Good Medicine - February 2010

By Su Byron February 1, 2010


Mental Gymnastics

You’re mingling at a party, having a good time. Behind you, you hear someone calling your name. You turn to look. A stranger walks up to you and enthusiastically greets you. “Hi! It’s great to see you!” You nod and smile. “Yeah, uh. It’s great to see you, too.”

Who are you talking to? You don’t have a clue.

Some of us have minds like steel traps. But as time marches on, many of us seem to develop steel sieves between our ears. But relax—there’s never been a better time to be an airhead.

Here’s why. Millions of baby boomers are on the downhill side of 50. They’re worried about their teeth, their hair, their hearts, their prostates, their sex lives—and their brains. Yes, in addition to battling gingivitis, boomers want to fight memory loss and dementia. American capitalism has happily responded to this need.

Google “brain training,” and you’ll see what we mean. The Internet is now stuffed with “brain gyms” to pump up our powers of memory and concentration. You can also stuff your Wii, iPod, iPhone or Blackberry with brain-training programs and games. Gadgets are great and software is swell. In the meantime, make a mental note about all that and we’ll get back to it. For now, let’s start with do-it-yourself training. Low-tech and gizmo-free.

A sound mind in a sound body

Nicci Kobritz, R.N., N.P, is the president of Sarasota’s Youthful Aging Home Health—the, er, brains behind the operation. Her organization develops programs that are designed to slow the loss of physical mobility and memory dexterity in seniors. Although her business focuses on the elderly, Kobritz stresses that brain training is for people of all ages.

“If you want to train your brain, start with the body,” says Kobritz. Mens sana in corpore sano, as Caesar used to say? No. According to Kobritz, the Romans didn’t quite get it right. “You can’t have a sound mind without a sound body,” she says. “Mind and body are one. You can’t separate the two.”

In other words, Descartes also had it wrong. You’re not a ghost in a machine. You can’t have a sound mind in a sick body. It’s physically impossible.

According to Kobritz, if you want to keep your brain in shape, keep your body in shape. This translates to a short list of requirements that we’ve heard ad nauseam. Still, just for the heck of it, let’s review that list again: Get a good night’s sleep. (Why? Because the mind processes memory during sleep.) Keep your stress levels down. (Excess stress leads to high cortisol levels—nature’s own fight-or-flight chemical. In layman’s terms, cortisol fries the brain.) Exercise daily. (Aerobic is best.) Eat a variety of fruits and vegetables (five to seven servings a day), drink a little red wine, but don’t overdo it. “The Mediterranean diet is great,” says Kobritz. “And don’t smoke—that’s a no-brainer.”

Get out of your comfort zone

OK, let’s say you’re in good physical health. If you got this far, it gets harder. To quote a first century brain-trainer, “You must be as a little child.”

That sounds nice, but it’s exhausting. Children are curious. They ask why, constantly. Most adults learn not to be curious. We narrow our minds down to a small set of ideas; we stick with what we know, avoid the unknown, and, consequently, get stuck in a rut. We drive to work the same way, we order the same thing at restaurants. We don’t have to think about a lot of things we do—and that’s not good for our brains.

According to Kobritz, “If you want to train your brain, do something you’re not good at. Learn a foreign language. If you’re good at crossword puzzles, do chess problems. Every new form of physical activity is also a mental challenge. Kayaking, dancing—these are all great, if they’re something you’ve never tried before.”

Simply put: Put yourself in foreign territory. Take the long way home.

Now let’s talk technology.

Tech toys

CogniFit’s MindFit is a plug-and-play CD. It starts by putting you to the test, which takes about 45 minutes. Using the test results, the program creates a baseline assessment of your 14 key cognitive abilities. Based on that, the program develops a training plan of brain fitness exercises tailored to you. Don’t think SAT multiple answer questions. It’s fun stuff—games, tasks and exercises that give your brain a real workout.

Brain Age, a system for the Nintendo or Nintendo DS, offers a variety of puzzles, including Stroop tests (a reaction time test involving a clash between colors and color names), mathematical questions and Sudoku puzzles.

BBC’s “Bang Goes the Theory” is currently running a Brain Test Britain experiment. The online program offers six weeks of brain training 10 minutes a day three times a week. It’s free!

These programs (and a host of others) all tap into the booming boomer market. But as Korbritz points out, brain training is for all ages. “Good habits of mind are not age-dependent. I’d say the opposite is true. The sooner you acquire these habits, the better,” she says.

