Below you can find the full transcript of our engaging Q&A session today on memory, memory techniques and brain-healthy lifestyles with Dr. Gary Small, Director of UCLA’s Memory Clinic and Center on Aging, and author of The Memory Bible. You can learn more about his book Here, and learn more about upcoming Brain Fitness Q&A Sessions Here.
Perhaps one of the best questions and answers was:
Question: Gary, you’ve worked many years in this field. Let us in on the secret. What do YOU do you, personally, to promote your own brain fitness?
Answer: I try to get at least 30 minutes of aerobic conditioning each day; try to minimize my stress by staying connected with family and friends; generally eat a brain healthy diet (fish, fruits, vegetables), and try to balance my online time with my offline time. Which reminds me, I think it is almost time for me to sign off line.
(Unedited, except to delete exposed email addresses. Please note that “AlvaroF” includes both Moderators, Alvaro Fernandez at SharpBrains.com and Harry Moody at AARP)
AlvaroF: We’d like to welcome everyone to today’s event.
Alvaro and Rick
AlvaroF: We’d like to thank Dr. Gary Small for joining us today and being willing to answer questions from all of you.
Dr. Gary Small: I am delighted to be here.
AlvaroF: I’d like to make everyone aware of the new “Best Books” guide on Brain Fitness.
(From Harry (Rick) Moody at AARP)
AlvaroF: Also, note that THE MEMORY BIBLE is one of the “Best Books” that we recommend. (Rick Moody)
AlvaroF: The procedure today is that people write their questions and we’ll introduce those questions into the public space. Let the questions start coming! (They already have started).
AlvaroF: Gary, ready to respond?
AlvaroF: Just to be clear, there is no audio. It’s all in writing.
Dr. Gary Small: I am ready.
Comment From Kim
I’m in interested how Neurofeedback can enhance brain performance, and how it could help depression and ADHD. ?
Dr. Gary Small: That depends on how you define “Neurofeedback.”
AlvaroF: Let’s reframe this: what about “biofeedback.” We hear a lot about that. Can it be helpful for brain fitness? How would that work?
Comment From Mary Lou Hely
Where is the current momentum, if any, in the market of brain fitness for healthy adults?
Dr. Gary Small: Biofeedback has been a technique used for decades to help people improve both physical (e.g., lower blood pressure) and mental (relaxation) response. Thus, if it can help people achieve a relaxation response, then it could increase focus and attention and help with depression and ADHD.
Comment From Pascale Michelon
In the Memory Bible you recommend 5–10 minutes of mental aerobic a day. Is this enough? Also, do you think that any kind of mental exercise is good for everyone or should it be specific depending on one’s goal?
Dr. Gary Small: It seems that the brain fitness industry is focusing on brain games that provide exercises to stimulate various neural circuits, as well as to improve specific cognitive abilities, particularly memory.
Dr. Gary Small: The amount mental aerobics each person wants or needs will vary. Some people have too much mental stimulation at work and need to relax instead. I agree that brain fitness exercises should vary depending on an individual’s baseline abilities.
Comment From Carol
Has there been any longitudinal research been published recently in support of a brain healthy lifestyle (diet, exercise, brain training, stress reduction, etc) to maintain or improve memory?
Dr. Gary Small: Most studies on brain healthy lifestyle have been short-term; however, several groups are planning long-term Alzheimer’s prevention trials, such as the research group at the Banner Institute in Phoenix, AZ.
Comment From Jeanette
How valuable are brain games, really? Wouldn’t brain fitness be more effectively achieved if people considered increasing the “challenge” of actual activities in their daily lives?
Dr. Gary Small: The value of a brain game does depend on the level of challenge — we all need to find that “sweet spot,” where the activity is challenging but not daunting. I like the idea of making the training more practical so that it applies to everyday life. The UCLA Memory Training programs were recently revised to focus on everyday memory challenges, such as names and faces and prospective memory (i.e., remembering to remember).
Comment From Kim
How would you explain the reason of someone being brilliant in memorizing phone numbers, and simultaneously “extremely poor” remembering peoples names ? — what would be the solution to enhance memorizing names ?
Dr. Gary Small: We all vary in our memory styles and personal interest in what we choose to remember. When we give new information meaning, it becomes more memorable. So the solution is in helping people to determine their memory goals and then teaching them specific techniques to achieve them.
Comment From Guest
Could you recommend a comprehensive standard assessment that is available without restricted licensing?
Dr. Gary Small: To my knowledge, all comprehensive assessments are licensed by the Amer. Psychological Assoc. However, the CERAD delayed recall task is in the public domain. Another very useful assessment tool is the MOCA (available in multiple languages without a licensing fee at www.mocatest.org).
Comment From Ralph from RosieCares
(Sent too soon.) I was building to my question…Our classes are based on viewing a online video and then engaging the participants in individual creative activities followed by small group discussions based on prepared questions. My question is how this sort of engagement may compare with some of the brain games and exercises for helping seniors?
