TreatmentUpdate
203

July 2014 

Good for the brain—advice from neuroscientists

According to Mark Mattson, PhD, chief of the Laboratory of Neurosciences at the National Institute on Aging in Bethesda, Maryland, research on animals and with HIV-negative people has found that regular exercise can do the following:

  • improve mood
  • lessen anxiety
  • improve cognitive performance
  • make people less susceptible to depression

Dr. Mattson adds that exercise can have these effects by doing the following:

  • stimulating cells in the brain to build new connections and strengthen existing connections
  • stimulate the production of new cells in some parts of the brain
  • release the protein BDNF (brain-derived neurotropic factor), which has been linked to improvements in memory. BDNF has also been linked to the formation of new brain cells

According to one of Canada’s leading neuroscientists, University of Toronto professor Sean Rourke, PhD, there are many things that are good for the brain. The easiest way to remember these, he says, is with this phrase:

“Anything that’s good for the heart is good for the brain.”

Professor Rourke recommends that people seek help from their healthcare providers to deal with issues that can significantly affect heart and brain health, such as the following:

  • smoking tobacco
  • overall cardiovascular health
  • moderate alcohol intake (too much is not healthy)
  • sleep that does not leave people feeling refreshed
  • pre-diabetes and diabetes
  • higher-than-normal blood pressure
  • stress, anxiety or depression

A significant body of research and a recent study published in the Journal of the American Heart Association backs up Rourke’s phrase about the connection between the brain and the heart. In that study of more than 17,000 Americans, researchers found that people with intermediate or good cardiovascular health were at substantially reduced risk of cognitive impairment.

The American Heart Association has a new measure of cardiovascular health called “Life’s Simple 7.” This is based on a mix of behaviours and assessments that can be improved over time to help increase a person’s cardiovascular health. The key points of “Life’s Simple 7” are as follows:

Behaviours:

  • not smoking or quitting smoking
  • eating a healthy diet
  • physical activity
  • body mass index (BMI)

Biological factors:

  • blood pressure
  • total cholesterol
  • fasting blood sugar (glucose)

By working with a care team to deal with these issues, heart and brain health can be improved.

Back to basics

The focus of care for HIV-positive people has historically revolved around assessments of the immune system and the response to anti-HIV therapy. However, as HIV-positive people live longer thanks to ART, looking after overall health becomes important. That’s where family doctors, nurses and, in some cases, pharmacists play a key role. Their wisdom, experience, advice and referrals to specialists are a vital part of maintaining and/or improving overall health.

For more information about improving cardiovascular health, see HIV and cardiovascular disease.

—Sean R. Hosein

REFERENCES:

  1. Mattson MP. Exercise and the brain: a slap on the HAND. Journal of Neurovirology. 2013 Oct;19(5):407-9.
  2. Rueda S, Law S, Rourke SB. Psychosocial, mental health, and behavioral issues of aging with HIV. Current Opinion in HIV/AIDS. 2014 Jul;9(4):325-31.
  3. Thacker EL, Gillett SR, Wadley VG, et al. The American Heart Association life's simple 7 and incident cognitive impairment: The REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Journal of the American Heart Association. 2014 Jun 11;3(3):e000635.
  4. Dufour CA, Marquine MJ, Fazeli PL, et al. Physical exercise is associated with less neurocognitive impairment among HIV-infected adults. Journal of Neurovirology. 2013 Oct;19(5):410-7.
  5. Mapstone M, Hilton TN, Yang H, et al.  Poor aerobic fitness may contribute to cognitive decline in HIV-infected older adults. Aging and Disease. 2013 Aug 27;4(6):311-9.
  6. Fazeli PL, Woods SP, Heaton RK, et al. An active lifestyle is associated with better neurocognitive functioning in adults living with HIV infection. Journal of Neurovirology. 2014 Jun;20(3):233-42.