It's never too late to grow your brain TheStar.com - Atkinson 2008 - It's never too late to grow your brain
There's much people can do to preserve and even enhance brain function — at any age.
Related stories. With medical breakthroughs, the quest for eternal youth and longevity has never been more in reach. But we may be searching for the wrong things, according to two University of Chicago scientists. Good news: there are many easy ways to mitigate the effects aging has on your brain. It's just a matter of firming up that grey matter. From Harvard-educated medical doctor Andrew Weil to naturopath Alan Logan, the advice about nourishing the brain is consistent.
The maximum human lifespan is 122, achieved by Jeanne Calment, who lived in the south of France all her life and ate a healthy Mediterranean diet.
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Brain fitnessSome simple techniques for improving brain function.
THE SERIES Toronto journalist Judy Steed has been writing about social issues for 30 years. Last fall, she embarked on a one-year project to document the most pressing policy implications of our aging society as part of the 2008 Atkinson Fellowship in Public Policy.She has visited dozens of nursing homes and interviewed hundreds of health-care workers, policy-makers and seniors to present this weeklong portrait.
MEMORY: Scientific research into neurological function has an uplifting message these days: It's never too late, and there's a lot you can do to preserve, and even improve, how your brain works
November 13, 2008 Judy SteedSpecial to the Star
"You can teach an old dog new tricks," says Dr. Donald Stuss, a leading neuroscientist. "The brain can potentially grow new cells and make new connections."
Until quite recently, medical science held that the brain, when fully developed, was "a finished deal," Stuss says. Now we know – thanks in part to the groundbreaking insights generated by Baycrest's Rotman Research Institute, where Stuss is director of research and senior scientist – that there is still much to learn.
Case in point: the brain's plasticity. The newly discovered extent of the flexibility and adaptability of our grey matter means "the brain can reorganize, brain networks can change, the brain is not a fixed, limited system," Stuss says. "The brain can generate new neurons and more brain regions can be recruited, brought into play, to help us as we get older."
This knowledge – gained through imaging technologies that show us the brain in action, letting us watch different regions of the brain light up, enabling the measurement of magnetic changes in neurons – has revolutionized scientists' approach to the brain, transformed medical education, and given us hope of delaying, if not preventing, brain dysfunction.
"Different areas of the brain can take over when others are damaged," Stuss says. "The brain can recruit capacity from other parts of the brain."
To take advantage of these incredible new findings, we have to change how we age.
We have to learn how to stimulate our brain in order to keep it healthy into advanced old age.
These are the odds: over the age of 85, between a third and a half of the population will develop dementia, in the present circumstances.
This is what longevity can mean: long years of not knowing what's going on, not knowing who you are.
Aging boomers may boast about their prospects for unprecedented longevity, but the harsh truth is that you can't enjoy old age if you haven't got the healthy brain to go with it.
At Extendicare Lakefield – a typical Ontario nursing home, just outside Peterborough – 86 is the average age of admission, and 85 per cent of residents have dementia.
But it doesn't have to be that way.
That's where the astounding new brain research comes in. The future of neuroscience lies in the exploration of brain regeneration.
Given the demographics – all the aging baby boomers living in fear of dementia, eager to be the first generation to benefit from the new research – and all the money flowing into brain research at advanced scientific facilities around the world, it's no wonder brain researchers can barely contain their excitement.
Thanks to the revolution in brain imaging, modern neuroscience is poised to penetrate the ultimate mysteries of the brain: how memory functions, what causes dementia, how brain deterioration can be prevented.
"There's a whole host of new therapies coming down the pipe," says Dr. Max Cynader, director of the Brain Research Centre at University of British Columbia. "We're the lucky ones."
We're in the right place at the right time, if we live long enough.
Certainly Cynader's Brain Research Centre is benefiting from the unprecedented passion for figuring out the brain. His centre has received upwards of $37 million since 2007 from government and private sources, enough to recruit some of the finest minds in the world.
"Health is more than the absence of disease," Cynader says. "What mechanisms in the brain enable us to age well? How can we avoid neuro-degenerative dysfunction?"
These questions signal a profound shift: from studying advanced brain failure – people with Alzheimer's disease – scientists are turning their attention to preventing dysfunction, supporting brain health, lowering the risks of brain disease – just as we've learned how to prevent heart disease.
After 25 years studying Alzheimer's disease, Dr. Gary Small of UCLA's world renowned Brain Research Institute, is embracing the shift. "It's easier to protect the healthy brain and treat it earlier, rather than trying to treat the brain already damaged (by dementia)."
Small is at the forefront of another development in brain research: "the digital divide," in which "digital natives" – kids who've grown up with technology – are worlds apart from "digital immigrants" — older folks.
Small's results, recorded in a new book entitled iBrain: Surviving the Technological Alteration of the Modern Mind, are startling.
For instance, he found that young men who play violent video games have "an impaired ability to recognize human facial expressions."
Our use of technology, and the way it "distracts from our human experience of face-to-face contact," he asserts, is having a profound impact on the actual wiring of the brain.
More proof of the brain's plasticity – and more uncharted territory for brain researchers to explore
Thursday, November 13, 2008
Wednesday, November 12, 2008
Steps to a nimble mind: Physical and mental exercise help keep the brain fit
Neuroscience is uncovering techniques to prevent cognitive decline.
By Kathleen Phalen Tomaselli, AMNews correspondent. Nov. 17, 2008.
The brain -- containing 100 billion neurons, 900 billion glial cells, 100 trillion branches and 1,000 trillion receptors -- reacts to stimuli in a series of electrical bursts, spanning a complex map of connections. Whether calculating an algorithmic equation or learning the tango, our brain continuously changes in response to our ideas, actions and activities.
Each time a dance step is learned, for instance, new pathways are formed. "Dancing is excellent for the brain and body," says Vincent Fortanasce, MD, clinical professor of neurology at the University of Southern California in Los Angeles. He wrote the Anti-Alzheimer's Prescription. "Not only are you moving around more, your brain is in constant motion as it recalls steps and movements. It's an example that highlights a wave of new thinking about the importance of brain fitness.
