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Category: healthy aging

Published on Leave a comment on Reading Books Linked To Living Longer

 Image result for books wikipedia There are some things we can do that are linked to living longer, such as not smoking and exercising regularly, but could reading books also have such an effect? A study published in the journal Social Science and Medicine concludes that those who regularly read books add several years to their lives. They found this effect in both men and women, found that reading books are "protective regardless of gender, wealth, education", but the effect holds only for books and not magazines and newspapers. Since surveys show that 87% of book readers read fiction, then it is likely that most of the book readers were reading fiction.

In the long-term (12 years) study of 3,635 people, the researchers found that those that read books for more than 3.5 hours per week lived on average two years longer than non-readers, and that there was a dose-response effect (the more one reads, the better). This appeared to be linked to cognitive enhancement rather than any other associated factor, such as age, sex, education, race, health, wealth, etc. The research team from the Yale University School of Public Health divided their subjects into three groups: those who didn’t read at all, those who read for 3.5 hours per week or less, and those who read for more than 3.5 hours per week. They found that the occasional readers were 17 percent less likely to die during the follow-up period than those who did not. This beneficial effect of reading was only linked to books, and not other forms of reading material such as magazines or newspapers. From the journal Social Science and Medicine:

A chapter a day: Association of book reading with longevity

This study examined whether those who read books have a survival advantage over those who do not read books and over those who read other types of materials, and if so, whether cognition mediates this book reading effect. The cohort consisted of 3635 participants in the nationally representative Health and Retirement Study who provided information about their reading patterns at baseline.....based on survival information up to 12 years after baseline. A dose-response survival advantage was found for book reading by tertile.....Book reading contributed to a survival advantage that was significantly greater than that observed for reading newspapers or magazines. Compared to non-book readers, book readers had a 23-month survival advantage at the point of 80% survival in the unadjusted model. A survival advantage persisted after adjustment for all covariates (HR = .80, p < .01), indicating book readers experienced a 20% reduction in risk of mortality over the 12 years of follow up compared to non-book readers. Cognition mediated the book reading-survival advantage. These findings suggest that the benefits of reading books include a longer life in which to read them.

While most sedentary behaviors are well-established risk factors for mortality in older individuals (Wullems et al., 2016; de Rezenade et al., 2014, Katzmaryk & Lee, 2012; Muennig, Rosen, & Johnson, 2013), previous studies of a behavior which is often sedentary, reading, have had mixed outcomes....We speculated that books engage readers’ minds more than newspapers and magazines, leading to cognitive benefits that drive the effect of reading on longevity. 

Reading books tends to involve two cognitive processes that could create a survival advantage. First, it promotes "deep reading,” which is a slow, immersive process; this cognitive engagement occurs as the reader draws connections to other parts of the material, finds applications to the outside world, and asks questions about the content presented (Wolf, Barzillai, & Dunne, 2009). Cognitive engagement may explain why vocabulary, reasoning, concentration, and critical thinking skills are improved by exposure to books (Stanovich, West, & Harrison, 1995; Stanovich & Cunningham, 1998; Wolf, Barzillai, & Dunne, 2009). Second, books can promote empathy, social perception, and emotional intelligence, which are cognitive processes that can lead to greater survival (Bassuk, Wypij, & Berkmann, 2000; Djikic, Oatley, & Moldoveanu 2013; Kidd & Castano 2013; Shipley, Der, Taylor, & Deary 2008; Olsen, Olsen, Gunner-Svensson, & Waldstrom, 1991).

The final sample consisted of 3635 individuals that were followed over 34,496 person years, with 27.4% of the sample dying during an average 9.49 years of follow-up. Consistent with the older population, the sample was predominantly (62%) female.....The average time spent reading per week was 3.92 hours for books and 6.10 hours for periodicals. The two types of reading were not strongly correlated, and 38% of the sample (n=1390) read only books or only periodicals; this allowed them to be treated as separate constructs.....Cognitive engagement was assessed with total cognitive score (available in the supplemental Imputation of Cognitive Function Measures) which is a summary variable based on 8 items, including immediate recall, delayed recall, serial 7s, backwards count from 20, object naming, President naming, Vice President naming, and date naming.

