1. Grow Your Brain at Any Age Majid Fotuhi, MD PhD Howard County Office on Aging Columbia, MD March 28, 2014

2. New Discoveries 2

3. “This book may be the most important you’ll ever read. Certainly, what Dr. Fotuhi teaches in this book has changed my life.” Michael Roizen, M.D. Chairman of the Wellness Institute- The Cleveland Clinic 3

4. “Dr. Fotuhi has summarized the latest discoveries that show how we can grow our brains bigger and stronger…” Mehmet Oz, M.D. The Dr. Oz Show 4

5. Objectives  What happens to our brain with aging?  How to reverse age-related brain atrophy?  Brain Fitness Program 5

6. Memory Lapses Memory lapses or Alzheimer’s? Age-Associated Memory Impairment MCI Alzheimer’s 6

7. Short-term: Hippocampus Long-term: Cortex Cortex Hippocampus 7

8. 8

9. Beautiful Neurons in Hippocampus 9

10. With Aging, Hippocampus Atrophies Faster than the Rest of the Brain  Hippocampus shrinks by about 0.5% per year after age 50  That is the reason memory lapses become more frequent after age 50 10

11. Overlapping Causes of Atrophy in Hippocampus Obesity Stroke Sleep Apnea Concussion AD Diabetes Hypertension Stress 11

12. Higher Risk of AD for Those with Midlife Hypertension plus High Cholesterol  Longitudinal Study (1972, 1977, 1982, 1998)  1449 participants  57 cases of dementia, 48 with AD  Mild hypertension: <140  Severe hypertension: >160  High cholesterol: >250 BMJ 2001; 322:1447–51 12

13. Less Brain Volume in Patients with Sleep Apnea Am J Respir Crit Care Med 2002; 166:1382–7 13

14. Vascular Risk Factors Shrink the Brain, Especially the Hippocampus Multiple Vascular Risk Factors No Vascular Risk Factors Hippocampus 14

15. Obesity Shrinks the Brain  Associated with reduced brain volume Ward, et al., 2005  Slows cognitive function Debette, et al., 2011  Brains of overweight and obese individuals appeared 8 and 16 years older, respectively Raji, et al., 2010 15 Brain Research Volume 1280, 14 July 2009, Pages 186–194

16. Stress Shrinks Brain Cells in Hippocampus Stress Control 16

17. Alzheimer’s: Plaques and Tangles  Plaques: gum-like collection of a protein called Amyloid  Tangles: abnormal aggregation of a protein called Tau  Inflammation 17

18. Why do we forget names?  Hypertension  Diabetes  Alcoholism  Depression  Heart failure  Obesity  High cholesterol  Head trauma  Aging  Poor sleep  Too much work  Information overload  Too many responsibilities  Fatigue  Poor attention  Poor diet  “Can’t do it” mentality 18

19. 19 Diabetes Hypertension Obesity Sleep Apnea Head Trauma Genes Stress Brain-healthy Diet Physical Fitness Cognitive Stimulation Meditation

20. Objectives  What happens to our brain with aging?  How to reverse age-related brain atrophy?  Brain Fitness Program 20

21. 6 Steps to Grow Your Brain 1. Get Fit 2. Tease Your Memory 3. Eat Well &Take DHA 4. Sleep 5. Relax Your Mind 6. Start Early 21

22. 1. Hippocampus Grows Bigger with Getting Fit Erikson, PNAS 2011 22

23. Brain is a Highly Vascular Organ Zlokovic et al. Neurosurgery 43(4), 877–78, 1998 23

24. Arch Gen Psychiatry, 2010 Hippocampus Grows Bigger with Exercise, Even After 3 Months After Before 24

25. Draganski et al. J Neurosci 2006; 26:6314–7 2. Hippocampus Grows Bigger with Memorization Training 25

26. 3. Hippocampus Grows Bigger with Eating Well & Taking DHA 26

27. 27 4. Hippocampus Grows Bigger with Treatment of Sleep Apnea Canesa, American Journal of Respiratory Medicine, 2011

28. 5. Hippocampus Grows Bigger with Relaxing Your Mind Holzel, Psychiatric Research, 2011 28

29. 29 6. Hippocampus Grows Bigger When You Start Early

30. Objectives  What happens to our brain with aging?  How to reverse age-related brain atrophy?  Brain Fitness Program 30

31. Brain Fitness Program  A multidisciplinary program devoted to: Improving memory and brain performance Enhancing long-term brain health Reducing risk for dementia, Alzheimer’s disease and stroke in the future  Each patient receives a comprehensive baseline assessment followed by a personalized treatment plan  This program is based on latest research and has shown remarkable results 31

32. Comprehensive Diagnostics to Evaluate Brain Health Customized Treatment Program to Maximize Brain Performance NeurExpand’s Unique Integrative Approach 32

33. Remarkable Results Hippocampus After Before 33

34. 34 Diabetes Hypertension Obesity Sleep Apnea Head Trauma Genes Stress Brain-healthy Diet Physical Fitness Cognitive Stimulation Meditation

35. THANK YOU! INFO@NEUREXPAND.COM 35