Description: While most of us have heard the phrase “use it or lose it,” very few understand what “it” means, or how to properly “use it” in order to improve brain function and fitness. This talk will provide an overview of the most recent research, guidelines and resources to “Use It and Improve It”, summarizing the main findings and topics from the new book The SharpBrains Guide to Brain Fitness. We will debunk 10 common brain fitness myths; discuss how the brain works and the 4 pillars of brain maintenance; explain the difference between mental exercise and mental activity and identify practical ways to integrate this research into our work and lives for maximum brain health and performance.

To order book: Here. (has been among Amazon.com’s Top 10 Preventive Medicine books basically since publication!)

Over the last few weeks I have given a couple of AARP-sponsored talks, both in English and in Spanish (this was my first Spanish presentation on a topic I mostly discuss in English, so I did get some extra brain points by trying to translate “neuroplasticity” and “hippocampus” on the fly), and had a great couple of meetings with AARP staff to explore collaborations. AARP can obviously play a major role in how rationally this whole category of “brain fitness” evolves.

Here you have a couple of my favorite recent media interviews:

4-minute Video interview on the Gilbert Guide:
Book Reveals Secrets Once Only Known to Scientists

30-minute radio interview on WMBR (MIT campus radio station):
Paradigm Shifts: Brain Fitness (mine is the second interview, starts around the middle)

Finally, a growing number of bloggers are reviewing the book. This is what they say:

• Is Your Brain a Couch Potato (Doc Gurley at SF Gate)
• Essential reference for brain fitness, cognitive health, neuroplasticity (Highlight Health)
• Fitbrains learn how to learn (Dr. Larry McCleary)
• Learn about cognitive functioning (Teen Health 411)
• A great dedication: to your Unique Brain, and Unique Mind (Play with your mind)
• Very valuable interviews (Nucleus Learning)
• Authoritative research and perspective (Greenstein Institute)

You can order The SharpBrains Guide to Brain Fitness here.

Changing our Minds

By imagining many possible worlds, argues novelist and psychologist Keith Oatley, fiction helps us understand ourselves and others.

-By Keith Oatley

For more than two thousand years people have insisted that reading fiction is good for you. Aristotle claimed that poetry—he meant the epics of Homer and the tragedies of Aeschylus, Sophocles, and Euripides, which we would now call fiction—is a more serious business than history. History, he argued, tells us only what has happened, whereas fiction tells us what can happen, which can stretch our moral imaginations and give us insights into ourselves and other people. This is a strong argument for schools to continue to focus on the literary arts, not just history, science, and social studies.

But is the idea of fiction being good for you merely wishful thinking? The members of a small research group in Toronto—Maja Djikic, Raymond Mar, and I—have been working on the problem. We have turned the idea into questions. In what ways might reading fiction be good for you? If it is good for you, why would this be? And what is the psychological function of art generally?

Through a series of studies, we have discovered that fiction at its best isn’t just enjoyable. It measurably enhances our abilities to empathize with other people and connect with something larger than ourselves.

Possible selves, possible worlds

People often think that a fiction is something untrue, but this is wrong. The word derives from the Latin fingere, to make. As something made, fiction is different from something discovered, as in physics, or from something that happened, as in the news. But this does not mean it is false. Fiction is about possible selves in possible worlds.

In terms of 21st-century psychology, we might best see fiction as a kind of simulation: one that runs not on computers, but on minds. Such mental simulation unfolds on two levels.

The first level involves simulating the minds of other people: imagining what they are thinking and feeling, which developmental psychologists call “theory of mind.” The theory-of-mind simulation is like a watch, which is a small model that simulates the alternation of day and night as the earth rotates. Often we can’t see sun or stars, so we refer to a little model that we can carry with us, a wristwatch, which, as it happens, is more accurate than a device like a sundial that offers a direct read-out from the heavens.

Similarly, although sometimes we know what other people are thinking and feeling because they have just told us, for the most part we have to construct a mental model of the person to know what’s going on inside their heads. When we do this for emotions, the process is called empathy, and neuro-imaging studies suggest that when we recognize an emotion in someone else, our brains generate the same emotion. In effect, we are simulating the other person’s emotional state.

Fiction, as Lisa Zunshine has emphasized in her 2006 book, Why We Read Fiction, engages our theory-of-mind faculties and gives us practice in working out what characters are thinking and feeling. Indeed some genres of fiction—for instance, the mystery novel—are entirely concerned with working out what characters are up to when they are trying to conceal it.

The second level of simulation is about what happens when people get together. Just as computer simulations of atmospheric pressure, winds, and humidity are used to generate weather forecasts, so novels can be thought of as simulations of how people react to combinations of social forces. Near the beginning of Pride and Prejudice, for example, Jane Austen describes a ball. The novel’s protagonist, Elizabeth Bennet, and her sisters are excited because they might meet potential husbands. But one of the most eligible men, Mr. Darcy, finds the proceedings provincial, and thinks they will be tedious. Austen is running a simulation in order to understand what happens in social groups when expectations clash in this kind of way. She’s offering insight into people’s lives and manners—insight that’s just as relevant to our world as to Elizabeth Bennet’s.

Understanding others

So if fiction is a kind of simulation of our emotional and social worlds, could it be that people who read a lot of fiction are more empathic and socially intelligent than those who don’t? This is the question that Raymond Mar, Jacob Hirsh, Jennifer dela Paz, Jordan Peterson, and I asked in a 2006 study.

First we measured whether 94 participants read predominantly fiction or non-fiction. Then, to estimate their social abilities, we used two tests. One is a measure of empathy and theory of mind: Simon Baron-Cohen’s “Mind in the Eyes” test. The participant looks at photos of people’s eyes—as if seen through a mail slot—and tries to guess the mental state of the photographed person. In the second test, the Interpersonal Perception Test, participants view 15 video clips of people interacting, then answer a question about each one—for instance, “Which of the two children, or both, or neither, are offspring of the two adults in the clip?”

Our results confirmed that reading fiction is associated with increased social ability. We found that people who read predominantly fiction were substantially better than those who read predominantly non-fiction at the Mind in the Eyes test, and somewhat better at the Interpersonal Perception Test.

But could it be that the personality characteristics of more socially intelligent people incline them to read fiction?

To help find an answer to that question, Raymond Mar used a fiction story and a non-fiction article from The New Yorker, and randomly assigned people to read one or the other. Mar gave all the readers an analytical reasoning task in a multiple choice format, derived from the LSAT exam for entrance to law school, and a social reasoning test in the same format with questions about the emotions, beliefs, and intentions of characters in social scenarios.

The result: The two sets of readers had similar analytical reasoning skills, but the short-story readers showed a stronger understanding of social situations than the essay readers.

How do we explain these results? My colleagues and I think it’s a matter of expertise. Fiction is principally about the difficulties of selves navigating the social world. Non-fiction is about, well, whatever it is about: selfish genes, or how to make Mediterranean food, or whether climate changes will harm our planet. So with fiction we tend to become more expert at empathizing and socializing. By contrast, readers of non-fiction are likely to become more expert at genetics, or cookery, or environmental studies, or whatever they spend their time reading and thinking about.

Changing ourselves

So there is evidence that reading fiction improves our social abilities. But does it affect our emotions and personality?

This was the question behind a different kind of study by Maja Djikic, Sara Zoeterman, Jordan Peterson, and myself, due to be published this year. We randomly assigned 166 people to read either a literary short story or a version of the same story rewritten in a non-fictional format. Before and after they read the text, we measured readers’ personalities using a standard personality test.