A 20% reduction in mortality was observed for those who read books, compared to those who did not read books. Further, our analyses demonstrated that any level of book reading gave a significantly stronger survival advantage than reading periodicals.....The mediation analyses showed for the first time that the survival advantage was due to the effect that book reading had on cognition....This finding suggests that reading books provide a survival advantage due to the immersive nature that helps maintain cognitive status.

Published on Leave a comment on Vitamin D Levels and Mental Decline In Older Adults

A new study conducted in China found an association between low vitamin D levels and future cognitive decline in older adults. The lower the vitamin D levels at the initial screening (the baseline), the more people with cognitive decline at a 2 year follow-up. There were were no gender differences. (Another study with similar results.) Vitamin D is produced naturally in the skin when exposed to sunlight, and also found in smaller amounts in food such as fish (e.g. salmon) and eggs. Vitamin D helps maintain healthy bones and muscles, but it also plays a key part in brain function and is viewed as neuroprotective. Low levels are associated with greater risk of cardiovascular and neurodegenerative diseases.

The 1,202 participants (60 years or older) in China had their baseline vitamin D levels measured at the start of the study, and their cognitive abilities assessed over two years. What I found interesting in this study was that the vitamin D levels in the people was in general pretty low - this was without any supplementation, thus from sunlight. The researchers specified vitamin D levels (25-Cholecalciferol) in nmol/l, but in the United States values are generally specified in ng/ml. In the study the median level of vitamin D levels in the lowest quartile converted to ng/ml was 10.0 ng/ml, and in the highest quartile the median level was 26.4 ng/ml. With those low numbers, all 4 groups in the United States would be advised to supplement daily with vitamin D (specifically vitamin D3). From Journals of Gerontology: Medical Sciences:

Vitamin D Levels and the Risk of Cognitive Decline in Chinese Elderly People: the Chinese Longitudinal Healthy Longevity Survey

Vitamin D has a neuroprotective function, potentially important for the prevention of cognitive decline. Prospective studies from Western countries support an association between lower vitamin D level and future cognitive decline in elderly people.

This community-based cohort study of elderly people in China follows 1,202 cognitively intact adults aged ≥60 years for a mean duration of 2 years. Plasma vitamin D level was measured at the baseline. Cognitive state of participants was assessed using the Mini-Mental State Examination (MMSE). Cognitive impairment was defined as an MMSE score <18. Cognitive decline was defined as ≥3 points decline from baseline....Participants with low vitamin D level had an increased risk of cognitive decline. This first follow-up study of elderly people, including the oldest-old, in Asia shows that low vitamin D levels were associated with increased risk of subsequent cognitive decline and impairment.

Vitamin D is a secosteroid hormone necessary for maintaining good musculoskeletal health; its deficiency is associated with increased risks of cardiovascular and neurodegenerative diseases. Vitamin D is primarily synthesized in the skin upon exposure to sunlight; smaller amounts are obtained through dietary intake. More recently, enzymes responsible for the synthesis of its active form have been found to be distributed throughout the human brain.... This growing body of evidence suggests that vitamin D has a neuroprotective function that is potentially important for the prevention of cognitive decline. Although the importance of vitamin D cannot be disregarded, there is still no consensus on its optimal level. This is especially pertinent in the elderly people, the oldest-old in particular, as cutaneous synthesis of vitamin D decreases with age. Moreover, their impaired mobility and limited outdoor activities can further exacerbate vitamin D deficiency.

Cross-sectional studies have generally found a positive association between vitamin D status and cognitive performance in older adults. Recent prospective studies from United States and Europe support an association between diminished vitamin D status and future cognitive decline. Since cutaneous synthesis is the main source of vitamin D, there exists great variability in vitamin D levels across populations due to differences in latitude, seasons, and race/ethnicity, such as level of skin pigmentation.

Our findings were consistent with previous cohort studies showing that vitamin D status predicts cognitive decline....A notable observation in the present study is that the association of vitamin D status and cognitive decline were similar in both oldest-old and less elderly people. In this study, there was a clear association between lower 25(OH)D3 level and cognitive impairment in subjects aged ≥80....An additional difference from previous studies is that the current study indicates that the association between vitamin D and cognitive impairment is not gender specific.

