SharpBrains

(Editor's Note: I recently came across an excellent book and resource, The Alzheimer's Action Plan: The Experts' Guide to the Best Diagnosis and Treatment for Memory Problems, recently released in paperback. Dr. Murali Doraiswamy, one of the authors and leading Alzheimer's expert, kindly helped us create a 2-part article series to share with SharpBrains readers advice on a very important question, "How can we help the public at large to distinguish Alzheimer's Disease from normal aging --- so that an interest in early identification doesn't translate into unneeded worries?" What follows is an excerpt from the book, pages 72-78, discussing the Pros and Cons of the most common assessments).

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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. Continue Reading »

This is a partial list of the literature we reviewed during the research phase of our new book, The SharpBrains Guide to Brain Fitness.  We know many friends of SharpBrains are researchers, healthcare professionals, graduate/ Ph.D. students, who want have direct access to the references (perhaps PubMed should promote itself as a never ending source of mental stimulation?), so here you have this list, organized by relevant chapter. Please note that the list below appears in the book - whose manuscript we had to close in January 2009.

Introduction

• Basak, C. et al. (2008). Can training in a real-time strategy video game attenuate cognitive decline in older adults? Psychology and Aging.
• Begley, S. (2007). Train your mind, change your brain: How a new science reveals our extraordinary potential to transform ourselves. Ballantine Books.
• DeKosky, S. T., et al. (2008). Ginkgo biloba for prevention of dementia: a randomized controlled trial. Journal of the American Medical Association, 300, 2253-2262.
• Doidge, N. (2007). The Brain that changes itself: Stories of personal triumph from the frontiers of brain science. Viking Adult.

Chapter 1. The Brain and Brain Fitness 101

• Bunge, S. A., & Wright, S. B. (2007). Neurodevelopmental changes in working memory and cognitive control. Current Opinion In Neurobiology, 17(2), 243-50.
• Damasio, A. (1995). Descartes’ error: Emotion, reason, and the human brain. Penguin Press.
• David Kolb, D. (1983). Experiential learning: Experience as the source of learning and development. FT Press.
• Draganski, B., Gaser, C., Kempermann, G., Kuhn, H. G., Winkler, J., Buchel, C., & May A. (2006). Temporal and spatial dynamics of brain structure changes during extensive learning. The Journal of Neuroscience, 261231, 6314-6317.
• Gage, F. H., Kempermann, G., & Song, H. (2007). Adult Neurogenesis. Cold Spring Harbor Laboratory Press, NY.
• Gardner, H. (1983). Frames of Mind: The theory of multiple intelligences. New York: Basic Books.
• Gaser, C. & Schlaug, G. (2003). Brain structures differ between musicians and non-musicians. The Journal of Neuroscience, 23, 9240-9245. Continue Reading »

(Editor's Note: I recently came across an excellent book and resource, The Alzheimer's Action Plan: The Experts' Guide to the Best Diagnosis and Treatment for Memory Problems, just released in paperback. Dr. Murali Doraiswamy, one of the authors and leading Alzheimer's expert, kindly helped us create a 2-part article series to share with SharpBrains readers advice on a very important question, "How can we help the public at large to distinguish Alzheimer's Disease from normal aging --- so that an interest in early identification doesn't translate into unneeded worries?" What follows is an excerpt from the book, pages 3-8).

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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 Continue Reading »

The growing field of cognitive training (one of the tools for brain fitness) can appear very confusing as the media keeps reporting contradictory claims. These claims are often based on press releases, without a deeper evaluation of the scientific evidence.

Let’s take a couple of recent examples, in successive days:

“It doesn’t work!” type of headline:
Reuters (Feb. 10, 2009) — Formal brain exercise won't help healthy seniors: research
“Healthy older people shouldn't bother spending money on computer games and websites promising to ward off mental decline, the author of a review of scientific evidence for the benefits of these "brain exercise" programs says”.

“It works!” type of headline:
ScienceDaily (Feb. 11, 2009) — Computer Exercises Improve Memory And Attention, Study Suggests
“According to the researchers, participants who used the Brain Fitness Program also scored as well as those ten years younger, on average, on memory and attention tests for which they did not train.”

So… does structured brain exercise / cognitive training work or not?

