[Paleopsych] WP: Lifestyle May Be Key to Slowing Brain's Aging

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Lifestyle May Be Key to Slowing Brain's Aging

    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

    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

    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,

    "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

    "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

    "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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