Sunday, January 27, 2008

Brain Fitness Delays Alzheimers


ref: SharpBrains Nov 2007

MYTH 1: It’s all in our genes
Reality: A big component of our lifelong brain health and development depends on what we do with our brains. Our own actions, not only our genes, influence our lives to a large extent.
“Individuals who lead mentally stimulating lives, through education, occupation and leisure
activities, have reduced risk of developing Alzheimer’s. Studies suggest that they have 35-40% less risk of manifesting the disease”- Dr. Yaakov Stern, Division Leader of the Cognitive Neuroscience Division of the Sergievsky Center at Columbia University

MYTH 2: The field of Brain Fitness is too new to be credible.
Reality: The field rests on solid foundations dating back more than a decade -- what is new is the number and range of tools that are now starting to be available for healthy individuals.
“Rigorous and targeted cognitive training has been used in clinical practice for many years.
Exercising our brains systematically is as important as exercising our bodies.”
- Dr. Elkhonon Goldberg, neuropsychologist, clinical professor of neurology at New York University School
of Medicine, and disciple of Alexander Luria.

MYTH 4: We need to buy expensive computer-based programs to improve our brains.
Reality: Every time we learn a new skill, concept or fact, we change the physical composition of
our brains. Lifelong learning means lifelong neuroplasticity.
“Today, thanks to fMRI and other neuroimaging techniques, we are starting to understand
the impact our actions can have on specific parts of the brain.”
- Dr. Judith Beck, Director of the Beck Institute for Cognitive Therapy and Research,
Clinical Associate Professor of Psychology in Psychiatry at the University of Pennsylvania,
“Learning is physical. Learning means the modification, growth, and pruning of our
neurons, connections–called synapses– and neuronal networks, through experience...
we are cultivating our own neuronal networks.”
- Dr. James Zull, Professor of Biology and Biochemistry at Case Western University

• Lifetime experiences, like education, engaging occupation, and leisure activities, have been shown to have a major influence on how we age, specifically on whether we will develop Alzheimer’s symptoms or not.
• This is so because stimulating activities, ideally combining physical exercise, learning and social interaction, help us build a Cognitive Reserve to protect us.
• The earlier we start building our Reserve, the better; but it is never too late to start. And, the more activities, the better: the effect is cumulative.

Saturday, January 26, 2008

Mental Activity Delays Alzheimer's

Mental Activity and Alzheimer's

Playing Cards, Reading Better Than Exercise in Reducing Risk of Memory Loss
By Sid Kirchheimer
WebMD Medical News

June 18, 2003 -- When it comes to preventing Alzheimer's disease and other forms of dementia, seniors may actually fare better with several laps around a Monopoly board than around the block.

A new study in this week's New England Journal of Medicine adds to mounting evidence that mentally stimulating activities such as reading, playing cards and board games, and doing crossword puzzles may prevent or minimize memory loss from aging.

But this time, researchers also compared these brain-boosting hobbies to more physical activities in 469 seniors. Dancing was the only one of eight that appeared to help with Alzheimer's prevention.

"And dancing isn't purely physical. It involves some mental effort, as opposed to climbing stairs or walking, which are more automatic as far as the brain is concerned," says lead researcher Joe Verghese, MD, of Albert Einstein College of Medicine in New York. "We're not saying that seniors shouldn't exercise because it offers so many health benefits. But a reduced risk of Alzheimer's doesn't appear to be one of them."

The role of regular exercise in Alzheimer's prevention has been questionable. Some studies suggest it mildly reduces risk, likely because exercise improves blood flow and aids in brain cell development. But other studies, like Verghese's, show no significant benefit in Alzheimer's prevention from activities such as walking, swimming, climbing stairs, and housework.

Verghese's study, which lasted 21 years and is the longest to date, is at least the fourth since 1995 to suggest a strong benefit from more sedentary but cerebral leisure activities -- likely because of what researchers call the "cognitive reserve theory."

Buffer Your Brain

"The theory is that by engaging in mentally stimulating activities, you're building a buffer against disease," he tells WebMD. "Basically, you're exercising your brain to keep it strong and make it more resistant to Alzheimer's and other illness. I strongly recommend that elderly individuals engage in [brain] stimulating activities like chess, board games, playing a musical instrument, or puzzles. And the more often they do, the better."

Overall, his study participants who read, did puzzles, or played cards, games, or musical instruments about four days a week were two-thirds less likely to get Alzheimer's compared with those who did these activities once a week or less. All were age 75 or older and had no symptoms of dementia when the study began.

