The Aging Brain: The Aging Brain: Strategies for Staying Strategies for Staying

Mentally FitMentally Fit

Rita Balice-Gordon, Ph.D.Professor of Neuroscience

University of Pennsylvania School of Medicine

Today’s talk

• Brain structure and function

• Normal aging vs. diseases of aging

• What we can do about it

• Adult weight: ~ 3 pounds

• Adult size: ~ a medium cauliflower

Brain vital statistics

Different brain parts have different functions

• Divided into right and left halves

• Left half controls movement on body’s right side

• Language area is mainly on left

• The brain has billions ofneurons, each with an axonand many dendrites.

• Number of neurons:100,000,000,000 (100 billion)

• Neurons communicate via synapses

• Number of synapses: 100,000,000,000,000 (100 trillion)

• To stay healthy, neurons and glia must communicate with each other, carry out metabolism, and repair themselves.

Brain components: Neurons, Glia, Synapses

Today’s talk

• Brain structure and function

• Normal aging vs. diseases of aging

• What we can do about it

Normal brain aging

• ~10% neuron loss by age 90

• No large-scale addition of new neurons in the mature human brain– Some addition of new neurons in some brain regions

(hippocampus, olfactory, etc.)– Function unknown

• New synapses are formed throughout life and you can modify your brain’s capacity to do this

What’s the difference between normal brain aging and

dementia / Alzheimer’s disease?

• Normal age-related memory problems– Forgetting where you put your car keys,

glasses, etc.– Not remembering names of people you

haven’t seen for several years– Forgetting an item or two on a memorized

shopping list– Forgetting why you went into a room

Changes in cognition with normal aging

• Intellectual abilities

– improve until late 30s or early 40s

– are stable until mid-50s or early 60s

– change begins to occur in late 60s

– noticeable effects beyond the mid 70s

What’s the difference between normal brain aging and

dementia / Alzheimer’s disease?

• Memory changes which may be abnormal– Forgetting relationships of close family

members (e.g., grandchildren)– Putting things in odd places– Forgetting an upcoming appointment, special

event, etc. – and still not remembering it after it is pointed out to you

– Getting lost in a familiar place while driving

• Dementia: the general term used to describe loss of previous memory or thinking function

– “de”: loss of– “mentia”: thinking power

• Alzheimer’s disease: a specific type of dementia

• $100 billion annually in health care and societal costs

• A new analysis suggests that about 3.4 million Americans age 71 and older - one in seven people in that age group -have dementia, and 2.4 million of them have Alzheimer’s disease (AD).

What’s the difference between dementia and Alzheimer’s disease?

Alzheimer’s disease

• Impaired memory (especially for recent events)

• At least one of the following:

– Difficulty with speech (aphasia)

– Difficulty with recognition (agnosia)

– Difficulty with fine motor skills (apraxia)

– Difficulty with judgment, insight, planning

ahead, organizing (executive dysfunction)

Memory problems in Alzheimer’s disease

• Short-term memory – affected first– leads to difficulty recalling events from hours

to several weeks

• Long-term memory – usually preserved early in the course of AD– very good recall of events from years ago

Progression of AD

• Starts very gradually, and inconsistently• Gradually progresses over months to years• In addition to memory difficulties, may see

– Apathy

– Other changes in personality

– Hallucinations (false perceptions)

– Delusions (false beliefs)

– Poor judgment

• AD spreads through the brain.

• The cerebral cortex begins to shrink as more and more neurons stop working and die.

Progression of AD: Changes in brain vital statistics

Brain of healthyindividual, age 60

Brain of individual with advanced

Alzheimer’s disease

Hippocampus learning

and memory

Progression of AD: Changes in brain components

• The brains of people with AD have:– an abundance of beta-

amyloid plaques, which are dense deposits of protein and cellular material that accumulate outside and around nerve cells

– an abundance of “neurofibrillary tangles,” which are twisted fibers that build up inside the nerve cells

Today’s talk

• Brain structure and function

• Normal aging vs. diseases of aging

• What we can do about it

Use it or lose itUse it or lose it

Four strategies to stay mentally fit

1. Maintain your general health.

2. Exercise your body.

3. Exercise your mind.

4. Stay socially active and connected.

1. Maintain your general health• Regular check-ups

• Follow physician’s instructions to manage diabetes, cardiovascular health, etc.

