BRAIN HEALTH BLOG

I read with some interest a recent article in The Wall Street Journal Tuesday, November 3, 2009 about caregivers of spouses with Alzheimer’s Disease (AD) who find new companions for love. The article questioned whether such behavior could be considered adultery?

We have nearly 5 million Americans with AD and at least that many at risk. The number of those with AD will likely continue to grow to as many as 15 million by 2050. A recent survey reported there will be nearly 35 million with AD across the planet. Many of those suffering AD are married and the healthy spouse can serve the role of caregiver for many years, including a significant amount of time when their spouse with AD no longer recognizes them. The role of caregiver is difficult and ripe with emotional, physical, and financial stress. The article in the Wall Street Journal raises another stressor which is the idea that the healthy spouse may be without intimacy, love, and companionship for many years.

It is nearly impossible to understand how emotionally difficult it must be to care for a spouse with AD. Some describe AD as two deaths, one when you are told about the diagnosis and the second with the actual physical death of your loved one. Along the course of AD, a spouse will no longer recognize his or her partner. A healthy spouse who provides care to their partner with AD is vulnerable to loneliness, depression, and ongoing loss. How does one cope with loss of the emotional connection or loss of love in the traditional sense when your spouse is physically still present?

The Journal article raises many thoughts and ideas that do not have easy answers. I think it points out that we need to support even more our caregivers who dedicate so much of their time to their spouses with AD.

I often am asked what one thing is most important for brain health promotion. I cannot answer this question because I do not believe there is such a thing. The human brain requires a comprehensive and integrated approach to health which is why I have developed my five part brain health lifestyle (see www.paulnussbaum.com).

I do believe that eating one meal a day with family members or even friends and those you may not know very well (be safe first) can be a major brain health activity. Sitting down to a meal helps you to slow down, you can listen to some music in the background, and tell stories over your meal. You can also use utensils that typically means you will eat healthier and eat less than when you eat with your fingers. These are several brain health boosts with one activity.

It is good to learn from Rasmussen Surveys that 65% of those surveyed by telephone eat with their family twice weekly. 38% eat a meal three times a week with their family and 27% report eating between two and three times weekly with their family. Only 22% do not eat with their family during the week.

I encourage everyone to carve out the special time necessary to sit down and eat a meal with your loved ones on a daily basis. Your brain and body will thank you.

A recent article in US News discussed the brain health of all 50 states and the District of Columbia in the United States. An index that was comprised of diet (36%), physical health (25%), mental health (24%), and social well being (15%) was used to compare the states. Data was gathered from the Centers for Disease Control and Prevention, the National Institute of Health, and the Bureau of Labor Statistics.

Results from the study revealed the following top ten brainiest cities:

1.    Washington DC
2.    Maryland
3.    Washington State
4.    Vermont
5.    Connecticut
6.    Colorado
7.    Massachusetts
8.    New Jersey
9.    Maine
10.  New Hampshire

It is important to be proactive in your brain health lifestyle. Dr. Nussbaum (www.paulnussbaum.com), Chief Scientific Officer for Fitbrains, Inc. underscores the importance of a brain health lifestyle that includes socialization, nutrition, physical activity, mental stimulation, and spirituality.

A recent study demonstrates daily surfing of the internet activates the brain of older persons. This is another example of how the environment in many forms can shape the brain and illustrates the power of neural plasticity.

24 neurologically healthy adults, aged 55 to 78, surfed the internet while their brains were being scanned by an MRI machine. Prior to the study, half the participants had used the internet daily while the other half had minimal experience. After the initial MRI scan, the participants were instructed to do internet searches for an hour a day for seven days in the next two weeks. Then they returned to the clinic for another MRI.

At baseline, those who had internet experience had much greater brain activation relative to those without internet experience. However, those who practiced on the internet during the study demonstrated significant activation in their brain to the point that they were nearly equal to the brains of the experienced internet users.

The idea of “use it or lose it” can really be taken a step further and the idea is to “use it in new ways” and novelty and complexity really is the foundation to brain health.

A recent study supported by the National Football League indicates that Alzheimer’s Disease (AD) or related conditions involving memory deficits appear to occur more frequently in the league’s former players significantly more than the general population. Indeed, the study indicates former players suffer dementia 19 times more often than the normal rate for men ages 30-49.

The study conducted by the University of Michigan’s Institute for Social Research is consistent with previous studies pertaining to NFL players and the effects of head injury. The study found that 6.1% of players age 50 and above reported that they had received a dementia-related diagnosis or 5x higher than the cited national average which is 1.2 %. Players ages 30 through 49 evinced a rate of 1.9% or 19 times that of the national average which is documented to be .01%.

Critics of the study question its methodology that reportedly used telephone surveys. However, research beyond the NFL consistently lists head injury as a risk factor for AD even though the exact mechanism for this relationship is not yet known.

Perhaps a more significant issue that the NFL/Dementia study underscores is the cumulative effect of head injury which likely begins with the sport of football well before any single player enters the NFL. Fortunately there are now sophisticated assessment protocols that provide each player in high school the opportunity to have his or her cognitive skills measured, thereby providing a baseline of their cognitive status. In the event a concussion occurs the player can obtain another assessment to measure the impact of the head injury that helps to keep the player off the field until his or her cognitive status returns to baseline.

It is most likely not a good idea to engage in any activity that has persistent striking of the head to any degree. Head injuries occur in football, hockey, and perhaps even soccer. The fact that the latter sport does not permit use of head bands or some type of head gear is amazing! The current study should alert the nation to re-consider youth sports as the cumulative effect of striking the head across the lifespan most likely contributes to the results reported. Equally significant is the idea that any child would be exposed to a potential head injury when his or her brain is undergoing critical development.