Until recently, conventional wisdom held that our brains were intractable, hard-wired computers. What we were born with was all we got. Age wore down memory and the ability to understand, and few interventions could reverse this process. But increasingly, evidence suggests that physical and mental exercise can alter specific brain regions, making radical improvements in cognitive function. "When you challenge the brain with new skills and new ways of doing things, it increases connections in the brain," says Ericka P. Simpson, MD, a neurologist who co-directs the MDA Neuromuscular Clinics and directs the ALS clinical research division at the Methodist Hospital System Neurological Institute in Houston. "It increases synaptic density."
With nearly 72 million Americans turning 65 over the next two decades, physicians need the tools to handle growing patient concerns about how to best maintain brain health. Armed with this new brand of science, frontline physicians will be better equipped to address the needs of aging baby boomers, already in the throes of the brain fitness revolution. "They are the gatekeepers of information, and people listen," says Eduardo Locatelli, MD, MPH, a neurologist and medical director of the Florida Neuroscience Center in Fort Lauderdale. Dr. Locatelli implements brain fitness techniques for his postsurgery epilepsy patients as well as patients who present with mild- to moderate-stage Alzheimer's and dementia. "Encourage new experiences. ... Use it or lose it. Challenge it and gain."
The plastic brain
Within the brain, the pathways and regions that are most utilized generally grow and become stronger while other parts shrink. "The brain is very Darwinian, it's survival of the fittest," says Edward Taub, PhD, a behavioral neuroscientist at the University of Alabama at Birmingham, who has researched neuroplasticity since the 1970s. "At one time it was believed we did not use 90% of our brain. That is false. The brain is a zero sum game. Every part of the brain is used. It has enormous plasticity."
Thus, by challenging the brain and forcing the use of different pathways, brain maps can be altered. And such changes offer young and old -- even brain-injured individuals -- an opportunity to learn or re-learn things. "Vocabulary can increase into age 90," says Gary J. Kennedy, MD, a professor in the Dept. of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine. He also directs the geriatric psychiatry division at Montefiore Medical Center in the Bronx, N.Y. "As people age they may be slower, but they are capable of more and more complex projects."
Brain volume shrinks up to 1% every year after age 65.
To best illustrate neuroplasticity, consider stroke patients with damaged limbs. Contrary to traditional therapy, which works to strengthen the good limb, Taub restrains the uncompromised limb, forcing patients to use the damaged arm or leg. The therapy, constraint-induced movement therapy, also known as CI therapy, helps to rewire the brain.
"The more you use it, more neurons are available ... the more demand for cortical space and the more the patient is able to use the [damaged] arm," Taub said. Over time, small steps lead to improvements in activities of daily living. Ultimately, the damaged limb, at least in part, recovers because, although the brain does not regrow damaged areas, it re-routes around them.
When the brains of CI patients were examined, a tremendous increase in grey matter was detected, and interestingly, Taub says, the healthy part of the brain was recruited for the task. Some of Taub's research was published in the Nov. 1, 2006, Journal of the American Medical Association.
CI applications are now being explored for other forms of brain injury.
Young brains, old brains?
Mental agility begins declining around age 24, says Dr. Fortanasce. But there is a big difference between agility and capacity. "I may be slower, but what I know now far outweighs what I knew at 24," he says. "Some individuals perform their greatest creative work in late life. Verdi, for example, composed Othello at 73 and Falstaff at 79."
Greg Jicha, MD, PhD, assistant professor of neurology at the University of Kentucky College of Medicine, shares related stories, such as that of an 82-year-old who learned to play the trumpet. "I've heard people say, 'You can't teach an old dog new tricks.' That can't be further from the truth," says Dr. Jicha, who also heads the healthy brain aging research group at the university's Sanders-Brown Center on Aging. "When you look at the plasticity of the adult brain, it is amazing."
Mental agility, but not capacity, begins declining around age 24.
But age also brings anatomic changes. Brain weight and blood flow to the brain decrease by 20%. The number of fibers and nerves decrease by 37%. And brain volume shrinks up to 1% every year after age 65. Dr. Fortanasce also points to hormonal shifts, with the presence of dopamine and serotonin diminishing as cortisol, an aging hormone, increases. "Between age 20 and 70, we lose nearly 90% of youth hormones."
So what keeps some brains younger than their chronology? Experts point to a prescription of neurobics. This concept includes life-long learning, trying new things, a healthy diet, social interactions, sleep and physical activity. "Exercise can actually increase neurogenesis and increase the size of the hippocampus," says Dr. Fortanasce, who promotes isometrics and weight-bearing exercise. "Exercise also increases youth hormones. And novelty, doing new things, builds branches."
In a 2006 study in the Journal of Aging and Physical Activity, Brandeis University researchers found that strength training increased the participants' working memory span. The higher the level of resistance, the more memory improved, suggesting that strength training benefits not only the muscles but also the mind.
Dr. Locatelli suggests reversing daily patterns. People who take the same route to work every day need to push themselves beyond their comfort zones. A person can try to eat using his or her weaker hand, for instance. Or someone could listen to another type of music than the type usually favored. Activate unfamiliar areas of the brain, Dr. Locatelli says. The key is new places, socializing with different people, and reading new things.
And primary care physicians can help communicate this message.
"When a patient expresses concern about memory loss, never cast it off as associated with age," says Tom Perls, MD, MPH, associate professor of medicine at Boston University Medical Center. Dr. Perls also heads the New England Centenarian Study. "This is an incredibly serious issue. Losing brain function is devastating." Ask about memory. And rule out other conditions like depression or low thyroid first. "Encourage them to exercise the brain in novel and complex ways," he says.
Exercising new connections
So what about dance steps? At McGill University in Montreal, researchers found that the tango may be better than walking for improving execution of complex tasks because it incorporates elements found in standard neurological rehabilitation programs. It's also fun and social.
Participants, ages 62 to 90, were randomly assigned to a walking group or a tango dancing group, meeting two hours twice a week for 10 weeks. The tango group improved in balance, posture and motor coordination, as well as cognition.
Physical and mental exercise improve cognitive function.
