The Complete Guide To The Aging Brain

In this article: How to improve cognitive abilities in older adults…

Aging is not an illness; it’s a typical sign of life. Research focuses on the negative aspects of aging, such as brain degenerative diseases, including Alzheimer’s, Parkinson’s, and other dementia disorders. We all know people who remain sharp mentally throughout their entire lives and with age and maturity comes creative genius. Unfortunately, the same doesn’t go for everyone.

On the other side of the spectrum, disease prevention, and concerns aside, there is simply the desire to keep the mind as active and healthy as possible no matter your age.

There are now facts surrounding the aging brain, and the brain’s trajectory through your life span is affected by a number of factors, including psychology, genetics, and physical. One thing we know for certain is that the brain benefits from an active, intellectual, social, healthy lifestyle.

Our brains reorganize as we are, as they learn to respond to new situations and experiences. The brain is flexible, as it aids in adjustments through traumatic events, and physical illnesses. The brain’s language system comes with an inbuilt resilience to ensure that it will remain robust throughout the entirety of your lifespan.

Researchers are keeping a close eye on how people age, cognitively speaking, looking to aging populations and the potential implications that has on society and economics. It’s vital that the aging demographic is prepared for the challenges that come with the passing years.

Table of Contents

Anatomy Of The Aging Brain

We perform hundreds of tasks every day that fall under the umbrella of cognitive abilities, however, we’re unaware of the effort out brains go to, to perform them.

The tasks include calculating equations, telling time, remembering names, as well as noticing smells, tastes, and colors. The areas of the brain that are most active when performing these tasks is dependent on the task itself. Our brain functions are made up of differing and diverse types of cognitive function.

Our mental ability shifts throughout life, initially as our brains mature and finally as they age. As we age our vision and hearing start to decline, and the speed of our reflexes and movements decrease.

Up until just over 20 years ago research regarding aging was focused on adults below the age of 80, however, recent research has included those above the 80s bracket, as it is a population growing rapidly. This has improved our understanding on the cognitive changes the elderly experience.

We often consider the aging population to be dulled intellectually, or write off the aged as being senile. For instance, once upon a time people believed that theoretical physics was only for young people. Richard Feynman disregarded that myth and went on to win the Nobel Prize in 1962.

Someone of high intelligence in their youth will remain intelligent as they age, however, this may dull in comparison to the knowledge and abilities that they had in their younger years. Changes in the brain occur on a continuum, from young to old.

The brain is a network, it contains different regions and structural and functional connections. The question is how those networks organize as changes occur during the human lifespan.

Firstly, the changes in relating to age follow very distinct trajectories during life. Each change occurs in a module of the intrinsic connectivity network. With age, however, each of these becomes less segregated. In these networks, the main regions that are excessively affected by aging also become less connected to the other regions of the brain. Additionally, functional connections through aging are supported by multi-step anatomical communication pathways.
Secondly, while the finer scaled modules grow less segregated, others seem to become more segregated. The modular structure alters with age, and it’s the specific areas that are associated with memory.
Finally, with age there are additional constraints that play a large part in shaping the structural network of the brain’s topology. Through age, the brain’s volume shrinks while the ventricular system enlarges. The pattern of change is varied, and the main changes that we see occur in temporal cortex, frontal lobe, thalamus, accumbens, and putamen. MRI data shows that there are changes in the volume of subcortical and cortical thickness. This can change by as much as 1% in a year.

Brain reductions in a healthy brain are minor, while unhealthy aging involves neuron shrinkage, a reduction in grey matter synapses, and a decrease in synaptic spines.

This sees a loss of cognitive abilities, including memory, and the speed of processing and function.

Cognitive Health And Older Adults

1| Memory

The majority of people consider the memory as one system. However, different types of information are stored differently, and experts believe that there is a variety of memory systems within the brain. Some information that we take in will only remain for a short period of time, just seconds if we don’t act on it. A great example would be someone offering you an email address or a phone number, if you don’t repeat it or write it down then it slips from your memory immediately.

Research indicates that the short-term memory contains two subsystems- the immediate memory, which holds information temporarily, and the working memory, which allows us to retain information provided we continue to use it. Aging compromises the working memory severely, making it difficult to process new data.