The literary story was “The Lady with the Little Dog,” by Anton Chekhov, who is generally acknowledged as the world’s greatest short story writer. It is about Dmitri Gomov, and a lady, Anna Sergueyevna, whom he sees walking with her little dog. They are both alone, on vacation at a seaside resort. They are both married to other people, but they begin an affair. At the end of their vacation they part. But their feelings for each other grow, and both are shocked to discover how much more important these feelings are than anything else in their lives. They encounter many difficulties, and overcome some of them. The story ends with this: “… their hardest and most difficult period was only just beginning.”

The version in a non-fiction format was written by Djikic as a courtroom report of divorce proceedings. It has the same characters and events, and some of the words, of Chekhov’s story. It is the same length and reading difficulty. Importantly, the readers of the non-fictional account reported that they found it just as interesting, though not as artistic, as Chekhov’s story.

We found that the personality traits of readers of Chekhov’s story changed more than those of the readers of the courtroom account. The changes in personality were not large, but they were measurable. They were different from the changes of belief spurred by a piece of writing meant to be persuasive, which tend to be all in the same direction as intended by the writer. Instead, Chekhov’s readers changed in different directions, with each change unique to the particular reader, mediated by the emotions that each individual felt while reading.

Why? We believe that as people read Chekhov’s story, they experienced empathy with the protagonists and identified with them so that each reader, in his or her own way, became a bit more like them, or decided not to think in the same ways as the characters. When we read “The Lady with the Little Dog,” we can be both ourselves and Gomov or Anna. Through stories, selfhood can expand.

My colleagues and I also believe that readers of Chekhov’s story were taken out of their usual ways of being so that they could connect with something larger than themselves, beyond themselves. This is an effect that goes beyond fiction. All art aspires to help us transcend ourselves.

Bittersweet creatures

So what is art, that it can enhance social abilities and transform the self? First of all, art is something that lasts and can spread to others. So although one can imagine a lover whispering an improvised poem into her lover’s ear, for the most part a poem will travel in time and space, and last beyond the moment of its conception.

Second, art is something made by humans that is both itself and something else. Archaeologist Steven Mithen argues that the first unequivocal works of art appeared relatively recently, between 50,000 and 30,000 years ago. For instance, a wooden flute has been discovered from 43,000 years ago, and the earliest cave paintings, at Chauvet in France, are from 31,000 years ago. In this same period, ornaments such as bracelets started to appear, as did sites of human burial. In all these cases, the thing produced was both itself and something else. A piece of wood was also a flute capable of sounding notes. Charcoal on a cave wall was also a rhinoceros. A piece of bronze was also an adornment. A burial site was something constructed to show that someone was dead and also alive on some other plane.

Mithen proposes that until this period, our prehistoric ancestors were knowledgeable, but their knowledge was confined within domains. One domain was interactions in the social group, another was, say, the properties of plant foods, and so on. But at some point in the evolution of the human brain, 30,000-50,000 years ago, the domains of our cognitive structures started to interpenetrate, and metaphor was born: marks on the wall of a cave could become a rhinoceros.

This later allowed the ancient Greek lyric poet Sappho to write, “Love shakes me again, that bittersweet creature.” Love is itself, and also something else. The domains of emotion and taste interpenetrate through Sappho’s poem, in a phrase that was so memorable that the idea of love being bittersweet has lasted 2,600 years. Such crossings of domain boundaries still surprise us. It is that surprise which can help expand our understanding of ourselves and the social world.

– Keith Oatley, Ph.D., is a professor emeritus at the University of Toronto. He is the author of six books of psychology and two novels, the first of which, The Case of Emily V., won the 1994 Commonwealth Writers Prize for Best First Novel. Copyright Greater Good. Greater Good Magazine, based at UC-Berkeley, is a quarterly magazine that highlights ground breaking scientific research into the roots of compassion and altruism.

Related articles by Greater Good Magazine:

- Arts and Smarts: Test Scores and Cognitive Development

- Cognitive and Emotional Development Through Play

- Mindfulness and Meditation in Schools for Stress Management

The Alzheimer’s Action Plan: The Experts’ Guide to the Best Diagnosis and Treatment for Memory Problems

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While no single test (other than a brain biopsy, which is a very invasive and risky procedure) can conclusively prove that a person has Alzheimer’s, many tests can give us a good idea. A list of all the tests that help us assess memory and thinking problems appears at the end of this chapter. Meanwhile, let’s take a good look at the whys and hows of a thorough memory assessment.

WHAT A DIFFERENCE AN EXTRA TEST CAN MAKE

To understand why getting tested (and retested as symptoms change and the disease progresses) is important, check out the experience of Katherine, who went to the doctor complaining of a memory slowdown. She took five of the most important neuropsychological tests, which assess brain function without actually physically looking at the brain. Then she underwent brain scans, a cardiovascular workup, and blood tests to see what else was going on that might be undermining her mental function.

- BUT FIRST, PAYING FOR THE DIAGNOSIS-

Ignorance can be costly, yet so is information. At the first visit, ask the doctor to spell out which tests he or she wants to run, then check that your insurance covers those tests and whether there are any conditions that are not covered. At the end of this chapter you will find the approximate costs of different tests.

Was it all worth it? Well, if she had stopped at just the two most common tests, she could have walked away with a very inaccurate diagnosis.

First, the doctor wanted to know if she had a family history of Alzheimer’s and, if so, at what age the relative developed Alzheimer’s. The doctor also needed to know her age. That’s not surprising—seems the older you get, the more people ask. But for an Alzheimer’s diagnosis, age really matters, because after age sixtyfive the risk of Alzheimer’s doubles every five years, and below age fifty the disease is relatively rare.Your education level is important, too. People who didn’t complete high school have a greater risk of developing Alzheimer’s than people with a higher level of education. Finally, women are more likely to get Alzheimer’s than men.

Katherine was seventy-two, a college grad, and had no family history that she knew of.Her parents both died before their seventy-fifth birthdays, but they certainly didn’t have early-onset Alzheimer’s.

THE STANDARD OF MEMORY TESTS

The test that all doctors should give at the first memory assessment, which Katherine’s doctor did, and at every follow-up visit is the Mini-Mental State Exam (MMSE), a short but very useful test that assesses a lot of different abilities.

• To demonstrate orientation:The patient tries to answer, “What is today’s date?” and “What county are we in?”
• To demonstrate memory skills: The patient tries to repeat the names of three objects immediately and again after five minutes.
• To demonstrate concentration: The patient tries to count backward or to spell backward.
• To demonstrate language abilities: The patient tries to name objects in the room, repeat a tongue twister, or follow simple directions such as to take, fold, and put a piece of paper on the desk.
• To demonstrate motor skills: The patient tries to copy a picture that includes intersecting shapes.

• Serves as a quick screen for dementia of any kind
• Provides a general measure of brain function
• Helps determine if the patient is in the early, middle, or late stage of Alzheimer’s
• Monitors changes in mental functioning over time, including the effects of treatment
• Provides a common language. Everyone from a general practitioner to a memory specialist understands the test results, so they serve as a common language spoken across different specialties.

What the MMSE Doesn’t Do

The MMSE doesn’t do subtle. It was developed thirty years ago to help doctors screen hospital patients for problems with their mental functioning. Now people are driving themselves to the doctor for a memory test, and the MMSE is not sensitive enough to pick up on subtle problems in thinking and memory. Nor does it probe any one aspect of mental functioning in depth or distinguish among memory disorders.

Some individuals with a very high IQ or those who are really good test takers appear merely “normal” on the MMSE when in fact they have an Alzheimer’s-induced memory slowdown. Doctors should, though not all do, consider IQ, gender, occupation, education level, and an individual’s age when scoring the MMSE. An assessment may not include a formal IQ test, but the doctor should find out about the person’s personality, capabilities, and occupation prior to developing memory problems, because Alzheimer’s is about a decline or change in memory and thinking. For example, the MMSE score of 26 is normal for a man in his early sixties who has an eighth-grade education, but it would be below normal if he had gone to college. (A chart showing what MMSE score is normal for a person’s age and education is available at www.tuftsnemc.org/ psych/mmse.asp.)

