Editor’s note:
Ken­neth S. Kosik, MD, and Ellen Clegg, authors of a recent book on Alzheimer’s Dis­ease pre­ven­tion and treat­ment, force­fully pro­pose a new frame­work and model for brain care: What about set­ting up “cog­ni­tive shops” as “a sort of one-stop shop­ping for every­thing from Alzheimer’s dis­ease pre­ven­tion to guided care for mild or mod­er­ate dis­ease”. What fol­lows is the thought-provoking con­clu­sion sec­tion from their book “The Alzheimer’s Solu­tion. How Today’s Care Is Fail­ing Mil­lions and How We Can Do Bet­ter” (repro­duced with per­mis­sion), not very dif­fer­ent from the “brain fit­ness cen­ter” model we have talked about in the past.

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Chap­ter 10. CONCLUSIONS

Just as the idea of hos­pice care rev­o­lu­tion­ized death and dying in Amer­ica, the idea of bundling many aspects of Alzheimer’s care under one roof in a cog­ni­tive shop could change the way we approach this dire disease—one that has no cure and leaves no sur­vivors. Cer­tainly, the scope of the prob­lem poses med­ical and eco­nomic risks for the coun­try. These risks, and poten­tial steps for a solu­tion, were charted by the bipar­ti­san Alzheimer Study Group in the spring of 2009. The report, issued by the Alzheimer Study Group co-chaired by for­mer con­gress­man Newt Gin­grich and for­mer sen­a­tor Bob Ker­rey, minces few words. Read the rest of this entry »

The L.A. Times reports today the neg­a­tive results of the lat­est ran­dom­ized trial test­ing the effects of DHA sup­ple­ments on Alzheimer’s symp­toms (DHA is an omega-3 fatty acid).

The study … exam­ined 402 peo­ple with mild to mod­er­ate Alzheimer’s. They were ran­domly assigned to take 2 grams a day of omega-3 cap­sules con­tain­ing docosa­hexaenoic acid (or DHA) or a placebo cap­sule. The par­tic­i­pants were fol­lowed for 18 months, and their cog­ni­tive and func­tional abil­i­ties were reassessed. They also under­went MRI to look at the brain.

There was no ben­e­fit seen in the patients tak­ing omega-3 fatty-acid sup­ple­ments in either brain vol­ume or cog­ni­tive function.

Com­ments: Does this study mean that DHA or omega-3 in gen­eral are not good for the brain? No! This study sug­gests that tak­ing DHA sup­ple­ments after Alzheimer’s diag­no­sis is not help­ful. Prior evi­dence shows that omega-3 con­sump­tion (espe­cially DHA) long before the onset of Alzheimer’s symp­toms reduces the risk of devel­op­ing the dis­ease. Indeed, sev­eral stud­ies have shown that eat­ing fish (the pri­mary source in our diet of omega-3 fatty acids) is asso­ci­ated with a reduced risk of cog­ni­tive decline or dementia.

The authors of the JAMA study also spec­u­late that DHA sup­ple­ments could be used as a treat­ment for peo­ple who have not yet been diag­nosed with Alzheimer’s but are already devel­op­ing demen­tia pathol­ogy in their brain: “Indi­vid­u­als inter­me­di­ate between healthy aging and demen­tia, such as those with mild cog­ni­tive impair­ment, might derive ben­e­fit from DHA sup­ple­men­ta­tion, although fur­ther study will be nec­es­sary to test this hypoth­e­sis.” 

You have heard that phys­i­cal exer­cise is good for the brain. How much exer­cise are we talk­ing about? Can the ben­e­fits be seen both for chil­dren and adults? In Fit­ter bod­ies = fit­ter brains. True at all ages? Dr. Pas­cale Mich­e­lon answers these ques­tions for you, based on lat­est sci­en­tific studies.

We need fun ways to get out the couch more and exer­cise both phys­i­cally and cog­ni­tively. What about set­ting up community-based adult play­grounds, such as this one in Beijing?