Research from the University of Virginia (http://faculty.virginia.edu/cogage/links/publications) carried out tests to evaluate the working memory. The researches, Timothy Salthouse, had participants’ complete equations while remembering the last digit of each. While people in their 20s could solve four or five problems while recalling all of the final digits, every decade of age above that struggled. Performance deteriorated up the age bracket, with those in their seventies unable to solve no more than two equations at a time.

The simplest way to assess memory is by reading out a list of words and then having participants repeat as many as possible.

A University of Colorado study (Lexical priming deficits as a function of age, Hasker, et al) found that those in their twenties could remember 90% of the list, and by their 80s, participants could recall less than half.

2| Thinking & Cognitive Slowing

Information that we store in the short-term memory is merged into another storage system, for long-term use. It will remain there for retrieval for months, and even years. Memories like a great meal, or a co-worker’s name, can last for at least five years, but it can last as many as 40 years. During aging the systems start to degrade, which makes it difficult to move those short-term memories into the long-term storage system.

If you’re over 50, you may have noticed it’s suddenly more difficult for you to recall lyrics to a song you haven’t heard in some years. When we are young, we find it incredibly simple to learn new things, but as we age, it will become increasingly difficult. One of the frustrating signs of aging is trying to access a word stored in long-term memory.

Older people struggle with this because there’s a disconnect between words and their meanings. Unfortunately, we also lose intelligence as we age. IQ is a relative measure, and it remains fairly constant. However, we tend to undergo intelligence tests at our peak- the teen years, which will remain static for years before declining. The reason scores remain stable is that people tend to decline at the same rate. Intelligence is like memory, it’s divided into different types, and they each decline differently.

Facts are the basis of crystallized intelligence, and much of that knowledge will remain strong throughout your sixties. Fluid intelligence, however, is the ability to reason and it declines dramatically. A 20-year-old is going to be able to handle reasoning tasks in half the time that it will take a healthy 80-year-old.

There is no cognitive function that declines as rapidly as the speed of processing. When neuroscientists tackle, this decline it’s in reference to executive function.

Within the brain there is a coach, a structure that prioritizes and schedules, directs attention, switches between tasks, and gathers resources. We struggle with multitasking as we age, because the brain struggles to redirect attention to the original task once it’s been interrupted.

Around 50% of Americans over the age of 85 have Alzheimer’s, and it is increasingly common as we age. According to UCLA neurologist Gary Small, if everyone lived to the age of 110, everyone would have Alzheimer’s.

3| Attention During Multitasking

If you’re over the age of 60, don’t let anything distract you from this part! Older brains struggle to multitask, simply because they’re not wired to deal with interruptions.

One ability that is essential to our mental functioning is the working memories ability to retain information. While younger brains do this easily, aging brains struggle. The modern world views multitasking as an essential skill, thanks to the high tech hustle and bustle of daily life.

According to research from the University of California, San Francisco published in the Proceedings of the National Academy of Sciences (April 11, 2011), there’s more to multitasking than memory, it’s a case of memory and attention. Older brains are rigid. They struggle to disengage from interruptions and revert to the previous task or memory.

If you’re struggling, remember these three tips: focus, cut distractions, and train your brain.

If you want to remember things, you’ll need to maintain your focus. Don’t allow interruptions.

If you need a high-quality performance, whether you’re at home or in the workplace, then turn your phone off, keep the doors closed, and shut down any background programs that could compromise your attention.

Find great activities to train your brain, such as exercising, learning new languages, and skills, and try new hobbies.

4| Cognitive Optimism

In addition to the other cognitive abilities that decline, there are those that decline very little. Vocabulary and language tend to stick with us throughout our lives. Our ability to recall information that we acquire in our youth starts to peak during our middle age years.

The cognitive abilities that are resistant to age tend to strengthen with experience. For instance, the majority of older people can tell you why it’s important to cook chicken thoroughly, simply because they have a lifetime of experience to draw from.

Older adults will also have a greater overview of a particular situation, or even a better appreciation concerning what type of impact a single event can have. We often forget how reasoning, memory, and attention play a part in the daily tasks we carry out.

There is a variety of activities that rely on a combination of cognitive abilities, includingtalking to friends, catching the bus, and grocery shopping. Your social skills are highly dependent on cognitive function, because it’s necessary to form judgements and impressions of people that you meet.