Katherine did okay on her MMSE. She scored a respectable 26 out of a possible 30. No big red flag there for most doctors, who don’t worry until they see a total score below 24. But the score actually concerned her doctor, who happened to know that for her years of education and age, normal for Katherine would be closer to a 28.

Doctors sometimes neglect to home in on how the test taker did on each set of questions. For example, forgetting today’s date is less important than missing other assessment questions. Before leaving the doctor’s office, find out your (or your relative’s) total MMSE score and what items were missed.

Katherine ended up taking the MMSE many times over the years. Her scores declined slowly because, as the tests revealed, she had MCI (mild cognitive impairment). But after three years, she, too,was diagnosed with Alzheimer’s and her decline accelerated.

It’s Time . . .

Probably the second most popular test to screen for dementia is the clock-drawing test, which requires patients to draw a clock showing a specific time. The test is a good way to screen for overall mental abilities, and it can reveal problems that the patient has been able to hide during day-to-day activities. Katherine did great on the test, which was lucky for her daughter, whose own little girl was just mastering the skill of telling time. It’s upsetting for family members to see a parent or spouse fail at a task most kids master in grade school.

Most general practitioners consider talking with the patient, ordering some blood tests and a brain scan, and giving the MMSE and clock-drawing test sufficient for diagnosing dementia. It might be sufficient for someone with obvious signs of Alzheimer’s. But it could miss the early-stage Alzheimer’s or MCI. Fortunately for Katherine and her family, her doctor did more.

ASSESSING LANGUAGE SKILLS

A diagnosis of Alzheimer’s requires being impaired in memory and one other mental function, such as language or attention. Language problems usually indicate that Alzheimer’s is somewhat progressed or that the problem is another type of dementia that strikes the language centers of the brain first.

To assess language, beyond just listening to how the person formulates and understands words, a doctor will ask the patient to name common objects, such as chair, shoe, or elbow. More sensitive tests of language skills involve asking the patient to name, for example, all the four-legged animals he or she can think of as quickly as possible, or to repeat complex phrases, such as “Nelson Rockefeller had a Lincoln Continental.” Katherine took one section of a language test called the Boston Naming Test that required her to name uncommon objects depicted in line drawings. She got only twentysix out of thirty right, which is slightly worrisome.

The Delayed Recall Test

One of the most sensitive tests to distinguish normal aging from Alzheimer’s is the delayed recall test, which tests a person’s memory for a story or list of ten to sixteen words heard thirty minutes earlier. It’s usually given as part of a larger memory test that also assesses immediate recall. Katherine’s MCI came out of the shadows here. She was in the bottom nineteenth percentile on these recall tests.

One delayed recall test, called the Buscke Selective Reminding test, helps distinguish Alzheimer’s from normal aging, because the tester is allowed to give clues to jog the test taker’s memory. A prompt usually does not help if Alzheimer’s is at the wheel, but it does help if the memory malfunction is due to depression or attention grabbers.

There are other tests, too. To assess attention, doctors see how well the patient can follow directions. They also ask the patient to spell words forward and backward or to subtract numbers forward and backward (for example, subtract by 7s starting at 100). There are computerized tests of attention as well, which are becoming increasingly popular in private practices and research centers.

Daily Living

The activities once taken for granted, from using the phone to fixing dinner, go from routine to frustrating to impossible as Alzheimer’s storms the brain. Katherine’s doctor used a Functional Activities Questionnaire (FAQ) to rate her ability to perform several common daily activities. The questionnaire assigns one point if a person has trouble with the activity but can do it alone, two points if he or she needs assistance, and three points if he or she is dependent on someone else to do it. The highest score, 30, indicates impairment in all activities; a score below 9 is normal. Katherine scored a 5, because she needs some help balancing her checkbook and assembling tax records.

DEPRESSION, DEMENTIA, OR BOTH?

Depression is a must-check condition for every person complaining of impaired thinking. Depression and Alzheimer’s have an insidious relationship: Depression masks Alzheimer’s, is mistaken for Alzheimer’s, worsens Alzheimer’s, may precede the onset of Alzheimer’s, and can be caused by Alzheimer’s. To screen for depression, the doctor may start by just asking a few important questions:

1. Are you able to have fun or experience pleasure during a normal day?
2. Are you sleeping well?
3. Are you in pain?
4. Is everything okay with home and family life?
5. Have you lost weight unintentionally? Are you overeating?
Katherine’s answers were: 1. not really; 2. not really; 3. not really; 4. I don’t have much of a home life;
5. I wish.

Her doctor decided to give her the Geriatric Depression Scale— Short Form, which asks fifteen questions to probe for depression. A score greater than 5 warrants further assessment and a score greater than 10 indicates clinical depression. Katherine scored 11.After asking a few more questions and reviewing her medical record, the doctor prescribed an antidepressant. He also recommended that her family get her more involved in physical and social activities, including walking. Three months later, her depression eased. Her memory problems persisted, but she was thinking more clearly and her attention and concentration improved. Also, she regained a good portion of her former desire to see her friends.

Doctors often give the relative of the person with Alzheimer’s the brief Neuropsychiatric Inventory (NPI) to assess changes in the patient’s sleeping and eating habits, appetite, depression, euphoria, irritability, hallucinations, paranoia, impulsivity, and nighttime behaviors.

The family member also describes how much each of these behaviors is disrupting the family.To fill out the survey, family members can rely on their memory or keep a weekly diary of changes they notice in the person with Alzheimer’s.The NPI can help a doctor:
• Be more thorough. Unusual symptoms, such as extreme euphoria or impulsivity, may point to frontal lobe dementia, for example.
• Determine if the person needs psychiatric drugs, such as antidepressants

• Identify the stage of Alzheimer’s—more severe behavior problems usually indicate more advanced dementia
• Monitor improvements following the start of new medications (such as Aricept or Namenda)

This scale is particularly useful if one is being treated by a nonspecialist, since most general practitioners often lack the time or experience to assess behavioral problems in detail. Doctors use the NPI when first assessing a patient and again at subsequent appointments to monitor change. Roughly one-third of people with MCI and twothirds of people with mild to moderate Alzheimer’s have a behavioral change.

Computerized Neuropsychological Tests

For people with mild memory loss, computerized tests of all aspects of mental functioning, including memory, are particularly useful though not widely used. Unlike paper-and-pencil tests, computerized assessments can easily be made more difficult to challenge patients who are only slightly impaired or who are highly able test takers. Computerized tests are becoming very feasible to administer, as more patients (though not all) are becoming more technology savvy and comfortable with a keyboard. You probably have to go to a specialist to take them, however, as they are not readily available elsewhere.

…(to continue reading, check out  The Alzheimer’s Action Plan: The Experts’ Guide to the Best Diagnosis and Treatment for Memory Problems).

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Dr. Murali Doraiswamy is the Head of the Division of Biological Psychiatry at Duke University’s School of Medicine, and co-author of The Alzheimer’s Action Plan: The Experts’ Guide to the Best Diagnosis and Treatment for Memory Problems, just released in paperback. The first article in this 2-part series focused on Alzheimer’s Early and Accurate Diagnosis: Normal Aging vs. Alzheimer’s Disease.