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Peo­ple of all ages read SharpBrains.com and this monthly update, so we are prepar­ing a series of arti­cles on Brain Health across the Lifes­pan. The series will include 4 parts:

Each part will include sur­pris­ing facts on how the brain works, debunk com­mons myths about cog­ni­tion and brain health, and link to resources such as books and doc­u­men­taries. If you want to read these arti­cles as we pub­lish them via SharpBrains.com, you can fol­low us in Face­book and Twit­ter. Tell your friends and col­leagues about the series!

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Walk­ing increases Brain Vol­ume: A recent neuro-imaging study shows that walk­ing reg­u­larly can increase brain vol­ume and reduce the risks of devel­op­ing cog­ni­tive impairment.

Move to another Coun­try, to another Occu­pa­tion: A cou­ple recent stud­ies rein­force the Cog­ni­tive Reserve frame­work that sug­gests we can pro­tect our brains by speak­ing more than one lan­guage and by not retir­ing early.

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Take that Nap - It May Boost Your Learn­ing Capac­ity: Scott Barry Kauf­man tells us why sleep is good for the brain. It turns out that sleep is tied to a bet­ter immune sys­tem, meta­bolic con­trol, mem­ory, learn­ing, cre­ativ­ity and emo­tional func­tion­ing.

Boost your Atten­tion with Med­i­ta­tion: Another way to slow down is to med­i­tate. Through sum­maries of stud­ies and an inter­view with Dr. New­berg, we dis­cuss how med­i­ta­tion can improve your con­cen­tra­tion skills.

Train your Brain to Focus on Pos­i­tive Expe­ri­ences: In this arti­cle by the Greater Good Mag­a­zine, Rick Han­son explains the “neg­a­tiv­ity bias” of the brain and what steps we can take to rewire our brains for last­ing happiness.

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Today is World Alzheimer’s Day. To raise aware­ness and funds, asso­ci­a­tions world­wide orga­nize mul­ti­ple activ­i­ties includ­ing impor­tant Mem­ory Walks, and a new report helps quan­tify the grow­ing per­sonal and eco­nomic bur­den of the disease.

Among the report findings:

• Close to 36 mil­lion peo­ple world­wide have demen­tia today
• Demen­tia care costs around 1 per­cent of the world’s gross domes­tic prod­uct (GDP), or 604 bil­lion US dol­lars. Of these, 252 bil­lion rep­re­sent indi­rect costs of care, while annual direct med­ical costs account for 96 bil­lion, and direct non-medical costs for 256 billion
• By 2030, world­wide soci­etal costs will increase by over 85 percent

The good news?

• That the num­ber 1 rea­son for the bad news is sim­ple: we live longer than ever before
• That, while there is noth­ing we can do today to pre­vent Alzheimer’s pathol­ogy, there is much we can do, as indi­vid­u­als and as a soci­ety, to build up Cog­ni­tive Reserve and sig­nif­i­cantly delay cog­ni­tive decline and Alzheimer’s symptoms

Which is why there is so much ongo­ing inno­va­tion to develop tools to effi­ciently mea­sure and enhance cog­ni­tive func­tion­ing and reserve and to fos­ter active aging.

Time per­haps for a World Cog­ni­tive Reserve’s Day?

What is work­ing mem­ory, and why it mat­ters? Can we multi-task as good as we seem to assume? What should we all know about how our brains work, and why?

We hope you enjoy this August eNewslet­ter, fea­tur­ing six dis­tin­guished con­trib­u­tors who answer those ques­tions, and more. Please remem­ber that you can sub­scribe to receive this free Brain Fit­ness eNewslet­ter by email, using the box in the right column.

Know Thy­self

Why work­ing mem­ory mat­ters in the knowl­edge age: As Dr. Tracy Alloway points out, one way to visu­al­ize work­ing mem­ory is as the brain’s “Post-it Notes” — we make men­tal scrib­bles of bits of infor­ma­tion we need to remem­ber and work with. With­out enough work­ing mem­ory we can­not func­tion as a soci­ety or as indi­vid­u­als. Learn more by par­tic­i­pat­ing in this study launched by Dr. Alloway’s team in con­junc­tion with the British Sci­ence Festival.

