PAD and Dementia Risk: 8 Pillars to Protect Your Brain

Okay, PAD Warriors, we need to talk about something that’s been on my mind lately. While we’re often focused on our legs and circulation (and rightfully so!), there’s another critical aspect of our health that deserves attention - our brain.

I recently had the opportunity to sit down with my dear friend and brilliant functional medicine practitioner, Nurse Practitioner Deidre from Ohio, who just returned from an intensive conference where she learned about the “8 Pillars of Cognitive Health.” What she shared literally blew my mind, especially when she connected the dots between PAD, diabetes, and Alzheimer’s disease.

Here’s the reality we face - PAD doesn’t just affect our legs. It’s a systemic vascular condition that can impact blood vessels throughout our entire body, including those that supply our brain. This puts us at higher risk for vascular dementia and other cognitive issues.

I’ve been talking with many of you at our support group meetings and community events, and I know this is something that worries you. When you’re already managing claudication, rest pain, and everything else that comes with PAD, the last thing you want to worry about is your memory slipping away too.

But here’s the good news - and I mean REALLY good news - there’s so much we can do about it! As NP Deidre told me, cognitive decline is often reversible when we address the root causes. This isn’t just about slowing things down - it’s about actually reclaiming brain function!

The 8 Pillars Framework: A Whole-Body Approach

What I love about this framework is that it acknowledges something I’ve been saying for years - everything in our body is connected. As Deidre explained, “Brain health isn’t just about the brain - it’s a whole body approach.”

The pillars are organized into three categories:

Lifestyle Pillars

1. Rest (sleep quality)
2. Nourish (nutrition)
3. Movement (physical activity)

Psychosocial Pillars

1. Connection (social relationships)
2. Growth (learning new things)
3. Reflection (mindfulness practices)

Environment Pillars

1. Remove (reducing toxins and infections)
2. Compose (gut health optimization)

Let’s break these down in a way that makes sense for those of us navigating life with PAD.

Pillar 1: Rest - The Sleep Connection We Can’t Ignore

When Deidre said, “During sleep, our brain is literally washing out toxins,” I nearly fell out of my chair. How many of us struggle with sleep because of leg pain at night? I hear this constantly from our PAD community.

Here’s the catch-22 we face: PAD can cause rest pain that disrupts our sleep, but poor sleep increases inflammation, which worsens both PAD symptoms AND cognitive health. It’s a vicious cycle we need to break.

What you can do tonight:

• Try elevating your legs slightly at bedtime to improve circulation
• Establish a wind-down routine that signals your brain it’s time to rest
• If medication timing is flexible, talk to your doctor about taking pain medications closer to bedtime
• Create a cool, dark sleeping environment

I know some nights are harder than others, but even small improvements in sleep quality can make a tremendous difference for your brain.

Pillar 2: Nourish - The Diabetes-Dementia Connection That Shocked Me

This part of our conversation literally stopped me in my tracks. When Deidre said, “Alzheimer’s is being called type three diabetes,” I had to ask her to repeat it. For our PAD community, where so many of us also manage diabetes, this is critically important information.

The connection is clear: insulin resistance and blood sugar imbalances don’t just damage the vessels in our legs - they’re doing the same thing to our brains. And the statistics Deidre shared are alarming: “Since COVID, our percentage of children with type two diabetes has went up 300%.” This doesn’t just predict more PAD in younger people (which we’re already seeing) - it forecasts a tsunami of cognitive issues too.

What your plate should look like:

• Base your meals around the Mediterranean diet pattern - it’s proven beneficial for both vascular and brain health
• Load up on those “purpley blues” as Deidre calls them - blueberries, blackberries, and purple vegetables that support brain function
• Consider a short-term therapeutic keto approach if your doctor approves (but not the “pure bacon diet” version!)
• Focus on blood sugar stability above all else

Remember when managing your diet: what’s good for your legs is good for your brain. They’re both part of the same vascular system!

Pillar 3: Movement - The Magic We Already Know

Here’s something that should make you smile - that supervised walking program your vascular specialist prescribed? It’s not just helping your legs; it’s feeding your brain too!

As Deidre explained, exercise boosts something called BDNF (brain-derived neurotrophic factor), which she described as “fertilizer for your brain cells.” It helps build new connections while reducing inflammation and insulin resistance - three powerful benefits from one activity.

I know walking isn’t easy for many of us. The pain can be discouraging. But now you have one more powerful reason to push through: every step is building a stronger brain while improving circulation.

Movement strategies that work:

• Start where you are - even small amounts of movement help
• Try chair exercises when standing walking is too difficult
• Consider pool walking for pain-free movement
• Remember the 3-minute rule: if you’re too uncomfortable, stop for 3 minutes, then try again when the pain subsides

The benefits extend far beyond your legs - your brain is thanking you for every minute of movement.

Pillar 4: Connection - Why Our PAD Community Matters

One of the most powerful moments in my conversation with Deidre was when she said, “Loneliness is now considered a risk factor for dementia.” It immediately made me think about how many of you have told me that PAD made you withdraw from social activities because of pain, embarrassment about walking slowly, or fear of not being able to keep up.

This is exactly why I started our support groups (which you should join HERE). The connections we form aren’t just emotionally supportive - they’re literally protecting our brains.

How to stay connected:

• Join our virtual support groups if mobility is limiting your in-person options
• Schedule regular phone or video calls with friends and family
• Be honest about your PAD limitations so friends can plan activities that work for you
• Remember that quality connections matter more than quantity

I’ve seen incredible friendships form in our PAD community. These connections aren’t just making life more enjoyable - they’re building cognitive resilience.

Pillar 5: Growth - Challenging Your Brain

When we’re managing the daily challenges of PAD, learning new things might feel like the last priority on our list. But as Deidre explained, challenging your brain builds “cognitive reserve” - essentially backup systems that help compensate for vascular-related changes.

I love seeing our PAD Warriors take on new hobbies, learn about their condition, or develop skills that don’t require extensive standing or walking. Your brain craves novelty and challenge!

Brain-boosting activities:

• Learn about the science behind PAD (understanding your condition actually strengthens brain networks)
• Try digital photography from a seated position
• Learn a new language using free apps
• Take up knitting, crocheting, or other crafts that exercise fine motor skills and creativity

Remember: learning doesn’t have to be formal education - any new skill or information lights up your neural pathways.

Pillar 6: Reflection - Finding Calm in the PAD Storm

Living with PAD is stressful - the pain, the medical appointments, the fear of progression. Many of you have shared with me how anxiety-producing this journey can be. What Deidre helped me understand is that “chronic stress shrinks the brain’s memory center.” That’s right - the stress of managing PAD could actually be affecting your cognitive health.

Mindfulness practices aren’t just about feeling good - they’re protecting your brain from the damaging effects of chronic stress.

Simple ways to practice reflection:

• Start with just 5 minutes of guided meditation (plenty of free apps available)
• Practice gratitude by noting three positive things daily
• Try body scanning relaxation techniques, especially focusing on releasing tension in your legs
• Use visualization to imagine improved circulation throughout your body, including your brain

These practices reduce inflammation throughout your body, benefiting both vascular and brain health.

Pillar 7: Remove - Clearing the Path to Better Brain Health

This pillar might surprise you, but Deidre emphasized how environmental factors like “mold, heavy metal exposure, or even chronic infections” can significantly impact memory and cognitive function.

While we’re focused on managing PAD, we might miss these other potential contributors to brain fog and memory issues. These environmental factors often promote systemic inflammation - something those of us with PAD definitely don’t need more of!

What to consider:

• If you’ve experienced unexplained cognitive changes, talk to your doctor about testing for mold exposure or heavy metals
• Address any chronic infections with appropriate treatment
• Reduce exposure to environmental toxins when possible
• Consider working with a functional medicine practitioner who can help identify hidden inflammatory triggers

Removing these obstacles allows your body to direct energy toward healing rather than fighting constant inflammation.

Pillar 8: Compose - The Gut-Brain Highway

I’ve been fascinated by gut health research for years, and Deidre confirmed what emerging science suggests: “Gut bacteria produces neurotransmitters, and it can influence inflammation, and it also can help regulate your mood and cognition.”

This connection is particularly relevant for PAD patients, as many of the inflammatory processes that damage blood vessels may be influenced by gut bacteria. Plus, many of us take medications that can affect gut health, creating another potential challenge.

Gut health strategies:

• Aim for Deidre’s recommendation of “30 different colors of fruits and vegetables in a week” to promote gut diversity
• Consider probiotic foods like yogurt, kefir, sauerkraut, and kimchi
• Limit unnecessary antibiotics when possible
• Talk to your doctor about how your PAD medications might be affecting your gut microbiome

A healthy gut supports a healthy brain - and may help reduce the systemic inflammation driving PAD progression.

The Hope Factor: Yes, You Can Improve!

The most exciting part of my conversation with Deidre was learning that cognitive decline is often reversible. “In many cases, yes, it’s reversible,” she affirmed. “The sooner we start to pay attention and focus, the better outcomes we have.”

I’ve seen this same principle apply to PAD - addressing root causes and taking a comprehensive approach often yields results far beyond what people expect. The body has an amazing capacity to heal when we give it the right support.

Your Action Plan as a PAD Warrior

Here’s what I recommend for every PAD Warrior concerned about cognitive health:

1. Get baseline testing: Ask your healthcare provider about inflammatory markers (CRP), glucose levels, insulin, and hormone testing.
2. Prioritize sleep: Address PAD-related sleep disruptions and establish consistent sleep routines.
3. Clean up your diet: Focus on Mediterranean eating patterns with plenty of colorful fruits and vegetables.
4. Move daily: Follow your PAD exercise prescription, celebrating every bit of movement you manage.
5. Stay connected: Join our PAD support groups and maintain your social relationships.
6. Challenge your brain: Learn something new every week, no matter how small.
7. Manage stress: Practice mindfulness daily, even just for a few minutes.
8. Support gut health: Increase the diversity of plant foods in your diet.

We’re In This Together

What inspires me most about our PAD community is how we face challenges head-on, armed with knowledge and surrounded by support. Understanding these 8 pillars gives us a roadmap not just for managing PAD, but for protecting our cognitive health for years to come.

Remember, you’re not just a PAD patient - you’re a whole person with interconnected systems. By caring for your brain, you’re supporting your vascular health, and vice versa.

I’d love to hear which of these pillars resonates most with you or what changes you’re planning to implement. Drop a comment below or reach out in our online community. Your journey matters, and your experiences help all of us learn and grow together.

Subscribe to our Youtube channel as well to learn more & to keep moving forward - one step and one healthy choice at a time.

-Kym

Want to learn more about cognitive health and PAD? The Global PAD Association offers resources, support groups, and the latest research on comprehensive PAD management. Visit our website at PADhelp.org or join our online community today at PADsupportGroup.org. You can also call the Global PAD Association’s Leg Saver Hotline at 1-833-PAD-LEGS.