12 Responses

1. Laurie Bartels says:

   November 15, 2008 at 5:47

   Hi Joshua,

   What you describe, and what it seems to me Sharp­Brains is a pro­po­nent of, is pre­ven­tive care, be it in the form of edu­ca­tion or check­ups or early treat­ment. I am a big fan of pre­ven­tive care, in gen­eral, because it can lessen the neg­a­tive impact of the par­tic­u­lar health issue in question.

   Spe­cific to your three state­ments above:
   1–I would want to know if my cog­ni­tive abil­i­ties were declin­ing so that I could have input into how my future plays out (in-home treat­ment, aide, nurs­ing home, etc)

   2-It’s pos­si­ble that any of the folks men­tioned would treat me dif­fer­ently, but if I was engaged in the process of man­ag­ing my care, I would include con­ver­sa­tions with these folks (plus prob­a­bly a social worker or some­one skilled at help­ing peo­ple nav­i­gate such cir­cum­stances). I would def­i­nitely be con­cerned about the insur­ance aspect.

   3-Absolutely!

   Regards,
   Laurie
2. Erin Matlock says:

   November 15, 2008 at 11:22

   Thanks Dr. Stein­er­man for open­ing this discussion.

   Here are my answers.

   1) The knowl­edge would actu­ally be empow­er­ing for me. It would spur me to take extra care of myself and be much more proac­tive about the activ­i­ties and treat­ment I pursued.

   2) Friends — no.

   Fam­ily– I would want them to treat me dif­fer­ently by help­ing me make the tran­si­tion and sup­port­ing the plan of treat­ment I chose.

   Physi­cians, employ­ers and insur­ers — yes, for sure. I would be extremely con­cerned. I think it’s a nat­ural reac­tion — and unfor­tu­nately, a part of aging that many peo­ple are cur­rently going through.

   3)It would def­i­nitely be a seri­ous moti­va­tor for me.
3. Aaron Jackson says:

   November 16, 2008 at 6:25

   Replies

   1> Not nec­es­sar­ily. Knowl­edge of a decline is an insuf­fi­cient con­di­tion to cause worse off. How­ever, cou­ple that knowl­edge with a per­ceived inabil­ity to address the decline and yes, worse off con­di­tions will follow.

   2> Con­cerned, no, because I’m quite com­fort­able that the pres­ence of the knowl­edge would cause a change in a behav­ior through their altered expec­ta­tions. And com­fort­able in my abil­ity to address peo­ple with pre­con­ceived notions. Now if they have knowl­edge and I don’t, you may get a dif­fer­ent answer.

   3> No. And for the gen­eral pub­lic a def­i­nite no. Strengths and weak­nesses are not direct moti­va­tors of behav­ior change. By anal­ogy, strengths and weak­nesses relat­ing to lack of phys­i­cal activ­ity are read­ily observed, yet the obser­va­tions lack the “juice” to stim­u­late exer­cise. To moti­vate fit­ness pro­gram adher­ence, peer group appre­ci­a­tion, and pos­i­tive expec­ta­tion of results are needed.
4. LifeGeeked says:

   November 17, 2008 at 5:34

   Very inter­est­ing questions

   1– It is bet­ter to know and under­stand in order to be able to play my strengths and work on my weaknesses

   2– I would only be con­cerned about Employers

   3 — I would agree on what Mr Aaron Jack­son Said, but I still find some­thing moti­vat­ing with know­ing, maybe it is the self deter­mi­na­tion and will !
5. Keith Rogers says:

   November 25, 2008 at 2:57

   1. The effects of know­ing I was suf­fer­ing cog­ni­tive decline would be depen­dent on what else is hap­pen­ing in life at the time. Right now, I can say I would be very open to know­ing where my abil­i­ties are suf­fer­ing in hopes of mak­ing a change. But there have been times when that knowl­edge may have been depressing.

   2. I am not con­cerned how friends and fam­ily would treat me. Employer — yes, some­what unless it was traced to a dis­abil­ity that could be “rea­son­ably accom­mo­dated”. Insurer — excel­lent ques­tion. I don’t know how I’d feel about that.