What should every­one learn about the brain?: Dr. Jo Ellen Rose­man and Mary Kop­pel from the Amer­i­can Asso­ci­a­tion for the Advance­ment of Sci­ence (AAAS) dis­cuss recent rec­om­men­da­tions on what all stu­dents should know. Not just the basics of brain struc­ture and func­tion, but also a good under­stand­ing of men­tal health—such as the mind/body rela­tion­ship, fac­tors that shape behav­ior, ways of cop­ing with men­tal dis­tress, and the diag­no­sis and treat­ment of men­tal disorders.

News

Pool­ing data to accel­er­ate Alzheimer’s research: A good arti­cle in the New York Times presents the rea­sons behind grow­ing research of how to detect Alzheimer’s Dis­ease. A pilot study shows how com­put­er­ized cog­ni­tive train­ing may help reduce falls among elderly. Amazon.com rec­om­mends The Sharp­Brains Guide to Brain Fit­ness in a thought-provoking mix.

Beyond News

Needed: fund­ing for inno­v­a­tive research on slow­ing cog­ni­tive decline via cog­ni­tive train­ing: Sharp­Brains reader and UK researcher Nick Almond shares a note debunk­ing the so-called BBC brain train­ing exper­i­ment  and out­lin­ing the type of research he and col­leagues at Leeds Uni­ver­sity deem necessary.

Long-term effects of neu­ro­feed­back treat­ment for ADHD: Dr. David Rabiner reviews the 6-month follow-up of a sci­en­tific study on whether neu­ro­feed­back can help kids with atten­tion deficits, find­ing that ben­e­fits indeed remained 6 months after treat­ment had ended. Given, how­ever, that only around 50% of chil­dren showed ben­e­fits, it is impor­tant to regard this tool as part of a mul­ti­modal treat­ment program.

Brain Teaser

Test your atten­tional focus and multi-tasking: How often do you read a doc­u­ment while talk­ing on the phone with a client? Or think about your prob­lems at work while help­ing your child with his home­work? Human atten­tion is lim­ited, and we need to man­age it well, as shown in this teaser pre­pared by Dr. Pas­cale Mich­e­lon.

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Have a great Sep­tem­ber. And, should you hap­pen to be in Barcelona, Spain, on Sep­tem­ber 14th, make sure to attend Alvaro Fer­nan­dez talk there titled “How and Why Dig­i­tal Tech­nol­ogy Will Trans­form Edu­ca­tion, Train­ing and Brain Health”.

Very inter­est­ing arti­cle in the New York Times on the rea­sons behind grow­ing research of how to detect Alzheimer’s Dis­ease: Rare Shar­ing of Data Leads to Progress on Alzheimer’s (New York Times)

(Sit­u­a­tion before) Sci­en­tists were look­ing for bio­mark­ers, but they were not get­ting very far. “The prob­lem in the field was that you had many dif­fer­ent sci­en­tists in many dif­fer­ent uni­ver­si­ties doing their own research with their own patients and with their own meth­ods,” said Dr. Michael W. Weiner of the San Fran­cisco Depart­ment of Vet­er­ans Affairs, who directs ADNI. “Dif­fer­ent peo­ple using dif­fer­ent meth­ods on dif­fer­ent sub­jects in dif­fer­ent places were get­ting dif­fer­ent results, which is not sur­pris­ing. What was needed was to get every­one together and to get a com­mon data set.”

(Sit­u­a­tion now) Com­pa­nies as well as aca­d­e­mic researchers are using the data. There have been more than 3,200 down­loads of the entire mas­sive data set and almost a mil­lion down­loads of the data sets con­tain­ing images from brain scans.

