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ForgettingThings?

20 Good Times I J u l y / A u g u s t 2 0 0 9

J u l y / A u g u s t 2 0 0 9 I Good Times 21

Over the past dec -ades, we’ve learneda lot about how tokeep our bodies

healthy as we get older. Butwhat can we do about thoseso-called senior moments, tipof the tongue problems, andother memory lapses thatseem to plague us more witheach passing year? And howcan we be sure it’s notAlzheimer’s disease or someother type of dementia?

In the bad old days, short-er lifespans meant most peo-ple didn’t live long enough todevelop memory problems ordementia; for those who sur-vived into old age, “senility”was seen as almost inevitable.But today’s seniors and agingbaby boomers aren’t willingto let their memories slipaway silently. Fortunately, thelatest research is overturningmany long-held, negativebeliefs about how the brainages, offering practical,proven advice on getting themaximum mileage out of ourminds.

It’s Not All DownhillBefore we delve into how to

mind our memories, let’s takea quick peek under the hoodto see what really happens tothe brain with age. As Dr.Louis Bherer, a professor ofpsychology at the Universitédu Québec in Montreal,explains, our mental facultiesare the product of two typesof abilities that are affecteddifferently by normal aging:fluid intelligence and crystal-lized intelligence.

Fluid intelligence refers tothe mind’s ability to think,reason, and cope with chal-lenges that require new skills.It’s highly dependent on thebrain’s raw computing power:information processing speed,or the time required for amental task. Processing speedstarts to slow down in our

20s, but most people don’tusually notice a differenceuntil after age 50. Attention,or the ability to focus on atask, may also suffer as olderpeople are often more easilydistracted and may havetrouble determining what’smost relevant to focus on.Working memory, which“juggles” information inyour head to perform a task,

such as calculating the tip andchange on a restaurant bill,tends to get maxed out earlieras we age.

Crystallized intelligenceconsists of the knowledge andskills gained by learning andexperience, as well as the abili-ty to use this information. Likefiles saved on a computer disk,this knowledge doesn’t tend todeteriorate with age and, infact, can even grow over theyears. So there may be sometruth to the old saying, “Withage comes wisdom.”

Scientists used to think that,in adults, no new brain cellswould grow to replace thethousands that died off everyday. Our brains seemeddoomed to do more shrinkingand less thinking with age.

The latest researchis overturning manylong-held, negative

beliefs about howthe brain ages.

Don’t panic. Memory troubles are perfectly normal in middle age andbeyond, and the good news is there’s a lot you can do to keep your memory from failing By Eva Chanda

22 Good Times I J u l y / A u g u s t 2 0 0 9

But now, researchers are dis-covering the forecast for ourmental performance isn’t sobleak after all. A hot topic inmemory maintenance is cogni-tive reserve, the idea that thebrain can keep performing at

a high level, despite damagefrom normal aging, injuries,and diseases (including Alzhei -mer’s), by getting around thesechanges. The secret to build-ing up cognitive reserve isneural plasticity, in whichbrain cells form new branchesto replace damaged areas andcommunicate with other braincells. There’s even evidencethat people can grow newbrain cells throughout life.

And what does this all boildown to? “Older people canstill learn and accumulateknowledge, but will probablybe slower in being able to reactto new situations,” Bherersays. So you can teach anolder brain new tricks, thoughit might take longer than itwould with a younger one.

But even this may be anoversimplification—Bherernotes that, just like our bod-ies, our brains don’t all age

the same way. He says peoplein their 20s tend to have fairlyuniform mental performanceprofiles, but as they get older,their test scores begin todiverge, not only from personto person, but also in the indi-

vidual mental processesaffected. Bherer sees 60-year-olds who look far older thantheir years on mental functiontests, while an 86-year-oldoutperforms people who aredecades younger. These differ-ences are what intrigue Bhererand other researchers who aretrying to pinpoint why suchpeople stay sharp as they getolder, while others fall preyto fail ing memories orAlzheimer’s.

