Brain Fitness for Your Patients:

Brain Fitness for Your Patients:

What you can encourage them to do about those

‘Senior moments’

Polk County Advanced Practice Nurses AssociationSeptember 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 ageLifestyle 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

growth is largely due to changes in individual

neurons, structured much like trees

Speed of neural processing:

newborn's brain slower than an adult's, transmitting

information less efficiently

increases dramatically during infancy & childhood,

maximum at about age 15

Synaptic development:

# of synapses in the

cerebral cortex peaks

within the first few years,

declines by about 1/3

between early childhood

& adolescence

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 "activity-

dependent" 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 P

ractice . 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

Brain Function Remains RobustBrain Function Remains Robust

Posit ScienceNormalPathological

Co

gn

itiv

e F

un

ctio

n

Age

“Normal” Age-Related Cognitive Decrease

“Normal” Age-Related Cognitive Decrease

Pathological Cognitive Decrease

Pathological Cognitive Decrease

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

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

Hearing:Transform sound waves into neural signals

How do we remember?A science perspective

Hearing:Transform sound waves into neural signals

Hearing:Transform sound waves into neural signals

Encoding:Transform neural code from ear into neural code for brain

Encoding:Transform neural code from ear into neural code for brain

How do we remember?A science perspective

Hearing:Transform sound waves into neural signals

Hearing:Transform sound waves into neural signals

Encoding:Transform neural code from ear into neural code for brain

Encoding:Transform neural code from ear into neural code for brain

Storage:Store neural circuit in memory-related brain structures

Storage:Store neural circuit in memory-related brain structures

How do we remember?A science perspective

Hearing:Transform sound waves into neural signals

Hearing:Transform sound waves into neural signals

Encoding:Transform neural code from ear into neural code for brain

Encoding:Transform neural code from ear into neural code for brain

Storage:Store neural circuit in memory-related brain structures

Storage:Store neural circuit in memory-related brain structures

Recall:Pull information out of storage for use

Recall:Pull information out of storage for use

How do we remember?A science perspective

Hearing:Transform sound waves into neural signals

Hearing:Transform sound waves into neural signals

Encoding:Transform neural code from ear into neural code for brain

Encoding:Transform neural code from ear into neural code for brain

Storage:Store neural circuit in memory-related brain structures

Storage:Store neural circuit in memory-related brain structures

Recall:Pull information out of storage for use

Recall:Pull information out of storage for use

High frequency hearing loss due to functional decline of inner ear

High frequency hearing loss due to functional decline of inner ear

“Fuzzy” encoding due to slow and inaccurate processing

“Fuzzy” encoding due to slow and inaccurate processing

Poor storage due to lowered levels of key neurochemicals

Poor storage due to lowered levels of key neurochemicals

Decreased ability to recall information due to poor encoding and storage

Decreased ability to recall information due to poor encoding and storage

What Do People Do About Cognitive Decline?

GoodBad Great

Do nothing

Compensate

Crosswords, etc

Targeted Exercise

We have control over important causes of brain function decline

Negative Behavior

Noisy Processing

Chemical Changes

Aging Machinery

Within our

control

“Negative Plasticity”

Loss of hearing in the ear

Shrinkage of brain

“Fuzzy” input reduces accuracy and slows brain processing functions

Lower levels of memory-enabling chemicals released

“Do Nothing” and compensatory Habits lead to under use

Characteristics of Activities that Prevent and Reverse Brain Function Change

• Appropriately challenging

• Repetitive and intensive

Negative Behavior

Noisy Processing

Chemical Changes

• Frequently Rewarding

• Attentionally demanding

• Surprising

• 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

…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

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

Findings: • 3 out of 4 people self-

reported positive changes in their everyday lives

• Benefits ranged from remembering shopping lists, being more independent, feeling more self-confident and hearing conversations more clearly

1000

1200

1400

1600

1800

2000

2200

2400

2600

CSRQ-64Post-Only Measure (+/0/- scale)(higher is better)

p = 0.003

The researchers found that people using the Posit Science program:

Noticed benefits in their everyday livesBest>

ACET

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/index.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

Dementia CareConsulting

BrainFitness!

Geriatric Care Management

Barbara Herrington, M.A., C.M.C.

Professional Geriatric Care Management

Dementia Care Consulting * Brain FitnessP. O. Box 2745, Winter Haven, FL 33883-2745

Serving Polk & Highlands Counties

Phone 863-557-7604

Barbara@allaboutagingllc.com

www.allaboutagingllc.com