The observation of temporal association between 25(OH)D3 levels and subsequent cognitive function supports the notion that vitamin D has a clinically important neuroprotective effect. A wide variety of mechanisms for this effect has been proposed and is supported by animal studies. Vitamin D has been found to modulate neuronal calcium homeostasis, cerebral process of detoxification, immunomodulation, and beta-amyloid clearance.....Further, it was unlikely that vitamin D supplementation would explain the association in this study, as 87% of the participants reported no use of vitamin supplements....In conclusion, our longitudinal study indicates that low 25(OH) D3 levels are associated with subsequent cognitive decline and cognitive impairment. 

Published on Leave a comment on Stopping All Exercise and Blood Flow In the Brain

What happens to your brain when you stop exercising? The results of this Univ. of Maryland study should be a wake up call for those who are not quite convinced of exercise's health benefits to the brain. The researchers examined cerebral blood flow in athletes (ages 50-80 years, who were recruited from running clubs) before and after a 10-day period during which they stopped all exercise. Using MRI brain imaging techniques, they found a significant decrease in blood flow to several brain regions important for cognitive health, including the hippocampus, after they stopped their exercise routines.

As the researchers pointed out: "...the take home message is simple -- if you do stop exercising for 10 days, just as you will quickly lose your cardiovascular fitness, you will also experience a decrease in blood brain flow." The only good news was that there were no differences on cognitive measures both before and after stopping exercise for 10 days. From Science Daily:

Use it or lose it: Stopping exercise decreases brain blood flow

We all know that we can quickly lose cardiovascular endurance if we stop exercising for a few weeks, but what impact does the cessation of exercise have on our brains? New research led by University of Maryland School of Public Health researchers examined cerebral blood flow in healthy, physically fit older adults (ages 50-80 years) before and after a 10-day period during which they stopped all exercise. Using MRI brain imaging techniques, they found a significant decrease in blood flow to several brain regions, including the hippocampus, after they stopped their exercise routines.

"We know that the hippocampus plays an important role in learning and memory and is one of the first brain regions to shrink in people with Alzheimer's disease," says Dr. J. Carson Smith, associate professor of kinesiology and lead author of the study, which is published in Frontiers in Aging Neuroscience in August 2016. "In rodents, the hippocampus responds to exercise training by increasing the growth of new blood vessels and new neurons, and in older people, exercise can help protect the hippocampus from shrinking. So, it is significant that people who stopped exercising for only 10 days showed a decrease in brain blood flow in brain regions that are important for maintaining brain health."

The study participants were all "master athletes," defined as people between the ages of 50 and 80 (average age was 61) who have at least 15 years history of participating in endurance exercise and who have recently competed in an endurance event. Their exercise regimens must have entailed at least four hours of high intensity endurance training each week. On average, they were running 36 miles (59 km) each week or the equivalent of a 10K run a day! Not surprisingly, this group had a V02 max (maximum volume of oxygen) above 90% for their age. This is a measure of the maximal rate of oxygen consumption of an individual and reflects their aerobic physical fitness.

Dr. Smith and colleagues measured the velocity of blood flow in brain with an MRI scan while they were still following their regular training routine (at peak fitness) and again after 10 days of no exercise. They found that resting cerebral blood flow significantly decreased in eight brain regions, including the areas of the left and right hippocampus and several regions known to be part of the brain's "default mode network" -- a neural network known to deteriorate quickly with a diagnosis of Alzheimer's disease. This information adds to the growing scientific understanding of the impact of physical activity on cognitive health.

Published on Leave a comment on Seafood, DHA Levels, and the Aging Brain

 Eating several servings of seafood (especially fish) weekly has beneficial health effects throughout life, and now research finds another benefit in older adults. Seafood contains both EPA and DHA, which are two types of omega-3 fatty acids. DHA or docosahexanoic acid has "neuroprotective qualities" and is found in both the gray and white matter of the brain. Higher DHA levels (measured in the blood) was associated with better memory, less brain atrophy (better brain volume), and fewer amyloid plaques (which are associated with Alzheimer's) in cognitively healthy older adults. From Medscape:

Higher Serum DHA Linked to Less Amyloid, Better Memory

New research supports neuroprotectant effects of docosahexaenoic acid (DHA) in the aging brain. In a small cross-sectional study of cognitively healthy older adults, higher serum DHA levels were associated with less cerebral amyloidosis, better memory scores, and less regional brain atrophy.

