brain fitness for your patients: what you can encourage them to do about those ‘senior moments’...
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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 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?
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
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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
www.allaboutagingllc.com