxiety.
At least that was the English wording I grew up hearing until a more literal translation of the Latin changed it to,
Keep us safe from all distress.
As a child sitting in church with my family and even into adulthood as I continued to attend Mass on my own,
That phrase and the idea that anxiety is dangerous,
Something unsafe,
Made me intensely curious.
I didn't know why at the time,
But maybe this work is why.
My interest in the brain didn't manifest until my late 30s when a close friend suddenly began having seizures,
Then speaking a strange language while we were in the hospital waiting for the results of blood tests,
Body scans,
And finally brain imaging and tumor biopsy.
This diagnosis of brain cancer changed my life,
But not in the way you might expect.
Within a year,
I was diagnosed with a painful autoimmune condition that I believe was triggered by being in such a prolonged state of distress,
Constantly alert for the next seizure,
Full of fear,
Worry,
And sadness.
When my friend spontaneously recovered to the absolute bewilderment of his doctors,
Instead of relief,
I felt extreme confusion and even a sense of worthlessness at no longer being needed as a care provider.
My path out of that pain involved a therapist's prescription for meditation and yoga,
And I soon decided to make it my work to honor my childhood curiosity to learn more about the connections between mind,
Body,
And spirit,
And why millions of people every Sunday ask God to protect them from anxiety.
There are many unseen processes involved when we experience stress,
Including high blood pressure and unhealthy levels of cortisol,
Which can trigger anomalies in the regions of the brain related to memory,
The hippocampus.
Ideally,
The cells in the hippocampus send chemical signals to the adrenal glands to stop the production of cortisol when a stressful situation passes.
With chronic stress,
The adrenal glands don't get that message because whatever is causing the stress seems to still be present.
And so more cortisol is released,
And this overload results in brain cell death.
It's a vicious cycle,
And the result is illness,
And not just impaired cognition.
Excess cortisol has been linked to hypertension and heart attacks,
Obesity,
And type 2 diabetes.
To compound the threat,
These health issues on their own are all risk factors for Alzheimer's disease.
Coping with stress through yoga and meditation beneficially impacts those known risk factors for Alzheimer's disease.
In general,
These practices normalize most bodily functions.
They decrease heart rate and systolic and diastolic blood pressures.
They decrease anxiety,
Increase feelings of emotional,
Social,
And spiritual well-being.
It comes down to something called the relaxation response,
In the words of Harvard cardiologist Herbert Benson.
Dr.
Benson's discoveries about the body's stress response in the 1960s led to a set of recommendations for how to defend against its harmful results,
Which he published in his book,
The Relaxation Response.
Research in the decades since then demonstrate how eliciting this relaxation response impacts genetic,
Physical,
And physiological well-being.
Since you are finding this offering on Insight Timer,
You may be familiar with a variety of meditation techniques.
Dr.
Benson's recommendation for eliciting the relaxation response involves what would probably be considered a traditional meditation practice with four components,
Comfort,
Quiet,
A tool for focus,
And the right attitude.
Comfort comes from sitting easily in a chair or on the floor.
For quiet,
It is best to find a spot where you won't be disturbed by your phone or other people unless you are meditating with others.
The tool you use is for maintaining focus.
It can be a word,
A mantra,
A short prayer,
A sound like a bell,
Or simply the breath.
When thoughts enter your mind,
As they surely will,
You turn your attention back to the tool,
To the exclusion of everything else,
Until the end of the meditation period.
Meditation becomes beneficial when practiced for just 10 to 20 minutes a day.
ARPF's recommendation for a specific kind of meditation,
The powerful kirtankriya,
Will be explained in part 5 of this series.
Just as the best type of exercise for your brain is the one you will actually do,
There are many techniques for managing stress.
Yoga,
Tai chi,
Prayer,
Journaling,
Contemplation.
Of those,
Yoga has a number of specific advantages for stress management.
ARPF focuses on yoga as a key component of managing chronic stress for dementia prevention based on studies that describe yoga's attention to not only physical movement and posture,
But also breathing,
Visualization,
And meditation.
To cite just one example,
Research published in 2014 demonstrated that yoga keeps the mind sharp by keeping it relaxed.
If you've ever tried yoga,
You know there's a difference between being relaxed and something being easy,
And I want to acknowledge that.
So let's look closer at the study findings.
The researchers randomly assigned the older adult participants to two groups.
One practiced stretching and strengthening exercises,
And the other practiced hatha yoga,
A gentle form of yoga that involves holding body postures over time,
Breathing techniques,
And meditation.
So one group focused only on exercising the body,
While the other,
The hatha yoga group,
Had an intervention of physical exercise that had mental and spiritual components.