The Alzheimer’s Action Plan: The Experts’ Guide to the Best Diagnosis and Treatment for Memory Problems

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As it turns out, Jane did not have Alzheimer’s. She consulted a doctor, who, in docspeak, told her that the passage of time (getting older) had taken a slight toll on her once-superquick memory. She was slowing down a little, and if she relaxed, the name or date or other bit of information she needed would come to her soon enough. She was still good at her job and home life. She had simply joined the ranks of the worried well.

Normal brain aging, beginning as early as the forties in some people, may include:

• Taking longer to learn or remember information
• Having difficulty paying attention or concentrating in the midst of distractions
• Forgetting such basics as an anniversary or the names of friends
• Needing more reminders or memory cues, such as prominent appointment calendars, reminder notes, a phone with a wellstocked speed dial

Although they may need some assistance, older people without a mental disorder retain their ability to do their errands, handle money, find their way to familiar areas, and behave appropriately.

How does this compare to a person with Alzheimer’s? When Alzheimer’s slows the brain’s machinery, people begin to lose their ability to

• remember recent events or conversations, yet they retain old memories. They may remember where they were born or their first job, but they won’t remember that they told you about both in some detail a few minutes earlier.
• plan, start, or organize tasks
• find the right words or name everyday things, such as a clock or a stove
• comprehend or follow even simple directions
• keep track of the time and where they are

The severity and the speed of the memory loss distinguishes aging from Alzheimer’s, yet the line between where normal aging ends and Alzheimer’s begins is as unclear as the memories of a person with Alzheimer’s. Even the changes that occur in the brain during Alzheimer’s are just a more severe version of the changes we see in the aging brain. Indeed, some scientists argue that Alzheimer’s is a form of accelerated but otherwise normal aging.

But to the family members of someone with Alzheimer’s, the differences between normal aging and Alzheimer’s are real and in their face. In contrast to their healthy older friends, people in the early stage of Alzheimer’s have more problems with shopping, handling money, or getting to familiar places. If someone has become a little uneasy driving and finds alternative routes to avoid major highways, that’s not a sign of Alzheimer’s. If a person avoids being alone in the car because he or she is getting lost, that could very well be Alzheimer’s.

Alzheimer’s is more than memory loss. People with the disease have trouble behaving appropriately. Even though they desperately want to appear like their normal selves, their brains aren’t up to it. Healthy individuals without Alzheimer’s or other forms of dementia still have that choice.

DEMENTIA VERSUS ALZHEIMER’S

Dementia is the broad general diagnosis given to a person whose thinking, particularly memory, is so impaired it affects day-to-day functioning. Not all dementia is due to Alzheimer’s, but everyone with Alzheimer’s has dementia. However, the term Alzheimer’s is often used incorrectly to refer to different types of dementia that impair memory and occur in older individuals. More than a hundred different disorders cause dementia, and their different symptoms depend on what parts of the brain they attack.

WHAT CHANGES IN ALZHEIMER’S?

Alzheimer’s is about change. If you are wondering if a family member has Alzheimer’s, think about how he has changed. It’s the decline that is telling. For example, your father may remember all sorts of interesting facts or stories, but when you think about it, you realize he’s actually become forgetful for him. Some people never knew the name of their senators, but a lobbyist forgetting a senator’s name could be a sign of serious memory loss. If your mother loves to read, has always forgotten the name of the author, and now finds the name slipping more often, she’s probably fine. If she is losing her interest in reading, she’s not.

Alzheimer’s is gradual, but not as gradual as normal aging. It comes on more slowly than some kinds of dementias. If you ask family members when they noticed the changes, they will have difficulty saying. If there is a sudden onset of memory loss or confusion, it is likely due to another cause, such as a stroke, medication side effects, or an infection that is disturbing the person’s thinking or mood. When these conditions are treated, memory sometimes improves as well.

Personality and mood shift as well in people with Alzheimer’s.We aren’t talking about normal changes in response to events or big decisions, such as retiring, falling in love, or losing a loved one.We mean, “Have you noticed how Dad is so sullen all the time?” or “What has gotten into Dad?” or “Why is he so irritable and suspicious?” Not all Alzheimer’s-induced mood and personality changes are for the worse. Some people become more accepting or spontaneous.

It’s not unusual for a person with Alzheimer’s to seem almost fine one day and do something quite out of character the next day. Symptoms seem to come and go. As the disease progresses, the variability continues, but the good days become less frequent and less good.

Eventually, Alzheimer’s can become quite intrusive. If a person doesn’t get proper help, Alzheimer’s can seem to undermine all aspects of life at work and at home.

WHAT DEFINES ALZHEIMER’S

To be diagnosed with the disease, there have to be signs that the person’s memory has declined along with one other cognitive or “thinking” function, such as language, sense of time, judgment, reasoning, or executive function, which includes the ability to plan, organize, and start or stay on task.The defining characteristics of Alzheimer’s are:

• A subtle onset followed by a slow decline in memory (not caused by reversible conditions such as thyroid imbalance)
• A slow decline in one other mental function, such as language
• Having problems in daily functioning as a result of the mental changes

These and other criteria are what doctors use to make a clinical diagnosis that someone has “probable Alzheimer’s.” If the person only partially meets these criteria, he or she has “possible Alzheimer’s.” A definitive diagnosis of Alzheimer’s is usually made only during an autopsy, by examining the brain tissue.

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DEMENTIA SCREENING INTERVIEW

If you are worried about whether your relative is developing Alzheimer’s, answer the following questions. Put a yes by the ones that describe a change that you’ve seen in your relative in the last several years, if you think the change is caused by thinking and memory problems. So if he has always had trouble remembering appointments but hasn’t gotten any worse, it’s not a yes. Or if he now has trouble with his financial affairs because he is losing his eyesight and is too stubborn to get someone to read him his financial documents, it’s not a yes, either (yes, it’s annoying; no it’s not necessarily dementia). Try to answer the questions quickly, without dwelling on the accuracy of your answers.

1. Problems with judgment (e.g., problems making decisions, bad financial decisions, problems with thinking)
2. Less interest in hobbies/activities
3. Repeats the same things over and over (questions, stories, or statements)
4. Trouble learning how to use a tool, appliance, or gadget (e.g., VCR, computer, microwave, remote control)
5. Forgets correct month or year
6. Trouble handling complicated financial affairs (e.g., balancing checkbook, income taxes, paying bills)
7. Trouble remembering appointments
8. Daily problems with thinking and/or memory

Scoring: If you put a yes next to none or just one, your relative probably does not have any kind of dementia. The questionnaire can’t rule out cases of very early dementia, nor is it perfect, so don’t hesitate to get help for your relative if he or she continues to worry you. If you answer yes to two or more, you do need to get your relative assessed promptly by a specialist.

Source: Adapted with permission from J. E. Galvin et al., “The AD8, a Brief Informant Interview to Detect Dementia,” Neurology 65 (2005): 559–64.

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Dr. Murali Doraiswamy is the Head of the Division of Biological Psychiatry at Duke University’s School of Medicine, and co-author of The Alzheimer’s Action Plan: The Experts’ Guide to the Best Diagnosis and Treatment for Memory Problems, just released in paperback. Next month he will share an additional excerpt from the book to introduce us to The Best Memory Tests, explaining the roles of the  Mini-Mental State Exam (MMSE), clock-drawing test, Language Skills, Delayed Recall Tests, Daily  Living, Depression, Computerized Neuropsychological Tests.

Human beings adapt to their environments. We draw on a range of skills and personality traits to fit into various settings. That is why we can behave one way in a social setting and then seem like a totally different human being at work. One of the enduring attractions of travel is that it takes us out of our native environments and forces us to adapt to new people, new cultures, and new ways. When we make those adaptations, we discover new facets of ourselves. As we’ll see shortly, discrepancy is the mother of all change: when we are in the same environments, we tend to draw upon the same, routine modes of thought and behavior.