The problem may in fact reside in asking this very question in the first place, as Alvaro pointed out a while ago in his article “Alzheimer's Disease: too serious to play with headlines“.

We need a more nuanced set of questions.

Why? Because:
1. Cognition is made of several different abilities (working memory, attention, executive functions such as decision-making, etc)
2. Available training programs do not all train the same abilities
3. Users of training programs do not all have the same needs or goals
4. We need to differentiate between enhancing cognitive functions and delaying the onset of cognitive deficits such as Alzheimer’s.

Let’s illustrate these points, by Continue Reading »

Welcome to the 8th edition of Hourglass, the blog carnival devoted to biogerontology. Enjoy!

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Use It or Lose It

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Cognitive Enhancement, Health and Assessments

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The Benefits of Caloric Restriction Continue Reading »

Here you have the January edition of our monthly newsletter covering cognitive health and brain fitness topics. Please remember that you can subscribe to receive this Newsletter by email, simply by submitting your email at the top of this page.

Bird's Eye View

Brain fitness heads towards its tipping point: How do you know when something is moving towards a Gladwellian tipping point? When health insurance companies and public policy makers launch significant initiatives. Dr. Gerard Finnemore provides a market overview, based on SharpBrains' client webinar held last December.

Ten Reflections on Cognitive Health and Assessments: Here are 10 highlights from several stimulating January events:  Symposium on Adaptive Technology for the Aging (by Arizona State University), Health Bloggers' Summit (by Consumer Reports), Traumatic Brain Injury (by Veteran Affairs in Palo Alto), and a new Alzheimer's/ Dementia Expert Panel organized by the city of San Francisco.

News and Events

Nintendo Brain Age vs. Crossword Puzzles: we need much public education in order to help consumers separate reality from hope from hype. Nintendo is not helping, neither is media reporting.

Collection of recent news: including training for senior fitness trainers, reports on the importance of purpose,  on older driver safety, and more.

Upcoming events: I will be speaking soon at the New York Academy of Medicine, the American Society on Aging/ NCOA conference, and the Silvering Workforce Summit at the University of North Carolina. Let me know if you are attending any.

Education and Learning

Learning about Learning: an Interview with Joshua Waitzkin: Scott Barry Kaufman interviews "child prodigy" Joshua Waitzkin on The Art of Learning. Many fascinating insights, including "I think losing my first National Chess Championship was the greatest thing that ever happened to me, because it helped me avoid many of the psychological traps...(associated with being called a "child prodigy")".

Resources to help students build emotional intelligence: Daniel Goleman introduces educators and parents to a new book that "adds an important tool to the emotional intelligence kit: mindfulness, a moment-by-moment awareness of one's internal state and external environment."

Resources

Top 10 Cognitive Health and Brain Fitness Books: Here you have The 10 Most Popular Brain Fitness & Cognitive Health Books, based on book purchases by SharpBrains' readers during 2008.

10-Question Program Evaluation Checklist: To help consumers and professionals navigate through the growing number of programs making "brain fitness" or "brain training" claims, we published last year this Evaluation Checklist. Now we are making the Checklist available as a Bookmark given recent requests by universities and conference organizers.

Brain Teaser

Brain Teaser to Exercise your Memory and Reasoning Skills: Dr. Pascale Michelon offers a stimulating teaser that not only helps exercise our brain but also educates us on how and why the same activity may exercise different brains differently - depending on where we are from.

Fyi, I will be speaking at the following events:

>> March 5th, New York Academy of Medicine, NYC. I will present Brain Fitness Software - Consumers Guide to distinguishing hope from hype, at the Comprehensive Approach to Dementia Symposium sponsored by Montefiore Medical Center and with credit designated by Albert Einstein College of Medicine.

>> March 15-19th, ASA/ NCOA annual conference in Las Vegas. I will be presenting two sessions. Registration is open now at 2009 Aging in America Conference, but there is limited information on the sessions. Will blog when there are detailed abstracts available.

- The State of the Brain Fitness Market, 16-Mar-09, 08:00 PM - 09:30 AM

- Brain Fitness in Senior Housing: 18-Mar-09, 11:30 AM - 12:30 PM

>> April 8th, University of North Carolina Greensboro: Cognitive Fitness and the Aging Workforce: Opportunities and Challenges, at the Silvering Workforce Summit.