Build Up Your Brain“Use it or lose it”—by beingmentally active—turns out tobe the best way to build andmaintain cognitive reserve.

Dr. Nathan Herrmann, ageriatric psychiatrist atSunnybrook Health SciencesCentre in Toronto, explains,“The more mentally challeng-ing activities you do, the lowerthe chance of developing

memory impairment or, if youalready have some impair-ment, of it getting any worse.”

Herrmann suggests activi-ties such as crossword orSudoku puzzles, playingcards (e.g. bridge), or evenengaging in conversation, topump up your mental mus-cles. He stresses, however,“Watching TV is not a men-tally challenging activity.”

“You have to be willing toget out of your comfort zone,to push yourself, if you reallywant to improve your mentalperformance,” Bherer says.He recommends activitiessuch as learning a new lan-guage, game, skill, or playinga musical instrument to staveoff brain drain.

Move Your MindThe next key to staying men-tally fit is to be physically fit.According to Bherer, aerobicexercise has the biggestbrain-boosting effect, proba-bly by enhancing blood cir-culation—people who onlydo stretching and strengthtraining, with no change inaerobic capacity, don’timprove as much.

“I typically recommend aminimum of a vigorous, 20-minute walk per day that rais-es a sweat. The more physicalactivity you do, the better,”Herrmann says, adding thatpeople should always checkwith their doctors first. “Buteven people who are quitefrail can still do a fair amountof activity and benefit from itmentally and physically.”

Bherer says dance classes,such as tango and salsa, maybe especially helpful, since

HealthFORGETTING THINGS?

“The more mentallychallenging activitiesyou do, the lowerthe chance ofdeveloping memoryimpairment.”

they offer an aerobic work-out and brain calisthenics—after all, you have to payattention to the instructor,learn the steps, and avoidstepping on your partner’s

feet. With any exercise, headvises having a workoutbuddy so you can pace your-self: you want your heartrate and breathing to speedup, but you should still be

able to have a conversation;if you can’t talk, slow down.

Most important, Bhereremphasizes, it’s never too lateto start exercising. “In mylab, an 89-year-old showed

The number-one concern about forgetfulnessis probably what’s normal and what’s not. Dr.Barbara Sherwin, a professor of psychology atMcGill University in Montreal, offers an easy wayto remember: “As the old joke goes, if you forgotwhere your car keys are, there’s nothing wrongwith you, but if you forgot you have a car, you’rein trouble!”

Dr. Nathan Herrmann, a geriatric psychiatrist inToronto, says, “It’s normal for older people to takea little longer to think of answers, come up withsomeone’s name, or remember appointments, butin general their ability to remember things ismaintained pretty well into late life, and wouldn’taffect their day-to-day functioning.” On the other

hand, he says, warning signs of more seriousmemory loss include frequent incidents of:

• leaving a stove turned on and burning potsand pans

• leaving taps turned on and causing floods• forgetting to lock the doors to one’s home• forgetting to pay bills or cash cheques Ironically, Herrmann notes, “Most people who

are really worried about their memory don’t havesignificant problems. But when patients saythere’s nothing wrong, yet their families complainbitterly about their memory, they almost alwayshave cognitive difficulties. Insight into one’s situa-tion is often lost very early in Alzheimer’s dis-ease.”

Senior Moment—or Something More Serious?

an improvement in physicalcapacity through exercise.This person enjoyed the pro-gram and became better atcompleting everyday tasks,such as climbing stairs, open-ing doors, and walking fast,”he says. Not being able to dothese mundane things, on theother hand, can set off avicious cycle of staying athome more, becoming evenless physically active, notsocializing as much, and lack-ing mental stimulation.

Food for ThoughtLike a race car, the brain needshigh-quality fuel to run at itsbest. According to Bherer,there’s no specific “super-

food” to fight brain aging yet,but a reasonable, balanced dietwill maintain better mentalfunction. He reports that peo-ple who are undernourishedor outright malnourished willshow loss of memory, atten-tion, and processing speed.