We build social impressions on how someone behaves, on their facial expressions, the quality of their voice, and their physical appearance. Older adults may have a limited ability to process information, however, their social impressions tend to be intact. Many people, especially those who are aging, will struggle to remember names after meeting someone new.

We tend to blame this on memory, however, it’s really due to the social interaction. The name didn’t register in your memory, and one effective way to remedy this is by repeating the name once you’ve heard it. For older adults, the deterioration in processing information speeds up their decline.

There are limitations when it comes to retaining information when you find yourself in a new situation. You are surrounded by distractions and in a position where you need to process information quickly and can’t. This results in a struggle for older adults to make decisions effectively, especially when they find themselves in an unfamiliar situation.

5| Senses

We rely on a variety of senses to learn, and remember. Touch, vision, smell, and hearing aren’t just detection systems. The make up a primitive type of memory, which is a buffer for our brains. The input of our senses echoes within our receptors, and even a weak stimulus will create an image flash that affects the decisions that we make.

Without the ability to buffer, we would lose a wealth of information on a daily basis. Unfortunately, we start to see the sensory system deteriorate as we age. For instance, in your youth you can hear tones at just 30 decibels, while it may require 90 decibels for an elderly person to detect the same sound.

Additionally, the size of the pupils decreases as we age, so for an elderly person they can only detect a third of the light as young people do in poor lighting. This affects the ability to access street signs, text, speech, and music. It results in an impairment in the ability to think and make decisions.

These are just part of the problem, one of the biggest issues is that older people may find that the senses aren’t outright rejecting information, but just struggling to filter irrelevant information.

If you were to sit and read a book, while also receiving tones through earphones, the older you are the more difficulty you will have ignoring the sounds. The stimuli in the background will flood your thinking, preventing you from performing and focusing on the task at hand.

Risks To Cognitive Health In Aging

Perhaps at the heart of the issue, is if it is possible for our brains to stay young, even as our bodies age.

There is no definition of normality when it comes to the aging of the brain, which restricts how we view the normal cognitive function of aging, from the abnormal. There are major differences in the brain’s structural and functional elements, which only complicate matters. The brain undergoes these changes naturally, even when there are no neurodegenerative diseases to consider.

Brain shrinkage in the front regions result in a brain volume loss of 10% for those older than 80. Even a brain that is aging normally will have signs of neurofibrillary tangles and senile plaques. However, a brain that is aging abnormally will features these in a higher number.

Studies have identified that even in healthy elderly people there are signs of age-related decline in regions of the brain. There is also evidence of an increase of activity in other regions, which suggests that the brain recognizes that it is aging and compensates for this decline in function.

Mild cognitive impairment is not the same as age related decline. People who have mild cognitive impairment can handle daily activities like driving a car, and balancing a checkbook, yet their impairment is obvious to those around them. Many experts believe that mild cognitive impairment is the transitional stage between typical aging and Alzheimer’s.

In fact, according to one study (Early Diagnosis of Alzheimer’s Disease: Is MCI Too Late?, Ronald C. Petersen, Ph.D., M.D.) mentioned on Mayo Clinic’s website, around 12% of people with mild cognitive impairment develop Alzheimer’s within a year. Other experts, however, suggest that mild cognitive impairment is just an early stage of dementia, with around 22% of those over 71 suffering cognitive impairment, but not dementia.

Alzheimer’s is the most common type of dementia, and the distinction between Alzheimer’s and typical cognitive decline is that the latter isn’t simply about memory loss. Alzheimer’s patients have damaged brain cells that result in behavioral changes, as well as issues with daily tasks. People with Alzheimer’s have an inability to learn or comprehend new information, as well as an inability to retain it. They will also exhibit a limiting in their verbal skills, and may struggle with making sound decisions.

When Does Cognitive Decline Start

That depends. There is plenty of evidence that supports a theory that cognition troubles start their decline in our early 30s, while others suggest it’s still until your 50s or 60s.

When it does begin, even incrementally, we have waited for too long to address it. The fact is that we shouldn’t consider our cognitive health as something separate to our overall health, it plays a part in physical health, and it’s vital that we begin to address it in the younger population.

There are nine elements to our cognitive health:

Remembered skills
Language
Attention
Thought
Perception
Memory
Judgement
Executive functions
Ability to live a life that is purposeful

Preserving these functions is the crucial difference between living a dependent, or independent life.

There is a variety of risk factors when it comes to the aging brain.