A few months ago I had an attack of acute appendicitis while staying in a LaGuardia airport hotel awaiting a return flight to Chicago. When I went to the nearest emergency room at Elmhurst Hospital outside Jackson Heights, Queens, I found that I was seemingly the only native English speaker in a sea of people awaiting medical care. After some difficulty attracting attention, I was admitted to the hospital and spent the next several days of recuperation navigating my way through patients and staff of every conceivable nationality. By the end of the experience, I felt at home there. I’ve since stayed at the same airport hotel and routinely make visits into the surrounding neighborhoods—areas I would have never in my wildest dreams ventured into previously. In adapting to that environment, I discovered hidden strengths. I also overcame more than a few hidden prejudices and fears.

The greatest enemy of change is routine. When we lapse into routine and operate on autopilot, we are no longer fully and actively conscious of what we’re doing and why. That is why some of the most fertile situations for personal growth—those that occur within new environments—are those that force us to exit our routines and actively master unfamiliar challenges.

In familiar environments and routines, we operate on autopilot. Nothing changes.

When you act as your own trading coach, your challenge is to stay fully conscious, alert to risk and opportunity. One of your greatest threats will be the autopilot mode in which you act without thinking, without full awareness of your situation. If you shift your trading environment, you push yourself to adapt to new situations: you break routines. If your environment is always the same, you will find yourself gravitating to the same thoughts, feelings, and behaviors. We are mired in repetitive patterns of thought and behavior because we are mired in routines: the same emotional and physical environments. Indeed, we repeat the same patterns—for better or for worse—precisely because those patterns are adaptations to our current settings.

So how can we change our trading environments? The key is recognizing that our physical settings are only a part of our surroundings. Here are a few routine-busting activities that can alert us to risks and possibilities:

1. Seek Out Divergent Views. Conversations with traders who trade differently from you—different time frames, markets, or styles—can often help cement your views or question them. Similarly, reading materials from fresh perspectives puts your ideas in a different light and pushes you to question your assumptions. I remained relatively bullish on the stock market’s longer-term picture into the final quarter of 2007. Only when I pushed myself to read informed views that clashed with my own—and consulting data that did not fit my framework—did I modify my perspectives and avoid significant losses.

2. Examine the Big Picture. It’s easy to get lost in the market’s short-term picture; how it is trading that minute, that day. I find it important to periodically zoom out to longer-term charts and place the current action into context. Indeed, some of the best trading ideas start with a big picture view and then proceed to shorter-term execution. I especially find this to be the case when looking at longer-term support/resistance, trading ranges, and Market Profile value areas. Often, shifting my field of vision will help me avoid an ill-informed, reactive trade based on the market’s last few ticks. If something seems obvious in the market, switch time frames and generate an entirely new perspective. What looks obvious from one view may well be obviously wrong from another.

3. Examine Related Views. Sometimes the action of a single stock or sector will illuminate what’s happening in the broader market; one currency cross will break out ahead of others. Are we seeing a broad fixed income rally, or is the yield curve steepening or flattening? Looking across instruments and asset classes keeps us from getting locked into ways of thinking. I find myself tracking sector ETFs during the trading day to see if stocks are moving in a single direction (trending) or are taking different paths within a range. If I see bond traders fleeing to safety or assuming risk, I can anticipate selling or buying stocks. Seeing the entire financial playing field helps keep us from becoming wedded to preconceived ideas.

4. Take the Break. Just as we take vacations to return to work refreshed, a break from the screen can help us generate fresh market views. It is easy to become focused on what is most dramatic and salient in markets. Pull back and clear out the head to help you see what’s not obvious and then profit by the time it’s recognized by others. I find breaks especially helpful following losing trades, enabling us to reflect on the losses and what can be learned from them.

In short, it’s the mental routines—the mental environment—that we most need to change to break unwanted and unprofitable patterns of thought and behavior. When you’re your own trading coach, you learn to think, but also to think about your thinking. Incorporate a fresh look at self and markets each day to inspire new ideas, challenge stale ones, and tap sources of energy and inspiration that otherwise remain hidden in routine. As with my adventure in Queens, you may find that the most exotic changes bring out your finest adaptations.

C O A C H I N G  C U E:

Many times it’s the market views we most scorn that we need to take most seriously, because at some level we’re finding them threatening. Seek out commentary from those you most disagree with and ask yourself what you would be seeing in the markets if that commentary proves to be correct. If you’re quick to dismiss a market view, give it a second look. You wouldn’t need to be so defensive if you didn’t sense something plausible—and dangerous—in the views you’re dismissing.

– Brett Steenbarger, Ph.D. is Clinical Associate Professor of Psychiatry and Behavioral Sciences at SUNY Upstate Medical University in Syracuse, and the author of The Psychology of Trading (Wiley, 2003) and Enhancing Trader Performance (Wiley, 2006). His latest book is The Daily Trading Coach: 101 Lessons for Becoming Your Own Trading Psychologist. A coach of traders and portfolio managers at hedge funds, banks, and proprietary trading firms, Dr. Steenbarger blogs at TraderFeed.com

You can read part 1 here.

Q – In your Harvard Management Update interview, you said that “When what we pay attention to is driven by the last email we received, the trivial and the crucial occupy the same plane.” As well, it seems to be that a problem is our culture’s over-idealization of “always on” and “road warrior” habits, which distract from the importance of executive functions such as paying attention to one’s environment, setting up goals and plans, executing on them, measuring results, and internalizing learning. How can companies better equip their employees for future success? Can you offer some examples of companies who have positive cultures that encourage and reward employees fully put their frontal lobes into good use?

A – As I mentioned above, we are working and living in ways that undermine our ability to strategize, focus, reflect, innovate. Skimming, multitasking and speed all have a place in 21st-century life. But we can’t let go of deeper skills of focus and thinking and relating, or we’ll create a society of misunderstanding and shallow thinking.

To create workplaces that foster strategic thinking, deep social connection and innovation, we need to take three steps:

First, question the values that venerate McThinking and undermine attention. Recently, my morning paper carried a front-page story about efforts “in an age of impatience” to create a quick-boot computer. “It’s ridiculous to ask people to wait a couple of minutes to start up their computer,” explained one tech executive. The first hand up in the classroom, the hyper business-man or –woman who can’t sit still, much less listen – these are icons of success in American society. Still, many of us are beginning to question our adoration of instant gratification and hyper-mobility.

Second, we need to set the stage for focus individually and collectively by rewriting our climate of distraction and inattention. To help, some companies and business leaders are experimenting with “white space” – the creation of physical spaces or times on the calendar for uninterrupted, unwired thinking and connection. Executives are scheduling “quiet time” in their calendars to recapture space for reflection. One architect’s design for a major new government laboratory specifically creates spaces for focus, as well as collaboration. IBM’s global practice of “ThinkFridays” began three years ago when software engineers decided to limit email, conference calls and meetings one day a week in order to focus on their creative, patent work. Now, different teams and departments interpret “ThinkFridays” in varied ways. This pioneering initiative is fluid, flexible and workable – more so than the rigid, top-down policies that ban email one day a week.

Finally, if there’s just one action we can take to spark a “renaissance of attention,” it should be to give the gift of our attention to others. Parents and leaders, in particular, need to role model attention. As contemplative scholar Alan Wallace says, “When we give another person our attention, we don’t get it back. We’re giving our attention to what seems worthy of our life from moment to moment. Attention, the cultivation of attention, is absolutely core.”

Q – Some essential skills to thrive in the Cognitive Age seem to be attention, emotional self-regulation, working memory. These capacities are today understood to be less immutable than once thought, with emerging research opening the way for training programs that, for example, perhaps Fortune 500 companies will want too offer in the future as part of their corporate training and leadership programs, Your view?

