[tt] and World Report: Keeping Your Brain Fit

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Keeping Your Brain Fit
http://health.usnews.com/articles/health/brain-and-behavior/2008/01/31/keeping-your-brain-fit_print.htm
[Linked by Arts & Letters Daily.]

There's plenty you can do to slow the effects of aging. Here's how to keep
your thinking and memory sharp

By Christine Larson
Posted January 31, 2008

Marian Conte's brain weighs 1,100 grams, according to Nintendo.
"That's up from 800 grams when I started playing," jokes Conte, 52,
a real-estate agent from Hamilton, N.J., who recently added the
video game Big Brain Academy to her fitness regimen. The better she
scores on brainteasers, the larger her fictional brain. Since
Conte's mother died of complications from Alzheimer's disease in
2003, she's trying to guard herself any way she can, embracing
crossword puzzles, fruits and vegetables, and a new genre of
high-tech workouts that aim to slow cognitive loss. This particular
game makes no such claim. But regular play certainly can't hurt,
Conte figures: "I want to do any little thing I can to protect my
brain."

If her Nintendo score isn't solid evidence, science increasingly
suggests Conte's efforts may pay off. Just within the past few
months, several groups of researchers have added support for the
growing consensus that plenty can be done to slow the age-related
declines in memory, mental speed, and decision making that affect
most people. In November, a team from the Mayo Clinic and the
University of Southern California announced that one computer-based
mental training program appeared to improve older people's cognitive
performance by as much as 10 years. That same month, a Harvard
researcher found that long-term use of beta carotene supplements
delayed cognitive decline by up to a year and a half.

And a new book out last month puts forth evidence that "exercise is
the single best thing you can do for your brain," says author John
Ratey, a clinical associate professor of psychiatry at Harvard
Medical School. The book is Spark: The Revolutionary New Science of
Exercise and the Brain.

"Some of the myths about the brain--that it was not changeable, that
there was nothing you could do about cognitive decline--have really
been dispelled in the past 10 years," says Lynda Anderson, director
of the Healthy Aging Program at the federal Centers for Disease
Control and Prevention, whose bold goal is "to maintain or improve
the cognitive performance of all adults." The potential payoff is
enormous. Alzheimer's now afflicts 4.5 million people in the United
States--double the number in 1980--and is expected to reach 16
million by 2050. "Statistics show if we could delay the onset of
Alzheimer's by five years, the number of people with the disease
would be cut in half," says Yaakov Stern, a cognitive neuroscientist
at Columbia University.

What are you up against? The inevitable physical changes start in
early adulthood but become especially marked after about age 60 or
so. Gradually, the brain shrinks, losing around 0.5 percent to 1
percent of its volume each year after that age threshold; brains
with Alzheimer's shrink about twice as fast. The effects are
greatest in the prefrontal cortex, the seat of executive function
(which includes working memory--responsible for remembering a
telephone number while you're dialing, say--and planning, focus, and
behavior choices), and sometimes in the hippocampus, involved in
memory. Brain cells' dendrites and axons--the slender filaments that
transmit electrical impulses--shrink. The brain's white matter,
which contains nerve fibers that transmit signals from one brain
region to another, starts to degrade around age 50. Result: It gets
harder and harder to remember what you wanted to buy at the grocery
store, to process and respond to information, and to reason your way
through a problem. In your 70s and 80s, executive function starts to
fail.

Not every mental skill suffers equally. Vocabulary, for instance,
tends to remain, as do skills practiced for a long time, like
playing the piano or using a spreadsheet. You might even improve at
some things: In tests of experienced crossword puzzlers of all ages,
the best were in their 60s and 70s.

Potential. The more scientists learn about the brain's decay, the
more curious they've become about how well people function anyway.
Even among people 85 and older, only 18.2 percent live in nursing
homes. "In the past, much of the research has focused on disease and
decline," says Gene Cohen, director of the Center on Aging, Health
and Humanities at George Washington University. "Now we're looking
at the concept of potential and how older people often continue to
thrive and grow even in the face of the most serious illness."
Recent studies of both animal and human subjects have found that
several factors go hand in hand with better mental performance,
including education, professional success, and intellectual, social,
and physical activities. A 2003 study reported in the New England
Journal of Medicine, for example, found that people over 75 who
danced, read, or played board games or musical instruments also had
a lower rate of dementia.