"The interesting finding was the association of low serum DHA levels with cerebral amyloidosis (amyloid plaques) in older adults without evidence of dementia," Hussein N. Yassine, MD, Department of Medicine, University of Southern California, Los Angeles, told Medscape Medical News. "This association was predominantly driven by persons at the lowest quartile of serum DHA levels who likely have limited intake of seafood." "This study adds to the existing evidence on the benefit of seafood consumption on [Alzheimer's disease] AD risk factors," Dr Yassine added.

The study was published online August 8 in JAMA Neurology. In a linked editorial, Joseph F. Quinn, MD, Department of Neurology, Oregon Health and Science University, Portland, notes that DHA is "the most abundant polyunsaturated fatty acid in the brain, playing an important structural role in synapses while also modulating a number of signaling pathways. "Brain DHA levels are also modulated by dietary intake, so it is plausible for dietary DHA to alter brain concentrations and affect downstream targets including brain pathology and function."

Dr Yassine and colleagues assessed serum DHA levels, measures of amyloid burden based on positron emission tomography with Pittsburgh compound B, brain volume, and neuropsychological test scores in 61 adults without dementia in the Aging Brain Study.

They found that serum DHA levels (percentage of total fatty acids) were 23% lower in those with cerebral amyloidosis relative to those without. Serum DHA levels were inversely correlated with brain amyloid load, independent of age, sex, years of education, and apolipoprotein E genotype. They also noted a positive correlation between serum DHA levels and brain volume in several subregions affected by AD, in particular the left subiculum and the left entorhinal volumes.

Clinically, there was a significant association between serum DHA levels and nonverbal memory. This association persisted after adjustment for age but not after adjustment for apolipoprotein E genotype. Serum DHA levels were not associated with measures of global cognition, executive function, or verbal memory scores.

Published on Leave a comment on Lifestyle Factors Influence Protein Buildups Linked to Alzheimer’s

  Again, another study showing the importance of lifestyle factors in the development of protein buildups in the brain that are associated with the onset of Alzheimer's disease. Specifically, the study found that each one of several lifestyle factors—a healthy body mass index, physical activity and a Mediterranean diet, were linked to lower levels of plaques and tangles on brain scans in people who already had mild memory changes, (but not dementia). Other posts discussing Mediterranean diet and brain health (brain volume, etc.) are here, here, and here. Activity levels and brain health posts are here, here, and here. From Medical Xpress:

Diet and exercise can reduce protein build-ups linked to Alzheimer's

A study by researchers at UCLA's Semel Institute for Neuroscience and Human Behavior has found that a healthy diet, regular physical activity and a normal body mass index can reduce the incidence of protein build-ups that are associated with the onset of Alzheimer's disease.

In the study, 44 adults ranging in age from 40 to 85 (mean age: 62.6) with mild memory changes but no dementia underwent an experimental type of PET scan to measure the level of plaque and tangles in the brain. Researchers also collected information on participants' body mass index, levels of physical activity, diet and other lifestyle factors. Plaque, deposits of a toxic protein called beta-amyloid in the spaces between nerve cells in the brain; and tangles, knotted threads of the tau protein found within brain cells, are considered the key indicators of Alzheimer's.

The study found that each one of several lifestyle factors—a healthy body mass index, physical activity and a Mediterranean diet—were linked to lower levels of plaques and tangles on the brain scans. (The Mediterranean diet is rich in fruits, vegetables, legumes, cereals and fish and low in meat and dairy, and characterized by a high ratio of monounsaturated to saturated fats, and mild to moderate alcohol consumption.)

"The fact that we could detect this influence of lifestyle at a molecular level before the beginning of serious memory problems surprised us," said Dr. David Merrill, the lead author of the study, which appears in the September issue of the American Journal of Geriatric Psychiatry.

