Positive Aging and Brain Fitness

Freedom to Choose

I just finished reading an article in AARP’s newsletter about diagnosing Alzheimer’s disease. As I anticipated, the meat of the article did not live up to the headline. Oh, there has been
progress in a doctor’s ability to identify if the brain has “plaques and tangles.” For years, it was hypnotized that these plaques and tangles were the cause of Alzheimer’s; however, science has yet to explain why others with plaques and tangles had no noticeable symptoms. As Dr. Peter Whitehouse points out in the Myth of Alzheimer’s, it is more than one thing and brain aging playsa role.

Of course, the drug companies hope they will eventually find the cure, or a preventative, in the form of a new drug. Big Pharma is cheered on by consumers who have come to look for magic
bullets to solve all their problems. Perhaps, if we focused as much time andmoney on non- pharmaceutical interventions and more time promoting whole body wellness, we could significantly improve the overall quality of life, and maybe improve cognitive well being for millions. For several decades, we have been replacing purpose with pills, which has resulted in an increasingly medicated older population while encouraging learned helplessness. In fact, all too often, interaction between drugs (both prescription and nonprescription) can produce
symptoms mistaken for Alzheimer’s or other problems.

As a proponent of the 7 Habits of Highly Effective People, I learned that the ultimate human freedom is our freedom to choose. We can choose to be reactive or proactive; but it is up to us to make the choices. While we know that optimistic people outlive pessimists by over 7 years, this is seldom factored in when evaluating quality of life. We are too quick to blame others when in fact the only person controlling our feelings is us.

While it would be great if there were a pill that could prevent or delay the onset of dementia, there is an ever growing body of anecdotal evidence, much of which is supported by science, that a variety of activities and habits may delay the onset of dementia, improve processing speed and enhance one’s memory. We now know that what is good for the heart is good for the brain; but that is seldom mentioned in articles about the search for the cure.

Maybe we can’t prevent Alzheimer’s disease any more than we can prevent aging. However, like aging, there is a lot we can do to improve our quality of life and battle future memory loss just as we can battle diabetes, heart disease and lung problems with lifestyle changes. At NeoCORTA (www.neocorta.com), we have developed self-evaluation tools to help users identify and understand their risk factor and provide customized plans to improve cognitive well being, but a person must want to take charge of their future to benefit from those plans and
change their behavior accordingly.

I have come to believe that positive aging is well within everyone’s reach…Believe you can; believe you can’t and you are likely to be correct – your choice. Both attitudes can become a
self-fulfilling prophecy once you understand and respect the mind body connection…aging is just a series of many beginnings and we control the starting points for each pathway.

Beginning a New Chapter

Waking up on my 65^th Birthday was very special. As I have addressed, my gift to myself was joining a greatest loser competition at our Wellness Center…and our team is currently in the lead. As of this morning, my team contribution is a loss of 18 pounds in four weeks. Physically, I feel a little stronger every week and slowly rebuilding my stamina. In spite of sore muscles where I did not remember even having muscles, I feel better than I have in years.

I am clearly the elder of my team of losers/winners, and see an incredible potential in the fitness industry for those operations wise enough to address the aging of the marketplace. The staff at the Wellness Center which is coaching us is fantastic and supportive. However, my observation is that they lack an understanding of what motivates older consumers. While there are numerous exceptions, most of us do not want to become marathon runners, extreme sports enthusiasts or hard bodies. In fact, I view my membership and class tuitions as a very affordable form of insurance policy.

My second gift to myself was returning to the world of being a self-employed entrepreneur. I have proven without question that security is something you create for yourself. We left SD over 10 years ago to seek the security of a paid executive position with benefits etc. I discovered the definition of security was being downsized twice and having a third position eliminated after a corporate buy out. Last June, we decided to return to our roots in SD and have had absolutely no regrets. Just before leaving Florida, I joined the “virtual team” of a startup brain fitness company called NeoCORTA, which has been an educational and rewarding experience…the entrepreneurial fire was rekindled. I have also recently landed a couple of consulting jobs that have been incredibly rewarding.

