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Cognitive health

Healthy brain aging:

To help older adults protect
brain health and function,
add activities that ensure a
flow of novelty, variety and

why we need to retool challenge

by Álvaro Fernández, MA, MBA

‘Use it or lose it’ By now you have probably heard about

brain plasticity, the lifelong capacity of
the brain to change and rewire itself in
response to the stimulation of learning
and experience. The latest scientific
research shows that specific lifestyles and
actions can improve the health and level
of functioning of our brains, no matter
our age.

Of particular importance to maintaining

cognitive functioning through life are the
hippocampus (deep inside the brain, part
of what is called the limbic system),
which plays a role in learning and mem-
ory; and the frontal lobes (behind your
forehead), which are key to maintaining
decision-making and autonomy. Is there
a way to physically protect these parts of
the aging brain? Yes. But the right answer
is far from “do one more crossword puz-
zle” or “do more X” (whatever X is). The
key is to add significantly different activi-
ties to ensure a flow of novelty, variety
and challenge, combining physical and
mental exercise while not ignoring factors
such as stress management and balanced

We need, in other words, to retool our

understanding and practice of “Use it or
lose it.” We must focus on the impor-
tance of getting out of our physical and
mental routines and activities to get the
benefits of real exercise—physical and
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Debunking 10 common Facts: Brain age is a fiction. No two indi-

myths viduals have the same brain or expression Resource
The extensive research process we of brain functions.
undertook for our recent book, The The SharpBrains Guide to Brain
SharpBrains Guide to Brain Fitness,1 high- Myth 9. That “brain age” can be reversed Fitness: 18 Interviews with Scientists,
lighted the need to debunk some popular by 10, 20, 30 years.
Practical Advice, and Product Reviews,
myths on brain health that may hinder Facts: Brain training can improve specific
to Keep Your Brain Sharp
efforts in the right direction. These brain functions, but, with research avail-
include: able today, cannot be said to roll back Authors: Álvaro Fernández and
one’s “brain age” by a number of years. Elkhonon Goldberg, PhD
Myth 1. Genes determine the fate of San Francisco CA: SharpBrains Inc.,
our brains. Myth 10. All human brains need the same May 2009
Facts: Lifelong neuroplasticity allows our brain training. Paperback, 182 pages, $24.95
lifestyles and actions to play a meaningful Facts: As in physical fitness, users must
role in how our brains physically evolve, ask themselves: What functions do I need
The SharpBrains Guide to Brain
especially given longer life expectancy. to improve on? In what timeframe? What
is my budget? Fitness is the result of over a year of
Myth 2. Aging means automatic decline. extensive research including more
Facts: There is nothing inherently fixed With these facts in mind, let’s delve into than 100 interviews with scientists,
in the precise trajectory of how brain different types of mental exercise and professionals and consumers, and a
functions evolve as we age. how they benefit the brain. deep literature review. Among the
leading scientists interviewed, Arthur
Myth 3. Medication is the main hope for Exercise requires cross-
Kramer explains the need for walking
cognitive enhancement. training and challenge
book clubs and Yaakov Stern discusses
Facts: Noninvasive interventions can The most common enemies of novelty,
have comparable and more durable variety and challenge are routine and building cognitive reserve. There is an
effects, side effect-free. doing things inside our comfort zones. accessible introduction to the brain
This is true for both physical and mental and brain fitness research combined
Myth 4. We will soon have a magic pill or exercise. with over 100 references to peer-
general solution to solve all our cognitive reviewed scientific studies for deeper
challenges. Consider the type of mental exercise study. The resource also reviews 21
Facts: A multipronged approach is rec- experienced daily by London cab drivers.
products for brain cross-training, tar-
ommended, centered around nutrition, Every new ride requires a complex men-
stress management, and both physical tal task to decide the most efficient route geted mental exercise, and emotional
and mental exercise. to complete the continually novel chal- self-regulation.
lenge at hand. Contrast that with the
Myth 5. There is only one “it” in “Use it or routine mental activity (we couldn’t really
lose it.” call it “mental exercise”) undertaken by
There are four types of mental exercise
Facts: The brain is composed of a num- London bus drivers who, day after day,
with more supporting scientific evidence
ber of specialized units. Our life and follow a precise itinerary. Clearly, if you
that they can enhance specific brain
productivity depend on a variety of lived in London and wanted to protect
functions.1 They are:
brain functions, not just one. and even grow your hippocampus, you
would choose to drive a cab, not a bus.
• Cognitive therapy (CT). The way we
Myth 6. All brain activities or exercises
perceive our experiences influences our
are equal. Of course, the brain has a variety of
behaviors, and we can learn cognitive
Facts: Varied and targeted exercises are structures and functions to maintain,
skills to modify our thinking, resulting
the necessary ingredients in brain train- well beyond the hippocampus, hence the
in actions. CT is commonly used in
ing, so that a wide range of brain func- need for cross-training. Not all mental
the context of anxiety and depression,
tions can be stimulated. exercise is equal in terms of its structural
but its core principles and techniques
and functioning benefits—in the same
show promise in a variety of other
Myth 7. There is only one way to train way that different types of physical fit-
applications such as healthy eating.
your brain. ness training bring different benefits.
• Meditation. This practice has been
Facts: Brain functions can be impacted in Mental exercise strengthens the synapses
shown to improve specific cognitive
a number of ways, such as meditation, or connections between neurons (nerve
functions such as attention and emo-
cognitive therapy and cognitive training. cells), thus improving neuron survival
tional self-regulation.
and cognitive functioning. Remember
Myth 8. We all have something called that “cells that fire together wire
“brain age.” together.” Continued on page 42