Much of the work has focused on finding ways to bulletproof people
against Alzheimer's. In mice, an Alzheimer's vaccine seemed to work,
but it proved toxic in humans and trials were suspended (although
research on vaccines continues). Beta carotene supplements may delay
cognitive decline if taken for many years--but only by a year and a
half. Education seems to lower your odds of Alzheimer's--but even
some Nobel laureates develop it. Cholesterol-lowering drugs seemed
to offer some promise in fending off Alzheimer's, but a 12-year-long
study published in January showed they had no effect. For now,
experts think the best approach is to take the sorts of steps that
Conte is taking to delay normal cognitive decline.

Stretch the plastic. For decades, scientists assumed that humans
were born with all the brain cells they'd ever have. Then, in the
1970s, researchers showed that new brain cells and neural pathways
form through the end of life. "This was the beginning of the brain
plasticity movement," says Cohen, "the understanding that when we
challenge our brains, the brain cells sprout new dendrites, which
results in increased synapses, or contact points." More recent
research has shown that there isn't an age limit: Training older
adults in certain memory tasks, like remembering faces and names,
seems to boost those specific abilities--though it won't remind you
to bring your shopping list to the store. And the newest evidence
suggests that intensive practice in reasoning skills or in
distinguishing sounds appears to lead to more generalized
improvements in brain function.

In 2006, for example, a controlled clinical study of more than 2,000
older people by researchers at Pennsylvania State University,
Indiana University, Johns Hopkins University, and elsewhere found
that those who received 10 60-to-75-minute training sessions in
reasoning--specifically, in recognizing word, number, and letter
patterns and filling in the next item in a series--reported less
difficulty with such activities of daily living as understanding
instructions on a medication label. The effects still were apparent
five years later. This past November, scientists from the University
of Southern California and the Mayo Clinic announced that study
subjects who spent an hour a day for eight to 10 weeks using a
program that asked them to recognize subtle differences in sounds
performed better than the control group on memory and speed tests,
too. Designers of the Brain Fitness Program (made by Posit Science,
which funded the study) claim that such ear training causes the
brain to convey information more precisely from one region to
another--which, in turn, improves other types of thinking.

"The amount of memory improvement was equivalent to going back 10
years in your ability," says Elizabeth Zelinski, professor of
gerontology and psychology at USC and a principal investigator on
the study, which has not yet been published.

Experts caution that most brain-training products haven't been
tested and that what data do exist are still shaky. If improvement
of daily living tasks is the goal, "we don't yet have the data to
suggest they accomplish that," says Arthur Kramer, a neuroscientist
at the University of Illinois. "Yes, we have data that says you can
get better at certain things with practice. But does it translate to
the real world? We don't know yet." Still, many doctors who work
with older people feel they don't have time to wait for the
research, and nursing homes and senior centers across the country
are adding "brain gyms" and other programs to help older people stay
mentally active.

"I've learned more about China than you can imagine," says Hortense
Gutmann, 100, who started using E-mail just over a year ago through
a new computer-education program for residents of Sarah Neuman
Center for Healthcare and Rehabilitation, a nursing home in
Mamaroneck, N.Y. She now keeps in touch with relatives there, as
well as in Minnesota and Israel, and takes great pleasure in having
mastered a new skill.

Consumers aren't waiting for more research, either. The market for
products like Brain Fitness Program, Nintendo's Brain Age, and
MindFit soared to an estimated $80 million in 2007, up from just $2
million to $4 million in 2005, according to SharpBrains.com, a San
Francisco-based group that follows the industry. Meanwhile, the
Alzheimer's Association recommends any activity that will keep you
curious and learning: reading and writing, attending lectures,
taking classes, even gardening.

Sound body, sound mind. Still, the best workout for your brain may
be the old-fashioned kind.

