Staying Socially and Mentally Engaged: Social and intellectual engagement is important to brain health. Pursuing interesting and meaningful social activities will help you keep connections with others and within your local community. Volunteer at a local church or animal shelter or just participate in the activities you enjoy with friends and family.
In a world inundated with distractions, constant connectivity, and a plethora of information, our cognitive well-being has never been more crucial. Amidst the clamor, how do we nurture our minds, keep our focus sharp, and cultivate habits that promote mental clarity? The right lifestyle habits can be the cornerstone to maintaining and even enhancing our cognitive abilities, ensuring not just longevity but also the quality of our mental faculties. As a part of this series, I had the pleasure of interviewing Dr. Roy Hamilton.
Dr. Hamilton is a professor of Neurology, Psychiatry, and Physical Medicine and Rehabilitation at the University of Pennsylvania School of Medicine. He is currently a Trustee of the McKnight Brain Research Foundation, Director of the Penn Laboratory for Cognition and Neural Stimulation and Director of the Penn Brain Science, Translation, Innovation and Modulation Center. Currently, Dr. Hamilton is working on a campaign with the McKnight Brain Research Foundation to educate the public on healthy cognitive aging and brain health, including steps and lifestyle changes to support cognitive well-being.
“Thank you so much for doing this with us! Before we start, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory?”
I’ve always been interested in minds and thoughts. When I was much younger, I thought I was going to be a psychologist, specifically a counseling psychologist. At that point, everything I knew about psychology and what a psychologist did, I learned from watching television. So, I went to college with that goal in mind and majored in psychology.
One semester, I took a course in what at that time was called psychobiology. That course helped change my view about what was most interesting about thinking. It’s so remarkable that there is this organ that we all have that is so small and circumscribed and yet capable of producing the infinite combinations of ideas that create who we are. That course piqued my interest enough that, for a time, I thought I would be a cognitive neuroscience researcher. However, I ended up going to medical school after realizing that a career as a cognitive neuroscience researcher may not have the direct clinical impact that I was hoping for.
One day, while still in medical school, I decided to check out a lecture series on behavioral neurology. Little did I know that lecture would once again change the trajectory of my career. One of the first talks was with a person who had come from the National Institutes of Health (NIH), where he’d done research involving the use of something called transcranial magnetic stimulation. He was using magnets to zap the brain and change how people think. He demonstrated that he could change how people could perform behaviorally and cognitively by just putting a magnet over their head. I thought, “That’s the most amazing thing I’ve ever seen in my entire life! I want to do that for the rest of my life.” I introduced myself to him and became his first student in the lab and got trained on how I could do this. Those pivotal moments in my life set the course of my career.
Is there a particular book, podcast, or film that made a significant impact on you? Can you share a story or explain why it resonated with you so much?
In addition to the shows on psychology I watched in my youth that helped shape the beginning of my college career, I listen to a podcast called Hidden Brain. The podcast is hosted by Shankar Vedantam and explores the difference between our psychological processes and behaviors, and how we usually imagine ourselves to be. He talks about hidden cognition and how we all behave in ways that are surprising even to us but make sense in the context of psychology research. It really resonates with me, and I would love to one day be on the show sharing my own research.
Let’s now talk about lifestyle habits that support cognitive well-being. Are there specific foods or diets that have been scientifically shown to enhance cognitive functions?
While there is growing evidence that various lifestyle modifications may help protect brain health now and in the future, the data on diets is not strong enough that anyone should go clearing out their pantry. There isn’t a lot to compel one to think that a specific food or a specific supplement is somehow going to be the key to enhancing one’s cognition. However, a healthy diet can play a role in supporting brain health and that’s largely because diet can help to protect us from risk factors to cognitive decline.
A healthy diet is important because it combats and decreases the risk of obesity, heart issues, diabetes, and other things that all impact overall health, which in turn impact the brain. The McKnight Brain Research Foundation (MBRF) recently conducted a survey that showed 74% of respondents recognize that the activities they participate in to care for their bodies will also help them care for their brain, while more than one-quarter miss the connection that taking better care of their body will also help take better care of their brain. It is important to recognize a healthy diet as being supportive of your cognitive well-being. A few things to avoid or limit also include excessive alcohol intake and smoking as it poses a definitive risk to cognitive health.
What are your thoughts on the importance of movement and exercise in the context of cognitive decline? How do different forms of exercise, such as aerobic vs. strength training, influence cognitive well-being?
Movement and exercise are important. First of all, they’re important for general health. Your brain is an organ and like any other organ in your body, anything that is helpful for your overall health will help you avoid other conditions that can affect your brain and overall cognition. Exercise helps you to avoid a lot of risks, like cerebrovascular disease, cardiovascular disease, and diabetes.