After eight weeks,
Researchers found that participants in the yoga group showed significant improvement in executive function,
Especially in measures of working memory capacity and efficiency of mental flexibility when compared with the stretching and strengthening counterparts.
At its core,
Yoga is about union,
The union of the body,
Mind,
And spirit.
I would add another word into the definition.
Yoga is the conscious union of body,
Mind,
And spirit.
Yoga practices all facilitate awareness of those connections to ourselves and to a higher truth,
However you think of that,
God,
The universe,
Life,
Awareness,
All that is.
Traditionally,
The words spiritual and religious have been used synonymously,
Yet they are not the same.
Spirituality encompasses religion,
But casts a wider net,
Which includes ideas such as the pursuit of happiness,
The meaning of life,
And transcendence.
The Alzheimer's Research and Prevention Foundation's idea of spiritual fitness includes a set of guidelines for psychological well-being,
Which don't sound particularly religious to me,
The acceptance of self and others,
Self-confidence,
Independence,
Personal growth,
Positive relationships,
And having a purpose or mission in life.
Cultivating these things can generate the energy and resilience that helps the body and brain create a kind of buffer against depression,
Illness,
And cognitive decline.
I will go into greater detail in the next talk dedicated to spiritual fitness,
But right now I want to examine how two of those benchmarks of psychological well-being contribute to overall health,
And brain health in particular.
Having a sense of purpose in life and choosing to connect with others in positive relationships both contribute to a deep and long-lasting inner peace because they remind us in different ways that we belong.
We belong in the world.
Isolation or lack of social connections is associated with cognitive decline,
Quote unquote,
And depression.
In older adults,
The two can be difficult to tease apart,
Even from the perspective of a physician,
Since the subjective awareness of impairment can be depressing and isolating.
And on the other hand,
Depression is associated with isolation and cognitive impairment.
The close link between depression and dementia is important,
But beyond the scope of this 20-minute talk.
Isolation is not only about spending most of one's time alone.
Actual isolation and perceived isolation have similar detrimental effects.
That is,
Someone who does not live alone,
But who feels alone or misunderstood is also isolated.
That feeling of loneliness,
Disconnection,
Or not belonging probably describes the person diagnosed with dementia and that person's care partner.
Ironically,
This makes unsupported caregivers vulnerable to the very condition affecting the person in their care and underscores the value of support groups where experiences can be shared with others who have greater understanding of the unique challenges being faced.
Expressing real or perceived isolation in people diagnosed with dementia was one goal of the adult day program where I worked for five years before the pandemic forced its closure.
One of the most moving things I witnessed materialized thanks to the perseverance of two women who came into the center one day and asked if they could engage the clients in a program of reminiscence that would give them a chance to record their life stories over a six-week period of group discussions based on a set of themes.
I explained that our program,
With its emphasis on dementia care,
Was not a typical senior activity center,
That some clients had such advanced memory impairment that they did not know the names or exact relationships of their closest family members.
How do you write a life story when you don't know your wife's name or how many children you have?
Furthermore,
Many clients at the center spoke limited English or none at all,
And some were mostly nonverbal due to disease progression.
None of it deterred the women from wanting to work with us,
To be with us,
And over the next couple of months,
On Thursdays after lunch,
We arranged the chairs into a big circle and we told versions of our life stories.
I listened and learned things about the people in my care I am certain I never would have known if not for the camaraderie that developed as we sat in that sacred discussion circle.
Men who normally argued about politics over morning coffee bonded over stories of their military service.
Several women had worked at the same fruit and vegetable canneries that were major employers in San Jose before the valley of heart's delight became Silicon Valley.
There were poignant stories of hard work,
Migration,
Internment camps,
Arranged marriages,
And of course,
Of course,
Family.
Every week,
Laughter and tears,
And a kind of group bonding that I was ashamed I ever doubted could be possible because of dementia.
If you ever hear this recording,
Judy and Amy,
Thank you.
When people come together with some shared intention,
An individual is more than just a fraction of a whole.
Through their contributions or simply their presence within the group,
They become whole in the belonging.
Working with like-minded,
Like-hearted people contributes to feelings of purpose and meaning,
And that profoundly affects well-being,
Impacting brain function too.
That is why socialization is considered a component of the fourth pillar of Alzheimer's prevention,
Spiritual fitness.
For more on this topic,
Join me soon for part five of this series.
Whether you are currently living with cognitive impairment or are more concerned about preventing it,
I share these teachings with love and as a witness to the renewed vitality that comes from compassionate connection.
Many future cases of dementia may be preventable.
Meanwhile,
There are millions of families who live with dementia today.
Let's not forget those individuals who are isolated from their relatives,
Who also deserve to be seen,
Heard,
And supported.
Thank you for your willingness to not look away.