Gratifying Findings

"I'm not surprised by this finding, I'm gratified by it," says Robert S. Wilson, PhD, of the Rush Alzheimer's Disease Center in Chicago. He led a study published last year in TheJournal of the American Medical Association that indicated a similar effect on Alzheimer's prevention among seniors who more frequently engage in these mental games.

"If you have the disease and it continues to progress, I don't believe and don't think anyone else believes that playing cards will stop it," he tells WebMD. "But this new research is really consistent with what we've seen -- that these mentally stimulating activities can help. Even if they can delay Alzheimer's for a few months or possibly several years, that can have a tremendous public health impact."

4 Must-See Articles

Level of Job Difficulty Linked to Alzheimer's

The Milwaukee Journal Sentinel - August 10, 2004

People who developed Alzheimer’s disease tended to hold jobs with lower mental demands during their 30s, 40s, and 50s than people who did not get the disease, according to new research.

The study is the latest in a growing body of research suggesting that higher levels of education as well as mentally stimulating activities may offer some protection against a disorder that now affects 4.5 million Americans, a number that is expected to grow dramatically in the coming decades.

The study is the first look at mental job demands over the course of several decades and link those demands to Alzheimer’s. An extensive U.S. Department of Labor ranking of occupational demands was used to determine mental and physical job demands.

Examples of jobs with high mental demands included engineers, doctors, science and math teachers, architects, computer programmers and journalists. Jobs with lower levels included janitors, construction laborers, machine operators, assemblers and food preparation workers.

The study, which compared 122 people with Alzheimer’s to 235 who did not have the disease, was published today in the journal Neurology.

When both groups were in their 20s, they had jobs with similar mental demands, a level that was about 15 percent above the national average. However, as they grew older those who would later develop Alzheimer’s tended to stay in jobs with about the same level of mental demands while those who did not get the disease tended to go into jobs with increasing mental demands.

As scientists now try to find ways to prevent the disease, a burning question is whether people can reduce their risk by staying mentally active throughout life.

"Not everybody can be an astrophysicist," said lead author Kathleen Smyth, a researcher at Case Western Reserve University. "(But) you want to keep your mind active. Some people call it novelty seeking . . . things that get you thinking in a different way."

Smyth said even lower-end jobs can be made more mentally stimulating. And people can find ways to keep their minds active outside of work by playing games such as chess or crossword puzzles, playing a musical instrument, reading novels or taking an educational course.

However, there still is some uncertainty about exactly how a job or education affects a person’s chances of getting Alzheimer’s disease.

One explanation is that the disease process actually begins decades before symptoms appear and that a person simply starts to adapt by finding progressively less demanding activities over the years.

However, another possibility is that staying mentally active strengthens connections between neurons and builds a brain reserve, which may delay the onset of the disease.

"You really can’t change your IQ, but this study underscores the protection of lifelong learning," said Diana Kerwin, an assistant professor of medicine and a geriatrics and dementia specialist with the Medical College of Wisconsin. "You can still have a manual labor job and overcome it by outside activities."

The concept of building a brain reserve also was bolstered by a 2003 study of 130 Catholic priests and nuns.

The study found that years of formal education, or something related to education, appeared to provide a type of cognitive reserve that reduced the harmful effect of plaques that build up in the brains of people with Alzheimer’s.

The study’s authors said it appeared that higher levels of education helped people tolerate the pathology of the disease.

A 2001 study found that leisure activity may reduce the risk of dementia regardless of a person’s education or occupational background.

Those with high levels of leisure activity had a 38 percent lower risk of developing dementia, even when controlling for other risk factors, including ethnic background. Leisure activities included reading, going to movies, taking walks and talking with friends.

To see more of the Milwaukee Journal Sentinel, or to subscribe to the newspaper, go to

(c) 2004, Milwaukee Journal Sentinel. Distributed by Knight Ridder/Tribune Business News. For information on republishing this content, contact us at (800) 661-2511 (U.S.), (213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail


Brain Fitness, Weight and Exercise

In a separate study published by The American Academy of Neurology, researchers found the corollary that “a higher BMI was associated with lower cognitive test scores. Results from a test involving word memory recall show people with a BMI of 20 remembered an average of nine out of 16 words, while people with a BMI of 30 remembered an average of seven out of 16 words.” They did not, however, find a correlation between a change in BMI and a change in cognitive performance, according to epidemiologist Maxime Cournot, M.D. of Toulouse University Hospital.

Take-Home Points
Managing obesity in middle-aged adults might help reduce dementia later. John Gunstad, PhD, an assistant professor of psychology at Kent State University in Kent, Ohio says “We’ve known [for many years] that obesity is linked to high blood pressure and other problems. The fact that its impact on brain function may be independent [of other problems] is newer.”