According to new research published in the October issue of the journal Nature Neuroscience, University College London scientists say complex brain processes that enable the memorization and replication of activities such as playing the piano or riding a bicycle require the execution of complicated sequences of movements involving dozens of muscles. According to their research, pianists who learned and practiced their art from an early age had elevated amounts of myelin. This finding suggests that when people learn new skills, myelination might occur. Earlier studies indicated that brains of patients diagnosed with senile dementia had lowered amounts of myelin.
The emphasis, though, is the importance of embracing the complex and novel. And Joe Hardy, PhD, a cognition neuroscientist who develops brain plasticity training programs, says some common-sense advice from physicians is not based on good evidence. "They often recommend doing crossword puzzles," he says. "But evidence suggests that crossword puzzles are not helpful."
Hardy has been developing brain games for the San Francisco-based company Posit Science. The games -- the Brain Fitness Program and Insight -- have been tested in several randomized clinical trials funded by the National Institutes of Health. The results indicate that the brain age clock can roll back 10 years. "The key thing in terms of exercise for the brain: You need to do new things, thus forming new paths," he says.
Some have even compared this new era in brain health to the 1950s, when heart health came to the fore. "New things are coming out all the time, and we are going to see a revolution in brain health," Hardy says. "I think this is going to change the way people age."
Discuss on Sermo Back to top.
ADDITIONAL INFORMATION:
Increasing cognitive reserve
Who will live to be 100?
In a bit of fortune-telling fun, a series of lifestyle-related questions might offer a calculated prediction. The Life Expectancy Calculator can help patients find out how they rate right now and how changes in diet, exercise or sleep patterns might add years to the forecast. The calculator is available online (www.livingto100.com). This tool was created by Tom Perls, MD, MPH, associate professor of medicine at Boston University Medical Center, who heads the New England Centenarian Study.
A related and very important question is whether your patients' brains -- or maybe your own -- will stay young as bodies age.
According to Dr. Perls, building cognitive reserve delays the onset of memory loss, and research suggests that novel and complex brain activities can delay cognitive decline and extend lifespan. "There's a natural tendency to lose muscle as we age," he says, and by building cognitive reserve, people are exercising their temporal lobes as they would their quads.
Dr. Perls has categorized a series of games based on cognitive function, available online (fun.eons.com/brain_games). For instance, stimulating areas in the temporal and frontal lobes with games that focus on recall and retention of past and present information targets memory. For language, focus on the parietal lobe with word-building games that prompt production and understanding of spoken and written communication. Exercising the frontal lobe can be done with problem-solving puzzles and strategy games in which players control and apply mental skills.
For motor function, engage the parietal lobe edge with navigation-type games that encourage body movement through the interaction of the brain, nerves and muscles. For visual-spatial skills, stimulate the occipital and temporal lobes. Games involving discrimination, perception, attention and tracking objects visually can achieve this goal.
Back to top.
London cabbies have bigger hippocampi
London cabbies' brains grow on the job. According to studies by scientists at the University College London Institute of Neurology -- the first published in the April 11, 2000, issue of Proceedings of the National Academy of Sciences with follow-up research presented in 2006 and 2007 -- these professional drivers have a larger posterior hippocampus, the brain region tied to learning and navigation.
Researchers credit complex daily tasks, such as navigating a labyrinth of 320 standard routes in a six-mile area, with increasing brain size. And functional MRI demonstrated that the longer on the job, the bigger the brain.
Still, there may be a price. As brain regions continually competed for space, the posterior hippocampus grew while the anterior hippocampus, which is associated with memory, decreased. "The brain has enormous plasticity," says Edward Taub, PhD, a behavioral neuroscientist at the University of Alabama at Birmingham. He has studied neuroplasticity since the 1970s. "Every part of the brain is used. The more you use a function, it may be at the expense of another."
As an outgrowth of the early taxi driver studies, U.S. scientists began exploring the effects of employing complicated navigational skills. At Brandeis University in Waltham, Mass., scientists created the virtual taxicab video game to study the way brains work. As subjects play, they become increasingly proficient in navigating complex routes, which researchers believe is tied to building cognitive maps of the environment.
Additionally, German scientists reported in the June 2006 issue of The Journal of Neuroscience that the brains of German medical students, while studying for final exams, showed increases in the posterior hippocampus, similar to the London cabbie study. Three months later, according to MRI imaging, the hippocampus had returned to its former size.
Weblink
Life Expectancy Calculator (www.livingto100.com)
Dr. Perls' brain games (fun.eons.com/brain_games
By Kathleen Phalen Tomaselli, AMNews correspondent. Nov. 17, 2008.
The brain -- containing 100 billion neurons, 900 billion glial cells, 100 trillion branches and 1,000 trillion receptors -- reacts to stimuli in a series of electrical bursts, spanning a complex map of connections. Whether calculating an algorithmic equation or learning the tango, our brain continuously changes in response to our ideas, actions and activities.
Each time a dance step is learned, for instance, new pathways are formed. "Dancing is excellent for the brain and body," says Vincent Fortanasce, MD, clinical professor of neurology at the University of Southern California in Los Angeles. He wrote the Anti-Alzheimer's Prescription. "Not only are you moving around more, your brain is in constant motion as it recalls steps and movements. It's an example that highlights a wave of new thinking about the importance of brain fitness.
Until recently, conventional wisdom held that our brains were intractable, hard-wired computers. What we were born with was all we got. Age wore down memory and the ability to understand, and few interventions could reverse this process. But increasingly, evidence suggests that physical and mental exercise can alter specific brain regions, making radical improvements in cognitive function. "When you challenge the brain with new skills and new ways of doing things, it increases connections in the brain," says Ericka P. Simpson, MD, a neurologist who co-directs the MDA Neuromuscular Clinics and directs the ALS clinical research division at the Methodist Hospital System Neurological Institute in Houston. "It increases synaptic density."
With nearly 72 million Americans turning 65 over the next two decades, physicians need the tools to handle growing patient concerns about how to best maintain brain health. Armed with this new brand of science, frontline physicians will be better equipped to address the needs of aging baby boomers, already in the throes of the brain fitness revolution. "They are the gatekeepers of information, and people listen," says Eduardo Locatelli, MD, MPH, a neurologist and medical director of the Florida Neuroscience Center in Fort Lauderdale. Dr. Locatelli implements brain fitness techniques for his postsurgery epilepsy patients as well as patients who present with mild- to moderate-stage Alzheimer's and dementia. "Encourage new experiences. ... Use it or lose it. Challenge it and gain."
