An Active Mind Is a Healthy Mind

How many studies do we have to see before we accept that exercising our brains makes them highly likely to be healthy throughout our lives? The Chicago Aging Study from the Rush University Medical Center has just released results of yet another aspect of their large, multi-year study. This time, more 700 than folks with an average age of 80 were observed. The people who regularly and consistently engaged in cognitively stimulating activities--reading the newspaper, playing chess, seeing plays, reading and visiting the library--were 2.6 times less likely (almost three times less likely!) to develop dementia and Alzheimer's than those who did not engage in such activities. Even mild cognitive impairment, typically associated with age, was greatly delayed and reduced.

I find it interesting that so many of the activities described were interactive ones. In other words, other people were involved, as in a chess partner or seeing a play or going to the library. I believe we will find in future studies that positive interactions with others is a significant method of motivating us to keep our minds in gear.

More Transitions

Quixit, Inc., the company I started in 2005 to distribute scientifically based casual online games that focus on specific cognitive skills, such as attention and memory, was acquired yesterday by SBT, a French firm based in Lyon, France. As of today, I will no longer be affiliated with the new company, now called HappyNeuron, Inc. In my roles as CEO of neuroscience technology companies, Quixit and previously Scientific Learning Corporation, I have enjoyed getting to know the scientists, researchers, journalists, publishers, and many others so keenly interested in trying to figure out how to add to our knowledge base about healthy lifestyle choices, the impact of nutrition and exercise on brain health, and the major effects of mental stimulation in keeping our minds healthy and agile. So much is known yet so little has made its way to most people. And there is so much work that needs to be done. I look forward to the now-frequent research reports coming out almost on a weekly basis from respected research institutions on these topics and applaud those in the trenches working to prevent and treat diseases of the mind.

I continue to be curious about and interested in brain fitness and how we all can lower the probabilities of age-related cognitive decline, especially Alzheimer's and other kinds of dementia. I've seen first-hand how devastating the effects can be on the patient, family, and friends. The good news? We can all hope and expect that we will see great strides in our lifetimes in what we know about these horrific diseases of the mind.

Change typically forces new learning and is an excellent way to keep our brains in shape. So change is in the air for me and I welcome this opportunity to move into something new and different.

Transitions

I flew in on the red-eye from the West Coast to Atlanta, rented a car, and drove the rental car 45 minutes northeast to the small town where my mother lives just as the sun was coming up. I’ve made this trip from west to east coast numerous times over the last few months and several times in a crisis mode, as I am now. My mother has gotten weaker and smaller and more vulnerable with each passing week, kicked off by a debilitating virus at the end of December.

Bleary-eyed, I walk into her darkened room at the assisted living home at around 5:30 a.m. The hospice caretaker is writing on a pad, sitting quietly in the often-reupholstered wing chair, my mother’s favorite place to sit, her grandfather’s chair. Many of her things have been moved to make room for a large, steel-framed hospital bed, with protective bars along the sides of the bed, that takes up most of the space. I slip the cold, metal bars down so I can move closer. I take my mother’s hand, smaller but still soft and smooth, in mine. Her brown eyes open and widen, with great intensity.

“It’s you,” her lips move into an almost smile, with great effort. She looks at me directly, extremely focused.

“Yes, I’m here, Mother. I love you.” I reach down to gather her frail, thin shoulders in my arms to hug her, to touch her, to let her know how much I love her. My ear is close to her lips.

“I’m dying.” She whispers, slowly and deliberately. She pauses. “Good-bye. I love you.”

I hug her. Tighter. Tears flood my eyes and spill in waves down my cheeks. Emotion clogs my throat. My mother has always, even when I was a small child, talked to me with unembellished honesty, sometimes entrusting me with secrets and knowledge well beyond what a child normally receives. She always tried to help me understand why things happen the way they do or the rationale behind her beliefs and values and those of others. She taught me to look at people as individuals. Once again she is sharing her honest assessment of the situation, at once bringing me into the inner circle of her secret thoughts, collaboratively, helping me to understand, and preparing me for what is ahead in her usual thoughtful, loving, and thoroughly open way. And this time, I know that she has summoned from somewhere deep inside her the energy to focus just on me, let me know how much she loves me, and help me with this transition I’m about to experience. She has somehow put her dementia and physical frailty aside to deliver this intense affection directly to me. The nicest gift I could ever receive.

This transition is a much larger one than I expected. I am no longer part of the sandwich generation. My mother has been my only living parent. I will no longer receive direct support and sustenance from my mother, although the dementia that my mother experienced much reduced her ability to express these emotions in the last years. But I still felt them every time her brown eyes got big and excited when I entered her room. She has never failed to recognize me and rejoice in seeing me, in her intense but increasingly smaller ways.

Suddenly, I am no longer arranging my schedule and that of my family to fly to see her as often as possible. I won’t be taking her on shopping excursions, to see movies or museums, or out to lunch and dinner. I won’t be making time in my life for calls and visits or analysis of her prescriptions, medical care, or bills. I won’t be ordering yellow roses or lavender orchids, her favorites, to brighten her room—and her face. I won’t be seeing her big brown eyes widen with joy when I come through the door. The void is huge. The transition is difficult. But I know that death is part of life. My mother taught me that.