At 65, I honestly feel no different than I did at 30, 40 or 50. Hopefully a little wiser; but I certainly do not feel “old;” whatever that is supposed to feel like. I am excited about the next chapter and looking forward to what is not so much an encore career as it returning to my professional roots.  

Getting in Shape

After two weeks of workouts at our Wellness Center as part of a weight loss program, I can testify without any hesitation whatsoever that it is way easier to get out of shape than is it is regain the lost ground. My nutrition education has also improved and played a role in a 5 pound weight loss for the week.

I now have a new appreciation for what a full body workout involves. For the past year, I exercised on an elliptical machine for 60 minutes at least five days a week. While good for my heart, I was building strength in a very limited muscle group. As we age, we need to become much more conscious of building both upper body and leg strength...and my knees really needed some work.

There are three groups of 10 participants in this program of which I am easily the elder. There are a couple of participants in their early 50s and the balance are in their early 30s...my children's age. There is no difference in the workouts conducted by personal trainers twice a week. Our coach is very understanding of the age difference and frequently encourages our team to listen to their bodies. However, the educational component of this program could use some work.

What has occurred to me in the past two weeks is what an incredible opportunity there is for similar program for adults 60 and older. We are not interested in becoming hard bodies; but are very interested in how to maintain lifelong independence, cognitive well being and shedding some pounds. Wellness Centers are missing  a huge window of opportunity, and income stream, if they continue to ignore this age group.

Zoomers or Peter Pan Syndrome?

It would seem the media in this country will go to any lengths to deny the aging of our culture. On October 18, the Huffington Post related “Tips for Staying Younger, Longer” to detail some “facts” about Zoomers – or Boomer narcissists in my view.

The article opened with the Warning: What you are about to read could very well extend your life by several years. According to the article Zoomers are “a growing segment of the baby boomer population who despite their advancing years are refusing to get old.”  

In reality, the article is about a growing fitness and wellness movement among older adults age 60 and over, which included both the Greatest and Eisenhower generations. Generally speaking, older adults have always been open to new experiences; this characteristic was not created by any fringe group of boomers.

 The author goes on to state that, “Zoomers … know true wisdom lies in the fact that learning is an elixir of youth. And who better to learn about being young, than from people who are young.” I offer a counter reality, “Old people know way more about being young than the young know about being old.” The explosive growth of Elderhostel and lifelong learning programs primarily populated by those age 70 and older blows a big hole in this theory.

Next is the claim that, “Zoomers have found a purpose that is greater than themselves.”  So Mother Teresa, Einstein, et al were slackers? Well, developmental psychologists have long documented that we tend to become more altruistic in later life. Likewise, Maslow felt self-actualization was most often found in later life. The late Dr. Gene Cohen was definitely not a Zoomer, but he most definitely pioneered the later life creativity movement with youthful exuberance.

Not surprisingly, the author missed a major factor in longevity – a positive aging self image. While all the other Zoomer “facts” play a role (exercise, diet, socialization, seeking purpose, and brain fitness) to deny one’s aging in pursuit of fading youth is the stuff of Peter Pan. Rather than holding on to the myth that you “can refuse to grow old,” let’s just redefine what aging is really all about.

The Many Dimensions of Brain Fitness

Just as physical fitness is about more than the strength of your biceps, brain fitness is much more than just the strength of your memory. To help in the definition of personal performance targets, we need to develop a better vocabulary for describing the full breadth of key brain functions. In fact, understanding this breadth is a critical piece of the brain fitness puzzle.