The plastic brain
Within the brain, the pathways and regions that are most utilized generally grow and become stronger while other parts shrink. "The brain is very Darwinian, it's survival of the fittest," says Edward Taub, PhD, a behavioral neuroscientist at the University of Alabama at Birmingham, who has researched neuroplasticity since the 1970s. "At one time it was believed we did not use 90% of our brain. That is false. The brain is a zero sum game. Every part of the brain is used. It has enormous plasticity."
Thus, by challenging the brain and forcing the use of different pathways, brain maps can be altered. And such changes offer young and old -- even brain-injured individuals -- an opportunity to learn or re-learn things. "Vocabulary can increase into age 90," says Gary J. Kennedy, MD, a professor in the Dept. of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine. He also directs the geriatric psychiatry division at Montefiore Medical Center in the Bronx, N.Y. "As people age they may be slower, but they are capable of more and more complex projects."
Brain volume shrinks up to 1% every year after age 65.
To best illustrate neuroplasticity, consider stroke patients with damaged limbs. Contrary to traditional therapy, which works to strengthen the good limb, Taub restrains the uncompromised limb, forcing patients to use the damaged arm or leg. The therapy, constraint-induced movement therapy, also known as CI therapy, helps to rewire the brain.
"The more you use it, more neurons are available ... the more demand for cortical space and the more the patient is able to use the [damaged] arm," Taub said. Over time, small steps lead to improvements in activities of daily living. Ultimately, the damaged limb, at least in part, recovers because, although the brain does not regrow damaged areas, it re-routes around them.
When the brains of CI patients were examined, a tremendous increase in grey matter was detected, and interestingly, Taub says, the healthy part of the brain was recruited for the task. Some of Taub's research was published in the Nov. 1, 2006, Journal of the American Medical Association.
CI applications are now being explored for other forms of brain injury.
Young brains, old brains?
Mental agility begins declining around age 24, says Dr. Fortanasce. But there is a big difference between agility and capacity. "I may be slower, but what I know now far outweighs what I knew at 24," he says. "Some individuals perform their greatest creative work in late life. Verdi, for example, composed Othello at 73 and Falstaff at 79."
Greg Jicha, MD, PhD, assistant professor of neurology at the University of Kentucky College of Medicine, shares related stories, such as that of an 82-year-old who learned to play the trumpet. "I've heard people say, 'You can't teach an old dog new tricks.' That can't be further from the truth," says Dr. Jicha, who also heads the healthy brain aging research group at the university's Sanders-Brown Center on Aging. "When you look at the plasticity of the adult brain, it is amazing."
Mental agility, but not capacity, begins declining around age 24.
But age also brings anatomic changes. Brain weight and blood flow to the brain decrease by 20%. The number of fibers and nerves decrease by 37%. And brain volume shrinks up to 1% every year after age 65. Dr. Fortanasce also points to hormonal shifts, with the presence of dopamine and serotonin diminishing as cortisol, an aging hormone, increases. "Between age 20 and 70, we lose nearly 90% of youth hormones."
So what keeps some brains younger than their chronology? Experts point to a prescription of neurobics. This concept includes life-long learning, trying new things, a healthy diet, social interactions, sleep and physical activity. "Exercise can actually increase neurogenesis and increase the size of the hippocampus," says Dr. Fortanasce, who promotes isometrics and weight-bearing exercise. "Exercise also increases youth hormones. And novelty, doing new things, builds branches."
In a 2006 study in the Journal of Aging and Physical Activity, Brandeis University researchers found that strength training increased the participants' working memory span. The higher the level of resistance, the more memory improved, suggesting that strength training benefits not only the muscles but also the mind.
Dr. Locatelli suggests reversing daily patterns. People who take the same route to work every day need to push themselves beyond their comfort zones. A person can try to eat using his or her weaker hand, for instance. Or someone could listen to another type of music than the type usually favored. Activate unfamiliar areas of the brain, Dr. Locatelli says. The key is new places, socializing with different people, and reading new things.
And primary care physicians can help communicate this message.
"When a patient expresses concern about memory loss, never cast it off as associated with age," says Tom Perls, MD, MPH, associate professor of medicine at Boston University Medical Center. Dr. Perls also heads the New England Centenarian Study. "This is an incredibly serious issue. Losing brain function is devastating." Ask about memory. And rule out other conditions like depression or low thyroid first. "Encourage them to exercise the brain in novel and complex ways," he says.
Exercising new connections
So what about dance steps? At McGill University in Montreal, researchers found that the tango may be better than walking for improving execution of complex tasks because it incorporates elements found in standard neurological rehabilitation programs. It's also fun and social.
Participants, ages 62 to 90, were randomly assigned to a walking group or a tango dancing group, meeting two hours twice a week for 10 weeks. The tango group improved in balance, posture and motor coordination, as well as cognition.
Physical and mental exercise improve cognitive function.
According to new research published in the October issue of the journal Nature Neuroscience, University College London scientists say complex brain processes that enable the memorization and replication of activities such as playing the piano or riding a bicycle require the execution of complicated sequences of movements involving dozens of muscles. According to their research, pianists who learned and practiced their art from an early age had elevated amounts of myelin. This finding suggests that when people learn new skills, myelination might occur. Earlier studies indicated that brains of patients diagnosed with senile dementia had lowered amounts of myelin.
The emphasis, though, is the importance of embracing the complex and novel. And Joe Hardy, PhD, a cognition neuroscientist who develops brain plasticity training programs, says some common-sense advice from physicians is not based on good evidence. "They often recommend doing crossword puzzles," he says. "But evidence suggests that crossword puzzles are not helpful."
Hardy has been developing brain games for the San Francisco-based company Posit Science. The games -- the Brain Fitness Program and Insight -- have been tested in several randomized clinical trials funded by the National Institutes of Health. The results indicate that the brain age clock can roll back 10 years. "The key thing in terms of exercise for the brain: You need to do new things, thus forming new paths," he says.
Some have even compared this new era in brain health to the 1950s, when heart health came to the fore. "New things are coming out all the time, and we are going to see a revolution in brain health," Hardy says. "I think this is going to change the way people age."
