Entertainer Rita Moreno believes years of therapy helped keep her brain sharp, and the idea that taking care of your mental health could protect your brain is gaining credence among researchers. A 2018 report from the AARP's Global Council on Brain Health found a correlation between mental well-being and brain health as people age.
“Poor mental well-being…may interfere with people's abilities to think and reason, as well as how they interact with others and how they regulate their emotions,” the report says, noting that multiple studies have connected greater mental well-being to better brain health later in life. An example is a 2018 analysis of more than 10,000 people participating in the Health and Retirement Study that found that a purpose in life was associated with a reduced risk of dementia.
“There are significant associations between stress and cognition, and clearly depression and anxiety are very stressful disorders that challenge one's well-being,” says Liana Apostolova, MD, FAAN, endowed professor in Alzheimer's disease research at Indiana University School of Medicine in Indianapolis. “Unsuccessfully coping with life's adversity can have a damaging effect on brain function and brain structure,” she says.
At least three reports published in 2020 supported the idea that improving mental health may help protect the brain. A study in the Journal of the American Medical Association (JAMA) showed that people who experience trauma early in life appear to face a higher risk of later cognitive impairment; a report in The Lancet included depression among the top 12 modifiable risk factors for dementia; and a 2019 review in Maturitas of existing studies found that anxiety is significantly linked to the risk of dementia.
“If you compare people who have depressive symptoms and those who don't, we know that those with depression have almost twice the risk for developing dementia over the next two years,” says Sudha Seshadri, MD, FAAN, founding director of the Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases at UT Health San Antonio in Texas. “But the question is, which came first, the dementia or the depression? We know that one of the first places in the brain to be affected by Alzheimer's disease is the locus coeruleus, which is also involved with responses to stress. It may be that depression is a reaction to the fear and anxiety of possibly being in the early stages of dementia.”
Research has also been finding that our social lives can have an impact on our brain health. “Having strong social networks and connections and not feeling lonely are associated with larger brain volume on MRI,” says Dr. Seshadri. “A 2021 study in JAMA Neurology from NYU researchers found that people who had someone to talk to did better on cognitive examinations than those who did not. The resilience of the brain may be improved by these social connections.” According to a study in The Lancet, older adults with stronger social networks had higher cognitive function (even if they had beta-amyloid plaques in the brain) than those with less social support.
“If anyone had any doubt about the effect of social interaction on cognition, we got our answer during the height of the COVID-19 pandemic,” says neurologist Christopher M. Wilson, MD, senior medical director for specialty care with American Health Network in Indiana. “Among our patients with mild cognitive impairment who are still high-functioning and able to live independently, the isolation of the pandemic really hurt them. I've never seen the cognition of so many people change so much in such a short time frame.”
Managing stress is another key factor. The AARP survey found that older adults who frequently managed stress effectively were more likely to rate their cognitive functions as “excellent” or “very good.”
“Many of the same habits that are good for your mental health and wellness are also associated with reducing your risk of developing dementia later in life,” says Dr. Wilson. “We know that people who get enough sleep and exercise, manage their stress, and are socially engaged tend to have lower levels of dementia later in life. While we don't have clinical trials directly showing that caring for one's mental health reduces dementia, it's pretty clear that what is good for your mental wellness is also good for your brain.”
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