   3. Absolutely! Even now, with­out know­ing of any cog­ni­tive decline, I try to find ways to exer­cise my men­tal fit­ness. Just like I try to tar­get areas of phys­i­cal weak­ness with spe­cial­ized focus, if I could know where I was “los­ing it”, I would focus on strength­en­ing those areas. KR
6. jairo obando says:

   November 25, 2008 at 3:00

   thank for the space for par­tic­i­pa­tion.
   I give these answers:
   1) No, I would treat to rec­og­nize my new real­ity and to begin to look the causes and pos­si­ble treat­ment.
   2)Sure. The peo­ple under­stant the sit­u­a­tion of every­one and of this form treat you.
   3)Before that occur I will put in prac­tice many advices that your and oth­ers give me .
   Its bet­ter pre­vent that to lament.
   Excel­lent web page.
7. mk says:

   November 25, 2008 at 8:14

   1) Even if my cog­ni­tive abil­i­ties were declin­ing, knowl­edge of this would leave me worse off.

   Actu­ally, this did hap­pen to me a lit­tle over a year ago. I was los­ing my abil­ity to think at work to an ever-increasing degree and, mis­un­der­stand­ing my doctor’s expla­na­tion, thought I had some form of dementia.

   2) I am con­cerned that fam­ily, friends, physi­cians, employ­ers, or insur­ers would treat me dif­fer­ently if they found out I had cog­ni­tive decline.

   My son’s wed­ding was a few months away and I decided not to ask the doc­tor to go into detail, afraid I’d be cry­ing all dur­ing the wed­ding. I didn’t con­fide in friends at the begin­ning, but did as I began mak­ing plans for retir­ing with a med­ical dis­abil­ity. I had to face the fact that if this was true, my place of employ­ment would need a head’s up to replace me and my insur­ance would find out no mat­ter how I tried to hide it. And yes, I was going to be broke and would shortly have to pay a for­tune for insur­ance even though the com­pany would not offi­cially drop me (just increase my rates so astro­nom­i­cally I would drop myself). Peo­ple did treat me dif­fer­ently. My friends were there for me, sup­port­ive, but not patron­iz­ing. Co-workers could be unthink­ingly cal­lous “Oh, she won’t be here next year any­way so we don’t need her input”. Or, they would go out of their way to talk with me and ask how I was, some­thing they may not have done before. My employ­ers them­selves were won­der­ful. Even though I didn’t think I could con­tinue on, they worked with me to alter my work envi­ron­ment, and lighten my load at great dif­fi­culty to them­selves. The human resources depart­ment gave me enor­mous sup­port as well. I was ter­ri­fied at the thought of sud­denly being unable to care for myself and not know­ing whom I could trust to make deci­sions for me. Thank God for the Alzheimer’s Foun­da­tion who gave me much good advice, did a lot of leg­work for me so I could make and take deci­sions, and called me to check up and see what I might need next. Now, recov­er­ing from my tem­po­rary cog­ni­tive impair­ment (tem­po­rary!!!), I have some idea of what to do should the need arise in the future.

   “Under­stand­ing my cog­ni­tive strengths and weak­nesses will moti­vate me to estab­lish and adhere to a per­son­al­ized brain fit­ness pro­gram.” When you have cog­ni­tive weak­nesses, you can lose the will to do any­thing. Hav­ing some­one who will help you get started might be the thing to help me. Will power? No hope for the future = no will power for the present.
8. Shauna MacKinnon says:

   November 26, 2008 at 3:33

   As a per­son with MS, I am only too aware of cog­ni­tive deficits.
   1) I am bet­ter off know­ing that my brain is on the decline.
   2) When friends and fam­ily are noti­fied of this fact, I use it as an oppor­tu­nity to edu­cate them about MS and its effects.
   3) I am cur­rently doing what I can to opti­mize my brain health through nutri­tion, exer­cise, and men­tal stimulation.
9. Alvaro Fernandez says:

   November 26, 2008 at 5:24

   Every­one, thank you very much for your gen­eros­ity in shar­ing these thought­ful answers.

   Joshua, here you have mine

   1– Igno­rance is what would leave me worse off, since it would pre­clude me from tak­ing appro­pri­ate action. We also need to clar­ify that a) while some abil­i­ties tend to decline oth­ers tend to improve, b) there seems to be lit­tle inher­ently genetic in our indi­vid­ual cog­ni­tive tra­jec­to­ries, which empha­sizes the impor­tance of select­ing our envi­ron­ments and our spe­cific lifestyles/ actions in an informed manner.