Aging in itself is the biggest risk factor for cognitive decline.

There is a link between cognitive decline and physical inactivity, specifically vascular disease.

Cardiovascular disease severely increases the risk of neurologic deficits. You can slow the decline by controlling the same risk factors used for reducing the risk of heart diseases.

The important risk factors include a failure to exercise, obesity, smoking, excessive alcohol consumption, and hypertension.

There are consistent factors that are associated with a decline in cognitive abilities; those include diabetes, age, stroke, high BMI, depression, and hypertension.

Poor mental health has long been associated with stress, and chronic illness. The risk is greater for women, especially those who have signs of neuroticism.

Additional factors include cancer, osteoporosis, and insufficient sleep.

Taking Care Of Your Brain: What You Can Do

You certainly have some level of control over how well your brain survives the aging process, it all comes down to the following strategies.

Managing Hypertension

Hypertension promotes arteriosclerosis, which can result in stroke. Hypertension causes degenerative changes in the blood brain barriers small vessels.

Lowering cholesterol: High levels of cholesterol cause plaques to form, causing neuronal death.

Diet

Omega-3 and Omega-6 Fatty Acids

There are key nutrients that your brain needs to function properly.

Deficiencies in both omega-3 and omega-6 fatty acids have been linked to various brain disorders and may contribute to depression and anxiety.

The main fatty acids associated with brain health are the following:

Docosahexaenoic acid (DHA, an omega-3 fatty acid)
Eicosapentaenoic acid (EPA, an omega-3 fatty acid)
Linoleic acid (LA, an omega-6 fatty acid)

Reducing your intake of cholesterol, and saturated fat is vital in reducing your risk of cognitive impairment. However, eating enough healthy fats is also key as these fats feed the brain, good choices are olive oil, olives, avocados, and unsalted unflavored nuts.

Omega-3 Foods

Marine forms of omega-3 (EPA and DHA) and are found in oily fish
Plant forms of omega-3 contain ALA and are found in plant foods

Good sources of EPA and DHA:

Experts advise all adults to eat 2 servings of fish each week

Mackerel
Wild Caught Salmon
Anchovies
Herring
Sardines
Sturgeon
Lake trout
Tuna

Good plant sources of ALA:

Enjoy healthy fats in moderation

Olives and olive oil
Walnuts and walnut oil
Avocados and avocado oil
Flaxseed and flaxseed oil
Canola oil
Soybean oil
Fortified eggs

Enjoy vegetables as much as you want

Brussels sprouts
Kale
Mint
Parsley
Spinach
Watercress

Omega-6 Foods

Poultry
Nuts
Pumpkin seeds
Eggs
Hulled sesame seeds
Cereals
Durum wheat
Whole-grain breads
Most vegetable oils
Grape seed, evening primrose, borage, flax/linseed, canola, rapeseed, hemp or and soybean, sunflower, corn and safflower oils

Vitamin D

Vitamin D plays a role in protecting from cognitive delays associated with aging. It plays a role in…

Enhancing synaptic plasticity
Memory
Learning
Brain function

Vitamin D deficiencies have been linked to some types of depression, including seasonal effective disorder.

Vitamin D helps reduce brain inflammation that protects against stress and anxiety. Some studies found a link to vitamin D deficiency and the development of schizophrenia.

Antioxidants

Antioxidants reduce the risk of free radicals, and free radicals increase the risk of injury to the brain cells. Antioxidants are readily available in plant foods, in vegetables and berries.

B Vitamins

B vitamins are key in brain health, specifically, vitamin B6 and vitamin B12 and each of these nutrients play a key role in brain cellular metabolism.

Deficiencies increase the risk of cognitive impairment, so supplementing these can prevent deficiencies and improve cognitive abilities.

Vitamin B6 Foods

Fish
Beef liver
Starchy vegetables – potatoes, corn
Fruit (expect citrus)
B6 fortified cereals
Poultry

Vitamin B12 Foods

Animal foods are the only natural source of vitamin B12, including:

Red meat
Poultry
Dairy products – milk and cheese
Eggs

Folate

The University Of Maryland Medical Center reports that folate (vitamin B9) plays a role in normal functioning of the nervous system function properly. B9 is also referred to as folic acid, and difference between folate and folic acid is that the latter is a synthetic form typically found in supplements and used in fortified foods, while the former occurs naturally in food.

