By Joseph C. Piscatella | Author of Strong Heart, Sharp Mind

I have been a heart patient since 1977 when, at the tender age 32, I underwent coronary bypass surgery. That was how I learned about the link between lifestyle habits — diet, exercise, stress, etc. — and coronary disease/health. Even in those early days, I came to understand the critical role of cardiac rehabilitation programs in educating me about cardiac risk factors and motivating me to live a heart-healthy lifestyle. And it worked! Today, I am 47 years post-bypass surgery.

Like many cardiac patients at the time, I tended to look at the heart as a singular organ, with little connection to other parts of the body and other diseases and conditions. That view is changing as new research shows an important connection between a dysfunctional heart and a cognitively impaired brain — or, more specifically, a link between heart disease (the nation’s number one killer) and Alzehimer’s (the nation’s most-feared disease). 

Both tend to impact older people; and with an estimated 110 million Americans now aged 50 years and older, the significance of this connection is critical. So is research showing that something can be done about it, that steps can be taken to maximize and improve heart and brain health together. It’s just one more reason why cardiac rehabilitation patients should practice healthy lifestyle habits.

WHAT THE SCIENCE SAYS

Some experts say the reason behind the heart-brain connection is simple: blood flow. It’s true that both the heart and brain rely on large amounts of precisely controlled blood coursing through arteries and veins to keep those conduits healthy. Many conditions can impact the circulatory system, including heart disease, stroke, diabetes, and high blood pressure. This has long been understood in terms of effect on the heart. But it has now become apparent that the well-known risk factors for cardiovascular disease are very similar to those of Alzheimer’s disease.

This wasn’t known in the past. We didn’t realize, for example, that both hypertension and type 2 diabetes, long known as predictors of cardiovascular disease, are also risk factors for Alzheimer’s. By the same token, we didn’t understand that ApoE4, the genetic signature associated with higher rates of Alzheimer’s, is also implicated in heart disease. We didn’t know that elevated cholesterol, another well-known risk factor in heart disease, is linked to higher levels of amyloid, the substance that forms the brain tangles that are a hallmark of Alzheimer’s.

These are profound discoveries. Why? Because three common risk factors for heart and brain health — hypertension, diabetes, and high cholesterol — can be managed, controlled and even, in some cases, reversed. So, when cardiac rehabilitation professionals educate and motivate patients to reduce the heart disease risk from high blood pressure, diabetes, and elevated cholesterol, they are also giving them the tools to manage Alzheimer’s risk.

BRAIN-BOOSTING WORKOUT

While the importance of certain types of aerobic exercise — brisk walking, for example — clearly help to manage both heart and brain risk factors, research suggests that we can add a new ingredient to further strengthen the brain: balance training. Let’s say you have just taken a brisk 45-minute walk and you’ve cooled down with a few minutes of easy walking and gentle stretching. Muscles are warm, and the blood is flowing; now it is time to challenge your brain.

Find a wall, tree, or pole for support. Standing erect and with the palm of one hand on the supporting surface, close your eyes and slowly raise your left knee, lifting your leg off the ground. Count slowly to 30. Then switch legs and repeat.

This is the first basic balance movement. Your brain immediately responds by rewiring and activating circuits. Now it is simply a question of upping the game a little bit each time. After your next aerobic workout, add 15 seconds to your one-legged stands, and the time after that, another 15 seconds, so that you are now standing — with support — for 60 seconds on each leg.

One more iteration of this basic move: Once you can stand unsupported, eyes closed, for 60 seconds on each leg, try turning your head slowly during each iteration. Your brain will rise to meet this challenge.

After about 2-3 weeks of single leg stands, you can move to a more advanced brain workout using a broomstick and a rubber ball.

BROOMSTICK KAYAKING

After you have finished your aerobic workout and cooldown, take your broomstick in both hands at shoulder width, using an overhand grip. Begin to form figure-eight motions with the broomstick with a rhythmic and smooth motion, as if you are kayaking. Do this for 60 seconds, rest a minute, and repeat.

It might take your brain a couple of times to get that fluid motion; but once it does, further challenge yourself by standing on one leg while you kayak — first the right for 60 seconds, then the left for the same amount of time. Your brain will respond.

SINGLE-LEG BALL TOSS

Add this exercise to the mix after a few sessions of kayaking. You can use a partner for this movement or find a concrete wall that will allow you to rebound a rubber ball (such as a palm-sized handball). Standing on your right leg, throw the ball to your partner or against the wall and catch it on one bounce. Do this five times, first with your right hand, then five times with your left. Change legs and do the same.

This exercise forces the brain to constantly adapt through what is known as “dual processing” — in this case, focusing on catching and throwing the ball while simultaneously adjusting to the instability of standing on one leg.

While such exercises are not easy, you can see improvements in balance and neural training, a tribute to the plasticity of the brain. In combination with aerobic exercise, brain-friendly exercise can help you to reach a new level of heart-brain fitness.

Author/speaker Joe Piscatella is one of the nation’s foremost experts on how to live a healthy lifestyle. He is Founder & CEO of the Institute for Fitness and Health, an organization dedicated to helping people initiate and sustain healthy lifestyle habits. TIME magazine calls him “a positive force for healthy changes.”