   2– Only if there was some kind of stigma asso­ci­ated to the word “cog­ni­tive decline”. Which I hope doesn’t hap­pen — for most peo­ple (we are not talk­ing demen­tia, cor­rect?), decline in some areas is part of the game, as is improve­ment in others.

   The only excep­tion would be insur­ance com­pa­nies — I would encour­age them, as an indus­try, to have very strong pri­vacy and non-discrimination safe­guards before offer­ing such assess­ments to consumers.

   3) Yes. That would be its main value.
10. Elizabeth Smith says:

    December 1, 2008 at 2:25

    Knowl­edge of cog­ni­tive decline is the only pro­tec­tion against its effects. It allows a per­son to adapt and change to circumstances.

    . My spouse’s expe­ri­ence has been that fam­ily and friends have adapted well to his cog­ni­tive decline. Employ­ment and insur­ance are another mat­ter because of lia­bil­ity and profit issues.

    Knowl­edge of cog­i­tive decline would be a sub­stan­tial moti­va­tor to main­tain fit­ness but it is dif­fi­cult to know how cog­ni­tive decline affects the abil­ity to orga­nize and adhere to a fit­ness regime.
11. Nancy Scalise says:

    December 2, 2008 at 5:46

    In answer to your ques­tions. #1. I would def­i­nitely like to know if I have any cog­ni­tive decline. Knowl­edge is power and Power is knowledge.This knowl­edge would give me the empow­er­ment to do what is nec­es­sary to cope and improve the sit­u­a­tion. #2. i would def­i­nitely limit knowl­edge of cog­ni­tive decline to cer­tain fam­ily members.I would want their help & sup­port. Human nature being what it is,I def­i­nitely would be cau­tious with employ­ers and insur­ers.
    #3.I had a brain tumor removed in may of this year. It was a benign occip­i­tal lobe minin­gioma. With­out any cog­ni­tive test­ing before or after surgery I really didn’t know where i stood with those abil­i­ties. There was some mem­ory loss but this is improv­ing with time. Cog­ni­tive test­ing was sug­gested after surgery, but due to lack of med­ical insur­ance was not under­taken. I stum­bled on the Happy Neu­ron at the Real Age web­site and was dis­ap­pointed when it was no longer avail­able there. You see it was play­ing those games that showed me that i was not up to speed. I had to do some­thing to get myself going again. I then found the games again at the AARP web­site. I con­tinue to play there and have decided that I should give myself a Christ­mas present and sub­scribe to the games. More so now than ever I am a very active par­tic­i­pant in my med­ical care.
    Thank you for this oppor­tu­nity to give my opin­ions. I hope it be of some use. I could go on with more but that is for another time.
12. Joshua says:

    December 4, 2008 at 8:00

    Thanks, all, for your thought­ful comments.

    Since there is a diver­sity of views, it is dif­fi­cult to sum­ma­rize. How­ever, most respon­ders empha­size that knowl­edge of one’s cog­ni­tive sta­tus is empow­er­ing, regard­less of age, con­di­tion, or whether one’s cog­ni­tion is improv­ing or declining.

    I am in total agree­ment with this imper­a­tive to mind the brain, and under­stand­ing the many poten­tial con­cerns that fol­low will allow our soci­ety to man­age this infor­ma­tion responsibly.

    An impor­tant caveat is that as Sharp­Brains enthu­si­asts, we are not rep­re­sen­ta­tive of the pre­vail­ing opin­ions in most com­mu­ni­ties. We need bet­ter research to sup­port this claim, but my impres­sion is that many still view cog­ni­tive decline as inevitable and unmod­i­fi­able and would not be pre­pared to use objec­tive feed­back on their men­tal abil­i­ties to empower or motivate.

    Thanks to Sharp­Brains and a grow­ing seg­ment of the health­care, pri­vate sec­tor, and gov­ern­ment uni­verses, we are wit­ness­ing cul­ture change and a shift toward pre­ven­ta­tive approaches.

    I know I don’t need to tell this com­mu­nity that suc­cess­ful brain aging is achiev­able, but each of us should con­sider how we can trans­mit this mes­sage to those around us.