Brain training technology works for any age. NASA researchers are even using biofeedback to train teen-agers with ADHD to focus their brains. The technique (originally developed for pilot training) uses off-the-shelf video games. One example is the Gran Turismo race track simulation. Teens play the game while wired up to EEG sensors. When a player’s brain produces high-frequency beta waves (indicating concentration), their car speeds up. If the brain produces theta waves (a sign of a distracted state), it slows down. To compete in the race, the teens learn to stay alert.

Don’t be surprised if this cutting-edge product hits the shelves before next Christmas. Good thing. Whether you’re 17 or 35, it’s never too early to learn good mental habits.

That being said, after the age of 50, it’s more than a good idea. It’s a survival skill.

Teaching old dogs new tricks

Dr. Bruce Robinson is Sarasota Memorial Hospital’s chief of geriatrics and heads up the hospital’s Memory Disorder Clinic. His approach is scientific and allows zero room for sentimentality and wishful thinking. The blunt truth?

“Evolution didn’t design humans to live as long as we do,” he says. “Aging contributes to continuous loss of neuropsychological function. The longer we live, the more cognitive problems we have. Some people keep up excellent cognitive function until very late in life. But the odds of losing brain function over time are good for most people.”

To improve those odds, science needs to understand what makes a few people different. “The truth is we don’t know—at least not yet. We don’t fully grasp the causes of memory and cognitive loss,” Robinson says.

He compares today’s understanding of dementia and Alzheimer’s disease with the notion of “consumption” in 1900. “Consumption was really a catch-all term for a host of respiratory diseases—tuberculosis, emphysema and others,” he explains. “Medical science of the day lacked the diagnostic tools to tell those diseases apart. I suspect the same is true of Alzheimer’s. It’s really many different conditions. Our knowledge of the brain, and our ability to monitor it, is too primitive to truly understand what we’re looking at.”

So there’s nothing we can do? Far from it. First, Robinson agrees that the elderly should stay active and watch their diets. According to Robinson, as we age, we become less active and burn fewer calories. Meals shrink, but the need for vitamins and micronutrients remains constant for both body and brain. “The elderly need to compensate with supplements,” he says. “It’s really a question of monitoring one’s diet more closely.”

Eat right, in other words. And don’t forget to think.

“In general, mental stimulation preserves brain function. The principle of ‘use it or lose it’ holds true,” Robinson says. He gives the example of a lifetime study of a group of nuns. “The essays they wrote when they first entered the nunnery proved to be predictive,” says Robinson. “The nuns with the richest minds—the ones whose essays showed the greatest idea density—were the ones who resisted dementia. The more you think, the more deeply you think, the better the chances your mind will be preserved.”

Not coincidentally, that’s one of the basic ideas behind Youthful Aging.

“The standard home health care concept is having a caregiver do things the client can’t do for him or herself,” says Kobritz. “We strive to get our clients to do as much on their own as they can.”

To keep her clients mentally independent, Kobritz follows her own good advice. Youthful Aging encourages Scrabble, card games and chess and is also a big backer of MindFit, Brain Age and other programs. Kobritz has also been an innovator.

“You can’t forget the social dimension,” she says. “We created a series of Jeopardy-style games in which our clients compete with each other answering questions in history, spelling and other categories. They never know where the next question is coming from—and they’re often surprised and delighted at how much they do know!”

The new program has worked so well Kobritz hopes to extend it. Youthful Aging clients have entered quiz show competition with clients from other elder care facilities.

“There’s a 98-year-old woman I know who rigorously does her memory exercises every morning,” Kobritz says. “She’s looking forward to the next competition and she really wants to win.”

Across the nation and the world, scientists are fighting against Alzheimer’s and other forms of memory and cognitive loss. One day, they may come up with a magic pill to make brains as good as new, but don’t count on it. Instead, says Kobritz, “Give your brain a workout every day—and the sooner you start the better. The exercises are actually fun. Your brain knows what’s good for you.”

Hey, and the next time you see that person at the party? You’ll feel great when you remember their name. z


Youthful Aging Home Health Care, 7220 Beneva Road, Sarasota; (941) 925-9532;

Sarasota Memorial Hospital’s Memory Clinic, at the Institute for Advanced Medicine, 5880 Rand Blvd., Suite 205, Sarasota; (941) 917-7197;

CogniFit’s MindFit:

Brain Age:

BBC’s “Bang Goes the Theory:

Fifty Ways to Boost Your Noodle:

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