Can you really fend off dementia with simplemental exercises? It’s an idea rapidly gainingcurrency among scientists, writes Roy Eccleston.
Reprinted with the permission of The Australian News Ltd.
y first encounter vast, developing market of baby with the cheery, boomers fearful of losing their bespectacled minds and memories to the Japanese brain awful, incurable Alzheimer’s expert Dr Ryuta disease. Kawashima is not Kawashima’s Brain Training:a happy one. I do all he politely How Old Is Your Brain? game hasasks, as quickly as I can, and already sold more than 5 millionafter a few minutes his verdict copies worldwide since itsis delivered: I have a brain age launch last year, including moreof 70. than 35,000 in Australia since Since I’m actually a few going on sale in June. With adecades younger, this is not stylus to write on the computer’sencouraging. But it’s hard to screen and voice-recognitionargue with Kawashima, since technology, the game claimshe’s just a disembodied head to determine your “brain age”bouncing across the screen of and then provide exercises tothe Nintendo DS handheld lower that score. The optimumcomputer games console. Later is 20, the age at which the brainI share the news with the head is supposed to be sharpest. Doof Alzheimer’s Australia, Glenn that, claims Kawashima, and itRees. “Well,” he says gloomily, will help ward off dementia.“that was better than I did.” Kawashima is no invention of All may not be lost. Just like the Pokemon crowd at Nintendoa bulging belly can become a - he’s a Japanese neuroscientistrippling six-pack and a wrinkled who has published studies on theface can be Botoxed smooth benefits to Alzheimer’s patientsagain, so new evidence suggests of brain exercises, as well asthe brain can also be buffed self-help books that have soldand toned despite advancing millions. The game includes ayears. Nintendo’s computer variety of counting and memorygame is an early foray into a exercises: how many words from Article Reprinted from: December 2-3 2006 / Thehe eekend Australian Magazine 3 Article Reprinted from: December 2-3 2006 / T WWeekend Australian Magazine
a list of 30 can you remember, how fastcan you count the syllables in a sentence,how accurately and quickly can you do100 simple sums? Nintendo sees the gamestimulating a new market; Kawashimasays it stimulates the prefrontal cortex - thebit of the brain that gives us an uprightforehead, and which is linked to creativity,self-control and communication. For the brain age check, I have to callout the colour of the words the computerflashes up. This is known as a Stroop test,and there’s a trick to it. The word maysay “blue” but be written in red. Thecorrect answer is red, but your naturalresponse is to read the word and say“blue”. The computer measures not justhow many you miss, but how quicklyyou do it. And, admittedly after a few Producing a bigger “brain reserve” can ward off dementia, says neuroscience researcher Dr Michael Valenzuela.problems recognising my voice, Dr K’sprogram is telling me my brain is 70! That’s also the view of associate professorAm I doomed already? Not at all, insists Michael Woodward, medical director ofthe real Kawashima by email. “TRAIN aged care at the Heidelberg RepatriationTHE BRAIN!!” It’s increasingly the cry, Hospital in Melbourne and a nationalas around the Western world Alzheimer’s expert on the disease: “I think anythinglooms as one of the great unsolved medical that provides a mental stimulus to thechallenges for a population that is living brain can help form new connectionslonger - and therefore is more susceptible between the brain cells - synapses - andto degenerative brain disease. there’s increasing evidence that the more First described by Dr Alois Alzheimer synapses we have, the more protection wea century ago last month, there is have against Alzheimer’s.”still no cure, although there are some There are plenty who hope to makehopeful developments. Kawashima’s money from the idea. Nintendo also sellsown studies show big improvements in Big Brain Academy, Sony has developedthe communications and social skills of PQ: Practical Intelligence Quotient, and PositJapanese dementia patients whose brains Science in the United States has the Brainwere exercised by reading aloud or doing Fitness Program. There’s also a growingsimple arithmetic for 20 minutes a day. number of internet websites where, for But does the “use it or lose it” strategy a fee, members can use computer-basedreally work? “I think there’s cautious exercises claimed to supercharge theiroptimism that they can make a difference,” brain cells. There’s Mybraintrainer.com,says Rees of the games, adding that Nintendo Happy-Neuron.com and Brainbuilder.has provided the association with a donation. com, among others. And real brain gyms Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