A – Remarkably, scientists are now beginning to understand the mysteries and workings of attention and its sister skills of working memory and self-regulation. They are also discovering that attention can be trained, a finding that should revolutionize parenting, education and workplace training. In just five days of computer-based training, the brains of 6-year-olds begin to act like adults on measures of executive attention, one study by Michael Posner found. Torkel Klingberg’s work has shown that boosting short-term memory seems to improve children’s ability to stay on task. We don’t yet know how long-lasting the gains are, but practices such as meditation, computer-based exercises and behavioral therapies are proven to boost focus, awareness, working memory and executive attention. The philosopher/psychologist Williams James thought that attention could not be highly trained by “drill or discipline,” but he was wrong.

Still, there are important caveats to keep in mind. Some researchers question computer-based efforts as too narrow in scope, arguing that people must be taught attention holistically, as a life skill. No brief training regime is likely to be a magic bullet. “Part of the problem in today’s society is that people are looking for extremely quick fixes that have no vision. People are looking to lose 20 pounds for the wedding next week,” neuroscientist Amir Raz of McGill University once told me. “But attention training is a slow process.” As well, machine-based training will not be the only way to strengthen attention. Certainly, technology truly augments the human mind, and our gadgets will evolve to better help us focus and think. Yet it’s a mistake to believe that computers, or pharmaceuticals for that matter, can replace the hard, difficult work that we all face in “upgrading” ourselves.

Q – Neuroscientist Torkel Klinkgerg recently told our readers that “modern life itself may help make us more cognitively able. And emerging tools may enhance our abilities and better prepare us for the demands of the Information Age.” What are the opportunities and the risks you see ahead of us?

A – We now have easy access to reams of data, ever-expanding social networks, and limitless experiences across the planet and in the new frontier of cyberspace. The potential for learning, connection, fulfillment is great. But at the moment, we are not realizing this potential. Despite our scientific and technical achievements, we are squandering our chances to create a high-tech, yet reflective and caring society. And yet I am optimistic. In this time of flux, uncertainty, mistrust and collapse, we may nevertheless be shaken enough to reconsider our taken-for-granted ways of thinking and being. We may be ready to effect change. The task before us – to spark a renaissance of attention – is monumental, and yet it’s as crucial as greening the planet or rebuilding our financial system. For we can only meet the challenges of our day by strengthening, not undermining, our powers of attention.

Maggie, thank you very much for your time and attention.

My pleasure!

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Maggie’s Book: Distracted: The Erosion of Attention and the Coming Dark Age

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Related articles and resources:

- Part 1 of the interview with Maggie Jackson

- The Overflowing Brain: Most Important Book of 2008

- Top 10 Brain Fitness Books

This is a 2-part interview conducted via e-mail: we will publish the continuation on Thursday March 12th.

Alvaro Fernandez: New York Times columnist David Brooks said last year that we live in a Cognitive Age, and encouraged readers to be aware of this change and try and adapt to the new reality. Can you explain the cognitive demands of today’s workplaces that weren’t there 30-40 years ago?

Maggie Jackson: Our workplaces have changed enormously in recent decades, and it’s easy to point to the Blackberry or the laptop as the sources of our culture of speed and overload and distraction. But it’s important to note first that our 24/7, fragmented work culture has deeper roots. With the first high-tech inventions, such as the cinema, phonograph, telegraph, rail, and car, came radical changes in human experience of time and space. Distance was shattered – long before email and red-eye flights. Telegraph operators – not online daters – experienced the first virtual love affairs, as evidenced by the 1890s novel Wired Love. Now, we wrestle with the effects of changes seeded long ago.

Today, the cognitive and physical demands on workers are steep. Consider 24/7 living. At great cost to our health, we operate in a sleepless, hurried world, ignoring cues of sun and season, the Industrial Age inventions of the weekend and vacation, and the rhythms of biology. We try to break the fetters of time – and live like perpetual motion machines. That’s one reason why we feel overloaded and stressed – conditions that are corrosive to problem-solving and clear thinking.

At the same time, our technologies allow us access to millions of information bites – producing an abundance of data that is both wondrous and dangerous. Unless we have the will, discipline and frameworks for turning this information into wisdom, we remain stuck on the surface of the “knowledge economy.” Today, half of college students can’t judge the objectivity of a website, and just 30 percent of college graduates can read a document as simple as a food label proficiently. A third of workers say they are often so busy and interrupted that they don’t have time to reflect on the work they do. I worry that we are creating new forms of ignorance, based not on a lack of information but on a lack of will or ability to wrest knowledge from the oceans of information surrounding us. Google isn’t making us stupid. And yet, are we using Google wisely?

Finally, we have developed a highly fragmented workstyle, thanks in part to the enormous influence of Frederick W. Taylor. Taylor was an efficiency guru who taught workers to chop up tasks so that each part of a project could be made to go faster. His theories, according to management guru Peter Drucker, have influenced the world as much as those of Marx or Freud. Today, the average office worker switches tasks every three minutes all day long, and nearly half of such interruptions – both external and internal – are self-imposed. Such a workstyle is correlated with stress, frustration and even lower creativity.

In this new world, we can revel in our ability to move freely across the globe, connect with millions of others instantly and tap newfound sources of potential knowledge. Yet too often, our new ways of working undermine our powers of attention, a tripartite set of skills related to awareness or wakefulness; focus or the spotlight of the mind; and executive attention, a package of higher-order skills related to judgment and planning. Our split-focus, frenetic, diffused lives undermine our powers of attention, leaving us detached, unfocused and scattered.

Q – What may the role of spending hours per day in front of a TV?

A – Today, we are exposed to far more than television everyday. YouTube, movies, animated billboards, laptops, Muzak, iPods and other devices envelop us by choice and by default in streams of visual and aural distractions, information and ads. The average American child is exposed to nearly six hours of non-print media a day. So determining the specific impact of just one type of media is difficult in this new mediated world. Still, it’s certain that this environment shapes us, and molds our incredibly plastic brains, in ways we can only begin to fathom. According to work by Daniel Anderson at the University of Massachusetts/Amherst, toddlers exposed to “background television” – tv running in the background of family life – are more likely to show attention deficiencies. They play more briefly with toys, show less focus with their play, and interact less with parents.

As humans, we are born interrupt-driven. In order to survive, we need to focus on new stimuli in our environment and stay vigilant to changes around us. This is why we are prey to and delighted by quick-moving, enticing, complex media – at home and at work. In the office especially, if we’re constantly reacting to the new, new thing, we wind up doing nothing more than putting out fires and keeping our email inbox empty. We are less inclined to wrestle with the bigger, messy, problems of the day. Today, we must place ourselves back in the driver’s seat of our attention. We need to take charge of our environment and our attentional skills, and recapture time for reflection, deep problem-solving and creativity. As one top executive once told me, “thinking can’t be done in sound bites.”

Q – In your Harvard Management Update interview, you said that “When what we pay attention to is driven by the last email we received, the trivial and the crucial occupy the same plane.” As well, it seems to be that a problem is our culture’s over-idealization of “always on” and “road warrior” habits, which distract from the importance of executive functions such as paying attention to one’s environment, setting up goals and plans, executing on them, measuring results, and internalizing learning. How can companies better equip their employees for future success? Can you offer some examples of companies who have positive cultures that encourage and reward employees fully put their frontal lobes into good use?

A – As I mentioned above, we are working and living in ways that undermine our ability to strategize, focus, reflect, innovate. Skimming, multitasking and speed all have a place in 21st-century life. But we can’t let go of deeper skills of focus and thinking and relating, or we’ll create a society of misunderstanding and shallow thinking.