Discuss on Sermo Back to top.
ADDITIONAL INFORMATION:
Increasing cognitive reserve
Who will live to be 100?
In a bit of fortune-telling fun, a series of lifestyle-related questions might offer a calculated prediction. The Life Expectancy Calculator can help patients find out how they rate right now and how changes in diet, exercise or sleep patterns might add years to the forecast. The calculator is available online (www.livingto100.com). This tool was created by Tom Perls, MD, MPH, associate professor of medicine at Boston University Medical Center, who heads the New England Centenarian Study.
A related and very important question is whether your patients' brains -- or maybe your own -- will stay young as bodies age.
According to Dr. Perls, building cognitive reserve delays the onset of memory loss, and research suggests that novel and complex brain activities can delay cognitive decline and extend lifespan. "There's a natural tendency to lose muscle as we age," he says, and by building cognitive reserve, people are exercising their temporal lobes as they would their quads.
Dr. Perls has categorized a series of games based on cognitive function, available online (fun.eons.com/brain_games). For instance, stimulating areas in the temporal and frontal lobes with games that focus on recall and retention of past and present information targets memory. For language, focus on the parietal lobe with word-building games that prompt production and understanding of spoken and written communication. Exercising the frontal lobe can be done with problem-solving puzzles and strategy games in which players control and apply mental skills.
For motor function, engage the parietal lobe edge with navigation-type games that encourage body movement through the interaction of the brain, nerves and muscles. For visual-spatial skills, stimulate the occipital and temporal lobes. Games involving discrimination, perception, attention and tracking objects visually can achieve this goal.
Back to top.
London cabbies have bigger hippocampi
London cabbies' brains grow on the job. According to studies by scientists at the University College London Institute of Neurology -- the first published in the April 11, 2000, issue of Proceedings of the National Academy of Sciences with follow-up research presented in 2006 and 2007 -- these professional drivers have a larger posterior hippocampus, the brain region tied to learning and navigation.
Researchers credit complex daily tasks, such as navigating a labyrinth of 320 standard routes in a six-mile area, with increasing brain size. And functional MRI demonstrated that the longer on the job, the bigger the brain.
Still, there may be a price. As brain regions continually competed for space, the posterior hippocampus grew while the anterior hippocampus, which is associated with memory, decreased. "The brain has enormous plasticity," says Edward Taub, PhD, a behavioral neuroscientist at the University of Alabama at Birmingham. He has studied neuroplasticity since the 1970s. "Every part of the brain is used. The more you use a function, it may be at the expense of another."
As an outgrowth of the early taxi driver studies, U.S. scientists began exploring the effects of employing complicated navigational skills. At Brandeis University in Waltham, Mass., scientists created the virtual taxicab video game to study the way brains work. As subjects play, they become increasingly proficient in navigating complex routes, which researchers believe is tied to building cognitive maps of the environment.
Additionally, German scientists reported in the June 2006 issue of The Journal of Neuroscience that the brains of German medical students, while studying for final exams, showed increases in the posterior hippocampus, similar to the London cabbie study. Three months later, according to MRI imaging, the hippocampus had returned to its former size.
Weblink
Life Expectancy Calculator (www.livingto100.com)
Dr. Perls' brain games (fun.eons.com/brain_games
Any new symptom in an older person should be considered a drug side effect until proven otherwise
They are the drugged-out generation, and they're not who you think they are.
They're 80. And 85 and 90 and 95 – overmedicated seniors clogging emergency departments, blocking hospital beds and sicker than they have any reason to be.
The Number 1 drug users in North America, outside of patients in long-term care facilities, are women over the age of 65. Twelve per cent are on 10 or more meds, sometimes up to 20 or more drugs; 23 per cent take at least five drugs. In long-term care, seniors are on six to eight medications, on average. Fifteen per cent of seniors admitted to hospital are suffering drug side effects. It's not uncommon to find seniors dizzy and dotty from being prescribed so many drugs. "You'd fall down, too, if you were on so many drugs," says Dr. William Dalziel, a prominent Ottawa geriatrician.
Typically, overmedicated seniors have been seen by numerous specialists who have prescribed various medications to treat a host of chronic ailments – high blood pressure, hypertension, diabetes, osteoporosis, arthritis, heart disease, cancer – but there hasn't been any oversight by a geriatrician skilled in looking at the big picture and assessing contra-indications and side effects.
Ask any doctor with expertise in seniors what their top health concerns are and they all cite overmedication.
Dr. Mark Nowacynski, an exceedingly rare family doctor who does home visits on a full-time basis, shakes his head. "So many old people are prescribed so many drugs, they don't know what they're for and they often don't take them properly," he says.
Nowacynski recalls taking care of an old man who was seeing six specialists.
"He was very anxious and confused; the specialists' advice often conflicted. I was astounded at how many meds he was on, more than 20. He wasn't taking them as prescribed and he was suffering from various side effects and interactions that weren't being monitored."
Over time, Nowacynski – or Dr. Mark, as his patients call him – was able to wean his patient down to fewer than 10 drugs.
One of the reasons overmedication is such a serious issue, apart from the biological aspects, is that seniors become vulnerable to serious falls when they're excessively drugged, and serious falls can lead to a downward spiral of hospitalization, extreme fear of going out, isolation and death. As well, many seniors have trouble sleeping; instead of being encouraged to tire themselves out with exercise and activities, they may become habituated to sleeping pills that leave them groggy during the day.
Another problem, says Dr. Paula Rochon, a Baycrest geriatrician, is that doses for older people should often be much lower than for younger people. She notes that Valium is long acting and very sedating and shouldn't be prescribed at all to seniors.
Not only does overmedication cost the health-care system millions of dollars annually in unnecessary, expensive prescriptions but also the entire system slows down – and wait times for other patients lengthen – as emergency departments and hospitals struggle to diagnose drug-related problems.
Doctors and nurses trained in the ailments of old age and alert to the problem of overmedication can resolve many of these issues quite quickly, but most doctors haven't had any significant geriatric training. Stories are legion about elders blocking emergency rooms and being admitted to hospital, with doctors thinking the old people are having heart attacks and ordering expensive tests when the problem is simply overmedication.
