Sedanter yaşam tarzının, Alzheimer hastalığı ve hafıza kayıpları risk düzeylerini arttırmaktadır (Voss ve ark., 2019). Üzülerek belirtmem gerekirse, hafıza kayıplarının tedavisi henüz tanımlanmamıştır (burada belirtilen hafıza kaybı tanımı, fonksiyonunu yitiren beyin hücreleri veya yolakları ile ilgilidir). Ancak sevindirici olan gelişme, fiziksel aktivitenin hem beyin fonksiyonlarının önlenmesine hem de yeni sinir bağlantılarının oluşmasına yardımcı olabileceğidir. Literatür incelendiğinde, insan ve hayvan denekleri üzerinde yapılan akademik araştırmalar, fiziksel aktivitenin yaşa bağlı beynin bilişsel fonksiyon bozulması veya kaybının önlenmesinde önemli rolü olduğu ve ayrıca beyin fonksiyonlarının ve bilişsel düzeyin gelişimine katkı sağlayacağı iddia edilmektedir (Duzel ve ark., 2016).
Ulusal Akademilerin ve Ulusal Tıp Akademilerinin uzun dönem prospektif çalışmalarında tutarlı bir şekilde fiziksel aktivitenin bilişsel fonksiyon azalımı ve demans (unutma ve hafıza kaybı hastalığı) görülme durumunu azaltma etkisi olduğu vurgulanmaktadır (Beydoun, 2014; Blondell ve ark., 2014). Çapraz kesitsel çalışmaların bulguları, yüksek fiziksel aktivite düzeyi veya kalp-solunum fitness seviyesinin yüksek olması beyin fonksiyonlarını doğrudan ilgilendiren “Beyin-Türevli Nörotrofik Faktör” (BDNF) salınımı üzerine olumlu etki edebileceği ifade edilmiştir (Whiteman ve ark., 2014).
Son yıllarda beynin hipokampüs bölgesi (şekil olarak deniz atına benzemesinden dolayı latince bu isimle anılan beynin hafıza ile ilgili bölümü) ile ilgili oldukça fazla araştırma yapılmaktadır. Hipokampüs, beynin temporal lobunun medial kısmında bulunur. Hipokampüs bölgesi, temel olarak hafıza, duygulanım, konumlama ve yön bulmada önemli rol oynamaktadır. Hipokampüs alan, bir gri cevher tabakadır (Voss ve ark., 2019). BDNF aynı zamanda, beynin hipokampüs bölgesinde bulunan dentat giruslar yoluyla (hipokampüsü oluşturan üç bölümden biridir ve yeni episodik-anısal bağlantıların oluşmasına yardımcı olur), erişkin memelilerde yeni nöron oluşumunu sağlayan bir dizi süreci de indüklemektedir. Ayrıca bu sürece erişkinlerde “Nörojenez” adı da verilmektedir (Sorrells ve ark., 2018; Boldrini ve ark., 2018). Fonksiyonel açıdan dentat girus aktivitesindeki artış nöron üretimine de bazı faydalar sağlamaktadır. Aynı zamanda, bu süreç omurga ve sinaps yoğunluğunun sürdürülmesine katkı sağlar ve sağlıklı yaşlanmayla ilgili hipokampal alan kaybını önlemeye yardımcı olabilir (Lister ve Barnes, 2009). Tüm anlatılan bu süreçler, yeni nöron oluşturma potansiyeli açısından incelendiğinde, fiziksel aktivitenin erişkinlerde sinaptik plastisiteye neden olabileceği iddia edilmektedir. Fiziksel aktivite kaynaklı erişkinlerde meydana gelen sinaptik plastisite artışı spatial hafıza ve teta ritim üretimi için önemli olan beyin bölgelerinde inervasyon artışına neden olabilir (Vivar ve ark., 2016). Ayrıca, literatürde hayvan modellerinden elde edilen ve insan odaklı bazı çalışmalarda fiziksel aktivitenin, hipokampal çemberlerdeki teta ritimde nöron ateşlemesinin senkronizasyonunu arttırdığı vurgulanmıştır (Vanderwolf, 1969; Randeiro ve Rhodes, 2018). Fiziksel aktivite, lateral entorinal kortekste sinaptik transmisyon için önemli gen ifadelerini uyarmaktadır (Vivar ve ark., 2012; Woods ve ark., 2018). Literatür örnekleri incelendiğinde, yaşlı 40 erişkin üzerinde yapılan bir araştırmada, fitness düzeyindeki artışlar hipokampal serebral kan hacmi artışları ile ilişkili olduğu vurgulanmıştır (Maass ve ark., 2015). Bu noktada fitness seviyesindeki değişiklik ile ilgili dikkat edilmesi gereken en önemli etkiler, tüm hipokampül alan üzerinde ve serebral kan hacmi değişikliklerinin anterior hipokampül hacim artışına neden olabileceğidir (Erickson ve ark., 2011; Thomas ve ark., 2016).