AlvaroF: We’ve gotten a question about “the elephant in the room”– namely, dementia
and Alzheimer’s Disease. Let’s focus on that one a bit.
Dr. Gary Small: It sounds like your classes differ from those we teach at UCLA (and license elsewhere). In our classes, we focus on developing specific and practical memory abilitites. Your classes seem to develop creative abilitites.
Comment From Melissa
How would one go about encouraging brain fitness games for those that are currently suffering from Alzheimer’s disease?
Dr. Gary Small: Alzheimer’s disease and dementia is on everyone’s mind and in the news every day. The 80 million baby boomers are beginning to turn 65 this year and reaching an age when risk increases.
AlvaroF: Gary, can you elaborate? We’re all concerned about Alzheimer’s. Is there some intervention that can prevent or delay it?
Dr. Gary Small: Most brain fitness games have been developed for people who are not suffering from Alzheimer’s disease. For someone with dementia, I would recommend more basic games. But a better approach might be to encourage them to spend time with family and friends or playing games they were familiar with before they became demented.
Comment From Pascale Michelon
What is your take on supplements for brain health (vitamin, fish oil, etc.)? Is a balanced diet enough? Should people take supplements without being tested for deficiency?
Dr. Gary Small: We don’t have a definitive long-term study to prove that we can prevent Alzheimer’s disease, but epidemiological studies and short-term clinical trials point to healthy diet, physical exercise, stress management, and mental stimulation as important, as well as treating medical conditions like hypertension, not smoking, etc. I just finished writing a book on this topic, “The Alzheimer’s Prevention Program,” (available Jan 2012) for those interested in more detail on this topic.
Comment From dorothy
is neuro feedback different from cognitive behavioral therapy and if so when does one use one over the other?
Dr. Gary Small: Supplements are another issue. Our group is currently studying such interesting anti-amyloid and anti-inflammatory supplements as curcumin. We don’t have results yet, but anyone who likes Indian food (which has curry) may get a brain boost from it.
Comment From Erica
Dr. Small, Do you see any changes with regard to the discussion of what may delay or prevent AD or other dementia when the DSM removes the actual word “dementia” from the definitions?
Dr. Gary Small: If you mean biofeedback when you say neurofeedback, then it is different from cognitive behavioral therapy (CBT). In biofeedback, the individual gets feedback on a biological process (e.g., skin conductance, blood pressure) in order to control it. In CBT, the individual works with a therapist who helps provide specific strategies for thinking and behavioral to improve their mental state and relationships.
AlvaroF: Gary, in your opinion, is there too much, or too little, attention to Gingko Biloba
(and other “alternative” remedies)?
Dr. Gary Small: I don’t think that changing the diagnosis from dementia to some other name will change the underlying research. It is just a semantic issue.
Comment From Elle
What is the role of creative arts in cognitive enhancement for seniors with normal age-related deficits? Is it better to actual participate in some creative process (writing, painting, etc.) or is simply observing, thinking about, and discussing art sufficient mental stimulation?
Dr. Gary Small: The latest large scale study of Ginkgo was negative. I don’t think we can pay too much attention to any new lead that might help us delay dementia and cognitive decline.
AlvaroF: What about the broader field of complementary and alternative medicine? Do you see any directions that are promising there?
Dr. Gary Small: I think it is helpful to encourage creative activities and help people participate rather than just observe.
Comment From Kim
How about “Fish Oil” ?
Dr. Gary Small: We now have an NIH institute dedicated to copmlementary medicine. I suspect that traditional Western medicine has a lot to learn from these older approaches but it is important to apply our scientific methods to determine whether something actually works (better than placebo).
AlvaroF: How do we encourage patients, and people in general, to have hope without encouraging “false hope” (and quack medicine)?
Dr. Gary Small: Omega‑3 fish oil use is associated with better cognitive and heart health, as well as improved mood. The Amer. Heart Assoc. recommends people eat fish 2X per week, and the Amer. Psychiatric Assoc. recommends fish oil capsules for people who are depressed.
Comment From Pascale
Can you say more about the UCLA Memory Training programs? Who is involved? How do you assess success? etc.
Dr. Gary Small: I think the best way to help people separate hype from hope is to translate the science into every day language so people can grasp the significance and limitations of findings for themselves.
Comment From Pascale
Does training people to use memory enhancing techniques has the same effect on everyday memory as brain training using memory, attention games, etc.?
Dr. Gary Small: We have several programs at UCLA — Memory Training is a 4‑week program taught by volunteer trainers. Memory Fitness is a 6‑week program designed for assisted living facilities. Anyone interested in obtaining an institutional or individual license should visit www.longevity.ucla.edu. Also, Dr. Karen Miller published our most recent study performed at Erickson Living in the Am. J. Geriatr. Psyschiatry.