Brain Fitness Buzz

The last couple of weeks have been filled with media reports about brain fitness programs. The NY Times weighed in on the topic on the front page on December 27 with "As Minds Age, What's Next? Brain Calisthenics?" This article was quickly syndicated across the US and around the world (the International Herald-Tribune) and became the number one-emailed article of the week. I think we can say with some certainty that brain fitness is a topic of interest to millions and millions of people. Several blogs picked up the drum beat, too. The Today show on NBC put their own spin on the topic on Tuesday morning. Happy Neuron was one of the programs showcased in the NY Times and on the Today show.

I think it's great that the media is picking up on the very real interests of so many people, who are really thinking hard and searching high and low for good science on keeping their mental edge as the years go by (another way to say prevention of Alzheimer's and dementia). I admit that I was irritated by two comments: (l) "just do crosswords" because we know from numerous research studies that crosswords may be fun but don't do much for the brain--they're just too one-dimensional; and (2) why turn to software for brain exercise? why not do something free like learn a language or learn to play a new musical instrument? Hey, last time I checked, those two learning adventures were far from free.

Let's look at the real value of sites like Happy Neuron. Most of us would prefer to take a walk in the park every day but some days it's rainy or we don't have time so we hit the treadmill. Some days we don't have time for learning the cello or practicing Chinese either so one convenient thing to do is go online and exercise specific cognitive skills, like memory, concentration, reasoning, visual-spatial and language skills--all keys to learning and everyday living.

I'm extremely glad that awareness is building: brain exercise should be a part of a healthy lifestyle just like good nutrition and physical exercise. All are critical to our overall health and quality of life.

Brain Health: We're Starting to Test the Right Things

As the director of a longevity center at a respected research institution said to me recently, "We just haven't figured out what to test. We haven't been creative enough." She was referring to our discussion of what kinds of exercises really keep our brains fit. That seems to be changing.

Jonathan McNulty of the School of Medicine and Medical Science, University College, Dublin, has tried a different approach. And it works. His team found that simple yet intensive memorization followed by a rest period resulted in ". . . both metabolic changes in the brain and improved memory performance." The 55- to 70-year-old volunteers were given six weeks for intensive rote memorization tasks, such as memorizing a newspaper article or poetry, of 500 words. They then had six weeks of rest.

Here's the kicker: when tested immediately after the memorization work, there was no change in brain metabolism or memory performance. But after the six-week rest, all of the volunteers showed improvements in verbal and episodic memory (the ability to relate story or tell a joke).

This reminds me of a trick I've long used: if I have a problem I need to figure out, I assign my brain the task, usually before going to sleep, and forget about it. Typically, later (and sometimes immediately when I wake up the next morning), a solution or at least a way of thinking about the problem pops up (without being summoned) in my mind. Our brains clearly need some down time to work on their own without our conscious interference.

Recently, there have been several studies using the Stroop test. That's the one with color words written in a different color (the word blue written in yellow, for example) and you're asked to identify the color of the letters. The distraction of automatic reading of the word makes it challenging to identify the letter color. Several researchers have shown that intensive work on the Stroop test (or similar tests or games) can substantially improve driving skills. Why? Because driving requires concentration--the ability to override distractions and automatic responses and choose the required response.

To me, these studies test the right things and are beginning to prove that practice on cognitive process (fluid intelligence) is just as important as acquired knowledge (crystallized intelligence). It takes both to keep our mental edge.

Mother Was Right: Eat Your Vegetables (They're Good for Your Brain)

Martha Clare Morris, associate professor at Rush University Medical Center in Chicago, has been observing the effects of diet on aging and the brain. She and her team have found that eating vegetables, especially green leafy ones, every day can make a big difference in the brains of those who crunched through kale, spinach, lettuce, chard, and other green leafies and those who didn't: faster thinking. Or, as she put it, the equivalent of being five years younger in age for the veggie-consumers.

The study involved six years of observation of 3,718 participants who were 65 and older and is part of the Chicago Health and Aging Project.

The reason? "Morris suspects that vegetables may help protect memory and thinking speed because they contain high amounts of vitamin E, an antioxidant that can help reduce the damage caused by free radicals, unstable oxygen molecules generated by normal metabolism that can damage neurons in the brain and contribute to dementia." These research results were reported in the Oct. 24 issue of the journal Neurology.

In another report issued by the AMA last year, Morris concluded that eating fish at least once a week increases brain fitness, too, equaling a brain-age three-to-four years younger. Fruit-eaters did not experience such brain-related benefits.

I think by now we all know that green leafy veggies and fish are good diet choices. We didn't know that they could make that much difference. Berkeley Professor of Integrative Biology, Marion Diamond, has been saying this for quite some time, however.

