Abstract

Feeling forgetful lately? Difficult to remember people's names or where you kept the house keys? Maybe certain words escape you, or you just can't put together a jigsaw puzzle the way you used to. Learn how you can awaken your mind and keep it sharp through some simple everyday actions…says Shobha Nair.

When it comes to how you'll experience future -- whether it’ll be a time of rich memories or one in which Alzheimer's or another dementia steals your past -- it really is all in your head. If you get off the couch, you may be able to actually do something about it. No, there are no memory-back guarantees, and lifestyle is not the only factor (can't forget those genes and those concussions you got playing sports). But the evidence is mounting that there are things you can do to keep your mental motor tuned up. And that has inspired a growing chorus of experts bugging us all to keep our brains healthy and thereby lessen our risk of developing dementia. These include the Alzheimer's Association's new "Maintain Your Brain" campaign. Before you start moaning that you don't want to be told to do any more exercising this or maintaining that, be forewarned: some of this is a matter of fun and games.

Use It or Lose It

Many factors can affect your ability to remember—a hectic lifestyle, ageing, stress, chronic disease, and certain medications. But you can take steps to sharpen your mind and help preserve your memory. Just as physical exercise maintains body tone, strength, and endurance, mental exercise has positive conditioning effects for people of all ages. The brain grows and sustains our human abilities, and its problems are expressed as our disabilities. The brain defines us, after all, as the person that we are. Have you ever witnessed the slow deterioration of a loved one with Alzheimer's? If so, you’ve watched the person you knew and loved slowly fade away, even while the body may have remained relatively healthy.

Marian Diamond enjoys walking along the edge of sidewalk curbs while whirling her arms over her head to challenge her balance -- and therefore her brain. It's what kids do to entertain themselves on the way to school, but Diamond is 78 and she does her curb-walking on her way to her office at the University of California, Berkeley, where she is a professor of anatomy. "On campus, it's easy. There are lots of curbs," she says. Diamond hits the curbs -- and everything else during her busy days -- with an eye toward keeping her brain healthy. Other things she does for her brain: swimming, tai chi and weight lifting, as well as going to work. "People ask, 'Why do you keep working so hard?' If I didn't, the input will decrease and that’ll affect my brain," she says. Diamond knows a thing or two -- or thousands -- about the topic as a leading brain researcher. She has examined bits of Albert Einstein's brain and has been known to carry a human brain in a hatbox to show students. Diamond is one of the scientists you can thank (or blame) for the research that leads to today's lesson that "use it or lose it" refers to our brains as well as our biceps.

Which is one of the reasons the Alzheimer's Association hosted its first conference on the prevention of dementia. "Five years ago, everyone would have laughed, because the research just wasn't there for prevention; the evidence is really lining up now," says Elizabeth Edgerly, presenter for the ‘Maintain Your Brain’ programme of the Association. "One of the things I ask is, 'When was the last time you worked your brain so hard, you felt like little puffs of smoke coming out of it?'" she says. "You’ve to use it." You can do so with games that require planning and strategising, whether it's bridge, chess or Scrabble. Busting your routines and doing something new is the key to taxing your brain. Another idea she suggests sounds like a slumber-party game: writing your name on a piece of paper in front of a mirror, while looking only in the mirror. Make sure your name is legible in the mirror.

Using your brain in new ways helps build more dendrites and therefore more connections within it. These may be the key to overcoming the action of the plaques and tangles that cause Alzheimer's. But brain health is not all about cerebral exercises; you need to flex your social and physical skills as well. If you can combine them it's a bonus – e. g., by taking salsa lessons with your friends or playing antakshari while swimming. You also have to eat right, lower your cholesterol and watch your blood pressure.

Be sure to load up on antioxidants (dark-skinned fruits and vegetables, including blueberries and broccoli, which are high in these) and omega-3 fatty acids (found specially in cold-water fish and flax seed). But wait, aren't those dietary guidelines all about your heart? Yes, and it turns out heart and brain health are very much connected. "We're seeing a connection between Alzheimer's disease and cholesterol and high blood pressure, and even diabetes" warns Dr Ramesh Patel, a geriatric neuro-psychiatrist.

One way to keep your brain in shape is to stay socially active. Your brain really needs company to be at its best. "You need love," Diamond says. "Hug everybody. I do it after a seminar, and I really shock my professors."

