Cognitive Vitality

PHILIP MCCALLION, PH.D., &

LISA A. FERRETTI, LMSW
CENTER FOR EXCELLENCE IN AGING
SERVICES
WWW.ALBANY.EDU/AGING
The Center for Excellence in Aging Services does not
endorse any of the programs, projects or
recommendations in this presentation as
scientifically valid; rather, we advise caution when
considering making changes that may effect your
general health and recommend that you consult with
your personal healthcare provider before making
such changes.
 Past Ideas

 For decades, the prevailing dogma in neuroscience

was that the adult human brain was essentially
- immutable,
- hardwired,
- fixed in form and function
so that by the time we reach adulthood it was thought
we were pretty much stuck with what we had.
 Normal Aging Changes
 Eyesight - loss of
peripheral vision and
decreased ability to judge
depth. Decreased clarity of
colors (for example, pastels
and blues).
 Hearing - loss of hearing
acuity, especially sounds at
the higher end of the
spectrum. Also, decreasing
ability to distinguish sounds
when there is background
noise.
 Taste - decreased taste buds
and saliva.
 Touch and Smell -
decreased sensitivity to
touch and ability to smell.
 Normal Aging Changes

 Arteries - stiffen with age, eventually causing

arteriosclerosis (hardening of the arteries).
 Bladder - increased frequency in urination.
 Body Fat - increases until middle age, stabilizes until
later in life, then decreases. Distribution of fat shifts -
moving from just beneath the skin to surround deeper
organs.
 Bones - somewhere around age 35, bones lose minerals
faster than they are replaced
 Metabolism - medicines and alcohol are not processed
as quickly. Prescription medication requires adjustment.
Reflexes are also slowed while driving.
 Muscles - muscle mass decline, especially with lack of
exercise.
 Normal Aging Changes

 Brain - loses some of the structures that connect

nerve cells, and the function of the cells
themselves is diminished. "Senior moments"
increase.
 Heart - is a muscle that thickens with age.
Maximum pumping rate and the body's ability to
extract oxygen from the blood both diminish with
age.
 Kidneys - shrink and become less efficient.
 Lungs - somewhere around age 20, lung tissue
begins to lose its elasticity, and rib cage muscles
shrink progressively. Maximum breathing capacity
diminishes with each decade of life.
 Normal Aging

 Normal aging or “healthy aging” is a term that is

widely used to describe the natural changes that
occur in the absence of any disease.
 Some changes in the ability to think are
considered a normal part of the aging process.
 Healthy older adults experience mild decline in
some areas of cognition.
 Changes may occur in the areas of visual and
verbal memory, visuospatial abilities, immediate
memory, or the ability to name objects.
 The Aging Brain

 As a person gets older, changes

occur in all parts of the body,
including the brain
 Some neurons shrink, especially
large ones in areas important to
learning, memory, planning, and
other complex mental activities.
 Tangles and plaques develop in
neurons and surrounding areas,
though in much smaller amounts
than in Alzheimer’s Disease
 Damage by free radicals
increases
 Inside the
Human Brain
Neurons
• The brain has billions of
neurons, each with an axon
and many dendrites.
• To stay healthy, neurons
must communicate with
each other, carry out
metabolism, and repair
themselves.
• Aging slows the repair
process, Alzheimer’s
disease disrupts all three of
these essential jobs.
Slide 14
 Risk factors for cognitive decline

 High blood pressure, diabetes, poor nutrition, and

social isolation are associated with a higher
probability of developing a neurodegenerative
condition
 Heart disease
 Family history of dementia
 Psychological factors such as stress and depression
also negatively affect the healthy aging process
 Contributors to healthy aging
 Routine medical care is
essential in maintaining good
health.
 What's good for the heart is
good for the brain!
 Extensive social support
networks are an important
mechanism; sharing the aging
process with other people who
are experiencing the same
challenges and joys.
 Contributors to healthy aging

 Stay away from

smoking and limit
alcohol consumption.
 Maintain a high level
of physical activity
through exercise.
Exercise facilitates the
maintenance of
muscle flexibility,
strength, and mood.
 Successful Aging

