Lifestyle May Be Key to Slowing Brain's Aging

[Guest guest]

By Rob Stein

Like many Americans sliding into middle age, McClain started

worrying that her memory was beginning to slip.

" It was little things. I couldn't remember what I had for dinner the night

before. I had to check to make sure I'd paid the insurance that month. I'd

walk into a room and realize I had no idea why I was there, " said the Los

Angeles marriage counselor, who is 44.

So McClain started a program designed to help -- a detailed regimen that

includes daily memory exercises.

" I'm much clearer now, " McClain said. " I have no problem finding my keys. I

can tell you what I had for dinner last night. I'm not walking into a room

thinking, 'Why did I come in here?' "

McClain is among the increasing number of Americans who are performing

mental calisthenics, taking Italian classes, deciphering crossword puzzles

and hunting for other ways to try to keep their minds from fading.

A large body of evidence indicates that people who are mentally active

throughout their lives are significantly less likely to suffer senility, and

a handful of studies have found that mental exercises can boost brain

function. Elderly people who go through training to sharpen their wits, for

example, score much better on thinking tests for years afterward. The minds

of younger people who drill their memories seem to work more efficiently.

But it remains far from clear exactly which of the myriad use-it-or-lose-it

methods promoted by researchers, self-help books and health groups protect

the brain in the long term, and actually reduce the risk for dementia. So

scientists, increasingly employing high-tech brain scans, have launched an

incipient wave of research to determine what works and why.

" We're right at the cusp of understanding this, " said Sherry Willis of

Pennsylvania State University. " Because brain imaging work has become so

much more technologically sophisticated, we're now at the point where we

literally look inside people's brains to try to understand what's going on. "

With the population aging, and the number of cases of Alzheimer's and other

forms of dementia rising rapidly, experts say preventing mental

deterioration from occurring in the first place will be crucial to

minimizing the mounting suffering and costs.

" It's really critical that we find ways to prevent, or at least delay the

onset of, cognitive decline, " said Neil Buckholtz of the National Institute

on Aging. " Once the pathology is established in the brain, it's very

difficult to treat. We need better ways to prevent the disease in the first

place, which could make a huge difference for the future. "

Several large studies are examining antioxidants such as selenium, vitamins

C and E and folate, as well as the popular herbal remedy ginkgo biloba.

Researchers also remain hopeful that anti-inflammatory painkillers such as

Celebrex and the hormone estrogen may prove useful, despite safety concerns.

Other researchers are exploring whether cholesterol drugs might protect the

brain as well as the heart. It has become increasingly clear that the same

strategies that cut the risk for heart attacks and strokes -- eating well,

lowering cholesterol and blood pressure, avoiding obesity and diabetes, and

exercising regularly -- protect the brain, too.

" We don't have to wait until tomorrow when we have some kind of wonder

drug, " said Arthur Kramer of the University of Illinois at Urbana-Champaign,

who has found that sedentary elderly people who start exercising regularly

are sharper and experience growth in crucial brain areas. " Many things that

we can do today can engender cognitive vitality and successful aging, and

one of them is exercise. "

Among the most tantalizing evidence are studies that have given rise to the

use-it-or-lose-it theory. Several large projects have found that people who

are more educated, have more intellectually challenging jobs and engage in

more mentally stimulating activities, such as attending lectures and plays,

reading, playing chess and other hobbies, are much less likely to develop

Alzheimer's and other forms of dementia.

Scientists suspect that a lifetime of thinking a lot may create a " cognitive

reserve " -- a reservoir of brain power that people can draw upon even if

they suffer damaging silent strokes or protein deposits that are the

hallmarks of Alzheimer's.

" Some people might have brain networks that are more efficient and so have a

greater capacity to compensate for disease, " said Yaakov Stern of Columbia

University, who is using brain scans to try to zero in on the circuits that

matter most. " So when they are challenged by disease, those networks

continue to operate longer. "

But it is also possible that such people are born with brains that lead them

to pursue intellectually stimulating lives, and are inherently less prone to

dementia. Educated, successful people also tend to have more money and get

better medical care.

" There's a lot of things that highly educated people do to take care of

themselves, " said Jerome Yesavage of Stanford University, who is evaluating

the benefits of combining cognitive training exercises with a drug already

used to slow the progression of Alzheimer's. " You have to be cautious. We

don't want to create false hopes that you can prevent Alzheimer's. "

In one of the first major attempts to test whether mental training works, a

federally funded study involving more than 2,800 elderly people found that

those who received 10 brain-training lessons scored much better on thinking

tests, and the effect lasted for at least three years. The training taught

strategies aimed at improving reasoning skills, the processing of new

information, and memory, such as mnemonic devices for remembering names.

Many researchers suspect, however, that people may benefit most from

engaging in a rich diversity of stimulating activities. New experiences may

be far more important than repeating the same task over and over. Moreover,

it may be key to combine mental stimulation with social interaction, which

studies have found also appears highly beneficial. Experts say the task

should be enjoyable, because stress and other negative emotions appear

harmful.

So scientists have launched a series of pilot studies examining more

real-life approaches. In Indiana, one team of researchers is testing whether

elderly people who take quilting classes fare better, while another is

following groups of elderly people as they participate in an adult version

of the Odyssey of the Mind competition originally developed for

schoolchildren. Outside Chicago, a husband-and-wife team of researchers is

experimenting with acting classes. In Baltimore, s Hopkins aging experts

are studying whether volunteering as tutors and librarians helps. All report

promising, though preliminary, findings.

" It was pretty amazing, " said Carlson of Hopkins, whose team found

that elderly volunteers scored much better on problem-solving tests and that

their frontal lobes seem to have been reinvigorated. " We observed changes

that appeared to show that their brains were functioning more like younger

adults'. "

But none of the researchers said the findings are strong enough to merit

specific recommendations.

" I think we'll get there, but we're not there yet, " Carlson said.

Other researchers say that although the evidence may remain inconclusive, it

is promising enough for people to start doing the things that look as though

they may help.

" It's hard to prove a lot of these things, but I'm convinced there's enough

evidence that there is a cause-and-effect relationship, " said Small of

the University of California at Los Angeles, who developed the " memory

prescription " that McClain uses.

The prescription combines a healthful diet with daily exercise, relaxation

techniques and memory exercises, such as making a mental note of one piece

of a family member's wardrobe each morning. Small tested the approach in a

pilot study that included McClain. Not only did those on the prescription

score better on memory tests, but brain scans lit up in ways that indicated

key areas of their gray matter appeared to be working more efficiently, he

said.

" One of the most striking findings was how it affected function in the area

of the brain that creates everyday working memory, " Small said. " We may not

have conclusive proof. But the evidence is strong. And these are all healthy

choices for other reasons. "

Even if such strategies work, getting large numbers of people to

fundamentally alter their daily lives remains daunting, many experts

acknowledge.

" We all know how difficult it is for all of us to exercise regularly even

though we know we should. Now we're telling people they need to be more

mentally active, too: 'Turn off " Wheel of Fortune " ' or 'Do your own taxes.'

That's going to be a difficult public health message, " said Marsiske

of the University of Florida.

Marsiske and other experts note, however, that it has been done before.

" The major way we've reduced the death rate from heart disease is through

lifestyle changes: eating better, exercising more, smoking less, " said

A. of Rush University in Chicago. " It would require a lot of people

to change the way they live, but there's no reason to think we can't have

the same impact on Alzheimer's and other forms of dementia. "