The Good News

According to the Mayo Foundation for Medical Education and Research, as you age, your brain remains capable of adapting to stimuli. Although declines occur in certain cognitive functions, others increase with age and can compensate for the decline. Research has found that people who age with greater stores of knowledge may show increased adaptation. Vocabulary also tends to improve with age. Certain activities can assist older adults in increasing their capacity to learn and adapt as they age.

A number of research studies have identified common, potentially modifiable risk factors for cognitive decline. These include: lack of mental activity; substance use and abuse, including smoking, illicit drugs, alcohol; lack of physical exercise; malnutrition; stress; and lack of involvement in social activities. Certain medical conditions such as high blood pressure, diabetes, high cholesterol and atherosclerosis (hardening of the arteries), depression, multiple medications, impairment in vision and hearing, head trauma, and sleep disorders also add to the problem.

The decline in specific mental abilities believed to be associated with ageing—such as memory loss, sluggish thinking, and blocks in problem-solving—are not inevitable if the brain remains challenged. Yet we’ve all seen elderly people who unmistakably experience mental decline as they grow older. What can be done to preserve, even enhance, our mental fitness as we grow older?

Challenge Your Brain

Just as physical activity keeps your body strong, mental activity keeps your mind sharp and agile. If you continue to learn and challenge yourself by learning new skills, your brain continues to grow, literally. An active brain produces new connections between nerve cells that allow cells to communicate with one another. This helps your brain to store and retrieve information more easily, no matter what your age. How can you challenge yourself? Try:

• Learning to play a musical instrument.
• Playing Scrabble or doing crossword puzzles (use a dictionary if you need it; you'll learn more that way) or brainteasers.
• Interacting with others, socialising – visit old friends or join groups to meet new ones.
• Travelling – experience the food, history, and culture of your destination.
• Going to museums, the theatre, or thought-provoking movies.
• Switching careers or starting a new one.
• Starting a new hobby, such as crafts, painting, gardening, or bird-watching.
• Learning a foreign language.
• Volunteering.
• Staying informed about what's going on in the world.
• Changing things in your daily life, such as reversing your pattern in the grocery store or brushing your teeth using your non-dominant hand.

Also, go for a healthy diet rich in fruits and vegetables. Nutritionists recommend "super foods" full of vital nutrients, antioxidants and minerals, such as berries, leafy greens, nuts, legumes and omega-3 fish. In studies, the antioxidant nutrients—vitamins C and E and beta carotene—have been associated with high marks on memory tests, along with B vitamins, specifically vitamin B6 and folate, that boost memory function. A simple way to find healthy foods is by sight, says Usha Sisodia, nutritionist at Lilavati Hospital, Mumbai. "The brighter the pigmentation, the more the antioxidants. Pick a bright-coloured red apple, and look for dark greens and bright oranges. The same goes for legumes. Dark-coloured red and black beans have more antioxidants than the paler ones," informs Sisodia.

Studies indicate that your brain works better if you stay physically active. Can this be true? If so, how? Exercise increases blood flow to all parts of your body, including your brain, and might promote cell growth. The best part is that you can make it fun. Pick an activity you enjoy, whether it's gardening or walking your dog. Exercise for at least 30 minutes most days of the week. Start by simply increasing your physical activity level. Park your car farther away and walk the extra distance. Take the stairs instead of an elevator. When watching TV, ride a stationary bike. Just get moving. Regular physical activity can help you think clearer, feel better and lower your risk of many diseases. Says Dr Jim McAdams, Director of Geriatric Psychiatry at Laureate Psychiatric Clinic and Hospital, Oklahoma. "I think in general what keeps your body healthy keeps your mind healthy." Exercise aids in faster information processing, better memory, and improved complex thinking. At the end of a 12-month trial, "the exercisers showed significant improvements in reaction time, strength, memory span, and measures of well-being."

You can add memory loss to the long list of health problems that come from smoking. Smokers may have twice the risk of getting Alzheimer's against who never smoked. Stop now — it's never too late. If you quit smoking now, you can still reduce your risk of memory loss later in life. Kick the habit for a long and healthy life.