Comment From Jeanette
According to news.scotsman.com (http://www.scotsman.com/news/health/brain_cell_breakthrough_in_alzheimer_s_fight_1_1939213) , an Edinburgh University study, just published in the journal Nature, “showed that brain cells are genetically different to other cells in the body and are genetically distinct from each other.” If this is the case, what might be the implications for brain fitness research and techniques?
Dr. Gary Small: I think that in order for people “transfer” their memory techniques to everyday life, they do better if they are provided specific exercises in this method.
Dr. Gary Small: It depends, Jeanette, on how the cells in the brain differ. Our reseach has found that new mental activities will stimulate neural circuitry throughout the brain and when people become familiar with a mental task, their brain cells become less active but more efficient.
Comment From Lindy
The current environment in education seems to be on teaching to the test and the focus is on the “average” learner. Do you have any recommendations for maximizing learning potential, specifically memory, in children?
AlvaroF: This question suggests an important dimension: how do we intervene earlier in life in order to prevent bad events later on? A big part of health promotion.
Dr. Gary Small: Lindy,
I think that we need to individualize training. A recent study found that when training of working memory in pre-teens was too challenging, there was no improvement in fluid intelligence.
Comment From Pascale
What is the point of brain training for children without deficiencies? Aren’t they training their brain everyday at school and in life in general?
Dr. Gary Small: Alvaro,
I say it is never too early to start training the brain. We tend to wait until people have symptoms. The brain fitness strategies for middle-aged and older adults should be adapted for a younger audience.
AlvaroF: What intervention strategies should we be recommending for people earlier in life– beyond individual differences?
Dr. Gary Small: Pascale,
Yes, young people are training their brains; however, today the average young person spends 11.5 hours each day with technology (computers, smart phones, etc.). That may have a negative effect on important mental skills involving face-to-face communication.
AlvaroF: This is fascinating because it’s somehow counter-intuitive. Does it mean that physical exercise or social connection is more important than working on the computer (in terms of brain health)?
Dr. Gary Small: Alvaro,
I suggest a few skills for young people:
‑specific memory techniques
‑face-to-face communication skills (eye contact, non-verbal cues during conversation)
Comment From Pascale
What is the neuro evidence that technology actually changes the brain, structurally and/or behaviorally?
Dr. Gary Small: I think physical exercise, social connection, and computer skills are all important, but we need to maintain a balance in our lives.
AlvaroF: We have less than 15 minutes left. If you have questions, be sure to send them in soon.
AlvaroF: The MEMORY BIBLE now has been out for a while now. What’s the big development or insight you’d point to that’s happened recently that readers need to know about?
Dr. Gary Small: Our study “Your brain on Google: Patterns of cerebral activation during Internet searching” (American Journal of Geriatric Psychiatry 2009;17:116–126) showed that Internet savvy older adults had significantly greater neural activity searching online compared with internet naive controls. Our follow up of this study showed that after one week of searching, there were significant increases in brain activity in the previously naive subjects.
Comment From Deborah
What mnemonic technique would work for the occasional lapse of recall of a word, a common word that one uses every day? I teach a memory improvement class–mostly seniors–and this is one issue I’m not sure how to approach.
Dr. Gary Small: I think that people are concerned not just in improving their memory ability, but also in lowering their risk for developing dementia. Drug development thus far has been disappointing, but some of the lifestyle strategies described in The Memory Bible also appear to delay the onset of dementia symptoms.
Dr. Gary Small: In “The Alzheimer’s Prevention Program” we describe a technique specific for these tip-of-the-tongue memory lapses. It involves writing down clues to the word when you can’t think of that word; looking it up later; and then using basic mnemonic techniques to restore the word’s place in memory.
Comment From Michelle
what is your opinion on acetyl-l-carnitene, phosphatidylserine; phosphosterycholine; and coenzyme Q10 as memory or brain enhancment supplements
Dr. Gary Small: Michelle,
Controlled trials of phosphatidylserine have demonstrated short-term benefits in people with normal aging. I am not aware of similar clinical trial evidence for the other supplements you mention, although they have been found to have antioxidant and other properties that may be brain protective.
AlvaroF: Gary, you’ve worked many years in this field. Let us in on the secret. What do YOU do you, personally, to promote your own brain fitness?
Dr. Gary Small: I try to get at least 30 minutes of aerobic conditioning each day; try to minimize my stress by staying connected with family and friends; generally eat a brain healthy diet (fish, fruits, vegetables), and try to balance my online time with my offline time. Which reminds me, I think it is almost time for me to sign off line.
AlvaroF: You’re right about timing, Gary. Good advice for all of us.
We want to thank everyone for participating in today’s most interesting session. In particular, we thank Dr. Gary Small for sharing his scientific expertise with our audience. The transcript for today’s session will be available at SharpBrains.com
Dr. Gary Small: Thank you Alvaro and thank all of you who participated for you excellent questions.
AlvaroF: AARP is pleased to co-sponsor today’s event. We do have our Best Books guide available on “Brain Fitness.”
AlvaroF: Bye everyone, go offline!
AlvaroF: Thank you Gary