 Relatively low risk of disease and disease-related disability

 Relatively high mental and physical functioning

 Active engagement with life including close relationships with

others and participation in productive activities

 Acceptance of age-determined decrements and doing the best

one can with what one has

 Application of external resources to enlarge an individual’s

opportunities and facilitate behaviors that make for success in
older age

(Baltes & Baltes, 1990; Riley & Riley, 1990; Rowe & Kahn, 1998; Kahn, 2002)
Some Definitions
 Mild Cognitive Impairment (MCI)

 Mild cognitive impairment (MCI) is a condition

in which a person has problems with memory,
language, or another mental function severe
enough to be noticeable to other people and to
show up on tests, but not serious enough to
interfere with daily life
 Cognitive Vitality
 Cognition is the process of knowing and thinking.
 It is a combination of skills, including knowledge
acquisition, attention, intuition, memory,
learning, language, perception, skilled motor
behaviors, decision-making, goal-setting,
planning, and judgment.
 Cognitive vitality results from a combination of
reserve brain capacity, acquired knowledge, and
a degree of protection against brain injury.
 People with high cognitive vitality remain
intellectually sharp as they age and such vitality
may make the difference between dependent and
independent living.
 Cognitive Reserve (or Brain Reserve)

 Theory that addresses how individuals vary in the

severity of cognitive aging.
 Mental stimulation, education and occupational level
are believed to be major active components of
building a cognitive reserve that can help resist the
attacks of mental disease.
 Neuroplasticity

 the brain's ability to reorganize

itself by forming new connections
throughout life
 Cognitive Training

 Consists of a variety of
brain exercises
designed to help work
out “mental muscles”
 The principle
underlying cognitive
training is we can help
improve "core"
abilities, abilities most
people mistakenly
consider as instincts
 Working memory or Short-term
(recent) memory is a system for
Working
temporarily storing and Memory
managing the information
required to carry out complex
cognitive tasks such as learning,
reasoning, and comprehension.
 Working memory is involved in the
selection, initiation, and
termination of information-
processing functions such as
encoding, storing, and retrieving
data
 Working memory offers the ability
to keep information current for a
short period while using this
information
 Working Memory is the target of
Brain Training
70 Ways to Increase Your
Brain Power

IN NO PARTICULAR ORDER
STEVE GILLMAN. EXCERPT FROM CHAPTER 5 OF
A BOOK OF SECRETS (EDITED)

NOTES
FOR MANY OF THESE RECOMMENDATIONS THERE IS
LIMITED SCIENTIFIC EVIDENCE
FOR THE RECOMMENDATIONS HERE ON USE OF
SUPPLEMENTS, HERBS, INCREASES IN EXERCISE OR
CHANGES IN NUTRITION PRIOR CONSULTATION WITH
ONE’S PHYSICIAN AND/OR OTHER HEALTH
PROFESSIONALS IS STRONGLY ENCOURAGED

THE CENTER FOR EXCELLENCE IN AGING SERVICES DOES

NOT ENDORSE THE WORKS OF MR. GILLMAN AS
SCIENTIFICALLY VALID AND CAUTION IS ADVISED
1. Breath deep. More air in means more oxygen
in the blood and therefore in the brain.

2. Meditate. A simple meditation you can do right

now is just closing your eyes and paying attention
to your breath.
3. Sit up straight. Posture affects your thinking
process.

4. Phosphotidyl Serine (PS). This supplement

has been shown in clinical studies to increase
lucidity and rate of learning, activate cell-to-cell
communication, helps regulate cell growth,
improves the functioning of the special receptors
found on cells, and prepares cells for activity.
5. Vinpocetine. This extract, derived from an
alkaloid found in the Periwinkle plant, is used as a
cerebral vasodilator.

6. Gingko Biloba. The leaves of this tree have

been proven to increase blood flow to the brain.
7. Saint John's Wort. This is a common weed
that is inexpensive to purchase. Hyperacum
Perforatum, its botanical name.

8. Good thinking habits. Just use a problem

solving technique for several weeks and it will
become a habit.
9. Use dead time. This is time that is otherwise
wasted or just under-utilized.

10. Learn a language. Learning a new language

has been shown to halt the age-related decline in
brain function. It is one of the best brain exercises.
11. Rosemary. This common herb may have an
effect on the brain when the scent is inhaled.