In 1995, the Canadian Medical Association Journal found that doctors who wrote the most prescriptions also had the highest death rates among their patients.
"This study found that some doctors, in trying to maximize the number of patients they could process per day, did not take the time necessary to find out what was wrong with these patients," writes David Foot in his bestseller Boom, Bust, Echo. "That kind of medical practice results in overmedicated and inappropriately medicated patients."
According to Dr. Jerry Gurwitz, chief of geriatric medicine at the University of Massachusetts Medical School: "Any new symptom in an older person should be considered a drug side effect until proven otherwise."
At Baycrest, Toronto's health sciences centre focused on geriatric care, Rochon has spent years working with the facility's doctors, researchers and residents in long-term care to find solutions to overmedication.
"When you're dealing with complex conditions (in seniors) and all these drugs, how do doctors make the right choices?" she asks. "It gets complicated for everybody."
Thanks to her efforts, Baycrest has developed software for a computerized physician order entry system. Instead of scrawling, often illegibly, on a prescription pad, doctors sign in to a database and get full access to residents' medical histories and comprehensive pharmacological information, before they order prescriptions.
Baycrest's wireless networks were upgraded and the centre became the first long-term care facility in Canada, and one of the first in North America, to do its drug prescribing electronically.
"At a glance, you can look at the patients' history, get their age, weight, see what other meds they're on, see their medication history, allergies, blood work, other consults," Rochon says. "Everything you need is at your finger tips."
The U.S. Department of Health and Human Services was so impressed that it funded a landmark study to determine Baycrest's effectiveness in reducing adverse drug events in long-term care. The U of M's Gurwitz, who was a principal investigator, stated that Baycrest was "ahead of the curve in adopting health information technology" and "there are few places like Baycrest in all of North America in which to carry out such a study."
Prescribing is now much improved at Baycrest, Rochon says, and "doctors are making better decisions because they've got better information."
Most Toronto hospitals have followed Baycrest's lead and use computerized physician order systems.
The Ontario government has responded to the issue with the MedsCheck program (MedsCheck.ca), in which pharmacists are paid to assess seniors' medications and detect problems. People who have an OHIP card and are taking three or more prescription drugs for a chronic condition are eligible. On presenting their card, they receive a one-on-one, private consultation for up to 30 minutes with a pharmacist, who will make sure they are taking their drugs properly and educate them about possible adverse drug reactions.
"Some over-the-counter medications can interfere with certain health conditions and adversely affect some prescription medications," the MedsCheck website states. Decongestants, for instance, may be taken to relieve cold symptoms, but they can have the effect of raising blood pressure. Vitamin C can reduce the efficacy of chemotherapy.
Still missing, however, is a Canada-wide policy. In 2002, Roy Romanow recommended a National Drug Agency that would include a national program for managing medications to, among other things, monitor prescriptions and adverse drug reactions among seniors.
"The evidence is that new drugs come on the market every few days and in Canada there is no comprehensive process to address their safety, quality and cost-effectiveness," Romanow says. "Health Canada says it does this, but it doesn't, not like the Food and Drug Administration in the United States."
Romanow says a national program would make a huge difference in the daily lives of seniors, the major consumers of drugs in Canada.
Six years since Romanow's prescription, it has yet to be filled.
They're 80. And 85 and 90 and 95 – overmedicated seniors clogging emergency departments, blocking hospital beds and sicker than they have any reason to be.
The Number 1 drug users in North America, outside of patients in long-term care facilities, are women over the age of 65. Twelve per cent are on 10 or more meds, sometimes up to 20 or more drugs; 23 per cent take at least five drugs. In long-term care, seniors are on six to eight medications, on average. Fifteen per cent of seniors admitted to hospital are suffering drug side effects. It's not uncommon to find seniors dizzy and dotty from being prescribed so many drugs. "You'd fall down, too, if you were on so many drugs," says Dr. William Dalziel, a prominent Ottawa geriatrician.
Typically, overmedicated seniors have been seen by numerous specialists who have prescribed various medications to treat a host of chronic ailments – high blood pressure, hypertension, diabetes, osteoporosis, arthritis, heart disease, cancer – but there hasn't been any oversight by a geriatrician skilled in looking at the big picture and assessing contra-indications and side effects.
Ask any doctor with expertise in seniors what their top health concerns are and they all cite overmedication.
Dr. Mark Nowacynski, an exceedingly rare family doctor who does home visits on a full-time basis, shakes his head. "So many old people are prescribed so many drugs, they don't know what they're for and they often don't take them properly," he says.
Nowacynski recalls taking care of an old man who was seeing six specialists.
"He was very anxious and confused; the specialists' advice often conflicted. I was astounded at how many meds he was on, more than 20. He wasn't taking them as prescribed and he was suffering from various side effects and interactions that weren't being monitored."
Over time, Nowacynski – or Dr. Mark, as his patients call him – was able to wean his patient down to fewer than 10 drugs.
One of the reasons overmedication is such a serious issue, apart from the biological aspects, is that seniors become vulnerable to serious falls when they're excessively drugged, and serious falls can lead to a downward spiral of hospitalization, extreme fear of going out, isolation and death. As well, many seniors have trouble sleeping; instead of being encouraged to tire themselves out with exercise and activities, they may become habituated to sleeping pills that leave them groggy during the day.
Another problem, says Dr. Paula Rochon, a Baycrest geriatrician, is that doses for older people should often be much lower than for younger people. She notes that Valium is long acting and very sedating and shouldn't be prescribed at all to seniors.
Not only does overmedication cost the health-care system millions of dollars annually in unnecessary, expensive prescriptions but also the entire system slows down – and wait times for other patients lengthen – as emergency departments and hospitals struggle to diagnose drug-related problems.
Doctors and nurses trained in the ailments of old age and alert to the problem of overmedication can resolve many of these issues quite quickly, but most doctors haven't had any significant geriatric training. Stories are legion about elders blocking emergency rooms and being admitted to hospital, with doctors thinking the old people are having heart attacks and ordering expensive tests when the problem is simply overmedication.
In 1995, the Canadian Medical Association Journal found that doctors who wrote the most prescriptions also had the highest death rates among their patients.
