(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 Read the rest of this entry »

If you could, you would. You can, but pre­fer not to know it?

More than any other organ, your brain is up to you. You are what you think, not just what you eat. Here’s some food for thought:

Design your Mind

Set­ting cog­ni­tive and behav­ioral goals raises chal­leng­ing and wor­thy ques­tions: What do you want from your brain? Will you know it when you achieve it?

To attain the brain of our choos­ing, we must under­stand our selves and cur­rent abil­i­ties. Intro­spec­tion and curios­ity are help­ful if they trig­ger and sus­tain the effort to enrich the mind. How­ever, objec­tive infor­ma­tion which leads to informed assess­ment of brain func­tion is often lacking.

Mind your Brain

Hon­esty. Open­ness. Self-awareness.

Irrefutable virtues, but in prac­tice most peo­ple fall short. Few reg­u­larly appraise their brain skills; even so, the abil­ity to accu­rately judge one’s own men­tal per­for­mance is not guar­an­teed. I believe the first step to mind­ing the brain is shed­ding hang-ups while offer­ing and solic­it­ing frank feed­back from fam­ily and close con­fi­dants. In the clin­i­cal set­ting, rou­tine cog­ni­tive screen­ing and “men­tal check ups” are not cur­rently prac­ticed, in part due to time con­straints and lim­ited util­ity of tra­di­tional paper-and-pencil tests. From a pub­lic health per­spec­tive, the U.S. Pre­ven­ta­tive Task Force reviewed Read the rest of this entry »

The Neu­rotech­nol­ogy Indus­try Orga­ni­za­tion (NIO) just announced the top ten emerg­ing areas of neu­ro­science that will “impact the future of treat­ments for brain and ner­vous sys­tem”: Top 10 Neu­ro­science Trends in 2007.

It pro­vides superb food for thought. And some of them will sound famil­iar to read­ers of this blog:

* 6. Nor­mal brain aging gets more atten­tion: More research and devel­op­ment is being focused on think­ing impair­ments that only par­tially limit inde­pen­dence and qual­ity of life for senior cit­i­zens, adults and school aged chil­dren. Neu­rosoft­ware will pen­e­trate nurs­ing homes and schools, as brain fit­ness soft­ware becomes new first-line treat­ment strat­egy.
* 8. Pre­ven­tion evi­dence grows: You are what you eat; smok­ing is as bad as we thought; and new stud­ies reveal the effects of envi­ron­men­tal sub­stances on Alzheimer’s dis­ease, Parkinson’s dis­ease and oth­ers.
* 9. Emo­tional dis­or­ders research advances:  New research con­tin­ues to link neu­ro­ge­n­e­sis to treat­ment of depres­sion.  A bet­ter under­stand­ing of PTSD should lead to new treat­ment regimes.

Want to read prob­a­bly the best overview of the neurosoftware/ brain fit­ness soft­ware mar­ket? Check this arti­cle, fresh from the oven: Thank Boomers for Buff­ing Up Brain Mar­ket.

To clar­ify the num­bers men­tioned: we project $225m in the US alone (grow­ing from $70m in 2003), broken-down as fol­lows: $80m for the Con­sumer seg­ment, $60m in K12 Edu­ca­tion, $50m in Clin­i­cal appli­ca­tions, and $35m in the Cor­po­rate seg­ment. The Con­sumer seg­ment, with a healthy aging value propo­si­tion, is the most recent one but the most rapidly growing.

To all new readers-Welcome!. The Digg Tsunami has brought over 40,000 vis­i­tors so far…and it con­tin­ues. We need to thank Andrey for his excel­lent tech­ni­cal work in help­ing us ride such a beau­ti­ful wave.

Let me give you an overview of what you can find in our blog, bridg­ing neu­ro­science research and brain health/ “brain exer­cise” prac­tice. First, here you have a few of my favorite quotes from the 10 inter­views we have done with neu­ro­science and psy­chol­ogy experts in cog­ni­tive and emo­tional train­ing in our Neu­ro­science Inter­view Series. You can read the in-depth inter­view notes for each if you want to stim­u­late those neurons…

• “Learn­ing is phys­i­cal. Learn­ing means the mod­i­fi­ca­tion, growth, and prun­ing of our neu­rons, con­nec­tions called synapses and neu­ronal net­works, through experience…we are cul­ti­vat­ing our own neu­ronal net­works.- Dr. James Zull, Pro­fes­sor of Biol­ogy and Bio­chem­istry at Case West­ern Uni­ver­sity: Read Inter­view Notes
• “Exer­cis­ing our brains sys­tem­at­i­cally ways is as impor­tant as exer­cis­ing our bod­ies. In my expe­ri­ence, “Use it or lose it should really be “Use it and get more of it.- Dr. Elkhonon Gold­berg, neu­ropsy­chol­o­gist, clin­i­cal pro­fes­sor of neu­rol­ogy at New York Uni­ver­sity School of Med­i­cine, and dis­ci­ple of the great neu­ropsy­chol­o­gist Alexan­der Luria: Read Inter­view Notes
• “Indi­vid­u­als who lead men­tally stim­u­lat­ing lives, through edu­ca­tion, occu­pa­tion and leisure activ­i­ties, have reduced risk of devel­op­ing Alzheimer’s symp­toms. Stud­ies sug­gest that they have 35–40% less risk of man­i­fest­ing the dis­ease - Dr. Yaakov Stern, Divi­sion Leader of the Cog­ni­tive Neu­ro­science Divi­sion of the Sergievsky Cen­ter at the Col­lege of Physi­cians and Sur­geons of Colum­bia Uni­ver­sity, New York: Read Inter­view Notes