12. Mindfulness exercises. Concentration and

clear thinking are more or less automatic once you
remove distractions.
13. Write. Writing is good for your mind in a number of
ways.
- It is a way to tell your memory what is important, so
you'll recall things more easily in the future.
- It is a way to clarify your thinking.
- It is a way to exercise your creativity and analytical
ability.

14. Listen to Mozart. In a study at the University of

California, children who studied piano and sang daily in
chorus, were much better at solving puzzles, and when
tested, scored 80% higher in spatial intelligence than the
non-musical group.
15. Develop your intuition. Intuition can be an
important part of brainpower.

16. Avoid foods that cause subtle allergies.

These can include wheat, corn, peanuts and dairy
products.
17. Sleep better. As long as you get a certain
amount of sleep - probably a minimum of five
hours - the quality seems to be more important
than the quantity.

18. Caffeine. The research shows higher test

scores for students who drink coffee before major
exams. In other studies, it has been shown that too
much caffeine leads to poorer quality decisions.
19. Avoid sugar. Any simple carbohydrates can
give you "brain fog."

20. Hypnosis audios. The power of suggestion is

real, and one way to use it is with hypnosis tapes,
CD's or downloads.
21. Speed reading. Contrary to what many
believe, your comprehension of material often goes
up when you learn to speed-read. You get to learn a
lot more in less time, and it is definitely a good
brain exercise.

22. Exercise. Long term exercise can boost

brainpower.
23. Imaginary friends. Talking to and getting
advice from characters in your mind can be a great
way to access the information in your subconscious
mind.

24. Develop your creativity. Creativity gives

power to your thinking.
25. Learn more efficiently. When you decide to
learn something, take notes from the start.

26. Use techniques for clear thinking.

Cluttered rooms and offices can contribute to
cluttered thinking.
27. Brain wave entrainment. The newest brain
wave entrainment products are powerful tools for
altering your brain function. Some will almost
immediately relax you, while others will put your
brain waves in a pattern that is most conducive to
analytical thinking.

28. Creatine. This is a compound found in meat,

used by athletes to help build muscle.
29. Talk. Talking is only good for the brain if you
are actually exercising it, of course.

30. Do something you enjoy. This is a way to

both lower stress and rev up your brain. The key is
to do something active. Watching TV doesn't
count.
31. Adjust your beliefs. Believe you are smarter,
and you'll become smarter.

32. Brain exercises. Do math in your mind

while driving. Think of a new use for everything
you see.
33. Learn new things. This is another way to
exercise the brain.

34. Walk. Exercise has been shown to benefit the

brain, and walking is one of the best exercises for
many. It is low impact, and the rhythmic nature of it
seems to put you in a state that is very conducive to
clear thinking.
35. Model others. Find others that are creative,
intelligent, or very productive.

36. Eat fish. Eating fish actually speeds up brain

waves, and improves concentration.
37. Avoid unnecessary arguments. When you
defend a position too vigorously, especially when it
is just to "win" the argument, you invest your ego
into it. This is not conducive to the easy acceptance
and use of new information.

38. Laugh. The release of endorphins caused by

laughter lowers stress levels, which is good for long
term brain health.
39. Play. Stimulating the brain causes measurable
changes in the structure of the brain. New connections
are made and new brain cells are grown.

40. Do puzzles. Crossword puzzles, lateral thinking

puzzles, and even good riddles are a great way to get
brain exercise. You can work on them while waiting for a
dentist appointment, or on the bus, if you are short on
time.
41. Sing. When you are alone in your car, try
singing about something you are working on. This
taps into and exercises your right brain.

42. Nuts. University students in Brazil and other

South American countries often eat several Brazil
nuts before an exam, believing they are good for
their mental power. The evidence is starting to
confirm this.
43. Olive oil. High in mono-unsaturated fat, olive
oil has been shown to improve memory.

44. Vitamin supplements. In studies, children

scored higher on tests when on a regimen of daily
vitamin supplements.
45. Fiber. It isn't just what goes in, but what comes
out that is important to brain function. Toxic build-
up in the body and brain can cause "brain fog."

46. Self awareness. This may not seem important

to brain power, but it is.
47. Motivate yourself. Motivation is as important
to mental tasks as it is to any other. Learn a few
simple techniques for self motivation.

