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Protecting your brainpower

Senior moments don't just happen to octogenarians. Almost everyone has had a disconcerting momentary lapse in memory.

For some it's the inability to recall the name of the famous actor who starred in a popular movie last year. Others may forget a well-known phone number. Then there's the embarrassing encounter with a person whose face is familiar but whose name you cannot recall.

Most of these slips are not early warning signs of Alzheimer's disease. But as baby boomers age, they worry about losing their cognitive edge.

Many people would like a strategy to boost their brainpower or at least prevent mental decline. No pills have yet been proven to make people smarter or protect them from dementia. There are, however, an astounding number of drugs that can interfere with cognitive function.

Acetylcholine is a crucial chemical that is essential for communication between brain cells. Many medications can impair the activity of this neurotransmitter. Such medicines are said to have "anticholinergic" activity.

Some of the most well known are available over the counter. Diphenhydramine (DPH) is an antihistamine found in allergy medicines like Benadryl. It is also a common ingredient in sleeping pills (Nytol, Simply Sleep, Sominex, etc.) and nighttime pain relievers (Advil PM, Excedrin PM, Tylenol PM, etc.).

Other commonly used medications with anticholinergic activity include those prescribed for overactive bladder, such as fesoterodine (Toviaz), oxybutynin (Ditropan) and tolterodine (Detrol). Physicians and family members may not realize that an older person's increasing confusion and disorientation could be exacerbated by one of these drugs (Journal of the American Geriatrics Society, December 2005).

Other medicines that could have a negative effect on cognitive function because of their anticholinergic action include the anti-anxiety agent alprazolam, the antidepressant amitriptyline, the ulcer drug cimetidine, the heart drug digoxin and the diuretic furosemide.

No one should ever stop such medications without medical consultation. Some of these drugs may be absolutely essential. People who would like a more detailed list and discussion of anticholinergic drugs may find our Guide to Drugs and Older People useful (www.peoplespharmacy.com).

Avoiding troublesome medications is only the first step in staying sharp. Investigators find that aerobic exercise helps promote cognitive function (Frontiers in Aging Neuroscience online, Nov. 29, 2010). Not only does regular, vigorous physical activity increase neuron formation and connections, it also facilitates mental flexibility.

Diet also may play a role in maintaining healthy brain function. A recent study of older residents on the South Side of Chicago found that those who followed a Mediterranean-style diet rich in vegetables, olive oil, fish and whole grains were less likely to experience significant cognitive decline during the seven-year follow-up period (American Journal of Clinical Nutrition online, Dec. 22. 2010).

Once again the time-honored advice to eat right and exercise regularly may be beneficial for both the body and the brain. Avoiding drugs that contribute to brain fog also can be a crucial step toward staying sharp.

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