"This study found that some doctors, in trying to maximize the number of patients they could process per day, did not take the time necessary to find out what was wrong with these patients," writes David Foot in his bestseller Boom, Bust, Echo. "That kind of medical practice results in overmedicated and inappropriately medicated patients."
According to Dr. Jerry Gurwitz, chief of geriatric medicine at the University of Massachusetts Medical School: "Any new symptom in an older person should be considered a drug side effect until proven otherwise."
At Baycrest, Toronto's health sciences centre focused on geriatric care, Rochon has spent years working with the facility's doctors, researchers and residents in long-term care to find solutions to overmedication.
"When you're dealing with complex conditions (in seniors) and all these drugs, how do doctors make the right choices?" she asks. "It gets complicated for everybody."
Thanks to her efforts, Baycrest has developed software for a computerized physician order entry system. Instead of scrawling, often illegibly, on a prescription pad, doctors sign in to a database and get full access to residents' medical histories and comprehensive pharmacological information, before they order prescriptions.
Baycrest's wireless networks were upgraded and the centre became the first long-term care facility in Canada, and one of the first in North America, to do its drug prescribing electronically.
"At a glance, you can look at the patients' history, get their age, weight, see what other meds they're on, see their medication history, allergies, blood work, other consults," Rochon says. "Everything you need is at your finger tips."
The U.S. Department of Health and Human Services was so impressed that it funded a landmark study to determine Baycrest's effectiveness in reducing adverse drug events in long-term care. The U of M's Gurwitz, who was a principal investigator, stated that Baycrest was "ahead of the curve in adopting health information technology" and "there are few places like Baycrest in all of North America in which to carry out such a study."
Prescribing is now much improved at Baycrest, Rochon says, and "doctors are making better decisions because they've got better information."
Most Toronto hospitals have followed Baycrest's lead and use computerized physician order systems.
The Ontario government has responded to the issue with the MedsCheck program (MedsCheck.ca), in which pharmacists are paid to assess seniors' medications and detect problems. People who have an OHIP card and are taking three or more prescription drugs for a chronic condition are eligible. On presenting their card, they receive a one-on-one, private consultation for up to 30 minutes with a pharmacist, who will make sure they are taking their drugs properly and educate them about possible adverse drug reactions.
"Some over-the-counter medications can interfere with certain health conditions and adversely affect some prescription medications," the MedsCheck website states. Decongestants, for instance, may be taken to relieve cold symptoms, but they can have the effect of raising blood pressure. Vitamin C can reduce the efficacy of chemotherapy.
Still missing, however, is a Canada-wide policy. In 2002, Roy Romanow recommended a National Drug Agency that would include a national program for managing medications to, among other things, monitor prescriptions and adverse drug reactions among seniors.
"The evidence is that new drugs come on the market every few days and in Canada there is no comprehensive process to address their safety, quality and cost-effectiveness," Romanow says. "Health Canada says it does this, but it doesn't, not like the Food and Drug Administration in the United States."
Romanow says a national program would make a huge difference in the daily lives of seniors, the major consumers of drugs in Canada.
Six years since Romanow's prescription, it has yet to be filled.
Monday, October 13, 2008
Brain Boost Drugs "Growing Trend"
Brain boost drugs 'growing trend'
Increasing numbers of people are using prescription drugs like Ritalin to boost alertness and brain power, say experts.
Up to a fifth of adults, including college students and shift workers, may be using cognitive enhancers, a poll of 1,400 by Nature journal suggests.
Neuropsychologist Professor Barbara Sahakian of Cambridge University said safety evidence is urgently needed.
Experts gather to debate this topic at a meeting in London on Monday evening.
The use of these cognitive enhancing drugs is spreading to younger and younger people. That's a concern Neuropsychologist Professor Barbara Sahakian
Professor Sahakian's own work shows 17% of students in some US universities admit to using the stimulant Ritalin (methylphenidate) - a drug designed to treat hyperactive children - to maximise their learning power.
One in five of the 1,400 people who responded to the Nature survey said they had taken Ritalin, Provigil (modafinil) or beta-blockers for non-medical reasons. They used them to stimulate focus, concentration or memory.
Of that one in five, 62% had taken Ritalin and 44% Provigil - a drug normally prescribed to alleviating daytime tiredness in people suffering from the rare sleep disorder narcolepsy.
Unchecked
Most users had somehow obtained their drugs on prescription or else bought them over the internet.
Although these are only snapshots of use, Professor Sahakian says it does suggest these drugs are becoming more popular.
Professor Sahakian said given the increasing use of these drugs outside of their intended clinical setting, safety trials were urgently needed.
"We do not really have long-term efficacy and safety data in healthy people. These are studies that really need to be done.
"The use of these cognitive enhancing drugs is spreading to younger and younger people. That's a concern.
"Methylphenidate does have substantial abusive potential so we have to be worried about substance abuse problems and the use of these drugs in the developing brain in children."
John Harris, professor of bioethics at the University of Manchester said people should be allowed to make their own minds up about these drugs.
He said: "If these cognitive enhancing drugs make our lives better and make us better able to concentrate and better able to perform, this would surely be a good thing."
The debate will be heard at Kings Place, London
Increasing numbers of people are using prescription drugs like Ritalin to boost alertness and brain power, say experts.
Up to a fifth of adults, including college students and shift workers, may be using cognitive enhancers, a poll of 1,400 by Nature journal suggests.
Neuropsychologist Professor Barbara Sahakian of Cambridge University said safety evidence is urgently needed.
Experts gather to debate this topic at a meeting in London on Monday evening.
The use of these cognitive enhancing drugs is spreading to younger and younger people. That's a concern Neuropsychologist Professor Barbara Sahakian
Professor Sahakian's own work shows 17% of students in some US universities admit to using the stimulant Ritalin (methylphenidate) - a drug designed to treat hyperactive children - to maximise their learning power.
One in five of the 1,400 people who responded to the Nature survey said they had taken Ritalin, Provigil (modafinil) or beta-blockers for non-medical reasons. They used them to stimulate focus, concentration or memory.
Of that one in five, 62% had taken Ritalin and 44% Provigil - a drug normally prescribed to alleviating daytime tiredness in people suffering from the rare sleep disorder narcolepsy.