That might not sound likea problem you’d encounterin Canada, but Dr. GordonWinocur, a psychologyresearcher at the RotmanResearch Institute at Baycrestin Toronto, reports, “Olderpeople are notoriouslyneglectful of their diets for avariety of reasons. They mayeat processed foods becausethey’re cheaper or easier toprepare, but they’re often

high in fat and nutritionallydeficient. But seniors’ bodiesdon’t have the resources todeal with deficiencies, sothey’re much more vulnera-ble if their diet isn’t nutrition-ally sound. A lot of researchshows high-fat diets can seri-ously affect mental function.”

By contrast, Herrmannnotes, a Mediterranean diethas been shown to preventmemory decline. The basicsof the Mediterranean dietinclude:- avoiding saturated fats

(butter, hydrogenated fats)and red meat

- eating more low-fat chick-en, turkey, and fish

- having plenty of fruits,vegetables, and legumes(beans, lentils)

- consuming healthy fats,such as olive oil and nuts,in small amountsMany people are turning

to dietary supplements to pre-vent memory loss and demen-tia. The most popular is prob-ably the herb ginkgo biloba—south of the border, sales tal-lied about $107 million USin 2007, according to theNutrition Business Journal.Bu t i s t h i s p o p u l a r i t yjustif ied? No, Herrmannconcludes, citing the recentG ingko Ev a l u a t i o n o fMemory (GEM) study ofmore than 3,000 seniors; inthat study, ginkgo didn’tmake a dent in the rates ofmental decline after six yearscompared to placebo.

Likewise, Herrmann cau-tions that the latest studieson vitamin E, for either pre-vention or treatment ofAlzheimer’s disease, or for

HealthFORGETTING THINGS?

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improving mental functionin healthy older people, werecompletely negative. In fact,high doses of vitamin E sup-plements (400 IU or more)are linked to a greater risk ofdying—better steer clear ofthat. On the other hand, hesays there’s some evidencethat eating lots of vitamin E-rich green leafy vegetables,such as spinach and kale,might help slow mentaldecline.

No-brainers for aHealthy HeadAlzheimer’s disease isn’t theonly medical condition thatcan rob you of your memo-ries. But unlike Alzheimer’s,most of these conditions canbe effectively treated, whichis why it’s always a good

idea to discuss memory con-cerns with your doctor.

Herrmann notes, “Vascularrisk factors—the things weworry about in terms of heartdisease and stroke—should bevery carefully monitored, andtreated if necessary, to preventmemory decline and demen-tia.” These risk factors includehigh blood pressure, high cho-lesterol, obesity, and diabetes.And if you smoke, quit—lighting up also raises theodds for Alzheimer’s andmemory loss.

Everyone knows a sleep-less night can leave you tired,cranky, and scatterbrained—but chronic sleep disorderscan take a serious toll onyour mental performance.The most dangerous is sleepapnea, a condition that

makes people stop breathingrepeatedly, for up to 30 sec-onds at a time, while theysleep. People with sleepapnea often don’t know theyhave it, but if others say yousnore loudly, alternating withsilence and gasping or chok-ing sounds, and you feelextremely sleepy during theday, see your doctor about it.The good news is that if sleepapnea is treated, usually withcontinuous positive airwaypressure (CPAP) therapy,brain function bounces back.

Stress and depressionoften lead to forgetfulnessand concentration problems.In older people, these symp-toms could even be mistakenfor dementia. Over time,these conditions may alsoincrease the risk of develop-

HealthFORGETTING THINGS?

26 Good Times I J u l y / A u g u s t 2 0 0 9

One way to stimulate the mind, and one that’s beengarnering a lot of attention lately, is with “brain fit-ness” software. In 2007, American consumersshelled out $80 million US on brain fitness products,according to market research firm SharpBrains.

If you enjoy playing brain training games, saysDr. Nathan Herrmann, a geriatric psychiatrist atSunnybrook Health Sciences Centre in Toronto, goahead; they’re probably helpful, though he adds,“There’s no evidence that they work any betterthan doing things on your own.”

