Diane Gottlieb writes open-hearted stories about people in pain who choose to grow.

What Was I Thinking? Prevent Cognitive Decline and Promote Brain Health

“Gum,” Steven said in the car, while we were at a stop sign on Wyndmoor Way in Wyndmoor Village, the 55+ community we spent this past January and February. “Gum tickles my throat and makes me cough.”


I’ll give him the benefit of the doubt—now. I had said something that may have been unclear because I coughed in the middle of my sentence. But at the time, I was irritated. Steven’s response didn’t seem to make any sense and it left me downright crotchety. “What is he talking about?!?” I thought.


“… He knows I don’t chew gum, don’t like gum, that I wouldn’t be talking about gum. We’ve been together just shy of 8 years, living together for 7, married for 5—and a half! Gum?” My thoughts were on a roll but, thank goodness, I kept them to myself. Instead, I said, in a tone much more snarky than deserved, “GUM? What does gum have to do with anything?”


Steven’s answer: “You said gum.”


“I didn’t say gum. I never said gum!”


“Then what did you say?” he asked.


His question made me pause. “I don’t remember,” I said. And then, I laughed. “We’re two old farts—you thought I said gum and I don’t remember what I actually said.”


It was funny. But is it really?


Memory “Lapses”


I don’t know about you, but over the past several years, I have been noticing a few memory “lapses” in myself—and in those around me who are my age or older.


We repeat ourselves and our stories. One of my sisters and I even have an ongoing joke about the phenomenon: When she starts telling me something that I’ve invariably heard (at least once), I interrupt.


“Wait a minute,” I say. “I think I’m having a psychic moment … I’m getting an image … It’s coming … I’m seeing …” And then I proceed to finish her anecdote. And then we laugh.


What else can we do?


My kids will sometimes let me know that I’ve repeated myself: “Yes, I know,” they’ll say. “You told me that already.” I can “see” the accompanying eye roll right through the phone.


What’s That Word I Was Thinking Of?


More disturbing than my occasional repetitions are the word retrieval challenges. I know the word I’m looking for—most often a person’s name or place. I can see the person, hear her voice. But her name … her damn name … has gotten stuck on the path from my brain’s warehouse to my lips. It’s there—somewhere—but I have no access to it. (It often magically “reappears” a few hours later. I’ve been known to randomly scream out “Rosie O’Donnell,” or “Susan Smith,” or “Costco!”)


And who among us hasn’t experienced the proverbial, “I came into the kitchen for something … What was it, again?” (I may not remember what sent me on that jaunt to the kitchen, but I invariably reach into the top cabinet for two dark chocolate Hersey kisses before I leave the room … Or did I take four?)


Right now, my small bouts with memory are just small annoyances—at least to me. They do not interfere in any significant way with my day-to-day functioning. I remember all of my work and personal appointments; I can communicate my thoughts and can bring to mind the vast majority of names, places, ideas I reach for.


But, I cannot say with all honesty that these “small annoyances” don’t make me question—even just a little bit—if I am entering the first stages of losing it.  And by “it,” I literally mean my mind.


Am I “Losing It?”


Alzheimer’s. Dementia. We all shudder when we hear those dreaded “A” and “D” words.  But how much do we really know about them? I realized that I knew very little—I actually turned away from information because of my fear—but I decided it was time to learn more.  So I began to educate myself by consulting the Alzheimer’s Association website:


“Dementia is not a single disease,” it said. “It’s an overall term — like heart disease — that covers a wide range of specific medical conditions.” Alzheimer’s disease is just one of the above.


The very words “Alzheimer’s” and “dementia” can freak people out. In fact, 92% of the participants in a recent survey reported they were afraid they’d develop a cognitive disorder, even though they were not currently experiencing any symptoms that would indicate a reason to be alarmed.


I think many of us can relate. But what symptoms truly indicate a need for concern?

Signs of Cognitive Decline


Experiencing some level of forgetfulness and memory decline is common as we grow older.  According to neurologist Ronald C. Petersen, of the Mayo Clinic College of Medicine in Rochester, Minn., “Subtle forgetfulness, such as misplacing objects and having difficulty recalling words … probably represents normal aging.”