Technorati tags: cognition, brain, Alzheimer's, dementia, memory, brain fitness, diet

Scheherazade

My mother sits in her grandfather's wing chair upholstered many times over, now covered in worn fabric with a creamy yellow background with small blue flowers. We have just moved all of her things, again. Her paintings fill the opposite wall, two and three deep, almost up to the ceiling. The high ceiling of the room, which we call an apartment, provides the space for my mother's precious drawings, prints, paintings, and found art that make up the framework of familiarity and memory of her 80-something-year-old life. We feel comforted by that and hope she is, too. Her children, my sister, the baby and now in her 40s, my brother who is retired, and myself, the oldest, have moved her choices of furniture and keepsakes into the "apartment" with one door leading out into the world and one door leading to the nurses' station and the cheerful atrium with dining tables and comfortable living room sofas.

I sense that Mother feels numb. I think she wants to laugh and smile and cry again. She wants to be interested again in life, love and adventure. She has always had such a strong inner life, protecting her most prized possession, her creativity. But now, her eyes have lost their gleam, their energy and willfulness, their life. Her life. She often complains of the intense pain in her lower back and has focused on her pain, the pain of going on and on and on, the pain of living beyond her routine, her fulfillments, her husband, her friends, the pain of having to learn everything, and every person, in a new place, all over again. She seems tired, worn with living. She often falls, sometimes head first, sometimes against the bed or the bureau, leading to more pain, more confusion. And fear.

Her muscles have contracted to nothing, her thin-skinned arms hang with flesh instead of flexing with taut muscles as they did in her gardening days, symbolic of all that has faded, evaporated, gone away. Her skin is paper-thin and so wrinkled, cream crepe with dark purple, light mauve and brown tie-dyed colorations, in strange patterns. her own patterns. She always covers her arms now with fabric, not with the lively colored stones of her many, many bracelets. She avoids deep v-neck shirts and blouses, for the same reason, and has lost interest in her vast collection of earrings and necklaces. She still takes some glory in her beautiful silver white hair. She hangs on to her weekly hair appointments like they're the last life raft available from the sinking ship of age. And she does perk up visibly after having her shampoo and coif; she clearly feels comfortable reminiscences of her former beauty and self.

I flew in from California to see her. We have had a heavy schedule of movies this week. My mother loves for me to take her to movies and restaurants when I am in town. We go in the early afternoon to avoid the crowds. Moving her body from car to wheelchair through the thick, slow-opening doors of the theaters is hard work. She always goes to the restroom afterwards, which is arduous for both of us.

"Mother, do you need anything or would you like anything?" I ask as my mother and I return from an art movie. We've had an early dinner at the French cafe next door to the film house, sitting on the terrace, enjoying the sun in our faces. My mother looks so small in her wheelchair. "Would you like some particular kind of food? Or books?"

She shakes her head and then suddenly brightens. "Classical music," she whispers.

"Great. So you've been using that CD player I got you?" She nods. "OK, what would you like? Mozart, Bach, Brahms, Vivaldi?"

"Yes, yes," she shakes her head up and down slowly, looking at me intensely. "I've missed music."

I hope so, I thought. This is a woman who has always had music in her life. I feel a pang. My sister and I sold her beautiful white enameled grand piano. She loved playing and owning that piano. She loved composing. She loved singing and playing for others. She loved to dance, too. Music brought joy to my mother's face, everyday as she played a few pieces alone for herself. As a child, I felt calmer and somehow more loved when I heard her magical soft touch on the piano. It meant Mother was having a happy, small spiritual energizing interlude. And I was included if I was in hearing distance.

Her short-term memory is shot. Her body is frail and broken. Her hand-eye coordination is pitiful. She's lost her sense of humor, her saucy edge, her flirtatious kick, and her multitude of interests. She has had many batches of TIA's, those nasty clusters of little strokes that put roadblocks on the brain's neural paths. We call them MIA's because the mother we knew is missing in action now.

I stop by the local music store and run in to buy an armload of classical CDs: Brahms, Beethoven, Rimsky-Korsakov. "Art, music, reading, writing, travel, and appreciation of nature are all manifestations of the great spirit within us that needs to be heard, " my mother often told me as I was growing up.

"Can you help me dress for bed?" Mother says, even though it's just now 6 p.m. We've arrived at her apartment after our afternoon foray into movies, food, and CD-buying.

"Sure." I carefully pull her pink sweater over her newly coiffed hairdo. Multiple folds of flaccid skin hang from her upper arms but her shoulders look like those of a young girl. I pull her black synthetic trousers down her legs, careful to keep her diaper and her dignity in place. I pull her pink nylon nightie over her head and gently lie her down on her bed.

"Please tuck me in," she says sweetly, like a small child trying to do the right thing.

I pull the covers up under her chin and give her a big kiss on her cheek. "I love you, Mother. Is there anything else you'd like me to do?"

"Yes, I want to listen to Scheherazade forever. Can you make it keep playing?" She softly sighs, worried.

"Yes, Mother, I will." As the wistful and sweet strains of that paean to exotic adventure begins to play, big tears roll from the edge of my eyes. I am overcome with grief and sadness.