Dr. Louis Bherer, a professor of psychology atthe Université du Québec in Montreal, warns thatcompanies often claim that their brain fitnessproducts are tested and proven—but on theirwebsites, they usually mention only the generalresearch showing that mental activity preventsmemory loss, not real clinical trials of their prod-uct. And even those that have published studiesdon’t show more than improvements on lab testsof memory.

“What have you learned in this game that willimprove your daily life,” Bherer asks, “or does it

only make you really good at the game? Thatwould be the critical test. And if it works, howlong would you need to play for an effect?”

Ultimately, brain fitness is about more than justgames. That’s why Baycrest, a geriatric hospitaland research centre in Toronto, has launched the$20-million Centre for Brain Fitness. Dr. GordonWinocur, a psychology researcher at the RotmanResearch Institute at Baycrest, and his colleaguesare working on a particularly promising initiative: a12-week program to help older people performbetter mentally. It consists of three four-week mod-ules: memory skills training, practical task planning(for real-life situations), and training to enhancepsychological well-being (confidence, self-esteem,happiness). So far, participants showed significantgains in memory, planning, and well-being at theend of the program and, more impressively, evengreater improvements when they re-tested sixmonths later. This means people kept practicingwhat they had learned and got better over time.The team hopes the program will be available incommunity clinics for seniors within five years.

Head Games

ing Alzheimer’s disease. Soit’s vital to manage stress—exercise, relaxation tech-niques, and taking time to dothings you enjoy are greatways to ease the pressure andrefresh your brain. Success -fully treating depression,whether with antidepres-sants, talk therapy, or both,usually also repairs the dam-age. Depression that doesn’trespond to such treatment,on the other hand, may be asign of dementia. Otherreversible causes of memoryloss and dementia includeunderactive thyroid, anemia,and certain medications.

Finally, Herrmann advises,“Protecting the brain is alsoimportant. If any of mypatients do activities thatcould cause head injuries, such

as biking or skiing, I makesure they wear helmets.”

Meeting of theMindsStaying socially active isanother important way tostave off memory loss. AsBherer explains, socialinvolvement probably bene-fits brain function in severalways: talking to friends reg-

ularly can improve yourmood, lower stress, and

enrich your life; maintain-ing social connections alsotends to keep people morephysically active by gettingthem out of the house; andinteracting with other peo-ple is mentally stimulating,as you have to interprettheir emotions, listen to

Stress anddepression often

lead to forgetfulnessand concentration

problems.

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what they’re saying, andexpress yourself.

Unfortunately, as Winocurobserves, “Society has lowerexpectations of older people,and we tend to buy into that.But if we don’t do very much,we have fewer stimulatingexperiences, and life can be alot less satisfying than it oth-erwise would be. So there’s alot of fallout from buyinginto a perception that we’rebeginning to lose our mentalabilities. The tendency is tounderperform, to not live upto our potential.”

So the most important fac-tor may be to reject thosestereotypes and make sureyou aren’t your brain’s worstenemy. Once you’ve decidedto make lifestyle changes tokeep your brain healthy,

have fun with them! Findmental challenges, exercise,foods, and social connectionsthat really get you revved up.As Bherer emphasizes, “Youhave to find things you enjoy,because you’re in it for the

long term—or else you’re notgoing to stick with it.”

Perhaps Abraham Lincolnsaid it best: “And in the end,it’s not the years in your lifethat count. It’s the life inyour years.” ■

HealthFORGETTING THINGS?

Alzheimer Society (www.alzheimer.ca): Click on “Healthy Brain” tolearn more on how to keep your mind at the top of its game.

Improving Memory: Understanding Age-Related Memory Loss(www.aarp.org/health/conditions/articles/harvard__improving-memory-understanding-age-related-memory-loss_0.html): An in-depth article from Harvard Health on memory, how it changes withage, and ways to improve it.

Free brain fitness games:

www.happy-neuron.com/games/free.phpwww.myseniorsite.ca/justfun-games_brainex.htmwww.gamesforthebrain.comwww.braingle.com

Sites to Remember