“Cognition” describes our “thinking” abilities- it’s about processing, coordinating, strategizing and responding to information. This includes a range of critical brain functions such as the ability to remember, pay attention, and make decisions. While there are many ways to categorize the key areas of cognition, one useful approach is to focus on the following four areas:

1. Recall measures the strength of your memory. It includes the ability to remember specific information (e.g., facts, ideas, experiences, etc.) as well as how to perform tasks (e.g., opening a door, tying your shoes, etc.).
2. Attention measures your ability to focus or concentrate while ignoring distractions and irrelevant information. Attention is a fundamental brain process that enables you to perform a wide range of activities (e.g., driving a car). Many activities require a person to divide attention among many things, while others require a shift of attention quickly from one task to another.
3. Processing Speed measures the time it takes for your brain to process information and/or respond to it. An increase in processing speed can make you feel more alert and better able to react. A decline in processing speed can make you misunderstand what people are saying, or make it difficult to follow instructions.
4. Executive Function measures high-level thinking skills such as planning, making decisions, solving problems, and reasoning. Executive function skills are required for everyday activities such as setting goals, organizing events, and playing games.

Meanwhile, “emotional well-being” describes how you “feel”. Emotional well-being allows you to calmly handle day-to-day challenges, maintain a positive outlook, adapt to change, and understand and care for others. One way to make sense of emotional well-being is to break it into five key areas:

1. Anxiety is a feeling of fear or apprehension involving physical and/or mental experiences. Anxiety appears in the form of physical symptoms (e.g., sweating) or as a feeling of increased nervous energy. Moderate, short-term anxiety is a normal part of life, but it can cause physical and psychological problems if it’s chronic.
2. Stress is a response to demands or changes in one’s environment. It involves emotional, mental, and physical components that each serve to help meet challenges. Moderate stress can be positive; for example, it enhances alertness and motivation, which increases abilities. On the other hand, longer-term or high levels of stress can weaken emotional, mental, and physical capabilities.
3. Mood can be described as a predisposition, attitude, or state of mind. It can include positive emotions like happiness or enthusiasm for everyday life. It also includes more negative states such as sadness.
4. Emotional Control includes the ability to evaluate your feelings, manage negative emotions, and handle conflict.
5. Emotional Recognition enables you to pinpoint feelings (in yourself and others) and to understand the ways in which your behavior may affect the emotions of others. This skill helps you to connect with others and better engage in social interactions.

The brain fitness movement is still in its early stages. If we want to pursue and achieve truly meaningful improvements in our capabilities over time, we need to adopt a perspective that enables us to understand, discuss, and track the full range of important brain functions.

What is Brain Fitness?

For centuries, it was assumed that mental decline and memory loss were just a natural part of aging and there was nothing that could be done. Whether or not someone became “senile” was just the luck of the draw. Once a myth is accepted as fact, it can quickly become a self-fulfilling prophecy – and did for decades. An insidious aspect of ageism is that it can operate without conscious awareness, control or intention to harm once the myths are accepted as fact.

A few researchers and authors railed against the “decline theory” of aging. Harvard’s Ellen Langer wrote her brilliant anti-ageism book, Mindfulness, in 1989. In the book, she shares the results of several research projects documenting that, “much of what older people experience could be the result of negative stereotypes, internalized in childhood.” Among those stereotypes studied was memory loss. As Dr. Langer observed, “When there is one ready explanation for something – being old – we rarely search for other possible causes.”

This paradigm began to change in the 1990’s as we scientists aggressively began conducting brain research to explore “other possible causes” for memory loss other than age.  In the last two decades, we have learned that not only does the brain continue making new connections between brain cells, it can grow new cells. Further studies have also documented the benefits of lifelong learning and the importance of keeping the brain active. Just as muscles grow stronger with exercise, so does the brain when engaged in brain fitness.

There is little doubt that the brain will change with age and there will be some declines, but studies show that only certain aspects of brain function actually decline. There is no sign of decline in long-term memory and knowledge retention in normal brain aging. Vocabulary has also shown to increase through at least age 60 and emotional intelligence, social skills, and self-control improve with age as well. The debate on the effectiveness of brain exercises, from crossword puzzles to expensive computer games, is ongoing, but studies have definitively shown that aerobic exercise does increase mental acuity. A study done by scientists at the University of Illinois found that 3 40-minute walks per week for six months improved memory, reasoning, and may spur the birth of new brain neurons. [1]

Dr. Mike Merzenich, founder of Posit Science, believes the recent brain fitness movement is a revolution, “It is the beginning of a great societal change in how we think about aging and how we think about making the most of our lives.” While there are new claims made almost daily about the benefits of a new computer game, vitamin, supplement or exercise, little time has been devoted to explaining what brain fitness is and how to pursue it holistically.

Brain fitness is NOT about the diagnosis or treatment of brain-related disorders. It's not just about delaying or preventing cognitive disorders. It is not just the latest memory enhancing computer game or nutritional supplement.

Brain fitness is about capability and performance. Having a fit brain means that we possess the thinking abilities and emotional well-being necessary to work productively, sustain meaningful relationships, and achieve our goals in life.

This definition of brain fitness has several important implications. First, it means that each of us can set our own performance targets. Just as a professional athlete might pursue a different level of physical fitness than an office worker, our brain fitness goals will naturally vary, depending on what each of us is hoping to achieve at each juncture in our lives.

This definition also means that brain fitness is about much more than just one or two narrow measures of brain function. Just as physical fitness is about more than the strength of our biceps, brain fitness is about much more than just memory. In order to pursue brain fitness, we need to consider all of the dimensions that define how we think (e.g. memory, attention, processing speed, problem solving) as well as how we feel (mood, anxiety, stress, etc.). The brain fitness movement is in its early stages, and we need to broaden our perspective if there is to be a meaningful impact on the health and well being of an aging society.

Finally, this means that brain fitness can (and must) be pursued through multiple modalities. Just as physical fitness is not achieved solely through the use of a bench press machine, a single activity (e.g. crosswords, computer-based brain exercises) cannot possibly provide a complete solution for maintaining or improving brain fitness. As with physical fitness, brain fitness is achieved through a wide range of different activities, proper nutrition, sound medical care, and many other lifestyle choices. Navigating through all of the scientific evidence and comparing the options is best done with the help of an expert advisor, but a comprehensive approach is clearly the best bet for achieving brain fitness.

Brain fitness is the capacity of a person to meet the various cognitive demands of life, and involves an ability to assimilate information, comprehend relationships, and develop reasonable conclusions and plans. It can be developed by formal education, being actively mentally engaged in life, continuing to learn, and exercises designed to challenge cognitive skills. Brain fitness is also accomplished with healthy lifestyle habits including mental stimulation, physical exercise, good nutrition, stress management, and sleep can improve brain fitness.

On the other hand, chronic stress, anxiety, depression, aging, decreasing estrogen, excess oxytocin, and prolonged cortisol can decrease brain fitness as well as general health. The first step in developing a brain fitness plan is to become mindful of the fact that living an active, purposeful life can dramatically improve motor abilities, strength, agility and mental responses; and then commit to a plan.

Professional fitness centers encourage people to see their physician before beginning a fitness program. When given the green light, the center then recommends a general fitness assessment to establish baseline parameters before developing a program to achieve optimum well being as well as the person’s primary personal goal which could be anything from reducing blood pressure to losing weight to looking better in a bathing suit. The same approach should be considered for creating a brain fitness program to fight future cognitive decline as much as possible.

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[1] Newsweek, June 18, 2010.

Key to Reversing Aging???

A member of the LinkedIn Changing Aging group asked me to comment on an August 23, 2010 article entitled, “Listening for the Key to Reverse Aging” by Jessica Hilo of Miller-McCune. The article is a perfect example of how the media dismisses positive news about aging – in this case by using analogies to sitcoms and condescension. Since the article demonstrates both the progress in brain research and the pervasiveness of ageism, I decided to post it here as well...

While the Neuroplasticity of the brain is now a generally accepted fact, it is not the key to "reversing aging;" nor is anything else. Aging is a biological process whereby an organism moves from a simple to a highly complex state. Physical and brain aging declines are both a part of this process; but not everyone ages the same. The problem is that way too many people age prematurely due to self inflicted physical deterioration, disease or the ravages of the "self-fulfilling prophecies" of aging that occur when adults accept and live out aging stereotypes.

