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Transcript: Dr. Gary Small on Enhancing Memory and the Brain

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:

2:55
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?
2:57
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.

FULL TRANSCRIPT

(Unedit­ed, except to delete exposed email address­es. Please note that “AlvaroF” includes both Mod­er­a­tors, Alvaro Fer­nan­dez at SharpBrains.com and Har­ry Moody at AARP)

2:00
AlvaroF: We’d like to wel­come every­one to today’s event.

Alvaro and Rick

2:01
AlvaroF: We’d like to thank Dr. Gary Small for join­ing us today and being will­ing to answer ques­tions from all of you.

2:01
Dr. Gary Small: I am delight­ed to be here.

2:02
AlvaroF: I’d like to make every­one aware of the new “Best Books” guide on Brain Fit­ness.

(From Har­ry (Rick) Moody at AARP)

2:02
AlvaroF: Also, note that THE MEMORY BIBLE is one of the “Best Books” that we rec­om­mend. (Rick Moody)

2:03
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).

2:03
AlvaroF: Gary, ready to respond?

2:03
AlvaroF: Just to be clear, there is no audio. It’s all in writ­ing.

2:03
Dr. Gary Small: I am ready.

2:04
Com­ment From Kim
I’m in inter­est­ed how Neu­ro­feed­back can enhance brain per­for­mance, and how it could help depres­sion and ADHD. ?

2:04
Dr. Gary Small: That depends on how you define “Neu­ro­feed­back.”
2:05
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?
2:06
Com­ment From Mary Lou Hely
Where is the cur­rent momen­tum, if any, in the mar­ket of brain fit­ness for healthy adults?

2:07
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.

2:08
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?

2:08
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.

2:09
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.

2:10
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?

2:11
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.

2:11
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?

2:13
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).

2:13
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 ?

2:15
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.

2:15
Com­ment From Guest
Could you rec­om­mend a com­pre­hen­sive stan­dard assess­ment that is avail­able with­out restrict­ed licens­ing?

2:17
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).

2:17
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?

2:19
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.

2:19
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.

2:20
Com­ment From Melis­sa
How would one go about encour­ag­ing brain fit­ness games for those that are cur­rent­ly suf­fer­ing from Alzheimer’s dis­ease?

2:20
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.

2:21
AlvaroF: Gary, can you elab­o­rate? We’re all con­cerned about Alzheimer’s. Is there some inter­ven­tion that can pre­vent or delay it?

2:22
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.

2:22
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?

2:25
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.

2:25
Com­ment From dorothy
is neu­ro feed­back dif­fer­ent from cog­ni­tive behav­ioral ther­a­py and if so when does one use one over the oth­er?

2:26
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.

2:27
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?

2:28
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.

2:28
AlvaroF: Gary, in your opin­ion, is there too much, or too lit­tle, atten­tion to Gingko Bilo­ba
(and oth­er “alter­na­tive” reme­dies)?

2:29
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.

2:29
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?

2:30
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.

2:30
AlvaroF: What about the broad­er field of com­ple­men­tary and alter­na­tive med­i­cine? Do you see any direc­tions that are promis­ing there?

2:30
Dr. Gary Small: I think it is help­ful to encour­age cre­ative activ­i­ties and help peo­ple par­tic­i­pate rather than just observe.

2:31
Com­ment From Kim
How about “Fish Oil” ?

2:32
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).

2:32
AlvaroF: How do we encour­age patients, and peo­ple in gen­er­al, to have hope with­out encour­ag­ing “false hope” (and quack med­i­cine)?

2:33
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.

2:34
Com­ment From Pas­cale
Can you say more about the UCLA Mem­o­ry Train­ing pro­grams? Who is involved? How do you assess suc­cess? etc.

2:34
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.

2:34
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.?

2:36
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.

2:37
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?

2:37
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.

2:39
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.

2:39
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?

2:40
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.

2:40
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.

2:41
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?

2:41
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.

2:42
AlvaroF: What inter­ven­tion strate­gies should we be rec­om­mend­ing for peo­ple ear­li­er in life– beyond indi­vid­ual dif­fer­ences?

2:43
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.

2:44
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)?

2:44
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)

2:45
Com­ment From Pas­cale
What is the neu­ro evi­dence that tech­nol­o­gy actu­al­ly changes the brain, struc­tural­ly and/or behav­ioral­ly?

2:45
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.

2:46
AlvaroF: We have less than 15 min­utes left. If you have ques­tions, be sure to send them in soon.

2:47
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?

2:47
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.

2:48
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.

2:49
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.

2:51
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.

2:53
Com­ment From Michelle
what is your opin­ion on acetyl-l-car­nitene, phos­phatidylser­ine; phos­pho­sterycholine; and coen­zyme Q10 as mem­o­ry or brain enhanc­ment sup­ple­ments

2:55
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.

2:55
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?
2:57
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.

2:57
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

2:58
Dr. Gary Small: Thank you Alvaro and thank all of you who par­tic­i­pat­ed for you excel­lent ques­tions.
2:58
AlvaroF: AARP is pleased to co-spon­sor today’s event. We do have our Best Books guide avail­able on “Brain Fit­ness.”
2:59
AlvaroF: Bye every­one, go offline!
2:59
AlvaroF: Thank you Gary

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