The Best Way to Improve Brain Health

By The Milken Institute Center for the Future of Aging from Next Avenue

Credit: Adobe Stock

(Advances in science and public health are increasing longevity and enhancing the quality of life for people around the world. In a series of interviews with the Milken Institute Center for the Future of Aging, 14 visionaries will be revealing exciting trends and insights regarding healthy longevity, sharing their vision for a better future. The Longevity Innovators interviews highlight new discoveries in biomedical and psychosocial science, as well as strategies to promote prevention and wellness for older adults. This is the first in the series.)
Renowned neurosurgeon Dr. Keith Black (chair of the department of neurosurgery and director of the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center in Los Angeles) has pioneered advances in our understanding and treatment of brain cancers and complex neurological conditions. Black is also a research scientist studying targeted drug delivery, cancer stem cells and Alzheimer’s detection through retinal imaging, among many other areas. In an interview with the Milken Institute Center for the Future of Aging, Black talks about the importance of developing a test for early onset Alzheimer’s and his goal to inspire the next generation.

Dr. Keith Black

What is the most important thing that people should know about improving brain health?

People need to know how important lifestyle is to sustain health. Lifestyle, diet, exercise, moderating stress, making sure you get a good eight hours of sleep when you can, making sure you keep your brain engaged particularly in novel activities — all of these matter. You have to remember the brain is a living organism very much like a muscle — the more you use it, the stronger it becomes.

We need to treat our brains better. For example, try to avoid excessive alcohol and make sure that you screen yourself for diseases like diabetes and hypertension that can be devastating to the brain.

What will be the benefits of having a reliable test for early onset Alzheimer’s?

I think there’s a huge misconception that if you get Alzheimer’s or if you’re going to get Alzheimer’s, there’s nothing that you can do about it. And I think the science shows that that perception is incorrect.

We know two things now that address your question. The first is that Alzheimer’s starts about two decades before a person develops symptoms. During that period of 20 years, you’re losing brain cells, and you’re losing brain connectivity. If you can detect the disease at the very start, particularly before you lose enough brain cells to become symptomatic, we may have the ability to stop the process or at least slow it down and prevent an individual from becoming symptomatic.

If people are developing Alzheimer’s in their 50s and 60s, they are going to become symptomatic in their 70s and 80s. If you can slow the overall process and have people become symptomatic in their late 90s or 100s, you have the ability to essentially prevent the disease from being symptomatic in most of our lifetimes. That’s really the major reason to move towards early detection, because preventing brain loss is a lot easier than restoring brain cells once they’ve died.

The other reason people should be interested is that even though we don’t have a pill that can stop the progression, we know that Alzheimer’s also has a lifestyle component. The scientific evidence shows that lifestyle habits such as a Mediterranean diet, exercise, sleep, meditation and other types of mindfulness modify stress levels. We’re seeing that potentially even micronutrients like the omega-3 fish oils may be very important in slowing the progression of Alzheimer’s disease.

What’s your take on Pfizer ending research to find new drugs aimed at treating Alzheimer’s and Parkinson’s diseases? How do you think it will impact ongoing research?

I think a lot of the trials that have failed for Alzheimer’s disease, including the Pfizer trial, could’ve been better designed and better developed. I think we have a lot to learn from the failure of those trials.

For example, how do we get the drugs into the brain more effectively? How can we better select the right population of patients to treat? I think addressing those potential reasons for the failures of those drugs will lead to successful therapies and hopefully successful approvals.
By The Milken Institute Center for the Future of Aging

The Milken Institute Center for the Future of Aging aims to improve lives and strengthen societies by promoting healthy, productive and purposeful aging.

Too Old to Learn a Language? Don't Believe It

As an older adult, you have skills that can help — and your brain will thank you


By Bill Ward for Next Avenue

 


Credit: Adobe Stock

Conventional wisdom holds that the older we get, the harder it is to learn a new language. Which is true — except when it’s not.

Turns out that while our brains might not be as quick or deft as in those halcyon days of youth, all that hard-earned experience, knowledge and discipline can come to the rescue.

Using Our Adult Knowledge to Learn a Language

“[Older adults] know more about culture, about how the world works, about how our native language works,” said Lisa Frumkes, senior director of content for Rosetta Stone, an education technology software company that develops language, literacy and brain-fitness software. “So we can build on these things. We also have to have discipline when learning a language, and that is something older people have more of. Knowing how to regulate your schedule, that’s 90 percent of the exercise.”

Other experts agree, pointing to learned skills such as a better grasp of syntax, grammar and pronunciation, plus a broader vocabulary in our native tongue.

Catherine Snow, a professor of education at the Harvard Graduate School of Education, has written that older adults are better at intentional learning and literacy skills.