My problem with the article is not with the content but the headline and conclusion. I am very familiar with the efficacy studies of the auditory cortex discussed. I did considerable research before investing in a computer program for an upscale community for older adults. We ultimately purchased the Posit Science program, which I have loaded on my personal computer and used. While we cannot reverse "aging," it appears we can reverse or delay cognitive loss by building a cognitive reserve and also increase the brain's processing speed. Posit’s research documents that use of their products can reverse the affects of cognitive decline by as much as ten years. Likewise, their programs that exercise the visual cortex have produced some impressive results. Like the body, you get the most from your brain by exercising it.

Just as it is improbable that we can "reverse aging," we can most definitely mitigate the impact of both physical and mental declines with fitness and wellness programs. I joined NeoCORTA because the company offered an affordable brain fitness assessment vehicle with which adults could evaluate their own brain fitness, identify risk factors that research indicates can result in cognitive decline and offer a holistic action plan to achieve comprehensive brain fitness. Whether or not it can be cured, wouldn't it be great if it could be delayed for 25 or 30 years? What would happen if we spent as much time and money on prevention as we did curing those things that are preventable?

The author of the article uses the analogy that this type of research is like the quest for the Fountain of Youth and so far has only benefited the "beloved aging lab rats." How sad that is the conclusion that can be drawn from such exciting research. Instead of celebrating advances in neurological research and memory, the media so long enamored with the youth culture tends to minimize the advances. Twenty years ago, the scientific and medical communities generally accepted that mental decline and memory loss was a "natural" part of the aging process. Just imagine what we may learn in the next twenty years now that we have data that dementia is not a "natural" part of brain aging.

Is Brain Fitness Bad for You?

There are times when I am convinced the media go out of their way to perpetuate aging myths and misconceptions of the aging process. Today a friend sent me a CNN article entitled, “Brain exercises delay, speed up dementia? The article related the results of a study of more than 1,100 participants aged 65 and older, none of whom had dementia when the research began.

The article reported that, “people who regularly engage in mentally stimulating activities such as reading, doing puzzles, and going to museums may stave off the onset of dementia longer than people who don't. This has been shown in several other studies in the past. But here's the flip side: Those who are cognitively active also decline more rapidly when they do develop symptoms of Alzheimer's disease, the new study in the journal Neurology found.”

So, is that a bad thing? Wouldn’t it be better to delay dementia for 20 years and be impacted for a few months or have dementia for 20 years? Seems like a no brainer.

All the research I have seen states that NEW learning and challenging activities are necessary for an effective brain fitness program. Numerous studies, such as the Nun’s Study, have documented that in fact there are numerous positive benefits from challenging the brain and having a positive aging self esteem, which this article totally ignored.

Generally, things like learning a new language, doing crossword puzzles and Sudoku, travelling, reading and attending classes are examples of being cognitively active. However for this study, "cognitively active" activities included going to a museum, watching television, listening to radio, reading newspapers, reading magazines, reading books, and playing games. Watching television? Listening to the radio? I’m not convinced that years of soap operas and game shows may not actually cause dementia.

Further, the article went on to report that “The researchers did not ask participants about whether they continued to be cognitively active after the initial assessment at the start of the study.” Wouldn’t that pretty much trash any assumption that what they found out really proved anything? Instead, the article reported that, “The National Institutes of Health delivered the grim news in April that evidence on preventing the onset of Alzheimer's disease continues to be fuzzy (evidently research methodology is a little fuzzy as well), and that there is no lifestyle modification a person can make that is proved to help.”

Both the headline and portions of the article imply that being cognitively active can be potentially harmful, which is exactly the type of uncertainty that can lead to inaction and fuel the self-fulfilling prophecy that dementia is just a natural part of aging and if you fight it you will lose. This is irresponsible as best.