48. Avoid too much stress. Long term stress has

repeatedly been shown to hurt the brain, not to
mention the rest of the body.
49. Get educated. Scientists have known for a
while that the less educated get Alzheimer’s more
frequently.

50. Avoid too much fat. In laboratory studies,

animals consistently learn slower when they are on a
diet high in fat.
51. Eat less. Overeating has the immediate effect of
redirecting more blood to the digestive process, leaving
less for the brain.

52. Avoid suspect foods. There is evidence that the

following foods can be bad for your brain: Artificial food
colorings, artificial sweeteners, colas, corn syrup,
frostings, high-sugar drinks, hydrogenated fats, sugars,
white bread, and any white-flour products.
53. Eat breakfast. When kids who didn't eat
breakfast started to, researchers found that their
math scores went up a whole grade on average.

54. Avoid diabetes. The development of diabetes

coincides with a dropping of IQ scores.
55. Eat foods high in antioxidants.
Antioxidants protect all your cells, including brain
cells.

56. Drink wine. In moderation, red wine can be

good for the brain, it seems. It is rich in
antioxidants, which protect brain cells.
57. Use alcohol in moderation. It is known that
alcohol can kill brain cells, so moderation seems to
be the key.

58. Folic acid. According to one study, 200

micrograms of folic acid, the amount found in 3/4
cup of cooked spinach, alleviates depression and
reverses some memory loss.
 59. Potential brain foods. Other foods that may be
good for your brain include: Avocados, bananas, lean
beef, brewer's yeast, broccoli, brown rice, brussel
sprouts, cantaloupe, cheese, chicken, collard greens,
eggs, flaxseed oil, legumes, oatmeal, oranges, peanut
butter, peas, potatoes, romaine lettuce, salmon,
soybeans, spinach, tuna, turkey, wheat germ, and
yogurt.
60. Vitamin E. Jean Carper, in researching her book,
"Your Miracle Brain," found that many brain
researchers are taking 400 I.U.s of vitamin E daily.

Definitely check with your physician before

beginning such a regimen!
61. Vitamin C. Taken in the form of orange juice in
a study at the Texas Women's University, vitamin C
was associated with increased IQ scores of children.

62. Selenium. 100 micrograms of selenium has

been shown to be a mood-elevator.
63. Alpha-lipoic acid. Alpha-lipoic acid (10 to 50
milligrams daily) improves memory and protects
nerve cells.

64. Inositol. This is a safe and natural substance

that is often grouped with the B-vitamins.
65. Huperzine A. This is a compound extracted
from the Chinese club moss.

66. Ask questions. This is a great way to keep

your brain in shape.
67. Sniff basil. This is another of the herbs that
may be good for your brain.

68. Temperature. Many people have noted that

they think better at certain temperatures.
69. Use systems. For example, mental math
shortcuts. 12 x 49 = (12 x 50) - 12. It's easier to
figure in your head this way.

70. Make a brainpower plan. It takes about

twenty to thirty days of repetition to establish new
habits.
More Specific Recommendations

 1. Exercise
 2. Civic Engagement
 3. Memory Training
 4. Nutrition
 Physical Exercise

 Protects against late-life cognitive decline and

dementia, and produces a significant effect on
cognition
 Increases blood flow to the brain, and stimulates the
proteins and molecules that keep our neurons
healthy and strong
 Physical Activity and Exercise might consist of
aerobic or cardio-vascular, strength and flexibility
training
 Physical Exercise
- Aerobic fitness training

At least 15 minutes a day three days of the week

at 75% of maximum heart
•Brisk Walking •Racquet Sports
•Aerobics •Bicycling
•Hiking •Skiing
•Swimming •Yard Work
•Aqua Aerobics •Dancing
•Jogging •Martial Arts
•Climbing stairs or
Hills
 Physical Exercise - Strength training

Movement of key muscle groups for at least

30 seconds at individual’s maximum length
tolerable with free weights and isoinertial
exercise equipment.
 Lifting weights
 Martial Arts
 Yoga
 Pilates
 Physical Exercise - Flexibility Training

Creating balance in the body through developing

both strength and flexibility through the
performance of poses or postures in succession and
creating heat in the body through movement
 Tai Chi
 Yoga
 Pilates
 Studies on Physical Exercise
 In a study of aerobic capacity, the study examined the effect of
physical exercise on cognition. When aerobic training was combined
with strength training lasting longer than 30minutes, peak oxygen
consumption predicted multiple cognitive functions in promotion of
cognitive vitality.