Com­ment: as dis­cussed in our recent mar­ket report, we’ll prob­a­bly see sooner rather than later a com­pa­ra­ble effort aimed at find­ing the bio­log­i­cal and or cog­ni­tive mark­ers for the Cog­ni­tive Reserve, the emerg­ing cor­ner­stone for a life­long men­tal well­ness (vs. a disease-specific) approach. For more on the need to stan­dard­ize data and care, read inter­view with Patrick Dono­hue on Rein­vent­ing Brain Care through Pol­icy, Stan­dards, Tech­nol­ogy. For more on the Cog­ni­tive Reserve, read inter­view with Dr. Yaakov Stern.

In late April 2010, an inde­pen­dent expert panel orga­nized by the NIH released a thought­ful report on the state of the sci­ence for pre­ven­tion of Alzheimer’s Dis­ease and cog­ni­tive decline*. The report sum­ma­rizes the panel’s review of the sci­en­tific lit­er­a­ture by saying:

“Firm con­clu­sions can­not be drawn about the asso­ci­a­tion of mod­i­fi­able risk fac­tors with cog­ni­tive decline or Alzheimer’s disease.”

Which was basi­cally reported as “noth­ing can pre­vent Alzheimer’s Disease.”

Which is very true. And also very dif­fer­ent from what most read­ers may assume it means.

Note: You can keep read­ing the arti­cle What the recent NIH Expert Panel on Alzheimer’s Pre­ven­tion Means – and Doesn’t Mean in the web­site of the Amer­i­can Soci­ety of Aging (arti­cle link opens PDF). ASA recently asked me to write a cou­ple of arti­cles on lat­est brain fit­ness and cog­ni­tive health trends for their Min­dAlert ini­tia­tive, and this is the first of two.

Dr. Michael Merzenich, Emer­i­tus Pro­fes­sor at UCSF, is a lead­ing pio­neer in brain plas­tic­ity research. In the late 1980s, Dr. Merzenich was on the team that invented the cochlear implant. In 1996, he was the found­ing CEO of Sci­en­tific Learn­ing Cor­po­ra­tion (Nas­daq: SCIL), and in 2004 became co-founder and Chief Sci­en­tific Offi­cer of Posit Sci­ence. He was elected to the National Acad­emy of Sci­ences in 1999 and to the Insti­tute of Med­i­cine this year. He retired as Fran­cis A. Sooy Pro­fes­sor and Co-Director of the Keck Cen­ter for Inte­gra­tive Neu­ro­science at the Uni­ver­sity of Cal­i­for­nia at San Fran­cisco in 2007. You may have learned about his work in one of PBS TV spe­cials, mul­ti­ple media appear­ances, or neuroplasticity-related books.

(Alvaro Fer­nan­dez) Dear Michael, thank you very much for agree­ing to par­tic­i­pate in the inau­gural Sharp­Brains Sum­mit in Jan­u­ary, and for your time today. In order to con­tex­tu­al­ize the Summit’s main themes, I would like to focus this inter­view on the likely big-picture impli­ca­tions dur­ing the next 5 years of your work and that of other neu­ro­plas­tic­ity research and indus­try pioneers.

Thank you for invit­ing me. I believe the Sharp­Brains Sum­mit will be very use­ful and stim­u­lat­ing, you are gath­er­ing an impres­sive group together. I am look­ing for­ward to January.

Neuroplasticity-based Tools: The New Health & Well­ness Frontier

There are many dif­fer­ent technology-free approaches to har­ness­ing –enabling, dri­ving– neu­ro­plas­tic­ity. What is the unique value that tech­nol­ogy brings to the cog­ni­tive health table?