Brain Fitness

Brain Fitness — written by the founder of the French National Institute for Research on the Prevention of Cerebral Aging, Monique Le Poncin—outlines strategies to strengthen various mental abilities. Le Poncin recommends an exercise regimen that focuses on building up abilities like perception, long- and short-term memory, and visuospatial, structuralisation, logic, and verbal abilities.

Day-By-Day Activation - Try the following exercises when travelling, during lunch, or while shopping and doing housework. They take only a few moments. Combine different variations of these exercises each day. It's important to keep a record of your progress. Note where you seem to have problems, and self-prescribe exercises where you’re the weakest.

Exercise Your Perceptive Abilities : The goal is to exercise perception in all five senses: sight, hearing, smell, taste, and touch.

• Sight -
  Each day, observe an object (e.g., a photograph) or a person you pass on the street. Draw it (or him or her) immediately. This exercises short-term memory. At the end of the week, redraw the seven objects or persons you’ve observed to enhance your long-term memory.
• Smell/Taste -
  When dining in a restaurant or at a friend's home, try to identify the ingredients in the dishes you’re served. Concentrate on the subtle flavourings of herbs and spices. Ask the waiter or your host to verify your perceptions.
• Memory -
  Try to memorise the dishes offered on your favourite restaurant's menu. To make the exercise more challenging, memorise the prices as well. At the end of the day, recall as many of the dishes/prices as you can and write them down.
• Hearing -
  On the telephone, practise recognising callers before they identify themselves. Memorise their phone numbers. At the end of the day, write down the people you’ve spoken to, and their numbers. At the end of the week, try noting as many of these as you can.
• Smell/Touch -
  Exercise your senses of smell and touch by trying to identify objects with your eyes closed.

Visuospatial Abilities : Are related to the ability to make quick and accurate estimates of distances, areas, and volumes—the general proportions of things and their distribution in space. Try the following: when you walk into a room full of people, try to quickly determine how many are on your right and your left, as well as the left-right distribution of furniture and other objects. When you visit some place and return home, try to draw a plan or map of the place you’ve seen. Repeat this exercise the next day and the day after.

Structuralisation Ability: Structuralisation involves building a logical whole from disparate elements after close observation. Try these --

• Take a sentence from a magazine or newspaper. Make another sentence using the same words.
• Buy a jigsaw puzzle and practise fitting the pieces together as quickly as possible. Note the time taken. Do it again a week later and note the time again.

Logic Abilities : Logic is the art of reasoning. To awaken the inherent logic in you, don't use a list when shopping. Instead, use memory aids, such as forming a complete word, or one that can be completed by adding a certain vowel or consonant from the first letters of the words for the things you need to buy. Or, you can classify foods into raw and cooked. Or, use any other system that works for you.

All games involve logical activities. Card games such as poker and bridge or board games of strategy such as chess or monopoly are good choices. So are crossword puzzles, anagrams, and other word games. Avoid playing the same games all the time. This leads to routine, the opposite of activation. The same cerebral circuits and neuronal regions are constantly used and everything else remains unused. Find new games and interests. Explore activities that are completely new to you and find new partners for old—and new—games and activities.

Verbal Abilities : Or, the precise use of spoken or written words, that make demands on short-term and long-term memory. Listen to the morning news on the radio or TV. During the day, write down the main points of the news that you remember. Do the same in the evening. Whenever you meet someone, try to come up with at least one anagram of his or her name. An anagram rearranges the letters of one word or phrase to make another word or phrase. For instance, an anagram for Clint Eastwood could be Old West Action. Or, when you see a word quickly think of others that begin with the same two letters. Each time you come to the end of a chapter in a book you’re reading, imagine that you must summarise it as briefly as possible, orally or in writing, to someone who has not read it. Do the same for the whole book when you finish it.

Creating the "Mentally Fit" Lifestyle

Le Poncin points out that doing mental exercises are not the end of mental fitness training. She stresses the importance—specially for older people—of overcoming monotony and routine in our daily lives. Monotony generates mental (and emotional) lethargy and resignation. The antidote here is to organise your life in such a way that you become involved and open yourself to others through dialogue, interaction, and confrontation.

Remember, failing memory and sluggish thinking are not inevitable cohorts of ageing. You’ve the ability to maximise your cognitive skills and enhance your older years. So, exercised your brain today?