[Paleopsych] WP: Lifestyle May Be Key to Slowing Brain's Aging
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Lifestyle May Be Key to Slowing Brain's Aging
http://www.washingtonpost.com/wp-dyn/content/article/2005/08/13/AR2005081300855_pf.html
Scientists Test Simple Ways to Keep One's Wits
By Rob Stein
Washington Post Staff Writer
Sunday, August 14, 2005; A01
Like many Americans sliding into middle age, Kimberly McClain started
worrying that her memory was beginning to slip.
"It was little things. I couldn't remember what I had for dinner the
night before. I had to check to make sure I'd paid the insurance that
month. I'd walk into a room and realize I had no idea why I was
there," said the Los Angeles marriage counselor, who is 44.
So McClain started a program designed to help -- a detailed regimen
that includes daily memory exercises.
"I'm much clearer now," McClain said. "I have no problem finding my
keys. I can tell you what I had for dinner last night. I'm not walking
into a room thinking, 'Why did I come in here?' "
McClain is among the increasing number of Americans who are performing
mental calisthenics, taking Italian classes, deciphering crossword
puzzles and hunting for other ways to try to keep their minds from
fading.
A large body of evidence indicates that people who are mentally active
throughout their lives are significantly less likely to suffer
senility, and a handful of studies have found that mental exercises
can boost brain function. Elderly people who go through training to
sharpen their wits, for example, score much better on thinking tests
for years afterward. The minds of younger people who drill their
memories seem to work more efficiently.
But it remains far from clear exactly which of the myriad
use-it-or-lose-it methods promoted by researchers, self-help books and
health groups protect the brain in the long term, and actually reduce
the risk for dementia. So scientists, increasingly employing high-tech
brain scans, have launched an incipient wave of research to determine
what works and why.
"We're right at the cusp of understanding this," said Sherry Willis of
Pennsylvania State University. "Because brain imaging work has become
so much more technologically sophisticated, we're now at the point
where we literally look inside people's brains to try to understand
what's going on."
With the population aging, and the number of cases of Alzheimer's and
other forms of dementia rising rapidly, experts say preventing mental
deterioration from occurring in the first place will be crucial to
minimizing the mounting suffering and costs.
"It's really critical that we find ways to prevent, or at least delay
the onset of, cognitive decline," said Neil Buckholtz of the National
Institute on Aging. "Once the pathology is established in the brain,
it's very difficult to treat. We need better ways to prevent the
disease in the first place, which could make a huge difference for the
future."
Several large studies are examining antioxidants such as selenium,
vitamins C and E and folate, as well as the popular herbal remedy
ginkgo biloba. Researchers also remain hopeful that anti-inflammatory
painkillers such as Celebrex and the hormone estrogen may prove
useful, despite safety concerns. Other researchers are exploring
whether cholesterol drugs might protect the brain as well as the
heart. It has become increasingly clear that the same strategies that
cut the risk for heart attacks and strokes -- eating well, lowering
cholesterol and blood pressure, avoiding obesity and diabetes, and
exercising regularly -- protect the brain, too.
"We don't have to wait until tomorrow when we have some kind of wonder
drug," said Arthur Kramer of the University of Illinois at
Urbana-Champaign, who has found that sedentary elderly people who
start exercising regularly are sharper and experience growth in
crucial brain areas. "Many things that we can do today can engender
cognitive vitality and successful aging, and one of them is exercise."
Among the most tantalizing evidence are studies that have given rise
to the use-it-or-lose-it theory. Several large projects have found
that people who are more educated, have more intellectually
challenging jobs and engage in more mentally stimulating activities,
such as attending lectures and plays, reading, playing chess and other
hobbies, are much less likely to develop Alzheimer's and other forms
of dementia.
Scientists suspect that a lifetime of thinking a lot may create a
"cognitive reserve" -- a reservoir of brain power that people can draw
upon even if they suffer damaging silent strokes or protein deposits
that are the hallmarks of Alzheimer's.
"Some people might have brain networks that are more efficient and so
have a greater capacity to compensate for disease," said Yaakov Stern
of Columbia University, who is using brain scans to try to zero in on
the circuits that matter most. "So when they are challenged by
disease, those networks continue to operate longer."
But it is also possible that such people are born with brains that
lead them to pursue intellectually stimulating lives, and are
inherently less prone to dementia. Educated, successful people also
tend to have more money and get better medical care.
"There's a lot of things that highly educated people do to take care
of themselves," said Jerome Yesavage of Stanford University, who is
evaluating the benefits of combining cognitive training exercises with
a drug already used to slow the progression of Alzheimer's. "You have
to be cautious. We don't want to create false hopes that you can
prevent Alzheimer's."
In one of the first major attempts to test whether mental training
works, a federally funded study involving more than 2,800 elderly
people found that those who received 10 brain-training lessons scored
much better on thinking tests, and the effect lasted for at least
three years. The training taught strategies aimed at improving
reasoning skills, the processing of new information, and memory, such
as mnemonic devices for remembering names.
Many researchers suspect, however, that people may benefit most from
engaging in a rich diversity of stimulating activities. New
experiences may be far more important than repeating the same task
over and over. Moreover, it may be key to combine mental stimulation
with social interaction, which studies have found also appears highly
beneficial. Experts say the task should be enjoyable, because stress
and other negative emotions appear harmful.
So scientists have launched a series of pilot studies examining more
real-life approaches. In Indiana, one team of researchers is testing
whether elderly people who take quilting classes fare better, while
another is following groups of elderly people as they participate in
an adult version of the Odyssey of the Mind competition originally
developed for schoolchildren. Outside Chicago, a husband-and-wife team
of researchers is experimenting with acting classes. In Baltimore,
Johns Hopkins aging experts are studying whether volunteering as
tutors and librarians helps. All report promising, though preliminary,
findings.
"It was pretty amazing," said Michelle Carlson of Hopkins, whose team
found that elderly volunteers scored much better on problem-solving
tests and that their frontal lobes seem to have been reinvigorated.
"We observed changes that appeared to show that their brains were
functioning more like younger adults'."
But none of the researchers said the findings are strong enough to
merit specific recommendations.
"I think we'll get there, but we're not there yet," Carlson said.
Other researchers say that although the evidence may remain
inconclusive, it is promising enough for people to start doing the
things that look as though they may help.
"It's hard to prove a lot of these things, but I'm convinced there's
enough evidence that there is a cause-and-effect relationship," said
Gary Small of the University of California at Los Angeles, who
developed the "memory prescription" that McClain uses.
The prescription combines a healthful diet with daily exercise,
relaxation techniques and memory exercises, such as making a mental
note of one piece of a family member's wardrobe each morning. Small
tested the approach in a pilot study that included McClain. Not only
did those on the prescription score better on memory tests, but brain
scans lit up in ways that indicated key areas of their gray matter
appeared to be working more efficiently, he said.
"One of the most striking findings was how it affected function in the
area of the brain that creates everyday working memory," Small said.
"We may not have conclusive proof. But the evidence is strong. And
these are all healthy choices for other reasons."
Even if such strategies work, getting large numbers of people to
fundamentally alter their daily lives remains daunting, many experts
acknowledge.
"We all know how difficult it is for all of us to exercise regularly
even though we know we should. Now we're telling people they need to
be more mentally active, too: 'Turn off "Wheel of Fortune" ' or 'Do
your own taxes.' That's going to be a difficult public health
message," said Michael Marsiske of the University of Florida.
Marsiske and other experts note, however, that it has been done
before.
"The major way we've reduced the death rate from heart disease is
through lifestyle changes: eating better, exercising more, smoking
less," said David A. Bennett of Rush University in Chicago. "It would
require a lot of people to change the way they live, but there's no
reason to think we can't have the same impact on Alzheimer's and other
forms of dementia."
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