“The memory loss that occurs in persons with amnestic mild cognitive impairment,’” Peterson continues, “‘is more prominent. Typically, they start to forget important information that they previously would have remembered easily, such as appointments, telephone conversations or recent events that would normally interest them.”


A political junkie who forgets the winner of this past Saturday’s South Carolina primary would be a good example.


According to healthline.com, other symptoms of concern may include changes in mood or personality, trouble completing familiar tasks, general confusion, and a deteriorating sense of direction. People in early stages of dementia often become depressed; they can also literary get lost while driving to the local market.

If you are experiencing symptoms that worry you, you may want to check them out with a neurologist. (I plan to mention my word retrieval issues to my internist during my next physical.)


“The Very Term ‘Age-Related Memory Loss’ May Be a Misnomer”


But before we get all doom and gloom about our cognitive futures, I have some good news to report. There is a growing body of scientific evidence that supports our ability to proactively maintain our cognitive health. We may not be powerless in this part of the aging process, and we don’t have to assume we’ll experience a big decline.

In fact, “‘The very term ‘age-related memory loss’ may be a misnomer,” according to neurologist Dr. Richard Isaacson, an Alzheimer’s specialist at Weill Cornell Medicine in New York. Paula Spencer Scott, in her engaging article “Our Brains Need Exercise Too,”  examines the research and gives the reader some helpful strategies. “Time and genetics alone don’t erode brain functions,” she says. “How we spend our lives managing the modifiable risk factors that affect our genes is highly significant for our brain health.”

Scott compares our current knowledge of brain health to our past knowledge of the heart: “When our fathers and grandparents died of a heart attack or stroke, we chalked it up to tragic luck. Clogged arteries, high blood pressure and high cholesterol were considered normal features of aging before 1948.” In that year researchers began a study of “the cardiovascular lives of some 5,200 residents of Framingham, Mass.,” and it was then that the term “risk factors” was born, along with ways to mitigate their effects. “Today,” Spencer writes, “it’s the brain we’re in the dark about.”

But we are learning. There has been a recent uptick in brain science research and much of the findings have given people hope. In one such study on dementia by Lancet, researchers  found that “one third of risk factors for dementia are potentially modifiable.” Below are several life-style choices that can do just that.


Mix it Up!


One of the great human paradoxes is that we love routine but benefit from challenge. Because our brains appreciate efficiency, we tend to gravitate towards familiarity. But when we stick only to what we know—to what we can do with our eyes closed—we minimize our potential growth and can stagnate. Unfamiliar activities that challenge your brain in new, unexpected ways can go a long way in promoting brain health. So take a course, learn a new card game, paint, draw, pick up a new hobby. Try anything that excites you—and pushes you beyond your comfort zone.


Don’t Go Solo!


Trying new things is wonderful for brain health, but trying new things with others (or where you will interact with others) is even better! According to many experts on healthy aging, one of the best ways to head off cognitive decline is to socialize. In a previous WomanPause post  I wrote about the importance of friendships as they relate to aging: “Dr. Julianne Holt-Lunstad from Brigham Young University analyzed data collected in over 100 studies on mortality rates as they relate to social relationships. Dr. Holt-Lunstad found that ‘people with stronger social relationships had a 50% increased likelihood of survival than those with weaker social relationships.’”

But friendships can not only keep you alive longer, they can “even reduce some of the cognitive losses people associate with aging. Barbara Hagerty in her book Life Reimagined: The Science, Art, and Opportunity of Midlife cites research that discovered that ‘socially active people had less than half the memory loss of those who were less engaged.’”


Friendships feed us in so many ways. They even provide “nutrition” for our brain!


Diet—(The Other “D” Word)


Speaking of nutrition …

My hackles always rise when I hear the word “diet,” but I can’t argue with science: eating healthy is not only good for the body but also great for the brain.

Jennifer Nelson in her wonderful article, “7 Things You Can Do to Reduce Your Risk of Dementia,” introduced me to a diet I’d never heard of (who knew there was such a thing!)