It’s all about effi­ciency, scal­a­bil­ity, per­son­al­iza­tion, and assured effec­tive­ness. Tech­nol­ogy sup­ports the imple­men­ta­tion of near-optimally-efficient brain-training strate­gies. Through the Inter­net, it enables the low-cost dis­tri­b­u­tion of these new tools, any­where out in the world. Tech­nol­ogy also enables the per­son­al­iza­tion of brain health train­ing, by pro­vid­ing sim­ple ways to mea­sure and address indi­vid­ual needs in each person’s brain-health train­ing expe­ri­ence. It enables assess­ments of your abil­i­ties that can affirm that your own brain health issues have been effec­tively addressed.

Of course sub­stan­tial gains could also be achieved by orga­niz­ing your every­day activ­i­ties that grow your neu­ro­log­i­cal abil­i­ties and sus­tain your brain health. Still, if the ordi­nary cit­i­zen is to have any real chance of main­tain­ing their brain fit­ness, they’re going to have to spend con­sid­er­able time at the brain gym!

One espe­cially impor­tant con­tri­bu­tion of tech­nol­ogy is the scal­a­bil­ity that it pro­vides for deliv­er­ing brain fit­ness help out into the world. Think about how effi­cient the drug deliv­ery sys­tem is today. Doc­tors pre­scribe drugs, insur­ance cov­ers them, and there is a drug store in every neigh­bor­hood in almost every city in the world so that every patient has access to them. Once neuroplasticity-based tools and out­comes and stan­dard­ized, we can envi­sion a sim­i­lar sce­nario. And we don’t need all those drug stores, because we have the Internet!

Hav­ing said this, there are obvi­ous obsta­cles. One main one, in my mind, is the lack of under­stand­ing of what these new tools can do. Cog­ni­tive train­ing pro­grams, for exam­ple, seem counter-intuitive to con­sumers and many pro­fes­sion­als “ why would one try to improve speed-of-processing if all one cares about is œmem­ory? A sec­ond obvi­ous prob­lem is to get indi­vid­u­als to buy into the effort required to really change their brains for the bet­ter. That buy-in has been achieved for many indi­vid­u­als as it applies to their phys­i­cal health, but we haven’t got­ten that far yet in edu­cat­ing the aver­age older per­son that brain fit­ness train­ing is an equally effort­ful business!

Tools for Safer Dri­ving: Teens and Adults

Safe dri­ving seems to be one area where the ben­e­fits are more intu­itive, which may explain the sig­nif­i­cant traction.

Yes, we see great poten­tial and inter­est among insur­ers for improv­ing dri­ving safety, both for seniors and teens. Appro­pri­ate cog­ni­tive train­ing can lower at-fault acci­dent rates. You can mea­sure clear ben­e­fits in rel­a­tively short time frames, so it won’t take long for insur­ers to see an eco­nomic ratio­nale to not only offer pro­grams at low cost or for free but to incen­tivize dri­vers to com­plete them. All­state, AAA, State Farm and other insur­ers are begin­ning to real­ize this poten­tial. It is impor­tant to note that typ­i­cal acci­dents among teens and seniors are dif­fer­ent, so that train­ing method­olo­gies will need to be dif­fer­ent for dif­fer­ent high-risk populations.

Yet, most dri­ving safety ini­tia­tives today still focus on edu­cat­ing dri­vers, rather that train­ing them neu­ro­log­i­cally. We mea­sure vision, for exam­ple, but com­pletely ignore atten­tional con­trol abil­i­ties, or a driver’s use­ful field of view. I expect this to change sig­nif­i­cantly over the next few years.

Long-term care and health insur­ance com­pa­nies will ulti­mately see sim­i­lar ben­e­fits, and we believe that they will fol­low a sim­i­lar course of action to reduce gen­eral med­ical and neu­rode­gen­er­a­tive dis­ease– (Mild Cog­ni­tive Impair­ment and Alzheimer’s– and Parkinsons-) related costs. In fact, many senior liv­ing com­mu­ni­ties are among the pio­neers in this field.

Boomers & Beyond: Main­tain­ing Cog­ni­tive Vitality

Main­stream media is cov­er­ing this emerg­ing cat­e­gory with thou­sands of sto­ries. But most cov­er­age seems still focused on does it work? more than “how do we define It”, what does work mean? or work for whom, and for what? Can you sum­ma­rize what recent research suggests?

We have seen clear pat­terns in the appli­ca­tion of our train­ing pro­grams, some pub­lished (like IMPACT), some unpub­lished, some with healthy adults, and some with peo­ple with mild cog­ni­tive impair­ment or early Alzheimers Dis­ease (AD). What we see in every case: Read the rest of this entry »

A few eter­nal ques­tions:
– Is caf­feine good for the brain?
– Does it boost cog­ni­tive func­tions?
– Does it pro­tect against dementia?

There is lit­tle doubt that drink­ing that morn­ing cup of cof­fee will likely increase alert­ness, but the main ques­tions that research is try­ing to answer go beyond that. Basi­cally: is there a sus­tained, life­time, ben­e­fit or harm from drink­ing cof­fee regularly?

The answer, so far, con­tains good news and bad news. The good news for cof­fee drinkers is that most of the long-term results are direc­tion­ally more pos­i­tive than neg­a­tive, so no clear harm seems to occur. The bad news is that it is not clear so far whether caf­feine has ben­e­fi­cial effects on gen­eral brain func­tions, either short-term or long-term (aged-related decline or risks of dementia).

It is impor­tant to note that many of the stud­ies show­ing an effect of cof­fee con­sump­tion on brain func­tions or risks of demen­tia report a cor­re­la­tion or asso­ci­a­tion (they are not ran­dom­ized clin­i­cal tri­als). As you know, cor­re­la­tion doesn’t prove cau­sa­tion: cof­fee drinkers may seem to do well in a num­ber in these long-term stud­ies, but there may be other rea­sons why cof­fee drinkers do better.

Q: How does caf­feine affect my brain?
A: Caf­feine is a stimulant.

It belongs to a chem­i­cal group called xan­thine. Adeno­sine is a nat­u­rally occur­ring xan­thine in the brain that slows down the activ­ity of brain cells (neu­rons). To a neu­ron, caf­feine looks like adeno­sine. It is there­fore used by some neu­rons in place of adeno­sine. The result is that these neu­rons speed up instead of slow­ing down.

This increased neu­ronal activ­ity trig­gers the release of the adren­a­line hor­mone, which will affect your body Read the rest of this entry »

Have you already read The Sharp­Brains Guide to Brain Fit­ness?

Let’s see…

1. Pick the only part of your body that does not con­tain fat:

a. Arm
b. Thigh
c. Brain
d. None

Answer: d) Fats are also present in the brain: in neu­rons’ mem­branes to keep them flex­i­ble. These fats are the omega 3 and omega 6 fatty acids mol­e­cules. (Page 32 of the book)

2. Pick the only food prod­uct that doesn’t con­tain Omega-3 fatty acids

a. Tuna
b. Wal­nut
c. Kiwi
d. Jelly Beans

Answer: d) Fatty acids can be found in cold-water fish (such as mack­erel, her­ring, salmon, and tuna), kiwi, and wal­nuts. (Page 33)

3. Pick the only food prod­uct that doesn’t con­tain antioxidants

a. Olive oil
b. Milk
c. Nuts
d. Berries

Answer: b) Antiox­i­dants can be found in veg­etable oils, nuts, green leafy veg­eta­bles (e.g., spinach), cit­rus fruit, and berries. (Page 33)

4. Chronic Stress cannot:

a. Pre­vent you from being cre­ative
b. Kill brain cells
c. Pre­vent you from sleep­ing
d. Kill liver cells

Answer: d) Pro­longed expo­sure to adrenal steroid hor­mones like cor­ti­sol, which is released into the blood stream when we are stressed, can lead to cell death and block the for­ma­tion of new neu­rons. (Page 35)

5. What type of phys­i­cal exer­cise is the best for your brain health?

a. Weight lift­ing
b. Aer­o­bic exer­cises
c. Flex­i­bil­ity exer­cises Read the rest of this entry »