It’s never too late to get your brain or your body in shape.

Physical Fitness – Brain Fitness – Social Fitness … they are all interconnected and essential to your general wellbeing.

herbal and vitamin supplements that protects memory

Are there herbal and vitamin supplements that will protect my memory?

Key Points:

  • Omega-3 and omega-6 fatty acids found in cold-water fish may be helpful to long term brain health.
  • Folic acid may also be helpful to both cognitive function and hearing.
  • Ginkgo biloba and DHEA do not appear to help your brain.
  • There is still more research to be done and never dismiss the placebo effect!


Perhaps. The New England Journal of Medicine published an article debunking DHEA, a steroid precursor to testosterone and estrogen used to fight aging. The conclusion of a two-year study at the Mayo Clinic in Minnesota and University of Padua in Italy showed it did not improve strength, physical performance, or other measures of health. The study’s lead author, Dr. Nair said, “No beneficial effects on quality of life were observed. There’s no evidence based on this study that DHEA has an antiaging effect.”

Ginkgo biloba is another over-the-counter memory-enhancing supplement frequently mentioned. Yet, Paul Solomon from Williams College found “when taken following the manufacturer’s instructions, ginkgo provides no measurable benefit in memory or related cognitive function to adults with healthy cognitive function.” Nicholas Burns from the University of Adelaide, Australia found longer-term memory improved in healthy 55-79 year olds, but no other cognitive measure improved for either younger or older participants. Sarah Elsabagh from King’s College London found ginkgo initially improved attention and memory. However, there were no benefits after 6 weeks, suggesting that a tolerance develops quickly. Not an overwhelming endorsement.

Omega-3 fatty acids found in cold-water fish such as mackerel, herring, salmon, and tuna look more promising. Giuliano Fontani’s work at the University of Siena in Italy associated omega-3 supplementation with improved attentional and physiological functions, particularly those involving complex cortical processing.

Folic acid supplementation also shows promise of protecting and improving cognitive function in older adults, according to a 2007 study published in Lancet by Jane Durga and colleagues. It may also reduce age-related decline in hearing.

What can you do right now?

  1. Eat a balanced diet with plenty of green leafy vegetables such as spinach, kale and collards.
  2. Get plenty of physical exercise.
  3. Stay cognitively active.
  4. Reduce your stress.
  5. And as always, talk with your doctor about any health concerns.

Further Reading

Tuesday, January 1, 2008

Pet Related Infections

Pet-Related Infections

Human contact with cats, dogs, and other pets results in several million infections each year in the United States, ranging from self-limited skin conditions to life-threatening systemic illnesses. Toxoplasmosis is one of the most common pet-related parasitic infections. Although toxoplasmosis is usually asymptomatic or mild, it may cause serious congenital infection if a woman is exposed during pregnancy, particularly in the first trimester. Common pet-borne fungal infections include tinea corporis/capitis (ringworm); campylobacteriosis and salmonellosis are among the most common bacterial infections associated with pet ownership. Less commonly, pets can transmit arthropod-borne and viral illnesses (e.g., scabies, rabies). Infection in a pet can provide sentinel warning of local vectors and endemic conditions, such as Lyme disease risk.

Treatment is infection-specific, although many infections are self-limited.

Prevention involves common sense measures such as adequate hand washing, proper disposal of animal waste, and ensuring that infected animals are diagnosed and treated. Special precautions are indicated for immunocompromised persons. Increased communication between primary care physicians and veterinarians could improve treatment and prevention of these conditions. (Am Fam Physician 2007;76:1314-22. Copyright © 2007 American Academy of Family Physicians.)

American Family Physician article (Free)

Obese child higher heart attack risk

Childhood Obesity Epidemic Holds Implications for Future Cardiovascular Health

Excess weight during childhood increases the risk for coronary heart disease during adult years, portending serious public health consequences, according to two studies in the New England Journal of Medicine.

The first study, based on annual height-and-weight measurements in some 275,000 Danish schoolchildren, followed their health after age 25. Researchers found that higher BMI scores predicted higher risks for coronary diseases — both fatal and nonfatal — in adulthood. For example, a 13-year-old boy overweight by 11 kg (25 pounds) had a 33% higher risk for coronary disease in adulthood.

The second study, using a model based on U.S. health statistics, finds that with current rates of childhood obesity, the prevalence of coronary disease will increase between 5% and 16% by 2035.

A commentator recommends laws to regulate advertising of junk food, changes in farm subsidies, and funding for "decent lunches and regular physical activities at school."

Physician's First Watch for December 6, 2007
David G. Fairchild, MD, MPH, Editor-in-Chief