To create workplaces that foster strategic thinking, deep social connection and innovation, we need to take three steps:

First, question the values that venerate McThinking and undermine attention. Recently, my morning paper carried a front-page story about efforts “in an age of impatience” to create a quick-boot computer. “It’s ridiculous to ask people to wait a couple of minutes to start up their computer,” explained one tech executive. The first hand up in the classroom, the hyper business-man or –woman who can’t sit still, much less listen – these are icons of success in American society. Still, many of us are beginning to question our adoration of instant gratification and hyper-mobility.

To Be Continued…

Please remember: we will publish the continuation of this interview on Thursday March 12th. (yes, you can consider this a test of your executive functions and/ or your memory).

Book: Distracted: The Erosion of Attention and the Coming Dark Age.

Related articles and resources:

- The Overflowing Brain: Most Important Book of 2008

- Top 10 Brain Fitness Books

Dr. Klingberg has just published a very stimulating popular science book, The Overflowing Brain, that should help in precisely that direction. Given the importance of the topic, and the quality of the book, we have named  The Overflowing Brain: Information Overload and the Limits of Working Memory  The SharpBrains Most Important Book of 2008, and asked Dr. Klingberg to write a brief article to introduce his research and book to you. Below you have. Enjoy!

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Research and Tools to Thrive in the Cognitive Age

By Dr. Torkel Klingberg

Do we all have attention deficits?

The information age has provided us with high technology which fills our days with an ever increasing amount of information and distraction. We are constantly flooded with on-the-go emails, phone calls, advertisements and text-messages and we try to cope with the increasing pace by multi tasking. A survey of workplaces in the United States found that the personnel were interrupted and distracted roughly every three minutes and that people working on a computer had on average eight windows open at the same time. There is no tendency for this to slow down; the amount and complexity of information continually increases

The most pressing concerns with this environment are: how do we deal with the daily influx of information that our inundated mental capacities are faced with? At what point does our stone-age brain become insufficient? Will we be able to train our brains effectively to increase brain capacity in order to stay in-step with our inexorable lifestyles? Or will we be stricken with attention deficits because of brain overload?

In his article “Overloaded Circuits: Why Smart People Underperform,” psychiatrist Edward Hallowell coins the term “attention deficit trait” to characterize the situation in which so many of us find ourselves. This is not a new diagnosis of any use to doctors, but rather a description of the mental state that information technology, a faster pace, and changing work patterns have induced. Some would call it a lifestyle.

The point of Hallowell’s term is that it illustrates how the modern work situation, with its pace and simultaneous demands, often gives us the feeling of having attention difficulties and of not quite having the capacity to do our jobs. Our brains are being flooded. But is it really the case that the information society generally impairs people’s attentional abilities? What are attentional abilities, anyway, and exactly what in our complex work situations is mentally demanding?

Cognitive Demands in the Information Age

In my book “The Overflowing Brain: Information Overload and the Limits of Working Memory” I try to pinpoint the nature of the cognitive demands of modern life and the psychological and neural basis of our capacity limitations. One demand factor in our working lives is the incessant distractions: all the impressions that buzz around us like mosquitoes and make it hard for us to concentrate on what we’re doing. The torrent of information increases not only the volume of data we’re expected to take in but also the volume we need to shut out.

Another important demand factor is multitasking, which is the quick and easy solution for all those who want to get more done in less time. However, doing (or at least trying to do) several tasks simultaneously is one of our most demanding everyday activities. Running on a treadmill while watching TV usually isn’t too taxing, nor is chewing gum while walking in a straight line. But even such a mundane situation as talking on a cell phone while driving is not as easy as we’d like to think. Apart from the fact that it’s difficult to hold the wheel and shift gears with the same hand, or to keep our eyes on the road and on the phone’s display at the same time, there’s something in the mentally demanding task of telephoning that makes us worse drivers.

Information overload, distractions and multitasking are probably the most important factors in making the information age so cognitively demanding are.

The Role of Working Memory: challenges and opportunities

There are plenty of indications that those three factors are loading on our working memory capacity, which is our capacity to hold on to relevant information for short periods of time. The problem is that our working memory capacity is a scarce resource. The increase in information load thus meets a biological constraint in how much we can handle. A question that has always fascinated me is how this capacity constraint is wired in our brain, and if we can in some way increase this capacity, and this question is a thread that I follow throughout the book.

In the research that my colleagues and I have done at the Karolinska Institute in Stockholm, we have shown that training on working memory tasks, close or above the limit of our capacity, can improve our working memory. This improvement is not only confined to the trained tasks, but generalizes to other cognitive tasks requiring working memory and control of attention. We have also shown that this training improves the ability to focus in everyday life. The working memory capacity limitation is not immutable, but actually possible to stretch.

Furthermore, it is possible that the increasing information load not only is harmless, but might actually improve our cognitive abilities through improvement of working memory. The now well known Flynn effect tells us that fluid intelligence is increasing, presumably due to environmental demands on cognition. The most important cognitive demands of modern life relates to working memory, and the most important cognitive function underlying fluid intelligence is working memory capacity. The way environmental demands improves fluid intelligence might thus be through improvement on working memory capacity.

In other words, modern life itself may help make us more cognitively able. And emerging tools may enhance our abilities and better prepare us for the demands of the Information Age.

Reflections for the Future

Training our brains might thus be a way to keep up with the increasing demands of the information age. This might be especially relevant for those of us that are over 25 years of age, when working memory capacity starts to decline year by year, at the same time as the demands increase. In my book I, half jokingly, suggested that in the future we might see company-funded cognitive fitness training for employees. It was with a certain satisfaction that I recently read in SharpBrains blog about a new initiative by the USA Ice Hockey league to provide computerized cognitive training -focused on important perception and decision-making skills- to its players.

In the future we might be as aware of cognitive function as we know are obsessed with calories, diets, glycemic index and cardiovascular training, and brain training might be a part of our every day life.

– Dr. Torkel Klingberg leads the Developmental Cognitive Neuroscience Lab at the Karolinska Institute, which is part of the Stockholm Brain Institute. He has recently written The Overflowing Brain: Information Overload and the Limits of Working Memory (Oxford University Press, November 2008).

Nutrients play key roles in brain function. Several have shown efficacy in clinical trials treating cases of mood disorders, cognitive decline and of course benefiting the physical health of the brain. Nutrients are both the raw materials employed in creating new neural connections and important components in regulating the activity of genes involved in these processes. Specific nutrients involved in mitochondrial efficiency, the energy factories of brain and body cells, are particularly important for many aspects of brain function. Other nutrients are involved in the inner workings of neuronal membranes, responsible for ensuring that electrochemical signals, which make up our thoughts, transmit efficiently and reliably. Finally, antioxidants, important throughout the body, are especially important in the brain due to its high energy production rates and concurrent high capacity for free radical leakage. Keeping this in mind, it is readily apparent that nutrition provides the building blocks for our brain’s structure and function, and therefore cannot be ignored.

Exercise is a clearly established component for promoting brain health as well. No longer can we think that the brain is completely separate from the brawn. Human studies have shown the value of exercise in controlling stress and maintaining positive mood states; in improving cognitive function, including performance on memory and executive tasks; and in improving the brain’s two-way communication streams with the rest of the body. Some of these benefits are likely due to the positive effects of exercise on neurovascular health, which parallel cardiovascular health. Other benefits seem due to increased grey matter in ‘front office’ functions of the cortex; and neuronal birth, or neurogenesis, in the hippocampus, a brain region that controls aspects of memory and mood regulation. Whatever the mechanism, giving your body a workout will produce substantial benefits in terms of brain health. Remember, a body in motion tends to stay in motion, and your brain and body will be together your whole life.