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heart beating has been shown to have

Healthy brain aging: why we need the greatest effect.
• Overall mental stimulation.
to retool ‘Use it or lose it’ Continued from page 41 Cumulated mental stimulation
throughout our lives (via education,
jobs, leisure activities) can help build
• Biofeedback. A growing number of Brain-friendly living a neuroprotective cognitive reserve
relatively inexpensive devices can Forget a magic pill. Healthy brain aging that can help delay the onset of
measure and graphically display vari- requires a brain-friendly lifestyle, in addi- Alzheimer’s-related symptoms.
ous physiological variables such as tion to mental cross-training. This life-
heart rate variability, so that users can style should at least include:1 Healthy, active living—with a focus on
learn to self-adjust and identify and good health in all the dimensions of
manage emotions better. • Balanced nutrition. As a general wellness—is the kind of brain-friendly
• Brain Fitness Software. These fully guideline, what is good for the body lifestyle that can help protect cognitive
automated applications are designed and heart is also good for the brain. function across the life span.
to assess and enhance specific cogni- Gingko biloba and other supplements
tive abilities. This is the area that has do not seem to bring the benefits peo- Implications for active-aging
exploded since 2007—and where we ple expect. professionals
observe the most confusion since dif- • Stress management. Chronic stress Active aging is one of the areas where
ferent packages tend to target different reduces and can even inhibit neuroge- this type of brain research can make a
functions (e.g., working memory, nesis (the creation of new neurons) profound difference in years to come.
auditory processing, divided attention) and affects memory and other brain While much more research needs to be
in ways that are not transparent or functions. It is then important to done to identify the right type of cogni-
understood by users. learn how to manage stress. tive exercise to improve the daily func-
• Physical exercise. Physical exercise tioning of any given individual, it is
Yet, even mental cross-training isn’t improves cognitive functioning beyond reasonable doubt that novelty,
enough on its own. What else is needed through increased blood supply and variety and challenge contribute to
to maintain the complex system of the growth hormone levels in the brain. healthy brain aging better than common
brain? Of all the types of physical exercise, alternatives (more passive or repetitive
cardiovascular exercise that gets the pastimes).