As far back as 1999, researchers at the University of Illinois found
that older people who started exercising showed faster reaction
times and better ability to focus after just six months than did a
control group. Now, it's becoming clearer why. In a second study
reported in 2006, the same team found that the aerobic exercisers
actually increased their brain size by about 3 percent. Last year,
researchers at Columbia University found that when people exercised
regularly for three months, blood flow increased to a part of the
hippocampus, which is important for memory. In studies of mice who
exercised on treadmills, increased blood flow to the same part of
the brain corresponded with an increase in the production of new
brain cells.

The power of exercise seems far more impressive than that of
brain-training software, says Sandra Aamodt, editor in chief of
Nature Neuroscience, a scientific journal on brain research, and
coauthor of the forthcoming book Welcome to Your Brain. A recent
meta-analysis of numerous exercise studies found that, on average,
faithful aerobic exercise might boost someone's cognitive
performance from average--say, from 10th place out of 20 people
tested--to notably above average--say, to No. 5. But cognitive
training would boost the same person to eighth out of 20.

Why is exercise so good for the brain? Maybe for the same reason
it's so good for the heart: its beneficial effect on blood vessels.
"It may be that a pretty significant amount of deterioration in
brain function relates to disruptions of the cardiovascular system
by microstrokes," in the tiny vessels in the brain, says Aamodt.
Exercise may help prevent them. It also stimulates the production of
proteins called growth factors, which promote the formation and
growth of brain cells and synapses.

Certain nutrients, too, are thought to be protective. The
antioxidants in fruits and vegetables have been linked to improved
cognitive function; berries, for instance, seem especially
beneficial in keeping brains spry. "Old neurons, like a lot of old
married couples, don't talk to each other anymore," says James
Joseph, director of the neuroscience lab at the USDA Human Nutrition
Research Center on Aging at Tufts University. "We have found that
the berry fruits improve neuronal communication." In November,
Harvard researchers announced that men who took a beta carotene
supplement for 18 years had slightly better cognitive function than
those who didn't--their memory scores matched those of people about
one year younger. However, men who took supplements for only one
year showed no improvement, and several other studies have found no
link between antioxidants and mental performance. The Alzheimer's
Association recommends a diet high in dark-colored veggies, like
kale, spinach, beets, and eggplant; colorful fruits like berries,
raisins, prunes, oranges, and red grapes; plus fish like salmon or
trout high in heart-healthful omega-3 fatty acids.

Making connections. It has been more than two decades since Bill
Harves, 90, quit singing in his church choir. Four years ago, he
joined the professionally led chorale that rehearses once a week at
his Bailey's Crossroads, Va., continuing care retirement community.
The chorale gives several concerts a year, including one at
Washington, D.C.'s Kennedy Center. He's gained in breathing
technique, enunciation, and music reading skills. "There's no doubt
I've improved as a singer," he says.

Besides having fun, Harves, who also serves as chairman of his
community's computer club and is active on a residents' committee,
is very likely protecting his cognitive function. In a study of more
than 2,800 people ages 65 or older, Harvard researchers found that
those with at least five social ties--church groups, social groups,
regular visits, or phone calls with family and friends--were less
likely to suffer cognitive decline than those with no social ties.

"The working hypothesis is that it has something to do with stress
management," says Marilyn Albert, a neuroscientist at Johns Hopkins
and codirector of the Alzheimer's research center there. In animal
studies, a prolonged elevation in stress hormones damages the
hippocampus. Social engagement appears to boost people's sense of
control, which affects their stress level. Creative arts seem to be
a highly promising way to increase social engagement. George
Washington University's Cohen has found that elderly people who
joined choirs also stepped up their other activities during a
12-month period, while a nonsinging control group dropped out of
some activities. The singers also reported fewer health problems,
while the control group reported an increase.

All the new research has senior programs rethinking their offerings.
In Chicago, for example, Mather LifeWays, a not-for-profit that
promotes healthful aging, has opened three neighborhood cafes that
serve coffee and sandwiches to people of all ages and offer fitness
classes, computer courses, lifelong-learning opportunities, and
volunteer activities for older adults. "I've met lots of friends
here," says Jill Wonsil, 66, who drops in at the cafe near her home
several times a week to socialize, check E-mail, and take exercise
and other classes. If living life to the fullest is the best way to
stay sharp, it's not such a tough prescription to swallow.