Unchecked
Most users had somehow obtained their drugs on prescription or else bought them over the internet.
Although these are only snapshots of use, Professor Sahakian says it does suggest these drugs are becoming more popular.
Professor Sahakian said given the increasing use of these drugs outside of their intended clinical setting, safety trials were urgently needed.
"We do not really have long-term efficacy and safety data in healthy people. These are studies that really need to be done.
"The use of these cognitive enhancing drugs is spreading to younger and younger people. That's a concern.
"Methylphenidate does have substantial abusive potential so we have to be worried about substance abuse problems and the use of these drugs in the developing brain in children."
John Harris, professor of bioethics at the University of Manchester said people should be allowed to make their own minds up about these drugs.
He said: "If these cognitive enhancing drugs make our lives better and make us better able to concentrate and better able to perform, this would surely be a good thing."
The debate will be heard at Kings Place, London
Thursday, October 9, 2008
Musicians Use Both Sides of the Brain Than Nonmusicians: Divergent Thinking
Supporting what many of us who are not musically talented have oftenfelt, new research reveals that trained musicians really do thinkdifferently than the rest of us. Vanderbilt University psychologistshave found that professionally trained musicians more effectively use acreative technique called divergent thinking, and also use both the leftand the right sides of their frontal cortex more heavily than theaverage person.The research by Crystal Gibson, Bradley Folley and Sohee Park iscurrently in press at the journal Brain and Cognition."We were interested in how individuals who are naturally creative lookat problems that are best solved by thinking 'out of the box'," Folleysaid. "We studied musicians because creative thinking is part of theirdaily experience, and we found that there were qualitative differencesin the types of answers they gave to problems and in their associatedbrain activity."
One possible explanation the researchers offer for the musicians'elevated use of both brain hemispheres is that many musicians must beable to use both hands independently to play their instruments."Musicians may be particularly good at efficiently accessing andintegrating competing information from both hemispheres," Folley said."Instrumental musicians often integrate different melodic lines withboth hands into a single musical piece, and they have to be very good atsimultaneously reading the musical symbols, which are like left-hemisphere-based language, and integrating the written music with theirown interpretation, which has been linked to the right hemisphere."
Previous studies of creativity have focused on divergent thinking, whichis the ability to come up with new solutions to open-ended,multifacetedproblems. Highly creative individuals often display more divergentthinking than their less creative counterparts.
To conduct the study, the researchers recruited 20 classical musicstudents from the Vanderbilt Blair School of Music and 20 non-musiciansfrom a Vanderbilt introductory psychology course. The musicians each hadat least eight years of training. The instruments they played includedthe piano, woodwind, string and percussion instruments. The groups werematched based on age, gender, education, sex, high school grades and SATscores.The researchers conducted two experiments to compare the creativethinking processes of the musicians and the control subjects. In thefirst experiment, the researchers showed the research subjects a varietyof household objects and asked them to make up new functions for them,and also gave them a written word association test. The musicians gavemore correct responses than non-musicians on the word association test,which the researchers believe may be attributed to enhanced verbalability among musicians. The musicians also suggested more novel usesfor the household objects than their non-musical counterparts.In the second experiment, the two groups again were asked to identifynew uses for everyday objects as well as to perform a basic control taskwhile the activity in their prefrontal lobes was monitored using a brainscanning technique called near-infrared spectroscopy, or NIRS. NIRSmeasures changes in blood oxygenation in the cortex while an individualis performing a cognitive task."When we measured subjects' prefrontal cortical activity whilecompleting the alternate uses task, we found that trained musicians hadgreater activity in both sides of their frontal lobes. Because weequated musicians and non-musicians in terms of their performance, thisfinding was not simply due to the musicians inventing more uses; thereseems to be a qualitative difference in how they think about thisinformation," Folley said.The researchers also found that, overall, the musicians had higher IQscores than the non-musicians, supporting recent studies that intensivemusical training is associated with an elevated IQ score.
One possible explanation the researchers offer for the musicians'elevated use of both brain hemispheres is that many musicians must beable to use both hands independently to play their instruments."Musicians may be particularly good at efficiently accessing andintegrating competing information from both hemispheres," Folley said."Instrumental musicians often integrate different melodic lines withboth hands into a single musical piece, and they have to be very good atsimultaneously reading the musical symbols, which are like left-hemisphere-based language, and integrating the written music with theirown interpretation, which has been linked to the right hemisphere."
Previous studies of creativity have focused on divergent thinking, whichis the ability to come up with new solutions to open-ended,multifacetedproblems. Highly creative individuals often display more divergentthinking than their less creative counterparts.
To conduct the study, the researchers recruited 20 classical musicstudents from the Vanderbilt Blair School of Music and 20 non-musiciansfrom a Vanderbilt introductory psychology course. The musicians each hadat least eight years of training. The instruments they played includedthe piano, woodwind, string and percussion instruments. The groups werematched based on age, gender, education, sex, high school grades and SATscores.The researchers conducted two experiments to compare the creativethinking processes of the musicians and the control subjects. In thefirst experiment, the researchers showed the research subjects a varietyof household objects and asked them to make up new functions for them,and also gave them a written word association test. The musicians gavemore correct responses than non-musicians on the word association test,which the researchers believe may be attributed to enhanced verbalability among musicians. The musicians also suggested more novel usesfor the household objects than their non-musical counterparts.In the second experiment, the two groups again were asked to identifynew uses for everyday objects as well as to perform a basic control taskwhile the activity in their prefrontal lobes was monitored using a brainscanning technique called near-infrared spectroscopy, or NIRS. NIRSmeasures changes in blood oxygenation in the cortex while an individualis performing a cognitive task."When we measured subjects' prefrontal cortical activity whilecompleting the alternate uses task, we found that trained musicians hadgreater activity in both sides of their frontal lobes. Because weequated musicians and non-musicians in terms of their performance, thisfinding was not simply due to the musicians inventing more uses; thereseems to be a qualitative difference in how they think about thisinformation," Folley said.The researchers also found that, overall, the musicians had higher IQscores than the non-musicians, supporting recent studies that intensivemusical training is associated with an elevated IQ score.
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