with computers instead of exercise bikes - of the brain’s cognitive functions, such asalready dubbed “neurobics” - are starting memory, attention and problem-solving.to appear in Australia. “And my own memory’s failing as well,” It will be great news if it works, because Fairhall says. “I’ll decide to do somethingdementia is a massive and growing and then forget what it was I’d decided toproblem, with Alzheimer’s the most do. It’s more minor things. I’ll plan to lockcommon form. Fatal over about eight a window and when I get into the room,years, it robs its victims of memory, reason I think, what am I here for?” But he didand even their ability to eat for themselves. remember his wife had told him about theUsually a disease of older age, dementia forum, and he’s hoping to learn somethingstrikes one in 15 Australians over 65 and useful. He does. Fairhall believed thatone in four over 85. As the average lifespan nothing could ward off dementia, butrises, and more move into that older group, some scientists are convinced that quite athe 210,000 who now have dementia is lot can be done to lower your risk.expected to double by 2030. To begin, the crowd is introduced to But old age alone isn’t the problem. some basics about the way their memoryResearch also shows a surprisingly strong actually works. With three stages - encodinglink between aerobic fitness and a healthy information, storage and retrieval - troubleheart and a healthy brain. The high-fat can arise if any stage fails. Then there is theWestern diet and sedentary lifestyle that short-term or working memory and, whenproduces high cholesterol, high blood information is repeatedly used, the long-pressure, coronary disease, obesity and term memory. They also get a crash courseType 2 diabetes is also believed to be in the brain’s structure, with one areacontributing to more dementia. In health attracting special focus: the hippocampus,terms, it’s the perfect storm. It means shaped like the tail of its Greek namesake,Kawashima alone can’t solve the problem. the seahorse. This small, central part ofM the brain is crucial to memory, transferring EMORY IS VERY MUCH ON THE MINDS OF information from short-term to long-term the 400 people who have jammed files. It’s like a sorting centre, moving into the Eastern Suburbs Leagues things back and forth until they become a Club in Sydney for a free forum memory.headlined “Train the Brain”, organised “It’s the first to go with Alzheimer’sby the University of NSW and Prince of disease,” says Dr Michael Valenzuela,Wales Hospital. Another 200 have been a neuroscience researcher whose workturned away, and the call goes up for those with University of NSW colleaguewith seats to give them up to anyone over Professor Perminder Sachdev earned him85. Not that the crowd is especially old, a prestigious Eureka Prize for medicalwith many in their 50s. research this year. Valenzuela, born here to Watching closely is 55-year-old Lloyd Chilean parents, trained as a psychologistFairhall, a keen-eyed man hoping to find specialising in older people before movingan antidote to a dodgy memory. Several into medicine and then research.members of his family have had dementia Now he tells the crowd that there’s- the general term for the degeneration good news. Analysis of 22 earlier studies, Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
THE BRAIN TRAINER QUIZ 1. If you turn your gloves inside-out and swap hands, will the palms of the gloves be against your palms or the back of your hands? covering 29,000 people, found that 2. Looking in the mirror, I notice that the clock on the boosting mental activity halved the wall behind me appears to be saying five to two. What chance of developing dementia. And, he time is it? adds, studies showed mice put into an 3. How many minutes before noon is it if one hour ago environment rich with puzzles, activities it was twice as many past 10am? and other mice for socialising experienced 4. Two clocks are set at noon. However, one gains five a 50 per cent cut in the chemical signs minutes every hour, while the other loses five minutes of dementia in their brains. The extra every hour. How many hours will it take for the clocks stimulation produced more brain cells and to read the same again? pathways for information, and maybe also 5. If Jack is older than Kyle, and Kyle is younger than slowed the march of the disease itself. Marie, but Marie is not as old as Scott, who is the same age as Jack, who is the youngest? Later, over lunch, Valenzuela runs through how he and colleagues produced 6. Which four-letter English word reads the same backwards, forwards and upside-down? their stunning finding that the brain can be trained to build defences against dementia, 7. There is a 10 per cent mortality rate with Major Croak’s operations. If two soldiers are tracked at by producing a bigger “brain reserve”. random from his ranks, what are the chances that The first step was to do a complex analysis both will die in his service? of existing research to see if there was a 8. Which are the next three numbers in this sequence: common theme. They found that increased 100, 93, 86, 79, ... ? mental activity slashed risk by 46 per cent. 9. I married my boyfriend, we had such fun; our But that very general finding gave no happiness grew when we had a son. If our son’s father clue as to what was going on in the minds is Roy’s first boy, what relation am I, then, to Roy? of people who appeared to be benefiting. 10. If it takes six elves one hour to fill four sleighs with So the researchers took a group of older toys, how long will it take one elf to fill one sleigh? healthy people and gave half of them Which is the odd one out in each of the following? five weeks of memory exercises. Using a brain-scanning technique called magnetic resonance spectroscopy, they checked 1] whether the exercises produced significant A B C D E changes to the brain’s chemistry. Mostly they did not. But in the hippocampus something was going 2] on, with increased levels of a chemical called phosphocreatine. This was doubly A B C D E interesting. “First, memory problems begin in the hippocampus,” says Valenzuela. “So 3] it makes sense that practising a memory A B C D E exercise will stimulate some kind of change in the memory area. Phosphocreatine was interesting because in animal studies, it was protective of neurons; it protected 4] them from dying off under stress.”COMPILED BY THERESE MOODIE-BLOOM A B C D E 2 LINES; C IS 2 ARCS 1 LINE) THE RIGHT OF THE BLACK TRIANGLE ON THE OTHERS) 4.C. (OTHERS ARE 1 ARC, 2.D. (BOOMERANG IS BLACK ON THE LHS IN THE OTHERS) 3.D. (BLACK DOT IS TO Reprint from Dec 2-3 ‘06 The Weekend Australian Magazine SAME TRIANGLE IS ROTATED IN THE OTHERS, BUT B HAS BEEN FLIPPED OVER) 8. 72, 65, 58 9. DAUGHTER-IN-LAW 10. 90 MINUTES. SHAPE ANSWERS 1.B. (THE ANSWERS 1. PALMS 2. 5 PAST 10 3. 20 4. 72 HOURS 5. KYLE 6. NOON 7. 1 IN 100