 A walking group study indicated that individuals assigned to a

walking group-6month fitness program showed improved
performance on the focused-attention task and more efficient
patterns of brain activation by MRI analysis.

 A pilot study that looked at physical fitness training over a 4 to 8

month period to examine the influence of physical training revealed
that generative physical activity (ex: Jogging, Bicycling, Yard work)
led to improved cognitive function when compared to passive, low
cognition activities like watching TV.

Studenski, S. Carlson, M.C., Fillit, H., Greennough, W.T., Kramer, A., & Rebok, G.W.(2006). From bedside to bench:
Does mental and
physical activity promote vitality in late life? Sci Aging Knowl. Environ., 10.
 Social Engagement

- Participating in group activities that provide

opportunities for social interaction
- Engaging in cooperative problem solving and
participating in program activities that exercise
multiple dimensions of cognitive ability and fulfills
the desire to feel needed and connected to society
 Social Engagement
Volunteering and Civic Activity

 Experience Corps program: Working for at least 15 hours

per week across the course of an entire school year with
children in Grades K-3 on meaningful activities involving
literacy tutoring, library use and behavioral management.
 Effectiveness:
-148 participants aged 60 years and older who served in
Experience Corps in Baltimore, Maryland reported being
more physically active, and there were significant increases
in calories burned and improved muscle strength.

Fillit H.M.,Butler, R., O’Connel, A., Albert,M., Birren, J., Cotman, C., Greenough, W., Gold, P., Kramer, A., Kuller, L., Perls, T.,
Shaganm B., & Tully, T. (2002). Achieving and maintaining cognitive vitality with aging. Mayo Clinic Proc,77,681-696.
 Social Engagement- Theater acting training

 Requires deep processing of character motives and interactions,

and extends more broadly to information processing
 Includes the interpersonal aspects of action, focusing on goals, and
interaction through a character’s eyes
 Effectiveness
- In an experimental study of theater arts as a cognitive
intervention, elderly adults who enrolled in a moth long training
program exhibited improved recall and problem solving ability as
well as heightened well-being. Participants maintained these
benefits for a post treatment follow-up period of 4 months.
- Findings suggest that engagement in broad, nontraditional
cognitive intervention can produce measurable effects on cognition
in older adults.

Park, D.C., Cutchess, A., Meade, M., and Stine-Morrow, E.(2007). Improving cognitive function in older adult: Nontraditional
approaches. Journal of Gerontology: Series B, 62B,45-52.
 Memory Training

 Verbal episodic memory, teaching mnemonic

strategies for remembering word lists and
sequences of item, text material and main ideas
and details of stories.
e.g.: recalling a list of nouns, recalling a
paragraph, recalling a shopping list, details of
prescription labels

 These novel trainerless training platforms are

designed to overcome limitations of the
traditional approaches involving accessibility and
costs of training.
 Memory Training - Reasoning training

 Ability to solve problems that follow a serial pattern.

 Involves identifying the pattern in a letter or number
series or understanding the pattern in an everyday
activity such as prescription drug dosing or travel
schedules.
e.g. Tasks-letter series, Reasoning problems related
to activities of daily living
Memory Training - Video and Audiotape Training

 A videotaped presentation of interactive imagery for object

location recall.
 Effectiveness
- Research indicated the effectiveness of videotape memory
training in two groups of middle-aged and older adults in their
homes.
 Audio training to improved memory for community dwelling
older adults.
 Effectiveness
- Study participants receiving the training were less likely to
develop Alzheimer’s disease after having completed the
training.

Ball, K., Berch.,D. Helmers, K., Jobe, J., Leveck, M., Marsiske, M., Morris, J., Rebok, G., Smith, D., Tennstedt, S.,
Unverzagt, F., and Willis, S.(2002). Effects of cognitive training interventions with older adults. American Medical
Association, 288(18), 2271-2281.
Memory Training - Online and Computerized
Training

 Alternative to traditional training

 Computerized versions of memory training
(on-line courses) may be effective with older
adults in light of studies examining older adults
and computer usage.

