By Joseph E. Scherger, MD, MPH

Vice President, Primary Care, Eisenhower Medical Center; Clinical Professor, Keck School of Medicine, University of Southern California, Los Angeles

Dr. Scherger reports no financial relationships relevant to this field of study.

SYNOPSIS: Healthy aging allows for hippocampal neurogenesis in the brains of adults into the eighth decade of life.

SOURCE: Boldrini M, Fulmore CA, Tartt AN, et al. Human hippocampal neurogenesis persists throughout aging. Cell Stem Cell 2018;22:589-599.

A group of investigators from New York and Macedonia performed 28 autopsies on healthy human individuals aged 14-79 years, focusing on the hippocampus, the main memory center of the brain. While older individuals exhibited less angiogenesis and neuroplasticity, investigators found similar numbers of intermediate neural progenitors and thousands of immature neurons capable of becoming mature neurons. The authors postulated that stem cell activity persists in the healthy aging brain.

COMMENTARY

These results provide further support for previous investigations that revealed cognitive decline may be reversed in elderly patients with a healthy lifestyle.1-3 Other researchers have documented growth of the hippocampus in seniors. More work remains to determine the most important determinants of healthy aging, but low-glycemic and anti-inflammatory nutrition, regular exercise, restful sleep, stress management, and executive cognitive function all play some role.3-5

Promoting a healthy lifestyle should be at the foundation of primary care practice. Patient education and motivational counseling toward better health practices are crucial skills for primary care physicians. This puts medication and procedures as secondary interventions when needed. Two influential figures in history reportedly predicted this role for physicians long ago. Maimonides was said to have advised that a disease that could be treated by diet should not be treated by any other means. Later, Thomas Edison’s focus on diet reportedly led him to predict that rather than focusing on dispensing medicine, doctors in the future would instruct patients in the care of the body, in diet, and in preventing disease.

REFERENCES

  1. Bredesen DE. Reversal of cognitive decline: A novel therapeutic program. Aging 2014;6:707-717.
  2. Bredesen DE, Amos EC, Canick J, et al. Reversal of cognitive decline in Alzheimer’s disease. Aging 2016;8:1-9.
  3. Bredesen DE. The End of Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline. New York: Avery (Penguin House); 2017.
  4. Sherzai D, Sherzai A. The Alzheimer’s Solution: A Breakthrough Program to Prevent and Reverse the Symptoms of Cognitive Decline at Every Age. New York: HarperCollins; 2017.
  5. Amen DG. Memory Rescue: Supercharge Your Brain, Reverse Memory Loss, and Remember What Matters Most. Carol Stream, IL: Tyndale House Publishers; 2017.