Physical and mental exercise to prevent cognitive decline

We offered some Brain Fit­ness Pre­dic­tions in our Mar­ket Report , including…

“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.  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 7^th 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.  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.

Relat­ed articles:

- Well­ness Coach­ing for Brain Health and Fitness

- Build Your Cog­ni­tive Reserve-Yaakov Stern