It also is the case that exercise may be specifically good for brain health. There’s at least some evidence that exercise can help with enhancing the plasticity of the brain and spur what’s called neurogenesis, a process that helps the brain to grow and regrow, which may be a benefit to learning and memory.
Further, physical exercise is helpful for things like mood and anxiety. Exercise helps you avoid some of the psychological risk factors that put you at risk for cognitive decline later in life, such as depression and stress. Exercise also helps you with sleep. People who exercise regularly sleep better and sleep is really important for the maintenance of cognition. One can be hard-pressed to find a panacea, where this one thing does everything. However, exercise does help with a bunch of things and people seem to be aware of that. In fact, the MBRF survey showed that 70% of respondents know exercise helps maintain brain health, but only 57% exercise adequately.
Can mindfulness practices or meditation offer measurable benefits to cognitive health?
As I mentioned, depression and anxiety are clear risk factors for developing worse cognition. Any steps that you can take to reduce the overall load of depression and anxiety in your life would be helpful for your cognitive well-being and maybe your cognitive health as you make your way through the ark of your lifespan. Mindfulness and meditation are two kinds of practices that are associated with stress reduction, the ability to have a more even mood, and the ability to cope with stressors. I would say that those are useful in terms of managing those risk factors.
Now, that’s not to say that those activities are the only way to manage depression and anxiety. There are many other ways in which one could manage one’s psychological risk factors. But certainly, I would think that these would be two of them.
How does the quality and quantity of sleep correlate with cognitive performance and long-term brain health?
Sleep is extremely important. It seems like the more we look into it, the more important it seems. It’s ironic, to some level, the degree to which we are discovering how medically important sleep is, given how sleep-deprived most people in the health profession have been most of their lives.
First, let’s talk about what sleep does for cognitive processing. Sleep is important for, amongst many things, what’s called memory consolidation. Memory consolidation is basically shoring up the information that you learn over the course of a day in order to form memory patterns that endure. Sleep has been shown to be extremely important for the process of memory consolidation. It’s a period of time when the unimportant information gets washed away, and the relevant memory information gets locked in place. Notably, people really don’t perform well over time on memory tests if they don’t have the ability to do that. It’s also biologically important for brain health. One thing that we know is that there’s this system of drainage called the glymphatic system, which is important for draining toxins from the brain. It’s sort of your brain’s natural drainage system, letting your brain take out the garbage. It’s especially active when you’re sleeping. So, if you are sleep-deprived chronically, you’re not giving your brain the optimal ability to “clear out the trash” so to speak. It’s also important generally for bodily repair, and that naturally includes your brain too.
I can’t stress enough that sleep is important in so many ways, but it has to be continuous sleep. Normally, people count their sleep in hours. But it’s not just about the number of hours you get. You also go through different phases of sleep, so you have to sleep continuously long enough to go through those cycles.
How do social connections and interpersonal relationships influence our cognitive well-being?
Social connections and interpersonal relationships are super important to our cognitive well-being. People who are socially isolated are at substantially greater risk of cognitive decline compared to people who are socially engaged. People with close relationships do better. There’s evidence of this for individuals who are married versus widowed individuals, people who have close family relationships versus people who don’t have those relationships, and having close friendships versus not having close friendships.
One thing that I clarify to my patients that’s often intuitive to them is that there would be a psychological benefit such that less isolated people are less depressed or happier. But, it’s not just that we’re talking about. We’re talking about actual benefits to cognitive health and cognitive performance. A lot of the brain’s hardware is dedicated to how we interact with other people. The brain is a use-it-or-lose-it kind of organ. So, if an enormous amount of the hardware is dedicated to how we’re interacting as a social organism, then it’s important to use that hardware to maintain your brain’s health.
What role do lifelong learning and continuous mental stimulation play in maintaining optimal cognitive health?
There is a disconnect between what people believe can promote brain health and what they engage in. In the MBRF survey, while 58% of respondents believe that social interaction is important for brain health, only half of respondents participate to benefit their brain health.
In the context of social engagement and with the brain being a social organ, there are a variety of social skills that the brain engages in. The extent to which you continue to engage the brain is critical to how you maintain those skills.
The brain operates via principles of neuroplasticity. In other words, your brain is responsive to use, that’s when connections form. Connections strengthen your cognitive health and so it’s to your advantage to continuously build up those sets of connections, whether it’s through hobbies and skills, maintaining complex tasks, learning new information, learning new languages, or whatever is of interest to the individual. In the long run, this practice will be very beneficial compared to individuals who are intellectually sedentary.
I would also suggest people participate in a variety of activities, not just a daily crossword. I consider any one activity a little bit like eating any one food. For example, we know carrots are good to eat. But if I just eat carrots every day, I am not gaining the full nutrients I need to sustain my body. You need to have some variety. The same idea can be applied to our cognitive well-being, we need a wide range of things to maintain optimal cognitive health.