• Treat depression

• Identify sources of stress and take action to reduce them: chill-lax

• Follow good nutritional guidelines

• Limit alcohol, recreational drug use, smoking

• SLEEP – is critical for memory formation (and general health)

2. Exercise your body• Aerobic exercise

– 20 minutes or longer– at 60% of maximum heart rate or higher – WITH YOUR PHYSICIAN’S

APPROVAL– 3-4 times per week

• What is aerobic exercise? – Emphasizes cardio / respiratory system– Longer duration exercise, involving large muscle groups in repetitive

actions– Important to include warm up and cool down periods– Stretching is important to avoid muscle and joint injury– Jogging, rowing, cycling, swimming, walking

• Aerobic exercise is not: – Fishing, golfing, strolling, grocery shopping, gardening, doubles tennis!

How to Keep Your Aging Brain Fit: AerobicsForget Crossword Puzzles -- Study Says 3 Hours of Exercise a WeekCan Bolster Memory, Intellect

By SHARON BEGLEYNovember 16, 2006; Page D1

The key to keeping intellectually sharp as we age may not bemental gymnastics, as commonly recommended, but realgymnastics.

According to a new study, the brain's long, slow decline maynot be inevitable. For the first time, scientists have foundsomething that not only halts the brain shrinkage that starts in aperson's 40s, especially in regions responsible for memory andhigher cognition, but actually reverses it: aerobic exercise. Aslittle as three hours a week of brisk walking -- no Stairmasterrequired -- apparently increases blood flow to the brain andtriggers biochemical changes that increase production of newbrain neurons.

As brains age, normal wear and tear starting in middle agecauses them to process information more slowly, which meansit takes longer to make judgments and grasp complexinformation. Older brains also take longer to switch from onetask to another and are less adept at "multitasking" (such asdriving while simultaneously tuning the radio and checking thetailgater)...

http://hpp.beckman.uiuc.edu/news/WallStJNov162006.pdf

3. Exercise your mind

• Degree of education is the strongest buffer and one of the best predictors of later memory impairment.

• Not related to IQ: education sets a pattern of reading, chess, crossword puzzles, etc. that become lifelong exercises.

• Mentally stimulating activity protects the brain in ways that are poorly understood.

• Develop strategies to address your particular behavioral concerns:– Make notes and lists– Use humorous visual images– Rehearse names, facts ahead of time– Do one thing at a time

• Brain calisthenics

Brain calisthenics

Instructions: Say the color the word is printed in, not the word itself. Try to say all 10 without a mistake in 15 seconds.

Blue Yellow Red GreenGreen Red

Green Blue RedRed Yellow Green

Brain calisthenics

Instructions: memorize these 20 words by studying them for 3 minutes. Then write down as many as you can remember in 1 minute.

CircleBreadDogSisterCoatPilotRopeOfficeMap Thunder

TubingPotteryShapeEdgeSectionAppleMindHeadKiteBrand

CircleBreadDogSisterCoatPilotRopeOfficeMap Thunder

TubingPotteryShapeEdgeSectionAppleMindHeadKiteBrand

Brain calisthenics

• Try Sudoko and other strategic games that require planning, strategy

• Develop new and challenging ways of doing household tasks– Brush your teeth with your non-dominant hand

• Try things outside your comfort zone– If you’re a math whiz, try painting; if you’re an avid

reader, try math games

4. Stay socially active and connected

• Solitary activities to increase brain fitness are great, but group activities are even better:– Book club– Music groups, choir– Dinner groups– Play cards in a group (great for multi-tasking)– Play chess and other games that require strategic

thinking– Play sports on a team, league– Travel– Lectures / courses

Four strategies to stay mentally fit

1. Maintain your general health.

2. Exercise your body.

3. Exercise your mind.

4. Stay socially active and connected.

Perspective

• Fears of memory problems in later life, although they are real, can become exaggerated.

• One can manage memory issues that arise as a result of normal aging by following 4 strategies and some memory tricks (make lists, do one thing at a time, etc.)

• In spite of age-related changes in some cognitive functions, the vast majority of older adults retain more than enough reserve capacity for a meaningful, satisfying life of independence.

• Talk to your familiy members, friends

• Talk to your personal physician

• Blood tests, CT scan or MRI scan

• Consult local Alzheimer’s Association

What should I do if I suspect that I have memory problems?

A few useful resourcesA few useful resources

• www.alz.org• www.nia.nih.gov• www.aarp.org• www.fi.edu/brain/index.com• www.time.com/time/covers/20060116/puzzles• www.braingle.com (and many others)• www.mybraintrainer.com (just for fun, free “test”

– don’t sign up for for-fee service!)