Strong thighs, strong brain

A ten-year study of older female identical twins, published in 2015, showed a robust correlation between thigh strength and cognitive health as they aged. So why don't we all know about it?

Last weekend, I was hanging out with two women in their late fifties, each of whom has or had a parent living with dementia. “Do you worry about getting it, too?” I asked one of them.

“Of course,” she said. “I think about it all the time.”

“Well, just keep doing those thigh exercises, I guess,” I said.

“What do you mean?”

“You know, squats? Lunges?”

My friend looked confused. What, she wondered, did squats and lunges have to do with cognitive health?

I spend so many hours every week reading studies, new and old, on the topic of women’s health in midlife, that I am constantly and wrongly assuming that this knowledge, as inadequate as it may be, is shared among us. But of course it isn’t. Not by a long shot. With our doctors only allowed to allot 15 minutes at our yearly appointments, at best; with a dearth of funding and access to midlife female-specific health; and with cognitive health often last on our list, it’s a wonder any of us knows anything about how our bodies and brains work, and what we can do to maximize their health in midlife.

“There was an observational study done like a decade or so ago on older female twins,” I said, googling it.

The ten-year study, I told her, concluded that there is a “striking protective relationship” between thigh strength, cognitive ability, and the amount of total grey matter measured ten years later. In other words, I told my friend, genetics are only part of the dementia picture. She could literally squat her way to a stronger brain.

How? In a nutshell, our leg muscles are the largest muscles in our bodies. When we force them to work hard and overload them with heavy weights, they begin to act like their own endocrine organ, releasing chemical messengers—myokines—into our bloodstream. These myokines, like BDNF—brain-derived neurotrophic factor, a vital protein that acts like brain fertilizer—then cross the blood-brain barrier, where they engage in what researchers call “muscle-brain cross-talk,” meaning they stimulate new neural connections and reduce the shrinkage of the seat of our memory, the hippocampus.

“Please write a story about this,” said my friend.

Okay! So. Here we are.

And no, it’s not lost on me that, just as we’re learning about how important thigh strength is to maintaining cognitive clarity in the aging female brain, society is once again promoting extreme weight loss in female bodies. To which I say, nuh uh, sorry, no way. We are not reviving the whole heroin chic thing yet again. It was bad enough the first time around, when some of us were in our teens, twenties, and thirties. In our forties, fifties, and sixties? No. Our bodies and brains literally cannot and should not endure that kind of restrictive abuse.

In fact, as the now famous FINGER study (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) showed, many of the small steps we take now, in midlife, can make a profound difference in whether or not our brains stay healthy as we age. What are those steps? Exactly what you might imagine they might be: eat brain healthy food—Annie Fenn, MD has an excellent Substack on this topic; get lots of rest and physical activity; use your brain daily, whether at work or with puzzles; manage and monitor cardiovascular health; and—this one’s my favorite—hang out with friends.

“This?” I said. “The three of us chatting away here for hours? This social interaction is one of the key aspects of brain health. And I wish I had more of it.”

Because I see, every day, what Alzheimer’s looks like up close, I know all too well why so many of us are worried about cognitive decline. Never mind the loss of self and memory and independence and continence, any one of which alone would be a profound loss, but together form a constellation of needs that devastate families both emotionally and financially. The other real pressing issue here in the U.S. is that our government provides zero support for this terminal disease that lasts, on average, seven years, but can also keep plodding along indefinitely. (My partner’s wife, for example, who today is 62 and in otherwise good physical shape, first starting showing signs of cognitive decline in 2013, thirteen years ago, when she was 49.)

Doing three sets of 8-10 squats with a heavy kettle bell or dumbbell followed by three sets of lunges using the same heavy weights just three times a week takes no time at all: five to ten minutes max. If you’re worried about proper form, I already covered that in an earlier post:

Anyway, all this to say, I promised my friend I’d put this information about the link between thigh and brain strength out there, and now that you have it in hand feel free to apply it to your legs and to tell other women you know, who might be worried about cognitive decline, to do the same.