What are your five favorite lifestyle habits that proactively support cognitive well-being?
- Managing Your Risk: You should manage your risk for hypertension, diabetes, cerebrovascular disease, and cardiovascular disease. Maintaining a healthy weight and diet can go a long way in helping reduce your risk for these things.
- Physical Exercise and Activity: Being physically active through regular exercise, household chores or other activities has many benefits; including helping preserve your cognitive health. Many recent studies have linked ongoing physical activity with benefits for the brain. Aerobic exercise, such as brisk walking, is thought to be more beneficial to cognitive health than non-aerobic stretching and toning exercises. Aiming to move for about 30 minutes for several days throughout the week is shown to have many benefits.
- Sleep: Not getting enough sleep may result in problems with memory and thinking, yet ⅓ of American adults report regularly getting less sleep than the recommended 7–8 hours. Make sure you are getting enough continuous sleep each night to help your body go through the different phases of sleep.
- Staying Socially and Mentally Engaged: Social and intellectual engagement is important to brain health. Pursuing interesting and meaningful social activities will help you keep connections with others and within your local community. Volunteer at a local church or animal shelter or just participate in the activities you enjoy with friends and family.
- Quitting smoking: Evidence shows that smoking increases the risk of cognitive decline. Quitting smoking can reduce that risk to levels comparable to those who have not smoked.
Are there any proven techniques or habits that can help protect against age-related cognitive decline?
Yes, while cognitive aging is a natural part of aging that can be both positive and negative, there is a great misunderstanding about what to expect. In fact, 1/3 of Americans who responded to a recent consumer survey by the MBRF said they feel uninformed about normal brain aging. The lack of information about cognitive aging causes a misconception of what to expect as brains age, which is shown by 87% of respondents stating they are concerned about age-related memory loss and decline in brain function as they grow older.
Most people do not understand that age-related memory loss is usually associated with mild forgetfulness and is a normal part of brain aging and not necessarily a sign of a serious memory problem. Nonetheless, there are some ways to maintain your brain health and protect yourself from age-related cognitive decline including many of the areas I previously touched on including:
- Taking care of your physical health
- Being physically active
- Eating healthy foods
- Managing high blood pressure
- Keeping a healthy weight
- Reducing cholesterol levels
- Keeping your mind active
- Staying intellectually engaged
- Managing depression, anxiety, and stress
- Participating in stress and anxiety-reducing activities
- Getting continuous sleep
- 7–8 hours of sleep per night as recommended
- Staying connected
- Staying socially engaged with friends and loved ones
- Quit smoking
In your professional or personal experience, what can be done to delay cognitive decline if the genetic predisposition is there?
Yes, there are certainly genetic predispositions. I have a lot of patients and families who come in with this concern. They usually are related to someone who is experiencing cognitive decline, and they want to know what their risk is. Oftentimes they come in with a very exaggerated sense of what the genetic implications are of being related to someone who has cognitive decline or a major disease.
There are just a handful of what we call autosomal dominant, inherited genetic factors. It’s pretty uncommon to have the kind of risks where if your parent passed you one of these genes, you are 100 percent going to have this disease or this decline. What is much more common to see is a combination of genetic risk factors — none of which is 100% predictive — along with a contribution from modifiable risk factors or factors you can do something about. For example, a modifiable risk factor could be your physical or cognitive activity.
Overall, modifiable risk factors actually comprise more risk together than some of the most common genetic risk factors. I would say even if you knew that you have some level of genetic risk, it is still worth your while to improve your modifiable risk factors. For instance, avoiding risks for cardiovascular disease, exercising, and staying intellectually engaged.
Is there a person in the world whom you would love to have lunch with, and why? Maybe we can tag them and see what happens!
As I mentioned earlier, I am a big fan of the Hidden Brain podcast. So, I would say Shankar Vedantam. It would be amazing to sit down with him and talk about some of my own research as well as pick his brain on various topics dealing with cognitive aging.
How can our readers follow you online?
Follow my work at BrainSTIM Center and check out my personal social channels:
- BrainSTIM: https://www.med.upenn.edu/brainstimcenter/
- Twitter: https://twitter.com/drroyhamilton?lang=en
- Facebook: https://www.facebook.com/mcknightbrain
- LinkedIn: https://www.linkedin.com/in/roy-hamilton-082b4850/
To learn more about my work with MBRF visit the pages below:
- McKnight Brain Research Foundation: https://mcknightbrain.org/
- Brain Works Campaign Website: https://mcknightbrain.org/brainworks/
Thank you so much for sharing these important insights. We wish you continued success and good health!