Michael Roizen, M.D.: How to protect your heart and brain from aging too soon

Q: I can tell my energy and mental sharpness are slipping, but my doctor says I don’t have any obvious warning signs of major heart or other problems. What should I be checked for at age 72, and how can I become stronger and more focused? — Janice R., Phoenix

A: Researchers are only now starting to recognize that many people begin to feel weaker, less alert, and less able to enjoy day-to-day life before there are clear signs of cardiovascular trouble such as a stroke or heart attack. A recent study in JAMA Cardiology followed people in their 70s for as long as 10 years before what the researchers described as a cardiovascular event. The study found that participants became frailer over time and showed declines in cognition, mobility, energy, and mood before serious heart problems appeared.

If you are noticing those kinds of changes now, it may be time to respond with lifestyle adjustments and, in some cases, medications such as statins and/or GLP-1s for weight loss, improved metabolism, lower LDL cholesterol, and added protection against cardiovascular problems, including dementia.

One especially effective lifestyle strategy is the MIND diet. A study in Alzheimer's & Dementia found that it helps protect the brain by reducing hardening and narrowing in the brain’s small blood vessels, which can also lower stroke risk and support sharper thinking. Berries and skinless poultry were associated with these benefits, while sweets and fried fast foods were linked to greater tissue loss. The study also recommended six or more servings of green leafy vegetables each week.

Other ways to improve energy and focus include moving more, with your doctor’s approval. Chair yoga, walking, wall squats, resistance work such as wall push-ups and planks, water exercise, and weight machines can all help heart health and brain function. For extra support and individualized coaching, there is an AI coaching program at 4YOUngevity.com.

Q: Why do women seem to have more problems with cognitive decline and dementia than men? And what can I do to lower that risk? — Josie P., Memphis, Tenn.

A: Part of the explanation is that women live longer than men, which means more women reach the ages when dementia becomes more common. But research also points to other influences, from hormonal differences to subtle physiological factors, all the way down to how proteins behave in the body over time.

We now know that only about 2% to 3% of people inherit the same APOE4 gene from both parents, but that raises dementia risk by 81% in women and by 27% in men. Other risk factors may also affect women more strongly than men, or at least they did in older generations. A 15-year study in Alzheimer's & Dementia found that older women with less stable work histories, or those who were self-employed, took early retirement, or never entered the labor force, had significantly lower memory and executive-function scores than peers with more work involvement. Those factors can affect men too, but not to the same degree, according to the researchers.

Bone health also appears to matter. Osteopenia and osteoporosis are linked to a higher dementia risk in women, who develop those conditions earlier and more often than men. A study in Radiology found that lower bone mineral density in the vertebrae is associated with changes in brain structure and cognition.

Another study in Alzheimer's & Dementia found that higher stress levels lead to steeper declines in language and attention in women 50 and older than in men.

To help protect yourself, get regular bone scans, follow a heart-healthy plant-based diet, exercise consistently, and use stress-management strategies. Having a strong support network can help, too. For more than 40 ways to protect your brain and heart from premature aging, see The Great Age Reboot and my new book, YOU: Getting Older: The Owner's Manual for Your Golden Years.

Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers.