Nov 19, 2008
By: Alvaro Fernandez
“7. Doctors and pharmacists will help patients navigate through the overwhelming range of available products and interpret the results of cognitive assessments. This will require significant professional development efforts, given that most doctors today were trained under a very different understanding of the brain than the one we have today.”
The American Medical News, a weekly newspaper for physicians published by the American Medical Association, just published an excellent article along those lines:
Steps to a nimble mind: Physical and mental exercise help keep the brain fit
— Neuroscience is uncovering techniques to prevent cognitive decline.
A few quotes:
– It’s an example that highlights a wave of new thinking about the importance of brain fitness.
– Until recently, conventional wisdom held that our brains were intractable, hard-wired computers. What we were born with was all we got. Age wore down memory and the ability to understand, and few interventions could reverse this process. But increasingly, evidence suggests that physical and mental exercise can alter specific brain regions, making radical improvements in cognitive function.
– With nearly 72 million Americans turning 65 over the next two decades, physicians need the tools to handle growing patient concerns about how to best maintain brain health. Armed with this new brand of science, frontline physicians will be better equipped to address the needs of aging baby boomers, already in the throes of the brain fitness revolution.
– “Encourage them to exercise the brain in novel and complex ways,” he says.
Full article: here
One of the physicians quoted in the article is Gary J. Kennedy, MD, Director of the Division of Geriatric Psychiatry at Montefiore Medical Center in NYC and a professor in the Dept. of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine.
To put the AMA article in better perspective for SharpBrains readers, we asked Dr. Kennedy a few follow-up questions. Below you have his questions.
Alvaro Fernandez (AF): Can you summarize how cognitive functions tend to evolve as we age?
Gary Kennedy (GK): As we age cognitive functions that rely on processing speed or reaction time decline, slow down.Ã‚Â Problem solving speed declines. This is in part the result of frayed neuronal insulation as the myelin sheath surrounding the axons wears thin with advanced age or illness. However it is possible to specialize and optimize some cognitive processes through experience, practice and planning. For example vocabulary can increase to age 90 provided there is ongoing stimulation and motivation to learn. And the growth and development of new brain cells can be augmented with the stimulating effects of physical exercise.
AF: Now, there are very significant cognitive differences among individuals of the same age, so age itself is not the main predictor. Can you explain what may be?
GK: Age also has the effect of amplifying differences between individuals. This is the result of variability in aging itself, freedom from or accumulation of illnesses and injury, and life style. The influence of genetics is largely exhausted by the 6 and 7th decades of life which means that habitual activities and social relationships have a larger and larger impact resulting in greater and greater variability between individuals.
AF: Can you please explain the relationship between cognitive and emotional health (what we typically call “brain fitness”)
GK: Cognitive health requires motivation to sustain it and motivation depends on emotion and social reinforcement. Emotional self-regulation is not simply self control. Rather it is the capacity to respond to an emotional stress without prolonged loss of equilibrium. And it is the capacity to modify emotional reactions to resonate with others in the environment. Thought and feeling when linked together can be a powerful stimulus for learning, both for better and for worse. A positive outlook with an active response style is more protective than a tendency toward negativism and withdrawal.
AF: What advice would you give to people who want to maintain their brain in top shape?
GK: Simply finding a partner for regular physical activity is one of the best prescriptions for improving brain function. Staying emotionally, intellectually and socially engaged is also good advice.Ã‚Â And the more the better. The brain is a muscle – use it or lose it.
AF: And what advice would you give to doctors and health professionals on how to help their patients?
Doctors and all health professionals need to know how to motivate their patients to make the changes in life style that will promote healthy aging. Small, meaningful changes are relatively easy to achieve if the professional simply asks. Two straightforward examples: “how often do you enjoy an alcoholic beverage?” and “how often do you get a half hour of physical activity, walking or exercising?” can help the older person to minimize alcohol and maximize exercise. Brief interventions work surprisingly well.