Earlier studies have linked a healthy lifestyle to delays in the onset of Alzheimer's. However, the new study is the first to demonstrate how lifestyle factors directly influence abnormal proteins in people with subtle memory loss who have not yet been diagnosed with dementia, Merrill said. Healthy lifestyle factors also have been shown to be related to reduced shrinking of the brain and lower rates of atrophy in people with Alzheimer's."The study reinforces the importance of living a healthy life to prevent Alzheimer's, even before the development of clinically significant dementia," Merrill said. 

Published on Leave a comment on Exercise Now to Protect Your Brain Decades From Now

Get out there and start getting active NOW - the earlier you start in life, the better for your brain decades later. All physical activity or exercise is good, including regular walks. From Medical Xpress:

Regular exercise protects against cognitive decline in later years

Regular exercise in middle age is the best lifestyle change a person can make to prevent cognitive decline in the later years, a landmark 20-year study has found.

University of Melbourne researchers followed 387 Australian women from the Women's Healthy Ageing Project for two decades. The women were aged 45 to 55-years-old when the study began in 1992. The research team made note of their lifestyle factors, including exercise and diet, education, marital and employment status, number of children, mood, physical activity and smoking....They were also asked to learn a list of 10 unrelated words and attempt to recall them half an hour later, known as an Episodic Verbal Memory test.

When measuring the amount of memory loss over 20 years, frequent physical activity, normal blood pressure and high good cholesterol were all strongly associated with better recall of the words. Study author Associate Professor Cassandra Szoeke, who leads the Women's Healthy Ageing Project, said once dementia occurs, it is irreversible. "In our study more weekly exercise was associated with better memory." 

"We now know that brain changes associated with dementia take 20 to 30 years to develop," Associate Professor Szoeke said. "The evolution of cognitive decline is slow and steady, so we needed to study people over a long time period. We used a verbal memory test because that's one of the first things to decline when you develop Alzheimer's Disease."
Regular exercise of any type, from walking the dog to mountain climbing, emerged as the number one protective factor against memory loss. Asoc Prof Szoeke said that the best effects came from cumulative exercise, that is, how much you do and how often over the course of your life.  (Original study)

Published on Leave a comment on Dietary Fiber and Successful Aging

New research looked at people who "aged successfully" over a 10 year period compared with those who were "suboptimal agers" or had died. The successful agers were less likely to smoke, and have higher intakes of fiber from fruits, breads, and cereals (primarily from rolled oats and whole grain breads), but not from vegetables. Successful aging was defined as including an absence of disability, depressive symptoms, cognitive impairment, respiratory symptoms, and chronic diseases including cancer, coronary artery disease, and stroke. Fiber intake was more important for successful aging than glycemic index, glycemic load, carbohydrate intake, or sugar intake. From Medical Xpress:

Dietary fiber intake tied to successful aging, research reveals

A new paper—published in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences by scientists from The Westmead Institute for Medical Research—reports that eating the right amount of fiber from breads, cereals, and fruits can help us avoid disease and disability into old age. 

Using data compiled from the Blue Mountains Eye Study, a benchmark population-based study that examined a cohort of more than 1,600 adults aged 49 years and older for long-term sensory loss risk factors and systemic diseases, the researchers explored the relationship between carbohydrate nutrition and healthy aging.

They found that out of all the factors they examined—which included a person's total carbohydrate intake, total fiber intake, glycemic index, glycemic load, and sugar intake—it was the fiber that made the biggest difference to what the researchers termed "successful aging." Successful aging was defined as including an absence of disability, depressive symptoms, cognitive impairment, respiratory symptoms, and chronic diseases including cancer, coronary artery disease, and stroke.

"Out of all the variables that we looked at, fiber intake—which is a type of carbohydrate that the body can't digest—had the strongest influence," she said. "Essentially, we found that those who had the highest intake of fiber or total fiber actually had an almost 80 percent greater likelihood of living a long and healthy life over a 10-year follow-up. That is, they were less likely to suffer from hypertension, diabetes, dementia, depression, and functional disability."