I was intrigued and researched it further. The diet’s called MIND (Mediterranean Intervention for Neurodegenerative Delay) and is a combination of both the Mediterranean and DASH  (Dietary Approaches to Stop Hypertension) diets. MIND recommends eating more of these 10 delicious foods:


  • Green, leafy vegetables
  • All other vegetables
  • Berries
  • Nuts
  • Olive oil 
  • Whole grains
  • Fish (Fatty fish is best because they have the highest amounts of omega-3 fatty acids.)
  • Beans 
  • Poultry
  • Wine: one glass daily—red or white. (This is optional, of course.)


That was the good news. Now here’s the challenge: MIND suggests limiting the following five foods (eliminating is always better, but the MIND diet knows we’re human, after all):


  • Butter and margarine: Try to eat less than 1 tablespoon per day. (But don’t despair—olive oil, a terrific substitute–is on the “good foods” list!)
  • Cheese: Limit your cheese consumption to less than ounce per week—OUCH. (This one will be tough for me!)
  • Red meat
  • Fried food: Huge no-no!
  • Pastries and sweets: Another big NO!


If it feels like MIND is asking too much, start by following those recommendations you can. One study specifically designed to examine the association between the MIND Diet and the incidence of Alzheimer’s found that “even moderate adherence to the MIND diet may decrease Alzheimer’s Disease risk.”


Move Those Hips!


We are all aware of how much exercise can benefit the body. But did you know, the same goes for your brain? A commitment to regular aerobic exercise is fantastic, but you don’t need to go crazy to experience positive brain results. Nelson cited at a 44-year study in Sweden that looked at women who were between the ages of 38 to 60 in 1968 and then again in 1974, 1980, 1992, 2000, 2005, and 2009 . The researchers found that even those women who worked out at the lowest fitness level (there were three exercise levels in the experiment) were “45% less likely to develop dementia, while women in the top fitness level were 88% less likely.”

So … no marathons or 5Ks necessary. If you want to lower the likelihood of developing dementia, just move!


Rest and Sleep!


As Scott so aptly stated in her article, “It’s not all about activity.” Downtime is also important for optimal brain functioning. Our brains need both rest and sleep.

Resting, or “taking intentional breaks from active thinking,” is easier said than done in our world  of technological overstimulation.  Sandra Bond Chapman, director of the Center for Brain Health at the University of Texas at Dallas, suggests “taking five minutes, five times a day, to sit still and do nothing.” Short meditations (or longer ones!) are terrific for the brain—and the spirit—and there are wonderful guided meditations available for free online. Jon Kabat-Zinn is one of my favorite meditation guides. Here’s one of his you can access on youtube.

Sleep. It’s something that most of us get far too little of. But if we knew how critical sleep actually is for brain health, we might go to bed a little earlier at night. Scott describes our glymphatic system as “a kind of internal trash-hauling system,” a system whose “pace increases by over 60 percent during sleep.” This may be why more sleep can translate into a reduced risk of developing dementia. Eight to nine hours of sleep a night are recommended by Alzheimer’s prevention experts.

So … turn off Netflix and hit the sack!


Take Care of Your Overall Health!


The state of your overall health is related to brain health. Research has shown that lowering your blood pressure can decrease your risk for mild cognitive impairment. Type II diabetes has been linked to several types of dementia, including Alzheimer’s. So has depression.

So … take care of yourself—please!


One Final Thought!


I guess the message here is there is a lot we can do to maintain a healthy brain. I hope this message—along with the options presented—has empowered you and does not feel overwhelming. But I feel compelled to add one other more difficult truth to the mix: Unfortunately, sometimes we can follow all the “right” recommendations and things still turn out “wrong.”

Growing older and facing declines in certain areas of our lives and functioning can be scary. We may throw ourselves into regimens designed to maximize our health, while secretly trying to control that which is not in our control. Genetics, God, the Universe, the luck of the draw, may have other plans for us. My great hope is that we will all grow from whatever we encounter and that we have love and support along the way.

Wishing everyone many terrific days to create new and wonderful, lasting memories.


Do you have any concerns about your brain health? Do any of these proactive recommendations resonate with you? If so, which and why?

