Cognitive & Emotional Health

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

World Helath Organisation

 

Maintaining sharp minds and high level cognitive functioning is concern as we age. There is a critical link between physiological “fitness” and brain “fitness”. Suboptimal conditions that promote cognitive decline and even dementia have a silent onset, decades before we become alert to them and many of the features overlap with those seen in “prediabetes” or type 2 diabetes.

Insulin Resistance and Fitness

Development of resistance to our blood sugar-regulating hormone, insulin is a common theme in these conditions and is termed insulin resistance [1]. Improving insulin sensitivity, through optimising cardiometabolic health proactively, is the likely to be the best way to keep our brains functioning healthily for as long as possible. Indeed, greater cardiorespiratory fitness has been linked to increased brain volume and improved brain functioning [2].

 

Stress and Emotional Health

In the UK, 15.4 million days of work were lost in 2017/18 due to work stress. It has the potential to have a profound effect on not only our mental health but our physical health too. It has both short- and long-term effects on our health. Both positive (eg exercise, sauna, job promotion, public speaking) and negative (eg bereavement, professional or personal relationship breakdowns) stressors have the potential to impact our health.

 

Acute Stress

Acute stressors are time-limited. Positive acute stressors can have the advantageous effect of a phenomenon called hormesis. This is when the cells and our bodies are able to adapt and become more resilient to a mild or moderate stress, such as exercise.

 

Chronic Stress

​Cumulative exposure to regular, repeated negative stressors results in greater risk of heart disease, diabetes, impaired immunity and poor brain (cognitive) function [3][4]. Significant life events can even alter the structure of our brains [5], including areas associated with memory, possibly the high cortisol levels [4]. Stress can, therefore, be a contributing factor for speeding up the ageing process and promoting an earlier onset of age-related disease [6].

 

Mitigating Stressful Environments

 

Throughout our programmes we take the following approach:

  • Developing a multi-faceted approach to increasing emotional and cognitive reserve confers resilience to the mental and physical consequences of these stressors. This can be through building a support team around you [7] which can help reduce cortisol levels [8].

  • Increasing our capacity to cope with everyday stress through practices such as mindfulness [9].

  • Sleep optimisation

  • Regular physical activity which can increase self-efficacy [10]. Independent of its effects on stress management, regular physical activity also mitigates the stress-related chronic health issues such as cardiovascular disease, diabetes, cognitive impairment and obesity.

  • Nutritional manipulation to support the gut-brain connection via the gut microbiome [11].

 

References

[1]       S. Kullmann, M. Heni, M. Hallschmid, A. Fritsche, H. Preissl, and H.-U. Häring, “Brain Insulin Resistance at the Crossroads of Metabolic and Cognitive Disorders in Humans,” Physiol Rev, vol. 96, pp. 1169–1209, 2016, doi: 10.1152/physrev.00032.2015.

[2]      K. Wittfeld et al., “Cardiorespiratory Fitness and Gray Matter Volume in the Temporal, Frontal, and Cerebellar Regions in the General Population,” Mayo Clin. Proc., vol. 95, no. 1, pp. 44–56, Jan. 2020, doi: 10.1016/j.mayocp.2019.05.030.

[3]      E. Zsoldos and K. P. Ebmeier, “Aging and Psychological Stress,” in Stress: Concepts, Cognition, Emotion, and Behavior: Handbook of Stress, Elsevier, 2016, pp. 311–323.

[4]      H. Yaribeygi, Y. Panahi, H. Sahraei, T. P. Johnston, and A. Sahebkar, “The impact of stress on body function: A review,” EXCLI Journal, vol. 16. Leibniz Research Centre for Working Environment and Human Factors, pp. 1057–1072, 21-Jul-2017, doi: 10.17179/excli2017-480.

[5]      S. A. Papagni, S. Benetti, S. Arulanantham, E. McCrory, P. McGuire, and A. Mechelli, “Effects of stressful life events on human brain structure: A longitudinal voxel-based morphometry study,” Stress, vol. 14, no. 2, pp. 227–232, Mar. 2011, doi: 10.3109/10253890.2010.522279.

[6]      E. S. Epel, “Psychological and metabolic stress: a recipe for accelerated cellular aging?,” Hormones, vol. 8, no. 1, pp. 7–22, 2009.

[7]      F. Ozbay, D. C. Johnson, E. Dimoulas, C. A. Morgan, D. Charney, and S. Southwick, “Social support and resilience to stress: from neurobiology to clinical practice.,” Psychiatry (Edgmont)., vol. 4, no. 5, pp. 35–40, May 2007.

[8]      E. Iob, C. Kirschbaum, and A. Steptoe, “Positive and negative social support and HPA-axis hyperactivity: Evidence from glucocorticoids in human hair,” Psychoneuroendocrinology, vol. 96, pp. 100–108, Oct. 2018, doi: 10.1016/j.psyneuen.2018.06.008.

[9]      J. D. Creswell, “Mindfulness Interventions,” Annu. Rev. Psychol., vol. 68, no. 1, pp. 491–516, Jan. 2017, doi: 10.1146/annurev-psych-042716-051139.

[10]     E. Goldstein, J. Topitzes, R. L. Brown, and B. Barrett, “Mediational pathways of meditation and exercise on mental health and perceived stress: A randomized controlled trial.,” J. Health Psychol., p. 1359105318772608, May 2018, doi: 10.1177/1359105318772608.

[11]      R. D. Moloney, L. Desbonnet, G. Clarke, T. G. Dinan, and J. F. Cryan, “The microbiome: Stress, health and disease,” Mammalian Genome, vol. 25, no. 1–2. Springer New York LLC, pp. 49–74, 2014, doi: 10.1007/s00335-013-9488-5.

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