Literatür incelendiğinde, orta yoğunluklu fiziksel aktivitenin beynin bölgesel olarak bazı alanlarının yapısal olarak büyümesine ve metabolik açıdan fonksiyonel gelişimine neden olabileceği ifade edilmektedir (Voss ve ark., 2010a). Bu noktada dikkat edilmesi gereken önemli konu, beyin fonksiyonlarında gelişmeye neden olan fiziksel aktivitenin ne kadar sürdürülmesi gerektiği sorunsalıdır. Literatür açısından bu sorunsal, beyin fonksiyonlarının hem yapısal hem de metabolik açıdan gelişimi için en az bir yıl süreyle takip edilen (fitness düzeyi yüksek olanlar 6 ay olabilir) ılımlı/orta yoğunluklu egzersizlerin etkili olabileceği yönündedir (Boraxbekk ve ark., Voss ve ark., 2016; Flodin ve ark., 2017).
Yaşla birlikte beyinde görülen fonksiyonel bağlantı problemleri (posterior ve prefrontal cortices) geniş anlamda bilişsel becerinin bozulmasına neden olmaktadır (Andrews-Hanna ve ark., 2007). Aerobik egzersizlerin, beyinde yaşla birlikte görülen fonksiyonel problemlerin giderilmesine katkı sağladığı düşünülmektedir (Voss ve ark., 2010a; 2010b). Bu noktada, düzenli aerobik egzersizler bilişsel becerinin fonksiyon bozulmasını önlemede etkili bir strateji aracı olduğu söylenebilir. Bir başka açıdan düzenli fiziksel aktivite yapmak, nörotransmiter fonksiyon, nörotrofik destekleme, sinaptik plastisite, vasküler perfüsyon ve reaktivite üzerine bütünleyici etkiler sağlamaktadır. Düzenli egzersiz kaynaklı trofik faktörlerin gelişmesi beyin fonksiyonlarını gelişimi açısından son derece önemlidir (Cotman ve ark., 2002). Aynı zamanda, BDNF, sinaptik plastisite, nörit büyümesi, nörojenesis ve hücre yaşamının korunmasında gibi önemli süreçlerde rol almaktadır (Sleiman ve Chao, 2015). BDNF aktivitesinin bozulması veya azalması beyin fonksiyon sinyallerinde bozulmalarla ilişkilendirilmiştir (Heldt ve ark., 2007). Bir meta analiz çalışmasında fiziksel aktivitenin BDNF aktivitesi üzerine yüksek düzeyde etki edebileceğine dair kanıtlar sunulmuştur (Szuhany ve ark., 2015).
Beyin Sağlığı için Fiziksel Aktivite Seçenekleri
Beyin fonksiyonları ve hafıza gelişimi için tercih edilmesi gereken egzersiz seçeneğinin belirlenmesi son derece önemlidir. Bu noktada, genel olarak egzersiz tercihleri oluşturulurken yaş, cinsiyet, sağlık geçmişi, vücut ağırlığı, güncel fitness seviyesi gibi bireysel farklılıklar göz önüne alınmalıdır. Ayrıca, yukarıda belirtilen bireysel farklılıklara göre egzersiz türü, süresi, yoğunluğu gibi antrenman bileşenleri ayarlanmalıdır. Tüm bu egzersiz düzenleyicileri göz önüne alınarak beyin sağlığı ve hafıza fonksiyonları için efektif egzersiz seçenekleri oluşturulabilir. Beyin ve bilişsel fonksiyonların gelişimi için optimal egzersiz seçeneği, maksimum kalp atım hızının %60’ ı üzerinde bir yüklenme yoğunluğu ile haftada üç kez günde 1 saat yapılan aktiviteler tercih edilebilir. Literatür açısından genel kabul görmüş egzersiz tavsiyesi, haftalık toplam 150-210 dk arasında ılımlı/orta yoğunluklu aerobik egzersizler olarak ifade edilmektedir. Ayrıca, kısa süreli yüksek yoğunluklu egzersizlerin de nöral plastisite ve hafıza fonksiyonlarını geliştirme potansiyeli olduğu ifade edilmiştir (Basso ve Suzuki, 2017; Roig ve ark., 2013; Suwabe ve ark., 2018).
Haftanın Mottosu: “Fitness düzeyinizin yüksek olması birinden iyi olmanız açısından önemli değildir. Önceki seviyenizden daha iyi olmanız ile alakalıdır.”(MEK)
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