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Combating Age-Related Brain Deterioration

October 2011

By Eric R. Braverman, MD, with Dale Kiefer, BS

Combating Age-Related Brain Deterioration

You probably won’t hear this from your doctor, but your brain’s gradually shrinking as you read this.


A certain amount of physical wasting or atrophy—also medically termed “regional deterioration of brain structure”—occurs in the brain naturally with age.1 The impact of these structural alterations is vastly underestimated by both physicians and patients alike. This process usually commences around age 30, with marked acceleration observed at 50.

The results of physical brain deterioration can be dramatic. They include neurocognitive deficits, such as diminished attention span, verbal skills, spatial perception, deficits in abstract thinking and creativity, along with increased difficulty learning new tasks and retaining new information, flagging memory, and deteriorating sleep quality.

Maintaining a youthful brain in the face of these detriments of aging is perhaps the most crucial challenge of aging. The brain, our most important organ, is responsible for orchestrating a complex symphony of hormonal, neurochemical, and electrical signals to maintain the body in a state of vibrant health.

In this article, you will learn of the many insults on brain health in the modern world and what you can do to halt and reverse them.

Attention Impairment

Subtle declines in memory, reasoning, and cognition are statistically likely to progress well beyond mere “forgetfulness” among many individuals. Sadly, a significant number of Americans will succumb to cognitive decline, and eventually to dementia, well before their bodies have given out. According to the Alzheimer’s Association, 5.3 million Americans are currently afflicted with this mind-robbing disease, and the ranks of the affected are expected to swell in coming years as more Baby Boomers attain elder status.2

Mild cognitive impairment (MCI) is a related condition that often precedes the development of Alzheimer’s-type dementia. Some international studies suggest that up to 40% of older people will be affected by mild cognitive impairment worldwide, and many of these patients will go on to develop Alzheimer’s-type dementia.3,4 In a lecture I delivered at Columbia University, I noted that dementia takes 15 to 20 years to develop; by 80-85 years of age, up to 50% of Americans will suffer some form of dementia. But even by 70 or 80, nearly everyone experiences some cognitive loss.

Obesity and Cognitive Decline

In addition to brain atrophy, researchers have reported that just being overweight in middle age puts you at greater risk of having decreased cognitive abilities and suffering “steeper cognitive decline” later in life.7

Using sophisticated brain imaging techniques, researchers have shown that obese people literally have smaller brains than their age-matched, normal-weight peers. Using MRI analysis techniques, for example, scientists at the University of Pittsburgh showed that, among elderly subjects with apparently normal cognition, obesity is associated with declining volumes in several key areas of the brain.8 Furthermore, research suggests that the decline of the key brain chemical dopamine is related to the impulse to overeat, which in turn encourages obesity, perpetuating a vicious cycle of weight gain and increasing imbalances in brain neurotransmitters.9,10 This means that obesity accelerates cognitive decline, damages attention, erodes memory, and decreases your brain’s processing speed, while altering brain voltage.

How to Detect Attention Impairment5,6
How to Detect Attention Impairment

Various forms of attention become impaired as the brain ages. Impairments can be quantified using objective tests, such as the test of variables of attention (TOVA). Forms of altered attention include the following:

  • Omissions (missed stop signs, for example)
  • Commissions (jumping the gun, for instance)
  • Response time (slow response indicates flagging attention)
  • Response variability (becomes inconsistent)
  • Complex attention (can the subject “pull it all together”?)


Aging is often accompanied by increased calcification; we essentially “turn to stone.” Brain calcification, which is sometimes associated with hyperparathyroidism, results in impaired brain processing speed.11-13 In older women with osteoporosis, bone loss has been shown to predict cognitive decline.14,15 That’s why I often say “frail frame; frail brain.” Osteoporosis and osteopenia destroy your brain, not just your bones.

Interestingly, menopause induced by surgical removal of the ovaries decreases brain processing speed.16 Evidently, hormonal factors may help explain why women have increased rates of cognitive decline and dementia compared to men, which illustrates the importance of restoring the whole body to youthful health through the use of bioidentical hormones.


Drug abuse and addiction impact numerous aspects of a person’s life. While the immediate costs are fairly well known, the long-term consequences of addiction receive less attention. Accelerated cognitive decline is one of them. Disturbances in the dopamine-driven “reward cascade” in the brain are associated with multiple drug-seeking behaviors. Alcohol, cocaine, heroin, marijuana, nicotine, and glucose all cause activation and neuronal release of brain dopamine. Dr. Kenneth Blum and I, along with other colleagues, have published numerous articles regarding our discovery that individuals with genetically determined deficits in certain dopamine receptors are at greater risk of addiction, due to abnormal cravings that are only satisfied by the “feel good” dopamine molecule. We have related this genetic abnormality to addictive, compulsive, and impulsive behaviors ranging from drug abuse to gambling to overeating that leads to morbid obesity.17-19

Experts are now projecting that as Baby Boomers age, the ranks of older drug abusers will grow significantly.20,21 Some drugs of abuse are outright neurotoxic, destroying brain structures even as they enhance the desire to continue abusing them.22 Others, like nicotine from tobacco, temporarily enhance memory and attention, but in the long term, tobacco “accelerates dementia processes.”23

Alcohol abuse results in cognitive impairment that may last long after sobriety is achieved. Alcohol abuse during pregnancy results in potentially severe, irreparable harm to the fetus’ developing nervous system. Tragically, fetal alcohol syndrome is the leading cause of retardation around the world.24 Alcohol-related impairments of executive brain functions manifest as a reduced ability to focus on tasks and pay attention.25 Other drugs that induce long-term cognitive deficits include cocaine, GBH (the so-called date-rape drug), amphetamines, MDMA (ecstasy), marijuana, and opiates such as heroin and oxycontin.22,26-31

Strong Muscles, Strong Brain

Fortunately, it is possible to fight back and greatly improve one’s odds of aging gracefully with a sharp mind fully intact. From nutrients that support healthy brain structure to bio-identical hormones that help maintain youthful brain function, there’s plenty that can be done to prevent cognitive decline. Surprisingly, it begins not with the mind itself, but with muscle. Studies have repeatedly shown that older individuals who exercise regularly and maintain a healthy weight are less likely to succumb to cognitive decline, mild cognitive impairment (MCI), and Alzheimer’s disease than their heavier, more sedentary peers.34-36

Shrinking muscle mass correlates with declining cerebral blood flow. Since sluggish cerebral blood flow is associated with a greater risk of cognitive impairment, it follows that building and maintaining adequate muscle mass equates with maintaining healthy cerebral blood flow. We once assumed that cerebral blood flow remains more or less constant, but we have recently discovered that exercise increases cerebral blood flow, possibly by speeding up brain metabolism.34,35,37,46,47

What You Need to Know: Preserving Cognitive Function
What You Need to Know: Preserving Cognitive Function
  • Your brain begins to structurally deteriorate as early as age 30.
  • Maintaining youthful cognitive function is a crucial challenge of aging.
  • Declining memory function may also begin as early as age 30 and is often evident after 50 years of age.
  • Fortunately, it is possible to take proactive steps to maintain youthful cognition with aging.
  • Maintaining a healthy body weight and body fat percentage may help preserve healthy brain structure and function.
  • Frail bones have been linked with cognitive decline in women.
  • Hormonal balance may promote healthy cognitive function.
  • Traumatic brain injury is a common yet overlooked cause of cognitive difficulties.
  • Exercise increases blood flow to the brain and may decrease the risk of cognitive decline, while promoting healthy sleep.
  • A healthy diet and extra nutritional support further enhance cognitive function.