Although this article by Anne Underwood from the New York Times is not specifically related to chemo-brain, it is a good discussion of the memory issues that worry many of us.
JUNE 11, 2009, 11:36 AM
Can Memory Loss Be Prevented?
By ANNE UNDERWOOD
Brandon Thibodeaux for The New York Times Bob Branham, 78, at home with some of his quilting projects. He participates in a study designed to see whether acquiring new skills can preserve cognitive function. At the age of 78, Bob Branham, a retired computer software developer in Dallas, Tex., took up quilting. It wasn't his idea, actually. He'd never dreamed of piecing together his own Amish diamond coverlet or rummaging around Jo-Ann Fabrics in search of calico prints. But then he enrolled in a trial sponsored by the National Institute on Aging to assess whether learning a new skill can help preserve cognitive function in old age. By random assignment, he landed in the quilting group.
When it comes to mental agility, we're more likely to think of crosswords than cross-stitch. But neuroscientists suspect that learning a challenging new skill — a new language, a new musical instrument — may be even more effective than mental games at keeping the brain sharp. And quilting is more complicated than it may seem.
"It's a very abstract task," said Dr. Denise Park, a cognitive neuroscientist at the University of Texas at Dallas, who is leading the trial. "You have to picture what the pattern will look like, match fabrics, manipulate geometric forms, mentally rotate objects." In Mr. Branham's case, he also had to learn to use a sewing machine. And while it's too early to tell if quilting is sharpening his mind, he quickly found that he loved his new pastime. He spends as much as 40 hours a week piecing and stitching, both at home and at the social center that Dr. Park set up for the trial. "I get ideas and pointers from the instructor and the other participants," he said. "We have a real good time."
Memory is among the least understood areas of neuroscience, and the sad truth is that there is no magic pill or potion at present that will prevent our parents' minds from failing. But a panel of 30 experts from the United States and Europe recently issued a consensus statement on what we do know about maintaining brain fitness (which includes not only memory, but also reasoning, attention and speed of processing). The verdict was that three things are crucial: physical exercise, mental challenges and good health habits in general.
But wait! What about the supplements and software programs we've been stocking up on?
"There's a lot of snake oil out there," warned Dr. Laura Carstensen, director of the Center on Longevity at Stanford University, who co-chaired the panel. In short, don't count on supplements. (The rationale behind ginkgo biloba is plausible, but there is no scientific supplements. (The rationale behind ginkgo biloba is plausible, but there is no scientific evidence it works.) Steer clear of anything that promises to prevent Alzheimer's disease. (Such a claim would require approval from the Food and Drug Administration, and no product has it.) And look skeptically on software programs. (Most improve performance only on the games themselves, not mental function in general.)
Instead, Dr. Carstensen said, get moving. Exercise may sound like an impractical way to boost Mom's cognition when her energy levels are dwindling. But multiple studies show it helps. In a study published in the Archives of Internal Medicine in 2001, women ages 65 and older who walked the most showed the least cognitive decline over an eight-year period — up to 30 percent less than their sedentary counterparts.
Another trial in the journal Nature by Dr. Arthur Kramer, a neuroscientist at the University of Illinois at Urbana-Champaign, found not just slower declines but actual improvements in working memory, attention and executive skills in older adults (average age 72) after six months of an aerobic exercise program — specifically, 45 minutes to an hour of walking, three times a week.
How could aerobic exercise possibly accomplish this? Among other things, it increases blood flow, encourages the formation of new synapses and reverses some of the age-related decline in brain volume. "If exercise were a pill, it would be the most expensive drug on the market," said
Dr. Carstensen. Other good habits are important, too. As neuroscientists like to say, what's good for the heart is good for the brain. That would include maintaining healthy blood sugar and blood pressure
levels. A study last December in the Annals of Neurology showed that controlling blood sugar, even in non-diabetic adults, can help prevent deterioration in a part of the brain that's necessary for memory formation. Another paper published in the Archives of Neurology in
February by scientists at Columbia University found that eating a heart-healthy Mediterranean diet — rich in fish, vegetables, whole grains, fruits, legumes and unsaturated fats — lowered the risk of mild cognitive impairment over four and a half years by as much as 28 percent.
But even if Mom follows all the advice she herself used to propound — eat your vegetables, go outside and exercise — there is no substitute for mental challenges. The brain is a use-it-orlose- it type of organ. Synaptic connections that aren't firing will weaken.
The problem with most of our favorite approaches to staying sharp is that they are narrowly focused when what's needed is global improvement. Crosswords are great for word retrieval. That's clearly important. But not even The Times's Sunday puzzle by Will Shortz will help you remember where you left your car keys. "If you want lots of improvement, you have to do mental cross-training," said Dr. K. Warner Schaie, a professor of psychology at Pennsylvania State University.
In short, engage in many types of mental activity. Do crosswords, Sudoku, acrostics, play bridge, read books, join clubs, get into debates, volunteer — anything to keep the mind alive , bridge, read books, join clubs, get into debates, volunteer — anything to keep the mind alive and engaged in new and interesting tasks. If the activity includes social interaction, so much the better. Or take up a new hobby, a new language or a new instrument that will challenge the brain in entirely different ways, preferably for years. "One problem with aging is that you develop expertise in a few things and do them over and over," said Dr. Carstensen. "Proficiency is good, but it's probably not growing new synapses."
Mr. Branham, on the other hand, seems to be sprouting plenty of neural connections. He's now completed two full-sized quilts — one a sampler with various patterns, the other a split rail design with stars in the four corners. He'd even like to launch a small business selling his patchwork place mats and table runners. When friends at church ask him why he signed up for such a study, and why on earth he agreed to start quilting, he has a ready answer. "Studies need participants," he says. "And you should sign up, too."