SharpBrains’ checklist for providers evaluating brain fitness programs

1. Target users: Who among your published, peer-reviewed scientific program? Does it require an
clients is ready and willing to do the papers? Internet connection? Who will
program? How are they reacting to help solve potential glitches?
the pilot testing of the activities? 5. Return on investment: What are
your key objectives, and how will you 8. Staff training: What type of train-
2. Cognitive benefits: What are the independently measure the progress ing will you and your staff need,
specific benefits claimed for using due to this program to expand, main- and who will provide it?
each program? Under what scenario tain or change course?
of use (how many hours/week, how 9. References: What similar organiza-
many weeks)? What specific cogni- 6. Total cost of ownership: What may tions have used this specific pro-
tive skill(s) does the program train? be the total cost of ownership over gram? What proportion of their
How will you measure progress? the next three to five years if you go clients use it regularly? What bene-
with different vendors: upfront fees, fits have they measured and ob-
3. Appropriate challenge: Do the exer- ongoing fees, hardware, software, served in their clients, and as an
cises adjust to the individual and training and support fees, cost of organization? Is the use of the pro-
continually vary and challenge resi- additional modules and staff time? gram growing, or is it flat or
dents at an appropriate pace? How many clients will likely end up declining?
using the system, and therefore what
4. Scientific credentials: Are there sci- is the cost of ownership per user? 10. Product road map: What is the
entists, ideally neuropsychologists, product roadmap for this compa-
behind the program? Is there a 7. Technical requirements: What are ny? What is the company develop-
clearly defined and credible scien- the technical requirements needed to ing and planning to offer next year,
tific advisory board? Are there successfully deploy and maintain the and in two to three years?

42 The Journal on Active Aging  July/August 2009

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Active-aging organizations can easily pro- How can you navigate this landscape? No Can you, the ambassadors of active aging
vide quality information for staff and program available today currently offers a and brain fitness, incorporate novelty,
clients and create a library of programs dream combination of ideal characteris- variety and challenge into your work set-
and activities to assist each person in tics, so you need to take into account tings, and help reshape and retool “Use it
finding an appropriate program—not your specific circumstances, priorities or lose it” for your clients?
necessarily with budget implications. and budget. That’s why we suggest you
Depending on the setting, older adults, launch a pilot and measure results in Álvaro Fernández, MA, MBA, recently
or their families, can buy the programs objective, independent ways before coauthored The SharpBrains Guide to
based on the available information and embarking on major rollouts. As you pre- Brain Fitness: 18 Interviews with
firsthand testing. pare your business case, try using the Scientists, Practical Advice, and Product
SharpBrains checklist on page 42 to Reviews, to Keep Your Brain Sharp, with
Finding the right mix between structure, select and introduce a new toolkit for neuropsychologist Elkhonon Goldberg, PhD.
science and fun involves trying options. cognitive exercise. Fernández is the CEO of SharpBrains Inc.,
There is no panacea, or program that and a member of the World Economic
works best for everyone. Some people Ready for the future? Forum’s Global Agenda Council on the
prefer “fun games,” while others prefer Based on our market research work, we Aging Society. For more information about
more structured sessions or a more sci- see clear signs of a growing “Culture of SharpBrains, visit
ence-based approach. Brain Fitness,” with a better integration
of physical and mental exercise and even Reference
Some options for mental exercise require mainstream awareness and broad initia-
purchasing a device. Others require tives. Better tools to assess cognitive 1. Fernández, A., & Goldberg, E. (2009). The
installing software in PCs in existing or functions and to improve brain functions SharpBrains Guide to Brain Fitness: 18 Interviews
with Scientists, Practical Advice, and Product
new computer labs, or are fully available are underway. And more actors will take Reviews, to Keep Your Brain Sharp. San Francisco
online. And still others may be technolo- brain fitness into consideration—think of CA: SharpBrains Inc.
gy-free, promising engaging combina- physicians, psychologists, insurance com-
tions of interactive, group-based activities panies, on top of residential communities
with pen-and-paper exercises. and seniors centers.

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Barry Larson
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The Journal on Active Aging  July/August 2009 43

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