Folate plays a crucial role in proper brain functioning and supports both emotional and mental health. In fact, folic acid deficiency can cause Forgetfulness, mental sluggishness and irritability.

Science also believes that folate lowers levels of an amino acid called homocysteine in the blood that plays an important role in the death of nerve cells in the brain.

Foods High In Folate

Spinach
Collard Greens
Turnip Greens
Mustard Greens
Romaine Lettuce
Asparagus
Broccoli
Oranges
Papaya
Grapefruit
Grapes
Bananas
Cantaloupes
Strawberries
Beans, Peas, and Lentils
Avocado
Okra
Brussels Sprout
Seeds and Nuts
Cauliflower
Beets
Corn
Celery
Carrots
Squash

Glycemic Index

Diabetes can result in cognitive decline, so it’s vital to avoid foods that are high on the index and make smart nutritional choices. Being overweight or obese is a high risk factor for type 2 diabetes, so eating a healthy diet and engaging in regular exercise is important to prevent type 2 diabetes and keep both your body and brain healthy.

Stop Smoking

Smoking results in atherosclerosis, which increases the risk for brain infarctions. It’s vital that you stop smoking if you want to retain your cognitive function.

Stress

Increased levels of stress have a severe impact on the health of your brain. It’s vital to manage your stress well and have a deliberate and mindful plan in place.

There are many ways to successfully manage stress, including:

Make a plan, identify your stressors, and get rid of all that you can from your life
Ask your doctor for a plan
Take vacations and regular breaks to recharge
Laugh and play
Hobbies
Deep breathing
Acupuncture
Yoga
Meditation
Aerobic and anaerobic exercise
Good sleep
Massage
Warm baths
Take time for relaxation every day
Aromatherapy
Tai Chi
Qi Gong
Mindfulness-Based Stress Reduction
Biofeedback Therapy

Exercise

Donald Stuss, PhD, a neuropsychologist and director of the Rotman Research Institute at Baycrest Centre for Geriatric Care in Toronto says, “The best advice I can give to keep your brain healthy and young is aerobic exercise.”

There is a strong link with physical activity and a decrease in the risk of cognitive decline.

Arthur Kramer, a preeminent exercise and brain-health researcher (University of Illinois) has conducted many studies into the effects of exercise on the brain and he and his team have proven two crucial findings:

People who are fit have sharper brains
Those who are not in shape, but become improve their brain power

Dr. Kramer confirms that not only does regular exercise make you smarter, it also helps prevent type 2 diabetes, obesity, and heart disease, all of which carry serious risk factors for age related brain problems.

The general expectation is 20-30 minutes of exercise a day, for at least four days a week. You can break this up into 10-minute bursts throughout your day as you start. As you start to exercise, you’ll find that you feel better, and are encouraged to exercise more frequently, or for longer bursts.

Get Social

Your Brain Matters reports that having an active social life with friends, family and community supports brain health and helps lower risks of dementia related disorders and helps to reduce the risk of a decline in cognitive abilities

Socializing is actually like exercise for the brain that helps build new connections and keeps the mind active and engaged. An active social life is also an effective way to reduce stress levels.

The Cleveland Clinic’s Healthy Brains website recommends a rich social network for obtaining support, reducing risks of depression, and enhancing intellectual stimulation. In fact, various studies have found that people who have the most social interaction also have the slowest rates of memory decline. Solid long-term relationships and happy marriages have proven to offer significant protection from age-related cognitive impairment.

Those who engage in a rich social life also report being happier and more content, and this is great news for mental and emotion health.

Sleep

It’s important to get enough sleep, your ideal sleep pattern should be somewhere between seven and eight hours of sleep every night. Sleep is when your brain rebuilds connections and processes information, and you won’t have memories to recall if you don’t provide your brain with enough time to file them away.

One study that was funded by NIH’s National Institute on Aging and published on 2013 in Nature Neuroscience found a significant connection between memory and sleep that helps explain some of the forgetfulness commonly found in the aging population.

Human brains naturally deteriorate with age as does slow-wave sleep activity, which is generated in the medial prefrontal cortex (mPFC) and exhibits age-related deterioration.

Drs. Bryce Mander and Matthew Walker and their team (University of California, Berkeley) explored the relationship between age-related sleep changes and brain structure to impaired memory. The study included 18 healthy subjects ages 18 to 25 and 15 healthy subjects’ ages, 61 to 81.

The study concluded that changes in the mPFC lowered slow-wave activity while subjects slept and this contributed to declines in long-term memory. This occurs because as slow-wave activity decreases, the brain must turn to the hippocampus for memory tasks, a part of the brain that only tackles short-term memory storage.

Dr. Walker stated, “When we are young, we have deep sleep that helps the brain store and retain new facts and information. But as we get older, the quality of our sleep deteriorates and prevents those memories from being saved by the brain at night.”

People who struggle with sleep often struggle with their memory. If you have sleep problems and can’t seem to solve it, speak to your doctor about it.

Learn To Play An Instrument

One study (Music drives brain plasticity, Lutz Jäncke) showed that playing an instrument for only one hour each week for four months resulted in seniors experiencing improvements in parts of the brain that control hand movement, hearing and memory.

Whether it’s piano, violin, guitar or even the old banjo, get to playing and save your brain.

Read

Reading is one of the best activities for keeping the aging brain active and well exercised. One study from Mayo Clinic (The Mayo Clinic Study of Aging: design and sampling, participation, baseline measures and sample characteristics, Roberts, et al) found reading to lower risks of developing dementia by 50%.

Write

Care.com advises you to step away from your computer and get back to the good old fashioned pen and paper, as a study published in the Journal of Cognitive Neuroscience found that handwriting stimulates those areas of the brain that handle memory, language and thinking.

You can keep a diary or journal, write letters to family, start writing down memories, or even write a book! Why not?

Learn

The Cleveland Clinic advises that earning is a great way to stimulate your brain, create new connections, keep the mind active and engaged, and stave off mental decline.

Remember the brain is like a muscle, and it needs to be worked out in order to keep it in shape. Take time to learn a new language, get to know new people, learn how to draw, knit, or dance, go back to school, learn how to play an instrument, the possibilities are endless.

Use It Or Lose It With Games

If you don’t exercise, you gain weight and lose muscle… the same goes for your brain. Find a way to exercise your brain, whether it is through reading new material, or completing brain teasers.

Get creative with crosswords, Sudoku, thought stimulating board games, strategy games like chess, brain game phone apps, video games, and brain teasers, some of their benefits include:

Stimulate the mind
Logical thinking
Learn new skills
Hone concentration skills
Improve mood
Feelings of accomplishment
Boost Focus Skills
May slow degeneration in brain-degenerative disease
May delay memory loss of dementia
Exercise critical thinking skills
Hone problem solving skills

Be Uncomfortable

A great way to keep your brain sharp is by diving outside your comfort zone. You should look to do things that stretch you; it’s okay to do something that makes you feel uncomfortable. Whether that is mixing your routine up, travelling, or being spontaneous. Even listening to a new genre of music is a great way to keep your brain active.

Left and Right

Try using your non-dominant hand when you brush your teeth, your hair, even when you’re drawing. This is a great way to challenge yourself and force your brain to think when you’re carrying out simple, everyday tasks that you generally do out of habit.

Singing Problem Solving

Just sing it out! When you’re faced with a problem, just sing about it. Singing activates the right hemisphere of your brain, the part of the brain that handles pattern recognition.

Strategy

You can increase the sharpness of your memory through an effective training strategy, techniques including concentration and visualization both effective ways to retain and recall memories. There are plenty of ways to do this, which includes a daily planner, a voice recorder, or even sticky notes.

Seatbelts

Yes, it’s important that you wear a seatbelt (and helmets), because head injuries can have a severe impact on your brain.

Final Thoughts

There is no way to stop the hands of time from moving. Aging is an inevitability. Your skin is going to wrinkle, it will start to sag, you will find it more difficult to lose weight, and your brain will let you down. These are simple facts of life that we will all experience.

However, you have control over just how much aging will affect your overall health and wellbeing. By employing the above strategies and tactics, you can reduce the risk of cognitive impairment.

The truth is the same strategies that you should be employing to manage your physical health, also play a role in your mental and brain health. It’s vital to stay physically active, to eat a well-balanced diet, and lead an active social life to keep your brain sharp.

There is no need for your life to be changed by a neurodegenerative disease. You have control over your total health, and by taking hold of it with both hands and making the right decisions, you can reduce your risk of ill health.