The new issue of the American Medical Association’s *American Medical
News* includes an article: “Steps to a nimble mind: Physical and mental
exercise help keep the brain fit; Neuroscience is uncovering techniques
to prevent cognitive decline” by Kathleen Phalen Tomaselli.

Some key points: life-long learning, trying new things, a healthy diet, social interactions, sleep and physical activity keep the brain fit

Here are some excerpts:

[begin excerpts]

The brain — containing 100 billion neurons, 900 billion glial cells,
100 trillion branches and 1,000 trillion receptors — reacts to stimuli
in a series of electrical bursts, spanning a complex map of
connections. Whether calculating an algorithmic equation or learning
the tango, our brain continuously changes in response to our ideas,
actions and activities.

Each time a dance step is learned, for instance, new pathways are
formed. “Dancing is excellent for the brain and body,” says Vincent
Fortanasce, MD, clinical professor of neurology at the University of
Southern California in Los Angeles. He wrote the Anti-Alzheimer’s
Prescription. “Not only are you moving around more, your brain is in
constant motion as it recalls steps and movements.”

It’s an example that highlights a wave of new thinking about the
importance of brain fitness.

Until recently, conventional wisdom held that our brains were
intractable, hard-wired computers. What we were born with was all we
got. Age wore down memory and the ability to understand, and few
interventions could reverse this process.

But increasingly, evidence suggests that physical and mental exercise
can alter specific brain regions, making radical improvements in
cognitive function. “When you challenge the brain with new skills and
new ways of doing things, it increases connections in the brain,” says
Ericka P. Simpson, MD, a neurologist who co-directs the MDA
Neuromuscular Clinics and directs the ALS clinical research division at
the Methodist Hospital System Neurological Institute in Houston. “It
increases synaptic density.”


Within the brain, the pathways and regions that are most utilized
generally grow and become stronger while other parts shrink. “The brain
is very Darwinian, it’s survival of the fittest,” says Edward Taub, PhD,
a behavioral neuroscientist at the University of Alabama at Birmingham,
who has researched neuroplasticity since the 1970s. “At one time it was
believed we did not use 90% of our brain. That is false. The brain is
a zero sum game. Every part of the brain is used. It has enormous

Thus, by challenging the brain and forcing the use of different
pathways, brain maps can be altered. And such changes offer young and
old — even brain-injured individuals — an opportunity to learn or re-
learn things. “Vocabulary can increase into age 90,” says Gary J.
Kennedy, MD, a professor in the Dept. of Psychiatry and Behavioral
Sciences at Albert Einstein College of Medicine. He also directs the
geriatric psychiatry division at Montefiore Medical Center in the Bronx,
N.Y. “As people age they may be slower, but they are capable of more
and more complex projects.”

Brain volume shrinks up to 1% every year after age 65.

To best illustrate neuroplasticity, consider stroke patients with
damaged limbs. Contrary to traditional therapy, which works to
strengthen the good limb, Taub restrains the uncompromised limb, forcing
patients to use the damaged arm or leg.

The therapy, constraint-induced movement therapy, also known as CI
therapy, helps to rewire the brain.

“The more you use it, more neurons are available … the more demand
for cortical space and the more the patient is able to use the [damaged]
arm,” Taub said. Over time, small steps lead to improvements in
activities of daily living. Ultimately, the damaged limb, at least in
part, recovers because, although the brain does not regrow damaged
areas, it re-routes around them.

When the brains of CI patients were examined, a tremendous increase in
grey matter was detected, and interestingly, Taub says, the healthy part
of the brain was recruited for the task.


Mental agility begins declining around age 24, says Dr. Fortanasce. But
there is a big difference between agility and capacity. “I may be
slower, but what I know now far outweighs what I knew at 24,” he says.
“Some individuals perform their greatest creative work in late life.
Verdi, for example, composed Othello at 73 and Falstaff at 79.”

Greg Jicha, MD, PhD, assistant professor of neurology at the University
of Kentucky College of Medicine, shares related stories, such as that of
an 82-year-old who learned to play the trumpet. “I’ve heard people say,
‘You can’t teach an old dog new tricks.’ That can’t be further from the
truth,” says Dr. Jicha, who also heads the healthy brain aging research
group at the university’s Sanders-Brown Center on Aging. “When you look
at the plasticity of the adult brain, it is amazing.”

But age also brings anatomic changes. Brain weight and blood flow to the
brain decrease by 20%. The number of fibers and nerves decrease by
37%. And brain volume shrinks up to 1% every year after age 65. Dr.
Fortanasce also points to hormonal shifts, with the presence of dopamine
and serotonin diminishing as cortisol, an aging hormone, increases.
“Between age 20 and 70, we lose nearly 90% of youth hormones.”

So what keeps some brains younger than their chronology? Experts point
to a prescription of neurobics. This concept includes life-long
learning, trying new things, a healthy diet, social interactions, sleep
and physical activity. “Exercise can actually increase neurogenesis and
increase the size of the hippocampus,” says Dr. Fortanasce, who promotes
isometrics and weight-bearing exercise. “Exercise also increases youth
hormones. And novelty, doing new things, builds branches.”


Dr. Locatelli suggests reversing daily patterns. People who take the
same route to work every day need to push themselves beyond their
comfort zones. A person can try to eat using his or her weaker hand, for
instance. Or someone could listen to another type of music than the type
usually favored. Activate unfamiliar areas of the brain, Dr. Locatelli
says. The key is new places, socializing with different people, and
reading new things.


So what about dance steps? At McGill University in Montreal,
researchers found that the tango may be better than walking for
improving execution of complex tasks because it incorporates elements
found in standard neurological rehabilitation programs. It’s also fun
and social.

Participants, ages 62 to 90, were randomly assigned to a walking group
or a tango dancing group, meeting two hours twice a week for 10 weeks.
The tango group improved in balance, posture and motor coordination, as
well as cognition.

Physical and mental exercise improve cognitive function.

According to new research published in the October issue of the journal
Nature Neuroscience, University College London scientists say complex
brain processes that enable the memorization and replication of
activities such as playing the piano or riding a bicycle require the
execution of complicated sequences of movements involving dozens of
muscles. According to their research, pianists who learned and
practiced their art from an early age had elevated amounts of myelin.
This finding suggests that when people learn new skills, myelination
might occur. Earlier studies indicated that brains of patients
diagnosed with senile dementia had lowered amounts of myelin.

The emphasis, though, is the importance of embracing the complex and
novel. And Joe Hardy, PhD, a cognition neuroscientist who develops
brain plasticity training programs, says some common-sense advice from
physicians is not based on good evidence. “They often recommend doing
crossword puzzles,” he says. “But evidence suggests that crossword
puzzles are not helpful.”

Hardy has been developing brain games for the San Francisco-based
company Posit Science. The games — the Brain Fitness Program and
Insight — have been tested in several randomized clinical trials funded
by the National Institutes of Health. The results indicate that the
brain age clock can roll back 10 years. “The key thing in terms of
exercise for the brain: You need to do new things, thus forming new
paths,” he says.

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The article is online — but requires a subscription — at: