Prevention Strategies - Mental Stimulation

New Hope for An Aging Brain

Note: This is not an official Alzheimer's Association publication. It was compiled for information purposes only. If you have a concern regarding your health, or what to take or do for any mental or physical ailment you should consult with a licensed physician.

Perhaps the most exciting discovery in modern brain research is the realization that even old brains can grow new nerves (axons and dendrites), which not only preserve, but expand mental capacities. More importantly, we now know how to promote this new brain growth, even into old age. It's all about making better use of what our genes have already given us.

There are two concepts of interest here - Cognitive Reserve, and Neuroplasticity. In 1989 a post mortem analysis of 137 people with Alzheimer's Disease showed that some patients exhibited fewer clinical symptoms than their actual pathology suggested. These patients also showed higher brain weights and greater number of neurons when compared to age-matched controls. The investigators hypothesized that the patients had a larger "reserve" of neurons and abilities that enable them to offset the losses caused by Alzheimer's. This was recently illustrated in a Canadian study which found that those who knew 2 or more languages had a 5 year delay in developing dementia.

Neuroplasticity is defined as the brain's ability to reorganize itself by forming new connections.

Both of these qualities have been demonstrated in what is now called the Nun study.1
The Nun study began in the early 90's when a group of 676 Minnesota nuns, agreed to join a study on aging and Alzheimer's disease, conducted by Dr. David Snowdon from the University of Kentucky. One of their most fascinating finds was that some who had died with Alzheimer's, as evidenced by autopsies, did not show the typical signs of memory loss. Why? These were those who had stayed the most mentally active, learning and sharing new things, even as they grew older. Most of them had been teachers, and not only had they continued teaching, even into their 70's, but more importantly they continued learning, and using their brains. This process of acquiring and communicating knowledge appears to provide potent protection against memory deterioration. In fact a recent major European study found "...the most effective neuroprotective therapy for Alzheimer's disease may well not be a pill, but education and intellectual activity."2

 

Often as people grow older they feel they have done their work, and now it's time to just kick back, relax and be entertained. But that's not what the brain was designed for. Our mind and memory were designed to be used. The brain would rather be active, learning, solving problems, working puzzles than doing nothing.

 

Best Brain Activities

In addition to the Nun study, other evidence suggests that those with significant cognitive impairment can benefit from brain and memory stimulating activities. In a small sample study, funded by an Alzheimer's Disease Demonstration Grant (which I help manage) involving six individuals with mild to moderate cognitive impairment, it was found that an intensive 12 week program of daily mental and memory exercises (based on research at the University of Washington in St. Louis and marketed as "Pathways to MemoryTM") resulted in significant cognitive enhancement for 4 of the 6 individuals.3 With an average improvement of 20% on the Mini Mental Status Exam and 32% on the seven minute screen, plus significantly improved social interaction. Of the 2 who did not make progress one refused to participate and the other was not able to focus long enough to learn. For more info on this program go to www.homewatchcaregivers.com or call 801 746-1080.

 

Brain Fitness programs from PositScience which target individuals with MCI (Mild Cognitive Impairment) or early to moderate Alzheimer's have demonstrated a similar positive effect. Preliminary results from a study conducted by scientists at Yale University, involving 60 subjects over a 10 week period show patients with early to moderate Alzheimer's disease who used a Posit Science computer based auditory training program, "trend toward better performance on cognitive tests and report improvement in symptoms related to depression."4 For more info go to: http://www.positscience.com/ The cost - about $365.

 

MindFit is another computer based program developed by Oxford University Researchers in the UK, and others in Israel, and marketed by Cognifit through
(www.e-mindfitness.com). Mindfit is believed to have even greater potential than the Posit program, for overall cognitive enhancement.5 And it cost less, about $150 A double-blind clinical trial with users over 50 years of age, including some with mild cognitive impairment, found that MindFit training may improve a variety of cognitive functions.6

During the two-year clinical trial, doctors conducted a prospective, randomized, double-blind study with 121 self-referred volunteer participants age 50 and older. Volunteers
were divided into groups. They were not told whether they were playing a MindFit training program or sophisticated computer games (such as X-O, Tetris, Labyrinth, Sudoku). Each study participant was randomly assigned to spend 30 minutes, three times a week during the course of 3 months at home.

 

While all study participants benefited from the use of computer games, MindFit users experienced greater improvement in the cognitive domains of spatial, short term memory, visuo-spatial learning and focused attention. Additionally, MindFit users in the study with lower baseline cognitive performance gained more than those with normal cognition, showing the potential therapeutic effect of home-based computer game training in those already suffering the effects of aging or more serious diseases. All mentioned improvements are significant to the level of p<.05 or better.6

 

The Balance Board by Body Fit, is another interesting device that claims to not only help exercise the body, but the brain as well. According to Neurobiologist Carla Hannaford, author of "Smart Moves" "Thinking and learning are not all in our head. On the contrary, the body plays an integral part in all our intellectual processes . . .right through old age."

 

In its simplest form, the balance board is round, 16" in diameter, made of a hard plastic, with a serrated top to prevent slipping, and a convex bottom that gives it an instability, which makes it a challenge to balance when one stands on it. And that is the challenge: to stand on the board and keep control of body and head (the brain) so that there is no movement, neither you nor the board. Balancing on this platform requires what is called "bilateral integration" of the right and left brains, all working in harmony. As we grow older our brain's ability to coordinate the two sides of the body, or the two hemispheres is diminished. The brain board may be able to remedy that, resulting in improved mental as well as physical abilities and wellbeing. For more info go to http://www.turningonthelight.com/gravity.html

 

Wii Fit is another higher tech computer/TV based program from Mario Brothers. They also have a board you stand on, but it's electronic and stationary. However, it has a variety of entertaining applications for physical as well as mental exercise. They are fun and interesting, but I haven't yet seen any study that validates their efficacy for brain fitness. Nevertheless, both of these devices, when used, likely provide additional activities of significant cognitive value. 7

 

Music

Additionally, certain types of music have also been found to have a therapeutic benefit and appear to facilitate various cognitive abilities, including enhanced memory in seniors with moderate cognitive impairment in residential senior care facilities.8 This topic is large enough however, that I plan to do a later review on it. So for the time being, just keep listening to or playing that good old classical music, especially from the Baroque era.

 

Inexpensive Good Alternatives

But you don't have to buy fancy new software or do exotic brain exercises, to get a good mental workout - though these can be fun and helpful. Here are 4 activities, great for your brain and they are free!

 

Read and recite. To often we rely on television for our education and entertainment. But reading is much better for the brain. When we are reading, we have to translate the letters, and then create the pictures in your head. In fact one study found we use more brain power while sleeping than watching TV. Why? Because while dreaming the brain is still coming up with pictures. But entertainment television has almost a hypnotic numbing effect on the brain.

 

If you would like to double the value of reading for your brain, try this simple exercise. After each page or perhaps each paragraph, put down what you are reading and answer the question - "What did I just learn?" That simple act of recalling and reciting what you read, can do much to help strengthen your memory. And for an even greater benefit to your brain, share what you've learned with someone else - family members, friends, neighbors, your dog or anyone else who will listen. Social interaction is another great boon for the brain. People who seldom talk with others are more than twice as likely to develop dementia. On the other hand people who talk a lot, who socialize and share seldom develop this disorder.

 

Write. Another great activity, especially if you are on your own, is writing. Writing to friends, family, grandchildren. If you don't have an e-mail account invite someone to help you set one up. It's easy and inexpensive. It may seem difficult at first, but that's good for your brain.

 

Writing personal and family histories is another great activity for memory maintenance. There is much you know and have experienced that needs to be passed on to posterity. That may be one of the greatest legacies you can leave - your recollections of your life and family history.

 

Arithmetic. Working math problems will help to exercise another important part of your brain that often deteriorates in old age. Do you remember your times tables? Can you could backwards by 5's, how about 7's? Do you try to calculate the cost of your groceries while you shop? All of these activities can help to keep this part of your brain sharp.

 

More for Less

In fact anything that requires you to use your mental faculties of focusing, analyzing, picturing, remembering, problem solving. Other great brain activities that require one or more of these skills and other cognitive abilities include crossword, jigsaw or other puzzles, sudoko, memorizing poems and verses, playing various card, word or board games, like chess, checkers, dominos, scrabble, charades, Jeopardy, Wheel of Fortune, knitting, making something, fixing something, attending a class or lecture, studying a new topic, discussing politics or religion with someone of a different opinion, taking up a new hobby, learning to play the piano or some other instrument, planning a trip or budget, balancing your checkbook, visiting a museum or mall, volunteering to assist others. It all helps!

 

A later study of Catholic Priests showed those who were the most conscientious, the most mentally disciplined, who lived with purpose, goals and plans, tended to stay the healthiest mentally.

 

Remember the brain was designed for life long learning. We must use it or lose it.
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References

  1. 1. http://www.mc.uky.edu/nunnet/scientific.htmSnowdon DA: Aging and Alzheimer's disease: Lessons from the Nun Study The Gerontologist, 37(2):150-156, 1997. Snowdon DA, Riley KP: Professor Snowdon replies. Gerontologist, 38:5-6, 1998. Tyas S, Snowdon D, Desrosiers M, Riley K, Markesbery W: Healthy ageing in the Nun Study: Definition and neuropathologic correlates Age and Ageing, 36(6):650-655, 2007. Mortimer JA, Borenstein AR, Gosche KM, Snowdon DA: Very early detection of Alzheimer neuropathology and the role of brain reserve in modifying its clinical expression Journal of Geriatric Psychiatry and Neurology,18(4):218-223, 2005.
  2. De la Fuente-Fernndez R (2006) Impact of Neuroprotection on Incidence of Alzheimer's Disease. PLoS ONE 1(1): e52. doi:10.1371/journal.pone.0000052
    Article URL: http://www.medicalnewstoday.com/medicalnews.php?newsid=5961
  3. Telephonic and e-mail correspondence with Kevin Whatcott Director of Homewatch CareGivers, providers of the Pathways to MemoryTM program, Salt Lake City, UT, on 29 May 2008. This program concentrates on the intact implicit memory to assist individuals struggling with cognitive decline, shortened attention span, memory gaps, and disorientation. http://www.homewatchcaregivers.com/Pathways-To-Memory.aspx
  4. 4. http://www.positscience.com/science/studies_results/cognitive_interventions/
    Kramer J., University of California at San Francisco, Computer-Based Training for Mild Alzheimer's Disease: Auditory Training Pilot Study, Manuscript submitted to the Journal of the International Neuropsychology Society (JINS), Manuscript in preparation for NeuroImage. Choi, J., et al. Efficacy of Personalized Approach to Rehabilitation in Early to Moderate Alzheimer's disease. Yale University School of Medicine, Department of Psychiatry.
  5. 5. http://www.sharpbrains.com/blog/2007/02/03/mindfit-and-posit-science-in-the-wall-street-journals-putting-brain-exercises-to-the-test/
  6. 6. These results were presented the 16th March 2007 at Eighth International Alzheimer's Disease/ Parkinson Disease Conference in Salzburg, Austria. www.mindweavers.com http://www.mindweavers.com/index.php?p=s1/trials&s=show_brainhealth&c=
  7. 7. http://www.nintendo.com/wii; http://us.wii.com/
  8. 8. Sheila Ostrander, SuperLearning 2000; http://www.superlearning.com/;
    Michael Ballam, PhD. Utah State Univerity, personal e-mail dtd 26 April 2007, plus the author's personal experience as well as the experiences of graduate students working in this setting with this population.