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Brain Fitness for Your Patients: What you can encourage them to do about those ‘Senior moments’ Polk County Advanced Practice Nurses Association September 22, 2012 Our Agenda Today How do you address your patients’ worry about their memory and their future due to their perceived memory loss? The facts, like them or not: Our brain function is less robust as we age Lifestyle changes and brain exercises can improve our brain function Senior moments, brain farts, what fors, mental glitch, drawing a blank… When is the brain fully developed? Brain size: a newborn's brain is only about one-quarter the size of an adult's; about 80 percent of adult size by three years of age and 90 percent by age five Synaptic development: neurons, structured much like trees # of synapses in the cerebral cortex peaks within the first few years, Speed of neural processing: & adolescence newborn's brain slower than an adult's, transmitting information less efficiently declines by about 1/3 between early childhood growth is largely due to changes in individual increases dramatically during infancy & childhood, maximum at about age 15 From Zero to Three, National Center for Infants, Toddlers & Families Brain development in babies Does experience change the actual structure of the brain? Brain development is "activitydependent" Every experience--whether it is seeing one's first rainbow, riding a bicycle, reading a book, sharing a joke--excites certain neural circuits and leaves others inactive As neuroscientists sometimes say, "Cells that fire together, wire together." Neuroplasticity Visionary researcher Paul Bach-y-Rita “We see with our brains, not our eyes” Today, Dr. Michael Merzenich professor emeritus neuroscientist at the University of California, San Francisco “The brain’s lifelong ability to change its structural and functional architecture in response to learning and experience.” Defined by Andreas Engvig, MD/PhD student Research http://www.cdc.gov/aging/healthybrain/research.htm Examining the Impact of Cognitive Impairment on Co-occurring Chronic Conditions (2010–2012) Examining the Prevalence of Chronic Health Conditions and Cognition (2010) Understanding the Publics’ Perception of “Brain Health” (2005–2009) New Research Explores Perceptions of Cognitive Health Among Diverse Older Adults [PDF-1.34Mb] Systematic Literature Reviews Community-based Interventions to Improve Emotional Health in Older Adults (2007–2010). Physical Activity Interventions Related to Cognitive Health (2007–2010). Physicians’ Perceptions, Knowledge and Practice about Cognition (2008–2010). Public’s Perceptions about Cognitive Health and Alzheimer’s Disease (2008–2009). Assessing Perceptions, Knowledge and Beliefs About Cognition (2008–2010) Research Meeting - the “Healthy Brain and Our Aging Population: Translating Science to Public Health Practice” (2006) Alzheimer’s & Dementia: The Healthy Brain and our Aging Population: Translating Science to Public Health Practice . This special issue of Alzheimer’s & Dementia includes articles from presentations given at the 2006 research meeting about the “Healthy Brain and our Aging Population: Translating Science to Public Health Practice.” Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (Ball et al., 2002; Willis et al., 2006), or the recent Nature Reviews article on cognitive interventions for Alzheimer’s disease (Buschert et al., 2010) The Gerontologist: Promoting Cognitive Health in Diverse Populations of Older Adults. The Gerontologist Volume 49 Issue S1 June 2009 Cognitive Ability = Quality of Life • Staying Sharp • Staying Vital • Maintaining Independence Source: Posit Science Qualitative Study 9/04 Brainspan Should Match Lifespan Cognitive Function Posit Science Normal Pathological Brain Function Remains Robust “Normal” AgeRelated Cognitive Decrease Pathological Cognitive Decrease Age The Brain Changes Functionally With Age – Encoding and Processing Speed At age 75, it takes us more than twice as long to process information than when we were age 20 And this is why we all need to work on keeping our brain sharp… Illustration: Immediate Memory Just for fun, I am going to give you an immediate memory test. No one else will know your results. Take out your pad and pen and wait until I finish reading the entire list. I will read you 16 words in total. Once I finish saying the 16 words, write down all the words you remember. How do we remember? A science perspective Hearing: Transform sound waves into neural signals How do we