It has become increasingly clear that most progressive dementias slowly unfold over the course of several decades. For example, Alzheimer’s disease forms decades before there are any signs or symptoms. It doesn’t appear suddenly or show up as a “conversion” from Mild Cognitive Impairment. This is good news. We can be proactive by life style and planning years ahead instead of just reacting to changes after they occur. Life style interventions must start decades before problems show themselves. The issue to resolve is what life style changes is worth the effort. Exercise is the one factor that is emerging as a clearly protective of the brain. Many short-term studies have suggested that increasing levels of fitness now pays benefits for future brain health. The Cooper Center Longitudinal Study, Cooper Clinic in Dallas, published a study that prospectively followed a large […]
Self Help
Alterations in short-term memory are the hallmark of Alzheimer’s disease as well as a whole host of other brain changes that can, in time, erode our ability to make complex decisions such as handling finances or making legal documents. The changes are subtle in onset and slow in progression. Neither our own self-evaluation nor that of competent professionals can detect the changes by observation in the very early stages. Despite our personal beliefs about our selves, most will not “know” when to give up the finances or when to stop driving. Changes in memory are not the province of medicine. Medical screenings are insensitive to early changes in memory and brain scans produce too many false positive results. Verbal learning tests used to assess short-term memory are better at detecting risk than are biomarkers such as PET scans. We need […]
Depression comes in many forms. Mild depression may range from the colloquial use of “I’m having a bad day” to depressive symptoms that are not severe or pervasive enough to meet current diagnostic standards for Major Depressive Disorder (which is more severe and has to persist for at least two weeks). Dysthymia is an enduring but comparatively mild form of depression. Sadly, recent surveys indicate that as many as 40% of community dwelling elders (by most standards those over 55) have some form of depression. This puts those afflicted at greater risk of mortality and suicide as well as poorer quality of life than those who are not depressed. Does having a diagnosis of dementia increase the prevalence of depression in the elderly? The answer depends on the cause of dementia. The prevalence of depression in dementia due to Alzheimer’s […]
Improving your memory is deceptively simple. Don’t forget the “One Minute Rule.” Anything given less than one minute of thought will fade from your memory. We have known this for years but as we get busy we ignore the truth that we knew when we were in school. We took notes at lectures and from reading and we reviewed them often. Notes allow us to think longer (the One Minute Rule) about the point we feel is important and they focus our attention. Additionally, taking notes allows us to review the important facts which again give more time to learn and later remember what’s important. In a world filled with massive and multiple sources of information we often ignore the fact that we learn most things well by spending time with the skill or information we want to remember. Human […]
We all confront the major myth of brain function which is that our brains work best in our youth. Even as early as middle age (40-69?) we are confronted by changes. Our brain slows as we get older. But we can’t run as fast or hit a ball as far either. The brain becomes more distractible as it ages. We can’t multitask as well and memorization takes more effort. As the brain ages (as early as 40), it has more difficulty with names and nouns. None of these changes compromises competency or the ability to learn. The truth is that the brain not only preserves its youthful skills but also develops new strengths well into middle age and beyond for many. The middle and old aged adult brain can rewire and elaborate itself. The catch phrase for this ability is […]
What can I do for my memory? That’s a question that I am asked many times a week. Let’s assume that your memory is not declining. In other words, you have a normal memory. There are two types of exercises you can do to improve your memory. First, you can exercise by doing memory or cognitive training. There are two types of cognitive training. You can do challenging mental activities such as computer mental training programs, do crossword puzzles, memorize phone numbers, play bridge, or learn a new language. You will improve your ability to do any of the tasks that you choose. Your brain needs these types of stimulation and they add joy to your life. However, they do not help you find your car in the parking lot or help you recall your appointments. Cognitive training is also […]
Ron Reagan reveals (My Father at 100) that his father was thrown from his horse six months after leaving office during July 1989. He sustained a closed head injury and needed neurosurgery to relieve the pressure in his brain. The surgeons discovered that he already had the neurological changes of Alzheimer’s disease. This raises two interesting issues about memory. First, there is a great deal of debate about whether President Reagan showed signs of Alzheimer’s disease while he was in office. Second, John McCain (aged 71) would have been the oldest elected president of the United States, if elected. First, consider age. Although we don’t have a standard of too old to be president of the United States, there are a number of prejudices about age and competence. Should there be an age for mandatory retirement? Should there be an […]
The New York Times (August 29, 2010) is running a series called “The Vanishing Mind” with the most recent installment titled “Years Latter; No Magic Bullet Against Alzheimer’s.” The article is based on the conclusions reached by a “jury” of 15 medical scientists along with scientists at Duke University with no vested interests in Alzheimer’s research. The National Institutes of Health convened this “court” to objectively evaluate the quality of research findings addressing the prevention of Alzheimer’s disease. These studies covered all of the bases: exercise, mental stimulation, healthy diet, social engagement, nutritional supplements, anti-inflammatory drugs, drugs lowering cholesterol, amount of education, being married, and being a loner. Last week’s article reviewed the conclusions of the panel and discussed the issue of standards of scientific proof. This article focuses on the meanings of prevention in medicine. Consider the notion of […]
Having a better memory is really quite simple. Anything given less than one minute of thought will fade from your memory. We have all known this for years. Consider taking notes at lectures. Notes allow us to think longer about the point we feel is important and they focus our attention. Additionally, taking notes allows us to review the important facts which again give more time to learn and later remember what’s important. In a world filled with massive and multiple sources of information we often ignore the fact that we learn most things well by spending time with the skill or information we want to remember. The more minutes you spend the better the memory. Indeed, Malcolm Galdwell, author of Outliers, points out that it takes 10,000 hours of practice to become an expert. Think of the multitude of […]
Current research suggests a number of “protective factors” that are associated with better mental skills as we age. These factors include higher educational attainment, higher socioeconomic status, social support, better mental abilities to start with (may be the cause of the education socioeconomic status effect), better lung capacity (an index of fitness and lifestyle), taking a multivitamin, and moderate alcohol use. Note that many of these factors are under your control. There is so much you can do. The persons that do best as they age work or volunteer, live with someone, rate their health as good to excellent, exercise moderately to vigorously, and do not smoke. If your short-term memory holds, engagement in the world improves memory, reasoning, and speed of thinking. There are no guarantees. However, if you manage the factors you can control, the quality of your […]