Rebok,G.W., Carlsonl, M.C., & Langbaum, J.B.(2007). Training and maintaining memory abilities in healthy older adults:
Traditional and novel approaches. Journal of Gerontology: Series B, 62B,53-61.
 Memory Training - Online and Computerized Training

Resources
a. Online courses -Memory University offers the online memory improvement
courses
 Current courses from: website-http://memoryuniversity.com/
- Remembering Names and Faces
- Remembering Important Facts
- Remembering Numbers
- Remembering Intentions

b. CD-ROM based memory training

 - Memory Works CD-ROM memory training programs- Website:
http://www.memoryzine.com/memoryworks.html#namesfaces
- MEMORY WORKS FOR NAMES & FACES CD-ROM
- MEMORY WORKS FOR FACTS & FIGURES CD-ROM
- BEST INTENTIONS CD-ROM
- NATURE OF MEMORY CD-ROM
 Some Examples

Nintendo DS Brain Age 1 & 2

Sudoku

Mindfit
 Combined Cognitive Vitality Training
Mind-body training program

Mind-body training program

 Currently conducting a pilot study funded by the Erickson
Foundation with senior adults living in a continuing care
retirement community.
 Goal:
- Developing a combined intervention program that will
improve memory
- Increasing physical activity
- promoting everyday functional performance and
independence in healthy older adults with in-class
computerized memory training program
Hickman H., Rogers,W. A. & Fisk, A.D.(2007). Training older adults to use new technology. Journal of Gerontology:
Series B, 62B,77-84.
Rebok,G.W., Carlsonl, M.C., & Langbaum, J.B.(2007). Training and maintaining memory abilities in healthy older
adults: Traditional and novel approaches. Journal of Gerontology: Series B, 62B,53-61.
 An Example

 The Nintendo Wii

 Nutrition
Brain Health Foods – Top 5 :Cacao Bean

 One of the world’s longest-reserved foods

- Cognitive enhancement
- Mood and bliss-enhancement
- Antioxidants
- Brain and body-enhancing elements
 Dark chocolate
- Not a candy bar (including sugars, milk fat, artificial
flavorings)
 Recommendation : high % of cacao dark chocolate
(minimally processed), 100% organic non-alkalized cocoa
power
http://www.brainready.com/blog/thetop5brainhealthfood.html, Retrieved on 12/11/07
 Nutrition
Brain Health Foods – Top 5 :Wild Salmon

 Wild Salmon (not farm-raised)

- Incredible food for brain health

- Essential Fatty Acids :

Omega-3
- High quality non-land animal

protein
- Low saturated fat

- Lowest amounts of contaminates among seafood (ex>mercury)

 Nutrition
Brain Health Foods – Top 5 :Matcha

 Finely ground powder of the highest-quality and

the shaded-grown green tea plant
 Unique effect on the brain function-calming and
focusing while stimulating at the same time
 e.g. Helping to endure 12-hour straight meditation
session with Monks in Japan
 EGCG (Epigallocatechine Gallate)
- a compound uniquely in green tea possessing
anti-cancer, anti-aging and overall health benefits
- higher amount of EGCG than regular brewed
green tea
 Nutrition: Brain Health Foods – Top 5 :
Acai berries & Blueberries

 Possesses Essential Fatty Acids

(Omega-3) as well as antioxidant
and vitamin
 Acai berries from South America
have the highest level of
antioxidant of any berry
 Blueberries aka the brain berry widely available
and easy to add to your daily diet
 Nutrition
Brain Health Foods – Top 5 :Coffee beans
 A safe, true super food
- Pure espresso
 Unique beverage that packs a host of
brain and healthy-friendly properties.
 Incredibly rich with antioxidants, amino acids,
vitamins and minerals.
 Regular coffee consumption has been shown to
actually reduce the risk of mental decline and
diseases such as Dementia and Alzheimer's
 Recently been found to be (shockingly) the "#1 source
of antioxidants in the average American diet"

** Consuming these brain health foods consistently in

moderation overtime along with the rest of a healthy
diet