remember? A science perspective Hearing: Encoding: Transform sound waves into neural signals Transform neural code from ear into neural code for brain How do we remember? A science perspective Hearing: Encoding: Storage: Transform sound waves into neural signals Transform neural code from ear into neural code for brain Store neural circuit in memory-related brain structures How do we remember? A science perspective Hearing: Encoding: Storage: Recall: Transform sound waves into neural signals Transform neural code from ear into neural code for brain Store neural circuit in memory-related brain structures Pull information out of storage for use How do we remember? A science perspective Hearing: Encoding: Storage: Recall: Transform sound waves into neural signals Transform neural code from ear into neural code for brain Store neural circuit in memory-related brain structures Pull information out of storage for use High frequency hearing loss due to functional decline of inner ear “Fuzzy” encoding due to slow and inaccurate processing Poor storage due to lowered levels of key neurochemicals Decreased ability to recall information due to poor encoding and storage What Do People Do About Cognitive Decline? Bad Do nothing Compensate Crosswords, etc Targeted Exercise Good Great We have control over important causes of brain function decline Aging Machinery Loss of hearing in the ear Shrinkage of brain Noisy Processing “Fuzzy” input reduces accuracy and slows brain processing functions Chemical Changes Lower levels of memoryenabling chemicals released “Negative Plasticity” Within our control Negative Behavior “Do Nothing” and compensatory Habits lead to under use Characteristics of Activities that Prevent and Reverse Brain Function Change Noisy Processing Chemical Changes • Appropriately challenging • Repetitive and intensive • Frequently Rewarding • Attentionally demanding • Surprising Negative Behavior • New • Demanding • Confronting Increase cognitive reserve? SCAT? Learn something new - Sudoku Dendrites • Treelike extensions of a neuron. • Most neurons have multiple dendrites: short & typically highly branched. • Dendrites are specialized for receiving information • They form synaptic contacts with the terminals of other nerve cells to allow nerve impulses (information) to be transmitted. Grow Your Dendrites Many Lifestyle Changes May Help With Brain Fitness • Regular Exercise • Sleep • Stress Relief • Socialization • Diet …The Real Power is in targeting the root causes of brain function change Designing a Program to “Really Use It” • Brain Plasticity-Based Workouts – – – – – – Learn to play the violin Learn Japanese Learn to juggle Learn to tango Learn to use your “other” hand Become an air traffic controller Use Programs Designed to Target the Root Causes of Brain Function Decline IMPACT Shows that the Right Kind of Cognitive Exercise Can Rejuvenate the Brain The researchers found that people using the Posit Science program: Best > Noticed benefits in their everyday lives CSRQ-64 Findings: • 3 out of 4 people selfreported positive changes in their everyday lives • Benefits ranged from remembering shopping lists, being more independent, feeling more self-confident and hearing conversations more clearly Post-Only Measure (+/0/- scale) (higher is better) 2600 p = 0.003 2400 2200 2000 1800 1600 1400 1200 1000 ET AC Illustration: Delayed Memory Take out your pen again On the back of your piece of paper, write down the words you now remember How is this research helping? The Benefits of DriveSharp Brain Fitness Training • Decades of research show the technology in DriveSharp: • Speeds up visual processing and increases "useful field of view" so drivers see more of the road with each glance • Decreases reaction time, so drivers can stop 22 feet sooner at 55 mph • Cuts at-fault crash risk by 50% How brave are you? http://www.positscience.com/testlets/jeweldiver/ind ex.php?session=cbomppsn4i8ijpp1o50o9bfcp0 Just to get you started online: http://www.sharpbrains.com www.alz.org http://www.marblesthebrainstore.com/visual.html http://www.cognifit.com/ http://www.lumosity.com/ http://www.fitbrains.com/ http://www.positscience.com Resources All About Aging, LLC Providing Solutions for Families Geriatric Care Management Dementia Care Consulting Brain Fitness! Barbara Herrington, M.A., C.M.C. Professional Geriatric Care Management Dementia Care Consulting * Brain Fitness P. O. Box 2745, Winter Haven, FL 33883-2745 Serving Polk & Highlands Counties Phone 863-557-7604 [email protected] www.allaboutagingllc.com