While it might have been expected that the level of sugar intake would make the biggest impact on successful aging, Gopinath pointed out that the particular group they examined were older adults whose intake of carbonated and sugary drinks was quite low.

This study backs up similar recent findings by the researchers, which highlight the importance of the overall diet and healthy aging. In another study published last year in The Journals of Gerontology, Westmead Institute researchers found that, in general, adults who closely adhered to recommended national dietary guidelines reached old age with an absence of chronic diseases and disability, and had good functional and mental health status.

Published on Leave a comment on Vitamin B12 and the Aging Brain

Another piece of the puzzle on how the brain ages. Vitamin B12 is important for brain health, and higher levels are associated with slower rates of brain changes associated with aging. And the opposite is true with homocysteine levels - increased levels are associated with faster rates of brain changes that are associated with aging (such as higher rates of total brain tissue volume loss). Keep in mind that these effects were modest, but this also raises the question of whether long-term B12 supplementation would benefit everyone or only those with a deficiency? From Medscape:

Vitamin B12 May Slow Brain Aging

Individuals with increased levels of circulating homocysteine have faster rates of brain changes associated with aging than other people, whereas higher levels of vitamin B12 are associated with slower rates of brain aging, new research suggests.

Babak Hooshmand, MD, PhD, Center for Alzheimer Research–Aging Research Center, Karolinska Institutet, Stockholm, Sweden, and colleagues found that total brain volume losses were lower in individuals with higher baseline vitamin B12 levels, whereas the opposite was true of those with increased homocysteine levels.

"Vitamin B12 and tHcy [total homocysteine] might be independent predictors of markers of brain aging in elderly individuals without dementia," the investigators write. They add, "[I]f the association is causal, supplementation with B vitamins may be effective for prevention of brain damage due to increased levels of total homocysteine. Adequately timed and powered randomized clinical trials are needed to determine efficient treatment guidelines." The research was published online April 27 in JAMA Psychiatry.

The researchers examined data on 501 participants aged 60 years and older from the Swedish National Study on Aging and Care, in Kungsholmen. All participants were free of dementia at baseline. Of these, 299 underwent repeated structural brain MRI between 2001 and 2009....Venous blood samples were collected at baseline, from which circulating levels of vitamin B12, red blood cell folate, and sulfur amino acids were determined. These were correlated with changes in brain tissue volumes and total white matter hyperintensity (WMH) over 6 years.

He also pointed to the single-center, randomized VITACOG study, in which 271 individuals older than 70 years who had mild cognitive impairment received supplementation with high-dose folic acid and vitamins B6 and B12. "They lost less brain compared to people who had normal homocysteine and normal vitamin levels, meaning that those with high levels of homocysteine or with clinical or biochemical vitamin deficiency can benefit from supplementation," said Dr Hooshmand.

Published on Leave a comment on Diet May Affect Body’s Biological Age

This study found that people with high red meat intake, combined with low fruit and vegetable intake and a poor overall diet (which was found most frequently in males of low socioeconomic status) had biological markers indicating accelerated aging and poor renal function (early indicators of chronic kidney disease). Bottom line: eat less red meat, more whole grains, more fruits and vegetables for your health. From Medical Xpress:

Too much red meat and too few vegetables may increase your body's biological age

A diet containing too much red meat and not enough fruit and vegetables could increase your body's 'biological age' and contribute to health problems. Research led by the University of Glasgow and published today in Aging, has found that a moderate increase in serum phosphate levels caused by red meat consumption, combined with a poor overall diet, increases biological age (miles on the clock) in contrast to chronological age (years of age).
The study, which looked at participants from the most deprived to the least deprived in the NHS Greater Glasgow Health Board area, also demonstrates that deprived males were the worst affected.

Data from the study suggests that accelerated biological ageing, and dietary derived phosphate levels among the most deprived males, were directly related to the frequency of red meat consumption. Researchers believe that excess red meat particularly affects this group because of their poor diet and "sub-optimal fruit and vegetable intake".
The research, led by the Institute of Cancer Sciences in collaboration with the Karolinska Institutet (Stockholm, Sweden), also found that high phosphate levels in deprived males correlated with reduced kidney function and even underlying mild to moderate chronic kidney disease.