Mental activity is an obvious, and critical, ingredient for optimizing and maintaining brain function. Studies have established relationships between the degree of life-time mental activity and late-life cognitive function. It’s clear that those who engage in intellectually challenging endeavors on a regular basis reap the benefits of a clear mind. There is, however a need for each individual to balance sufficient variety with a proper degree of challenge. Without variety and challenge, tasks become too mundane and too easy, eventually growing stale and losing their capacity to adequately stimulate the brain. We must also realize that mental activity goes beyond ‘cognitive’ tasks. Mental activities also include practices like meditative focus, relaxation and stress reduction techniques, as well as social interaction. These active and dynamic processes challenge the mind as well. Mixing cognitive challenges with emotional regulation provides a more complete mental workout that will help you to use it to improve it.

An often neglected component contributing to brain health is optimal sleep. On average, we sleep approximately 1.5 hours per night less than we did 100 years ago. Modern technology makes it easier to get less sleep and our busy lives encourage us to do it. Sleep is far more than a time of rest, and is too often misclassified as a period of lost productivity. It is an active metabolic period for our brains. Sleep is a time when we consolidate memories of the previous day, a time when we re-synchronize the circadian rhythm of at least dozens, if not hundreds, of hormones controlling our metabolism. Sleep loss is associated with a high percentage of mood disorders and certainly reduces our cognitive efficiencies. We must give ourselves permission to sleep by realizing that it is counterproductive to steal from it.

In our new book BrainFit For Life: A User’s Guide to Life-Long Brain Health and Fitness, we focus equally on the cognitive, emotional and physical health of the brain and all of the lifestyle factors that come into play to maintain them. Today’s aging population is becoming increasingly focused on the maintenance of cognitive health and the value of ‘brain training’ programs. But we must realize that such training is not unlike that of an athlete, who must focus on their diet, sleep needs and psychological preparation in addition to their physical skill development. We explore specific aspects of nutrition, exercise, mental activity and sleep. We discuss how they regulate emotional, physical and intellectual functions of the brain. After all, they are not separable.

“To keep the body in good health is a duty…otherwise we shall not be able to keep our mind strong and clear.” – Buddha, circa 500 B.C.

– This article was co-written by Drs. Simon Evans and Paul Burghardt. Drs. Evans and who currently collaborate in the University of  Michigan’s Department of Psychiatry, and the Molecular and Behavioral Neuroscience Institute to study the effects of nutrition and exercise on brain function. They are co-authors of BrainFit For Life: A User’s Guide to Life-Long Brain Health and Fitness.

To Blink or not to Blink?

To Think or not to Think?

We are pleased to present, as part of our ongoing Author Speaks Series, an article by Madeleine Van Hecke, author of Blind Spots: Why Smart People Do Dumb Things. In it, she offers the ”on the other hand” to Malcolm Gladwell’s Blink argument. 

 

 

To Think or to Blink?

- By Madeleine Van Hecke, PhD

Is thoughtful reflection necessarily better than hasty judgments?

Not according to Malcolm Gladwell who argued in his best-selling book, Blink, that the decisions people make in a blink are often not only just as accurate, but MORE accurate, than the conclusions they draw after painstaking analysis.

So, should we blink, or think?

When we make judgments based on a thin slice of time – a few minutes talking with someone in a speed dating situation, for example – are our judgments really as accurate as when we analyze endless reams of data?

Gladwell says sure – that’s why Blink is called “the power of thinking without thinking.” Gladwell tells some compelling stories to demonstrate that power, including his opening gambit about the Greek kouros sculpture that two experts accurately detected as a fake within a few moments perusal, after months of scientific testing had deemed it genuine.

But Gladwell’s own examples show that people are most likely to be correct in their “blink” judgments when they are like the two art experts – when their judgments rest on a mother lode of background experience or information. So a “blink” judgment might serve you well at those times – but the rest of the time, you need to slow down in order to avoid the blind spots that can trip up even the smartest people. In my book, Blind Spots, I suggest tactics to help one make better decisions because they help sidestep the pitfalls that our blind spots keep us from seeing.

While some “blink” decisions can be on target when they’re based on our expertise, they don’t always serve us well, for two reasons. First, because in highly-charged, emotional situations – such as when a police officer becomes suspicious of someone and fears danger – blink decisions can result in tragedy. Gladwell acknowledges this– he notes that some police departments have adopted one-officer squad cars. Why? Because an officer alone will act more slowly, often wait for back-up. This delays the time between becoming suspicious and taking action, and it apparently reduces the number of inaccurate blink-decisions that officers make.

In Blind Spots, I point out that failing to stop and think is a blind spot – we don’t think because we don’t recognize “this is a situation in which I really need to step back from what’s going on and figure out what to do.” As a result we shoot off an e-mail that we later regret, or exuberantly embrace a flawed marketing plan. Every time you have ever said “I realize now,” you’re recognizing an earlier time where you failed to stop and think.

The second reason that expert blink decisions can go astray is because sometimes our very expertise blinds us to new, more creative perspectives. Why, for example, did people design early train cars with no central aisles, and with brakes that had to be operated by a conductor seated outside, on top of the train car – a dangerous practice? Because these early cars were almost exact replicas of what the expert designers were most familiar with – the stagecoach. So our expertise can sometimes trap us.

Now, I think intuition is important, and one of the good things about Blink is that it’s kind of a corrective book, one that celebrates the value of intuitive thinking and pokes fun a bit at careful, analytic reasoning. But Blink oversimplifies the issue. Blind Spots reflects more deeply on the tension between analytic thought and intuition. It’s a mistake to enthrone logic as the sole and sure-fire way to Truth, but it’s also a mistake to blithely accept every whim as inspired. A better slogan might be “Don’t believe everything that you think.” The strategies in Blind Spots help you figure out what you should and shouldn’t believe.

Some of the stories that Gladwell tells are testimony to the mystery of our minds, and I absolutely agree that our minds often work in mysterious ways. But that mystery goes way beyond the nature of intuition. Take the evidence that children can be incredibly logical in their thinking. One three-year-old girl was being teased by her Aunt, who was nibbling at the child’s toes and threatening “I’m going to eat you up!” “No!” said the little girl, “I’m going to eat you up!” “Aha,” said the Aunt, “but I’m bigger than you, so I’ll eat you up first.” “Uh-uh” retorted this youngster: “because I’ll eat your mouth first.” The logic of this preschooler is quite breathtaking. How did she do that?

On the other hand, there’s also research that raises the opposite question: the “How could anyone be so dumb?” question. Some studies, for example, show that intelligent adults consistently make mistakes in reasoning. How do you explain that? To me, the apparent stupidity of adults – the enigma of why smart people do dumb things — is a puzzle to be solved.

Smart people do dumb things because our minds work FOR us – 80 or 90 percent of the time. But the rest of the time they work against us: they create blind spots that trip us up. Some of these blind spots are familiar to us, like “my-side bias” – not seeing another point of view. One smart fellow told me what he did to get a squirrel out of his basement. He opened a window, piled up some planks and boxes to create a road, and set down a trail of nuts, ending with a heap on the patio. Now that MIGHT have been a smart thing to do – but it could have backfired. Because that trail went both ways – possibly leading the troublesome squirrel out of the basement, but possibly leading other squirrels INTO the basement. Some smart plans fail because of my-side bias. Forgetting that there’s another point of view is one of the natural blind spots that work against us.

It takes some time, it takes some effort – it takes more than a blink – but paying attention to your Blind Spots can help you think more critically and more creatively.

– Madeleine Van Hecke, Ph.D., is a licensed clinical psychologist, speaker, consultant, and author. She is the author of Blind Spots: Why Smart People Do Dumb Things (Prometheus Books, Inc., 2007).

 

 

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