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Optimizing Cognition: Neuroprotective practices you need to know

Optimizing Cognition: Neuroprotective practices you need to know
Kim McCullough, PhD, CCC-SLP
May 20, 2016

ditor's Note: This text-based course is a transcript of the webinar, Optimizing Cognition: Neuroprotective practices you need to know, presented by Kim McCullough, PhD, CCC-SLP. 

I think that you will find the content of this course to be relevant to you both clinically across all settings and personally. The learning objectives for today are: 

  • Explain the rationale for providing education regarding neuroprotective lifestyle practices
  • List the key neuroprotective practices that contribute to cognitive health
  • Describe current research associated with each neuroprotective practice


My area of interest is adults with dementia and MCI so this course will have that focus.  However, this information is completely relevant to any client on your caseload.

If you look at the World Alzheimer's Report for 2015, it is quite startling. Every 3 seconds, someone is diagnosed with dementia and by 2050, there will be a 68% increase in dementia.  Individuals who will be considered old in 2050, were born around the 1970s.  This information may be particularly relevant to those of you who may have been born in the ‘70s.

Shockingly, the funds spent on caring for people with dementia will total $2 trillion by 2030 which is as big as the 18th largest economy in the world.  The global cost for dementia care is larger than the market values of companies like Apple, Google, and Exxon.  The main takeaway message for this course is to prepare for a potential paradigm shift in healthcare and public health in the years to come.

The World Alzheimer's Report describes the concept of “care now, cure later” and “spend to save”. The idea is that if there are things that we can do to prevent cognitive decline before it happens, we ought to be doing that now. If we can develop an intervention that can delay the onset of dementia by just 5 years, that could result in a 57% reduction in the number of people with dementia. It could also result in an estimated reduction of $367 billion in Medicare cost.

Interestingly, ASHA has a campaign called Identify the Signs.  The campaign states that lack of awareness is the number 1 barrier to early detection of communication impairments and that 17% of people who report issues with dementia report that they were not aware of some of these neuroprotective practices that will be discussed today. Lack of awareness is a big issue.

Rationale Supporting Neuroprotective Practices

Cognitive Reserve

What is the rationale for educating about and supporting neuroprotective practices? There is a concept called “cognitive reserve” which is the mind’s resistance to brain damage.  It can be thought of as a retirement savings plan. It is not something that you get or gain overnight. It is built over a lifetime.

Cognitive reserve assists with your ability to cope with pathology.  Because of cognitive reserve, there is no direct relationship between the amount of brain pathology and the clinical manifestation of the damage. For example, almost 25% of the individuals with autopsies who have postmortem evidence of Alzheimer's disease never exhibited any symptoms of dementia during their lifetime.

Additionally, cognitive reserve can be protective. We know that people with higher levels of education and occupational attainment can sustain greater brain damage before exhibiting functional impairments.


Neuroplasticity, which is the brain’s ability to reorganize as a result of experience, also contributes to good brain health and cognitive reserve.

Brain-derived Neurotrophic Factor (BDNF)

BDNF is a protein that is important for neuroplasticity. It assists in preventing the death of existing brain cells and induces growth of new neurons and synapses. It is very important for learning and memory.  Reductions in BDNF have been associated with depression, decreased cognitive function and heart disease.  Low levels of BDNF have also been linked to Alzheimer's.

kim mccullough

Kim McCullough, PhD, CCC-SLP

Kim McCullough, Ph.D., CCC-SLP is Graduate Program Director and an Associate Professor in the Department of Communication Sciences and Disorders at Appalachian State University. She teaches courses in adult neurogenic disorders. Her current research interests include developing clinically efficient assessment and treatment protocols for individuals with cognitive impairments.

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