High Expectations

The benefits of learning a language are enormous, but sometimes so are the barriers, starting with busy schedules and self-doubt (thanks in part to that old bugaboo, conventional wisdom).

“As we get older, we have much, much bigger expectations of ourselves,” Frumkes said. “We ask a lot more of ourselves, so we need to cut ourselves some slack. I think Americans also think there is something particularly difficult about learning a language. But it isn’t harder than learning to do anything at an older age, whether it’s calculus or golf. I see older people going out and learning the violin. No one tells them it’s hard to do that, even though they have less dexterity and learning how to read music is hard.”

The Brain’s Resilience

Even for those who have suffered cognitive decline, learning a language can be feasible.

Judith Campisi, a professor at the University of California at Berkeley’s Buck Institute for Research on Aging, said research on “chemobrain” (cognitive loss after chemotherapy) indicates that our brains are more resilient and adaptable than previously believed.

“When there’s a decline, the brain has the ability to call on other parts of the brain,” Campisi said. “We suspect that’s happening in aging, that the brain has more plasticity and we have better ability to draw on other parts of the brain. It could be that people learning a language are calling on other parts of the brain.”

Or, as Frumkes put it, “As long as you’re continuing to work your brain in a variety of ways, you will find things in your brain that you thought were gone that are still there. There’s a lot locked up in our brains that just needs to be shaken.”

Babies vs. Adults

That goes against the prevailing thinking from a half-century ago, which centered around a “critical period hypothesis:” that infants and toddlers effortlessly acquire language and that such learning becomes increasingly difficult after the first few years of life (dubbed “the critical period”).

A research paper called “The Older Language Learner” by University of Michigan education professor Mary J. Schleppegrell, a linguistics expert, put the kibosh on that notion: “Studies indicate that attaining a working ability to communicate in a new language may actually be easier and more rapid for the adult than for the child. Adults learn differently from children, but no age-related differences in learning ability have been demonstrated for adults of different ages,” the paper said.

Besides, as Frumkes noted, “When you learn something as a child, you’re not learning at a high level. It’s not as high a bar.”
Bilingual Benefits Abound

The ability to learn a new language varies — “everything like this is always individual,” Campisi said — and, not surprisingly, those who already are bilingual have advantages.

“It’s just as if you played tennis when you were younger, some other racquet sport will be easier to learn,” Frumkes said. “With bilingual people, knowing that words and phrases are not one-for-one and that word order works differently — that grammar works differently — really helps, because you know what things to look out for.”

Frumkes added that she’s not sure if there are gender differences for learning a language when you’re older. “There’s always been talk that women are better, but that may be more of a social construct rather than how we are biologically,” she said.

Changes in the Brain

Regardless, experts are absolutely convinced that whatever the gender, learning a language improves overall brain functions.

Recent research has found that bilingualism changes the brain structurally and functionally for the better and helps stave off dementia.

“Like physical exercise, the more you use specific areas of your brain, the more it grows and gets stronger,” said Ping Li, a Penn State University professor of psychology, linguistics and information sciences and technology and an author of one of the studies.

Enlarging Our World

In the end, immersing ourselves in another language at whatever age expands not only our minds, but our lives.

“Learning a language is about learning a culture,” Frumkes said. “It can take you in so many directions: literature, travel, learning to understand the news of the day or just being able to be in contact with people in other cultures. Once you think about these things, they change the way you see the world.”


© Twin Cities Public Television - 2017. All rights reserved.



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4 Myths About Brain Health and How to Stay Sharp

What your doctor may not know, but you should

By Leslie Kernisan, MD for Next Avenue

Credit: Thinkstock

Want to stay mentally sharp for as long as possible?

I certainly do, and I’m guessing you do, too: an AARP survey found that 87 percent of respondents reported being very concerned about this issue.

And in April, a highly influential nonprofit released a new report whose recommendations represent the best available medical knowledge on how our brains change as we age and what we can do about this.

The report by the Institute of Medicine (IOM), the health arm of the National Academy of Sciences, is called “Cognitive Aging: Progress in Understanding and Opportunities for Action.” The full report is a pretty lengthy and comprehensive review. But in a series of shorter related materials, the IOM highlights some practical approaches we can all take to maintain better brain health — whether for ourselves or for an older loved one. It also provides tips on compensating for some common problems related to cognitive aging.

Here are the highlights I consider most important:

Cognitive Aging Happens to Everyone

The IOM defines cognitive aging as “a process of gradual, ongoing, yet highly variable changes in cognitive functions that occur as people get older.”

This process is not considered a disease. Rather, it’s a natural process of age-related changes in the brain. Like other aspects of aging in the body, it tends to happen a little differently for every person, in part due to things like genetics, lifestyle and environmental factors.

In Alzheimer’s, there is extensive neuron loss, and the disease is chronic and progressive. The IOM’s related “Cognitive Aging Action Guide for Individuals and Families” provides a distilled summation.

The action guide also lists four common myths about brain health and aging, and provides the corresponding facts you should know. I’ve paraphrased them below.

Myths and Facts About Cognitive Aging

Myth: Maintaining cognitive health means preserving your memory.
Fact: Cognitive health is far more than having a good memory. It also involves decision-making, attention and problem-solving.

Myth: Cognitive function always declines with age.
Fact: Aging can have positive and negative effects on cognition.

Myth: Brain neurons die as you age, so there is no way to prevent cognitive decline.
Fact: In the absence of disease, neuron death is minimal.

Myth: There is nothing you can do to improve your cognitive health.
Fact: There are actions individuals and families can take to help support their cognitive health and adapt to age-related cognitive changes.

6 Ways to Protect Your Brain as You Age

In its full report, the IOM devotes 120 pages to reviewing the factors that affect cognitive aging, along with interventions that might improve brain health. It summarizes the most important suggestions for the public in its handy action guide, and I’ve paraphrased them below (the first three are the most important):

1. Be physically active.
2. Reduce your cardiovascular risk factors (including hypertension, diabetes and smoking).
3. Manage your medications by reviewing them with a clinician and learning about their effects on cognitive health.
4. Be socially and intellectually active.
5. Get adequate sleep.
6. Learn to prevent delirium, a decrease in cognitive function that can be triggered by hospitalization, medications or certain illnesses.

Risky Medications and Delirium Prevention

All six of these recommendations are important and useful. But two particularly caught my eye, because they are actions that we especially focus on in geriatrics: medication management and delirium prevention.

Now I hate to say this, but I think you should know the truth: We geriatricians focus on them in part because they are often overlooked by our doctor colleagues. Most clinicians are very busy and usually have not had special training in modifying healthcare to be a better fit for older adults.

The IOM’s “Action Guide for Health Care Providers” spells out what doctors should be doing in those areas. For instance, it mentions that the use of over-the-counter anticholinergics should be assessed. (This is a topic I covered recently in a Next Avenue blog post.)

We hope that many health providers read this IOM action guide and modify their work accordingly.

But here’s an insider tip from me to you: When you find out that expert organizations feel the need to remind doctors to do something, that’s a sign that doctors aren’t doing it reliably. Which means it is smart to be proactive and remind your doctors to help you.

For more information about avoiding risky medications, see this list of online resources.

Why Seniors Get Delirium

Delirium is an incredibly common and important health complication that affects seniors.

It’s basically a state of worse-than-usual mental function that can be brought on by some illness or stress on the body or mind. It is the reason older adults are often confused after surgery, but can also be the only outward sign of a potentially serious infection in someone living at home.

Delirium is associated with all kinds of bad health outcomes, including longer hospital stays, health complications and even acceleration of cognitive decline. But you can help prevent it, or at least make sure it gets noticed and managed promptly. Here’s where to learn more:
HospitalElderLifeProgram.org: A great program and website founded by Dr. Sharon Inouye, a geriatrician who is the leading researcher on delirium in older adults. (She was also part of the committee that worked on this cognitive aging IOM report.) Information tailored for families is here.
HealthinAging.org: This is the health information site affiliated with the American Geriatrics Society, and it includes a comprehensive section on delirium.

Driving and Finances in Seniors

The IOM reports that cognitive aging can affect an older adult’s ability to manage complex tasks such as driving and finances. It notes that victims of financial elder abuse lose billions every year. (My guess is that many of those victims are suffering from more than cognitive aging, but yes, this is a serious problem.)

Hence, the IOM has created related resource lists to help people be proactive about preventing, detecting, and addressing problems with finances and driving. See “Online Resources Related to Elder Financial Abuse” and “Online Resources Related to Older Adult Driving.”

Nutrition and Other Approaches for Brain Health

In preparing this report, the IOM conducted a comprehensive review of different approaches that have been studied in relation to cognitive health. So if you are wondering about a particular approach that’s not mentioned above, chances are it is covered in the full report.

The summary on the effect of various diets, including the Mediterranean diet, is here and the summary regarding vitamins, including antioxidants, starts here.

Basically, for now the IOM has concluded that some of the dietary approaches have promise but we need more research to confirm their effectiveness. The report also concludes that the medical literature doesn’t convincingly support vitamin supplementation to prevent cognitive decline.

If You or a Relative Has Alzheimer’s

Part of the purpose of the IOM report is to draw attention to cognitive aging as a health issue that is distinct from dementia and deserves its own attention from the public, practicing clinicians and researchers.

This is a reasonable position. That said, if you’re concerned about brain health for someone with a dementia diagnosis, you should know this: The cognitive aging recommendations listed above do improve the brain health of people with Alzheimer’s or another form of dementia.

Why? Because the recommendations are basically about how you can optimize brain health and brain function; they apply whether a person has experienced brain aging or extra damage from a disease.

If we can all do better in helping people optimize their brain health and in compensating for any cognitive aging, our society will be a better place for aging Americans.

© Twin Cities Public Television - 2016. All rights reserved.



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Maintaining Your Independence

By Peggy Buchanan and Maddie Kong, Vista del Monte Retirement Community Fitness, Aquatics and Physical Therapy

Summertime is here and with that comes many celebrations: graduations, summer vacations, backyard barbeques, and of course, Independence Day. While the parades and fireworks are traditionally reserved for the Fourth of July, the staff at the Fitness and Aquatic Center believe that you can achieve and celebrate your independence all year long by adding more walking to your daily routine.

Walking is a comprehensive way to help maintain your independence, and the benefits can be seen with even the smallest additions to your daily routine. Walking will keep your heart, bones, and muscles strong, and your brain healthy. Walking increases oxygen to your brain, helping to prevent dementia. In addition, walking can improve your mood by increasing BDNF, “brain fertilizer”, and endorphins, “feel good hormones”.

Regular walking can also help decrease joint pain by as much as 30% from arthritis. Finally, regular walking can lower your risk for cancer and diabetes. The NIH-AARP Diet and Health Study, which tracked 150,000 people, showed that those who walked more were more likely to live longer and maintain a higher quality of life.

Vista del Monte is a wonderful place to walk and can be done on your own schedule! Most all the walking areas are level, surrounded by beautiful scenery and lots of fresh air!

 A few tips to incorporate more walking into your routine:


1) Start with “baby steps” and set a distance or timed goal that you are willing to increase on a regular basis. 


2) Walk before or after a meal. That’s easy to do if you set a goal to walk to and from the dining room.


3) Walk with a friend. Company is more fun and creates accountability.


4) Walk tall, not small: check your posture and keep your center of gravity over your base of support. If using a walker, walk between the handle bars and as close as safely possible to the seat.


5) If you use an electric cart, use it as little as possible and set a walking goal to counter balance the sit-time.


Make every day in July and all year long for that matter, a celebration of your independence. Go on a walk and know that you are benefitting your overall health and well-being!

Peggy Buchanan is the Coordinator of Vitality and Wellness Programming for Front Porch and serves as the director of fitness, aquatics and physical therapy at Front Porch’s Vista del Monte Retirement Community. Madeline Kong is the fitness specialist at Vista del Monte Retirement Community, where she teaches balance and strength. Front Porch is a not-for-profit organization, based in Glendale, California, that serves individuals and families through full-service retirement, active adult communities, affordable housing communities, and related management and development services.

"Ask the Doc" on June 18th

Front Porch is a not-for-profit support system for a family of companies that serve individuals and families through full-service retirement, active adult communities, and affordable housing communities.

More information is available at www.frontporch.net and www.walnutvillage.org

Join us for an Informative and Interactive Presentation on Brain Health

Innovative ways to boost brain health have emerged in recent years. Come and learn what it takes to keep your brain fit and try some new techniques to stay sharp. 

Guest speaker Tonia Vojtkofsky, Psy.D., researcher for UC Irvine Institute for Memory Impairments and Neurological Disorders and UC Irvine Alzheimer’s Disease Research Center, is our guest presenter for this exciting event. Don’t miss this unique opportunity to hear from an expert in the field of brain health. 

Please join us for this informative and interactive presentation, 

hosted by Summer House at Walnut Village:

Thursday, May 7, 2015 from 4:00 pm to 6:00 pm 

Walnut Village’s Lifelong Learning Center 891 S. Walnut Street, Anaheim, CA 92802 

Beverages and appetizers • Complimentary valet parking 

Tours available RSVP by Friday, May 1 to Marina (714) 507-7005.

ABOUT SUMMER HOUSE AT WALNUT VILLAGE

Summer House is part of Walnut Village, Orange County’s most award-winning continuing care retirement community with full-service, resort style living. Summer House is a memory care support neighborhood that’s spacious in size, yet offers an intimate setting of 14 accommodations for private or companion living.

Summer House at Walnut Village
891 S. Walnut Street Anaheim, CA 92802 

(714) 507-7005 

 summerhouseatwv.org

We’re an equal opportunity housing provider.

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