Mind training and meditation is now being used by some parts of the military. The mind body connection is now being recognized by military leaders to teach soldiers how to build confidence, set goals and channel their energy to a higher focus. The benefits of such training include better aim on the shooting range, higher test scores, enhanced ability to handle combat stress and to adjust back to civilian life. In fact nearly 70% of a small sample of soldiers who completed the training reported they felt better able to handle stressful situations and 66% had improved self control.

Neural energies is a term I use to describe the brain’s ability to modify or control internal workings of the body and external experiences. The mind training is but a first step to more advanced neural energy utilization that we will witness in the near future.

Many people sleep six or fewer hours a day, but they don’t come by it naturally. They rely on caffeinated drinks and alarm clocks to keep them going.

But about 5 percent of the population are considered naturally short sleepers — meaning they go to bed at a normal hour and wake up alert and energized in the wee hours of the morning, sleeping about two hours less a night than the average person. Finding out what makes short sleepers tick and why they need so much less sleep than the rest of us could unlock answers about insomnia and other sleep problems.

In a landmark study, University of California-San Francisco researchers have identified a gene mutation associated with less sleep, a finding considered to be a major breakthrough in sleep science. To learn more, read the full story, “Mutation Tied to Need for Less Sleep Is Discovered”.

Sleep and Brain Health

Let me begin this blog with “I do not know” whether cell phone used causes brain cancer in the form of tumors or not. However, not knowing something means you do not know and hence caution is most likely in order, particularly when cancer is the point of discussion.

Let me try to ease the confusion and suggest some lifestyle steps to avoid unnecessary risk if it is present. A primary malignant brain tumor is one in which the cancer originates in the brain itself rather than traveling to the brain from another region of the body (metastases). There are over 20,000 new cases of primary brain malignancies each year. A specific form of brain tumor known as the glioblastoma multiforme has increased 30 to 70 percent from one decade to the next in some metropolitan areas of the United States. It is believed that ten times the number of metastatic brain tumors will also occur in the same time period.

Risks for cancer include pesticides, air pollution, chemicals found in meats, power lines, and plastics. Xrays are also on the list of risk factors including the microwave type radiation emitted from cell phones. This is why cell phone companies suggest we hold the phones away from out ear when using it.  Further, there have been several studies indicating a relationship (not cause and effect) between cell phone use and risk of brain cancer, increased risk of acoustic neuroma, and glioblastomas. It is important to note that other studies that have not found any relationship between cell phone use and increased risk for brain cancer. We will most likely learn more about this relationship as we have more time to study the use and effects of cell phone use on a larger number of people over a greater period of time.

As cell phone use is a lifestyle issue, what can be done at this point? There certainly has been an increase in the number of users and the amount of time each user spends on their cell phone. Some homes do not even have land lines anymore. Children are using cell phones at unprecedented rates as well. Dr. Black, renowned neurosurgeon suggests that parents try to curtail cell phone usage in their children. Even adults are encouraged to use an earpiece (not a blue tooth) to avoid direct contact between the phone and the ear.

I have started to use an earpiece myself.

Are there different regions of the brain that create a liberal, moderate, or conservative way of thinking? Are these particular and other types of political ideologies learned from our parents? The answer is probably both.

Like any other belief system we are most likely the product of genetics and environmental shaping. That shaping can take many years and it is okay to have a different political leaning at one age versus another. The critical thing is to understand your own belief system and values and act consistently with them. You may find that your values change over time based on experience and that is also okay.

Far too often people will get into strong verbal disputes about politics and it tends to be about one’s belief about how terrible this guy is or how great that lady is. In fact, most of us do not know our political leaders and it is also probably true that most leaders are decent people. What we really need to discuss in civil ways are our beliefs and why we think such beliefs can advance something good. It is okay to disagree. When it gets personal the conversation has moved from the beliefs.

As neural plasticity involves a type of shaping of the brain for thought, emotion, and behavior we can be fairly sure that our political philosophy has a place within the cortex that is dynamic and probably attached to emotional centers. When we connect the philosophy with reason and communication skill we have developed a real talent. When we remain at the emotional level and try to articulate our beliefs we might get a bit personal.

Stick to your own values and what you believe regardless of any leader. These are your beliefs and that is a good thing

Baby boomers can hardly believe it themselves. In 11 short years - by 2020 - they will hold that unthinkable collective title of “the older generation.”

Just as that milestone looms large, so do statistical realities. According to the U.S. Census Bureau, in 2020 almost 20 percent of the U.S. population will be over 65; over 12 million people will be over 85; more than 500,000 Americans will be over 100 - the fastest growing age group of all!

How fast can you say “geriatrics”? The field is exploding by necessity. And providers are realizing the best way to tame projected healthcare needs is by taking preventive, proactive measures - now.

One area rife with possibility is brain fitness.

Yet baby boomers live in fear of Alzheimer’s disease and its accompanying dementia, rating it second only to cancer as their most dreaded medical diagnosis.

There is good news: there’s plenty that can be done to prevent cognitive loss by keeping the brain enriched. Clearly, nurses need to be on the cutting edge of awareness to help aging patients and families stay on the healthy aging highway.

Paul Nussbaum, PhD, associate adjunct professor, department of neurological surgery at the University of Pittsburgh School of Medicine in Pennsylvania has been lecturing across the country in an effort to educate healthcare providers, senior specialists and John Q. Public of the necessity for brain fitness.

The Promise of Brain Fitnes with Dr. Paul Nussbaum