“What research has shown is that Read the rest of this entry »

Dr. Yaakov Stern is the Divi­sion Leader of the Cog­ni­tive Neu­ro­science Divi­sion of the Sergievsky Cen­ter, and Pro­fes­sor of Clin­i­cal Neu­ropsy­chol­ogy, at the Col­lege of Physi­cians and Sur­geons of Colum­bia Uni­ver­sity, New York.

He is one of the lead­ing pro­po­nents of the Cog­ni­tive reserve the­ory, which aims to explain why some indi­vid­u­als with full Alzheimer’s pathol­ogy (accu­mu­la­tion of plaques and tan­gles in their brains) can keep nor­mal lives until they die, while oth­ers –with the same amount of plaques and tan­gles– dis­play the severe symp­toms we asso­ciate with Alzheimer’s Dis­ease. He has pub­lished dozens of peer-reviewed sci­en­tific papers on the subject.

The con­cept of a Cog­ni­tive Reserve has been around since 1989, when a post mortem analy­sis of 137 peo­ple with Alzheimer’s Dis­ease showed that some patients exhib­ited fewer clin­i­cal symp­toms than their actual pathol­ogy sug­gested. These patients also showed higher brain weights and greater num­ber of neu­rons when com­pared to age-matched con­trols. The inves­ti­ga­tors hypoth­e­sized that the patients had a larger “reserve” of neu­rons and abil­i­ties that enable them to off­set the losses caused by Alzheimer’s. Since then, the con­cept of Cog­ni­tive Reserve has been defined as the abil­ity of an indi­vid­ual to tol­er­ate pro­gres­sive brain pathol­ogy with­out demon­strat­ing clin­i­cal cog­ni­tive symp­toms. (You can check at the end of this inter­view a great clip on this).

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Key take-aways

- Life­time expe­ri­ences, like edu­ca­tion, engag­ing occu­pa­tion, and leisure activ­i­ties, have been shown to have a major influ­ence on how we age, specif­i­cally on whether we will develop Alzheimer’s symp­toms or not.

- This is so because stim­u­lat­ing activ­i­ties, ide­ally com­bin­ing phys­i­cal exer­cise, learn­ing and social inter­ac­tion, help us build a Cog­ni­tive Reserve to pro­tect us.

- The ear­lier we start build­ing our Reserve, the bet­ter; but it is never too late to start. And, the more activ­i­ties, the bet­ter: the effect is cumulative.

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The Cog­ni­tive Reserve

Alvaro Fer­nan­dez (AF): Dear Dr. Stern, it is a plea­sure to have you here. Let me first ask you this: the impli­ca­tions of your research are pretty astound­ing, pre­sent­ing major impli­ca­tions across sec­tors and age groups. What has been the most unex­pected reac­tion so far?

YS: well…I was pretty sur­prised when Read the rest of this entry »

Update: we now have an in-depth inter­view with Yaakov Stern, lead­ing advo­cate of the cog­ni­tive reserve the­ory, and one of the authors of the paper we review below: click on Build Your Cog­ni­tive Reserve-Yaakov Stern. 

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In honor of the Week of Sci­ence pre­sented at Just Sci­ence from Mon­day, Feb­ru­ary 5, through Sun­day, Feb­ru­ary 11, we will be writ­ing about “just sci­ence” this week. We thought we would take this time to dis­cuss more deeply some of the key sci­en­tific pub­li­ca­tions in brain fitness.

Today, we will high­light the key points in an excel­lent review of cog­ni­tive reserve: Scarmeas, Niko­laos and Stern, Yaakov. Cog­ni­tive reserve and lifestyle. Jour­nal of Clin­i­cal and Exper­i­men­tal Neu­ropsy­chol­ogy. 2003;25:625–33.

What is Cog­ni­tive Reserve?
The con­cept of a cog­ni­tive reserve has been around since 1998 when a post mortem analy­sis of 137 peo­ple with Alzheimer’s Dis­ease showed that the patients exhib­ited fewer clin­i­cal symp­toms than their actual pathol­ogy sug­gested. (Katz­man et al. 1988) They also showed higher brain weights and greater num­ber of neu­rons when com­pared to age-matched con­trols. The inves­ti­ga­tors hypoth­e­sized that the patients had a larger “reserve” of neu­rons and abil­i­ties that off­set the losses caused by Alzheimer’s. Since then the con­cept of cog­ni­tive reserve has been defined as the abil­ity of an indi­vid­ual to tol­er­ate pro­gres­sive brain pathol­ogy with­out demon­strat­ing clin­i­cal cog­ni­tive symp­toms.
Read the rest of this entry »