Phosphate is naturally present in basic foodstuffs, including meats, fish, eggs, dairy products and vegetables. Intestinal absorption of naturally occurring phosphate is minimally regulated, as absorption is efficient, hence high supplementation results in markedly elevated levels of serum phosphate, which can have adverse health consequences. Indeed high phosphate levels, as a consequence of dietary intake, have already been linked to higher all-cause and cardiovascular mortality risk, premature vascular ageing and kidney disease.

The researchers observed significant relationships between serum phosphate and biological age markers, including DNA content and telomere length. (Original study.)

Published on Leave a comment on Some Popular Medicines Have Negative Brain Effects

Another study showing big problems with anticholinergics, which are in many popular medicines - both non-prescription and prescription (e.g., Chlor-Trimeton, Benadryl, Tavist, Dimetapp). An earlier study with older adults found a dose-response link with dementia, but the current study explored this issue further. They followed 2 groups of  "cognitively normal older adults" in their early 70s for several years: those who took anticholinergic medicines and those who did not take anticholinergic medicines. They found that those who took anticholinergic medicines had reduced brain volume (brain shrinking) and cognitive decline (when compared to those who did not take anticholinergic medicines). The researchers summarized their findings as the "use of anticholinergic medication was associated with increased brain atrophy and dysfunction and clinical decline". This finding was greatest for those taking drugs with the most anticholinergic activity.

See a list of anticholinergic medicines  from the Aging Brain Program of the Indiana University Center for Aging Research. Definitely try to avoid medicines with a score of 2 (medium effect) or 3 (high effect), but I would even be cautious about score 1 (low effect) medicines - use all medicines only as long as absolutely needed. My one very important question is: If these effects are found in older adults, what do anticholinergics do to younger brains, especially the developing brains of children? From Medical Xpress:

Brain scans link physical changes to cognitive risks of widely used class of drugs

Older adults might want to avoid a using class of drugs commonly used in over-the-counter products such as nighttime cold medicines due to their links to cognitive impairment, a research team led by scientists at Indiana University School of Medicine has recommended. Using brain imaging techniques, the researchers found lower metabolism and reduced brain sizes among study participants taking the drugs known to have an anticholinergic effect, meaning they block acetylcholine, a nervous system neurotransmitter.

Previous research found a link between between the anticholinergic drugs and cognitive impairment and increased risk of dementia.....Drugs with anticholinergic effects are sold over the counter and by prescription as sleep aids and for many chronic diseases including hypertension, cardiovascular disease, and chronic obstructive pulmonary disease. A list of anticholinergic drugs and their potential impact is at http://www.agingbraincare.org/uploads/products/ACB_scale_-_legal_size.pdf.

Scientists have linked anticholinergic drugs and cognitive problems among older adults for at least 10 years. A 2013 study by scientists at the IU Center for Aging Research and the Regenstrief Institute found that drugs with a strong anticholinergic effect cause cognitive problems when taken continuously for as few as 60 days. Drugs with a weaker effect could cause impairment within 90 days.

The current research project involved 451 participants, 60 of whom were taking at least one medication with medium or high anticholinergic activity. The participants were drawn from a national Alzheimer's research project....and the Indiana Memory and Aging Study. To identify possible physical and physiological changes that could be associated with the reported effects, researchers assessed the results of memory and other cognitive tests, positron emission tests (PET) measuring brain metabolism, and magnetic resonance imaging (MRI) scans for brain structure.

The cognitive tests revealed that patients taking anticholinergic drugs performed worse than older adults not taking the drugs on short-term memory and some tests of executive function, which cover a range of activities such as verbal reasoning, planning, and problem solving. Anticholinergic drug users also showed lower levels of glucose metabolism—a biomarker for brain activity—in both the overall brain and in the hippocampus, a region of the brain associated with memory and which has been identified as affected early by Alzheimer's disease. The researchers also found significant links between brain structure revealed by the MRI scans and anticholinergic drug use, with the participants using anticholinergic drugs having reduced brain volume and larger ventricles, the cavities inside the brain.