Let me summarize ten highlights and reflections from stimulating discussions on cognitive health and assessments I have had this month so far.

January 8-9th: Symposium on Co-Adaptive Learning: Adaptive Technology for the Aging (details Here), organized by the Arizona State University's Center for Adaptive Neural Systems:

1. Cognitive health is a critical factor in overall healthcare, but is often approached in a fragmented, non-systematic way. Most speakers in the symposium did mention how cognitive health issues interact with their specific areas of focus (aging, Parkinson's Disease, traumatic brain injury, Alzheimer's...) but there was a lack of a common framework and taxonomy to define the problem and identify solutions and interventions to measure and help maintain cognitive health across the lifespan.

2. For example, Parkinson's Disease. Did you know (I didn't) that a significant percentage of Parkinson's patients have well-identified cognitive impairments, mostly in their executive functions but also perceptual problems?

3. We truly need a Culture of Cognitive Health, as Randal Koene pointed out.

4. May online cognitive games serve as ongoing, real-time assessment of cognitive function? Misha Pavel thought so. He also added we may well see "cognitive exercise coaches" sometime in the horizon.

5. Skip Rizzo presented how virtual reality can help address Post Traumatic Stress Disorder (PTSD) and even to administer innovative cognitive assessments.

6. My presentation, titled The Emerging Cognitive Fitness Market: Status, Trends and Challenges, is available Here

7. January 22nd: Consumer Reports organized a health summit titled Continue Reading »

Learning & the Brain is a conference that gets marked on my calendar annually because I always return home having either been exposed to new information, or with a new perspective on an old topic. Last month’s conference in Cambridge, MA, themed Using Emotions Research to Enhance Learning & Achievement, was no exception. As with previous conferences, in addition to the many keynote sessions, I focused on the adult learning strand, since so much of my time is spent providing professional development for, and collaborating with adults. Here are five conference cues as they relate to education.

1. CHALLENGE YOURSELF WITH NEW LEARNING

Aaron Nelson stated that our memory starts to decline between ages twenty-five and thirty, or to phrase it a bit more positively, Sam Wang says our memory peaks around age thirty. On the other end of the age spectrum, according to Ken Kosik, there is unequivocal evidence that education protects against Alzheimer's. Both Nelson and Kosik mentioned the theory of cognitive reserve, which translates roughly to the more we learn, the more connections we create, and therefore the greater the neuronal buffer we have to draw upon as we age.

Elkhonon Goldberg, at last April's conference, stated that “as one ages, the domain of the novel shrinks, and the domain of what is known grows". He cautioned the audience to beware of being on mental autopilot. Thus, the goal is not to simply get better at doing more of the same. The type of learning that makes a difference consists specifically of new, novel challenges. The result of such engagement is that Continue Reading »

Given the growing media coverage mentioning the terms Cognitive Reserve and Brain Reserve, you may be asking yourself, "What exactly is my Cognitive (or Brain) Reserve?"

The cognitive reserve hypothesis, tested in multiple studies, states that individuals with more cognitive reserve can experience more Alzheimer’s disease pathology in the brain (more plaques and tangles) without developing Alzheimer’s disease symptoms.

How does that work? Scientists are not sure but two possibilities are considered.
1. One is that more cognitive reserve means more brain reserve, that is more neurons and connections (synapses) between neurons. Individuals with more synapses would then have more synapses to lose before the critical threshold for Alzheimer’s Disease is reached.
2. Another possibility is that more cognitive reserve means more compensatory processes. The brain of individuals with more cognitive reserve would use more alternative networks to compensate for the damages caused by the pathology in previously used networks.

In a newly published study, Roe and colleagues from Washington University in St. Louis, used the number of years of education as a measure of cognitive reserve. Why years of education? Because previous studies have shown that people who have more education also exhibit a greater resistance to Alzheimer’s symptoms, even while pathological changes are occurring in the brain (see Bennett el al., 2003 or Roe, Xiong, et al., 2008).

Roe and her colleagues studied 198 individuals whose mean age was 67. Out of these 198 individuals, 161 were nondemented and 37 were diagnosed with Alzheimer’s Disease.

All the participants in the study took a Continue Reading »