As always, I’d love to hear your thoughts. Please leave a comment or send me an email.

See you in two weeks!





  1. Greta Holt on March 6, 2020 at 3:10 pm

    Your research has led to a perfectly understandable article, which is more than can be said for ‘pros’ who like to obfuscate! Diet and exercise do seem essential in preventing decline. I wonder which comes first: depression or decline. I wonder how the two interact.

    Great article. (Of course, I ‘thank you’ for showing rows of donuts and telling us that we can’t have any! Man, I like a cream-filled, chocolate-topped donut.)

    • Diane Gottlieb on March 6, 2020 at 3:50 pm

      Great question, Greta! The old chicken or the egg. I’m not sure about depression and decline but I did read that there are studies being conducted about sleep deprivation and decline–if there is a causal connection and which direction that goes.

      And … I am totally with you on the donuts–and on your choice. A Boston Cream would taste so good right about now!

  2. Trisha Kostis on March 3, 2020 at 3:00 pm

    Very helpful article, Diane. I’ve read so many: mom, dad, grandmother, aunt – all with dementia! My two sisters and I are continuously patrolling each other’s brain health! I love how you clarified the differences between “normal” cognitive hic-cups in the aging brain and more worrisome changes. I’ll be sharing this piece with my family!

    • Diane Gottlieb on March 3, 2020 at 4:44 pm

      Thank you, Trisha. I can understand why you and your sisters keep tabs on each other’s brain health! Differentiating between the “norm” and the more serious is certainly crucial. It’s so easy to go to extremes–either get overly concerned about “cognitive hic-cups” or living in denial about the “worrisome changes.” Awareness and balance–learning what we can do to maintain our brain health is so important. I appreciate you sharing with your family!

  3. Annis on March 3, 2020 at 3:39 am

    Diane, thank you. As the friend of a person who has recently been placed in “memory care,” I’ve been questioning myself and wondering how to help myself. Your well-written post gives me some ideas of where to start. Cheers and hugs, xoA

    • Diane Gottlieb on March 3, 2020 at 3:46 am

      Thank you, Annis. I am sorry about your friend. I totally get the whole “questioning myself” thing. I am so glad that you have found some guidance in the post.

  4. Bill Hayden on March 3, 2020 at 2:03 am


    Excellent easy-to-read and understand article! Wish more neurologists had this ability to share the information on the journey of dementia!

    One good source for guidance I have found is Teepa Snow. She is my “saint” on my own journey! She has a healthcare background and can talk science, medicine or caretaker ups n downs. She can be found on YouTube.

    Will share your article with folks I know that have dementia or have family members with dementia

    Terrific article, I’m a good judge, i have Early Onset Dementia!

    Thanks 🙏


    • Diane Gottlieb on March 3, 2020 at 3:10 am

      Thanks, Bill, for your kind comments and for the recommendation of Teepa Snow. Will definitely check her out. I am so sorry to hear that you have Early Onset Dementia. It seems like you are making sure to immerse yourself in all the latest information. Hopefully the medical community will continue to break ground and you and so many others will benefit. Best of luck and please stay in touch!

  5. Nicky Mendenhall on March 2, 2020 at 4:08 pm

    Diane – this was a fabulous post! Made me feel hopeful! And that’s a good thing.
    I’d write more but hubby is waiting in the car for the drive to our Active Adults exercise
    class so I best go! But thanks thanks thanks!

    • Diane Gottlieb on March 2, 2020 at 4:13 pm

      Thank you, Nicky! Hopeful is always good, although it sounds like you’re putting your hope into action with the Active Adults exercise class!

  6. Alison McGhee on March 2, 2020 at 3:53 pm

    Terrific and enlightening column! I had to do TONS of research on Alzheimer’s (esp. early onset) for my novel “Never Coming Back,” sparked by observation of my friends’ parents who were coping with the disease. I love these positive recommendations for keeping our brains healthy and exercised.

    • Diane Gottlieb on March 2, 2020 at 4:12 pm

      Thank you, Alison! And thanks for mentioning your novel that deals with the topic. I LOVE your writing and will definitely read that one! Just received Opposite of Fate and can’t wait to dig in!

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