S O EXERCISING THE BRAIN SEEMED TO TRIGGER year study of stroke victims led by Brodaty increased production of a protective and Sachdev, reinforced that idea. That chemical - but did it make new brain showed that the memory centre - the cells, or new connections? With 100 hippocampus - shrank at just half thebillion neurons, the number of connections rate in older, mentally active people asin a human brain runs to about 100 trillion those who weren’t mentally stimulated. So- which according to experts provides the Kawashima’s game ought to help?brain with more pathways than there are Maybe not. Valenzuela fears games aren’tatoms in the universe. the solution because they’re too narrow Alzheimer’s clear-fells in this neural and likely to be short-term. He stressesforest, producing deadly deposits known as the key is to have fun and do something“plaques” from a protein called amyloid. that involves long-term social, physicalCreating more connections might give and mental activities. Learn to sail, hethe brain more options in the event of advises, take up Tai-chi, tango dancingAlzheimer’s. It wasn’t possible technically or learn a new language. “If you want toto see if the exercises made this happen get a benefit, you’re really going to have toin people, although it had with mice. sustain it for the rest of your life,” he says.“Greater mental activity, social activityand physical activity means your chances ofreducing risk are better.” DR MICHAEL VALENZUELA I But Valenzuela thinks these new cells T’S A DREADFUL THING TO SEE DEMENTIA ATand pathways are being produced. And work. This is not a disease that strikesthe evidence that this could help ward off quickly, like flicking a switch. Instead,dementia comes from studies showing that the light dims gradually over timenot everyone whose brain is attacked by before flickering and fluttering, offeringAlzheimer’s loses their mind or memory. fewer and briefer glimpses of a mind In fact, autopsies have shown that up covered by deepening shadow. For thoseto 30 per cent of people whose brain of us forced to watch, the overwhelmingcontained significant cell damage typical feeling is of powerlessness. I recall oneof Alzheimer’s showed no obvious sign particularly awful moment in my ownof dementia in life. How is this possible? father’s gradual submission to dementia:Valenzuela thinks it’s evidence that some there he was, banging on the other sidepeople have a “brain reserve” that allows of the door, pleading with me to comethem to compensate for the damage. Some back. And there was I, sneaking out afterpeople have more natural brain reserve - an hour spent walking and talking, at thebut anyone, at any age, ought to be able hostel that had become a prison to preventto build it up with enough stimulating him wandering off. “Roy, Roy, come back,”exercises, he thinks. he called desperately through the door. A second result, stemming from a five- I wanted to shout the same thing to the Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
SO HOW DID YOU SCORE? Brain Training. A noisy characters - it’s more TV interfered with the learning and honing your results. “I ended up with a skills. I normally play brain age in the 80s. So I games with first-person switched the TV off and did shooters and RPGs (rocket it several more times and propelled grenades) and got my brain age down to stuff. So it’s nothing like the 60s, 50s and the 40s. it - you’re doing maths It’s a great idea - it’s a real questions and readingDEANE HUTTON (65) hook that gets people in, GAVIN STEWARD (19) aloud and stuff like that.PRESENTER if they think they have a TAFE STUDENT I did the 20 calculations chance to improve on their in 19 seconds. No, I don’tHutton fronted the Curiosity score. It is training part of “When I started I got have any problems with myShow for 18 years and your brain ... but there’s 24 - and I did it again memory. I’d like to thinknow appears on The New so much more in brain today and I got 24 again. my brain’s in good shape.Inventors. “I found it so training such as making So that’s all right. The But it did say to me,addictive that I flattened comparisons, judgment, game’s different to what ‘You’re under 20 so takethe battery,” he says being curious, asking you expect in a normal the results with a grainof playing Nintendo’s questions.” game. It’s not, like, with of salt.’”man whose name I share. having forgotten the purpose of that switch The disease was taking him rapidly away. on the wall. And a CD player I bought himIt had stolen his independence and was to play some relaxing music proved uselessnow eating away at his memory, although when he couldn’t remember how to turn ithe still knew me back then. Just by being on.there, I had taken away some of his fear. One weekend I took him to the beach.And now I had to leave. I could do nothing, On the drive there, I was disconcertedknowing his condition was irreversible. to hear him say how he’d recently been The best I could hope for at that time talking with one of his sisters in his house,was for a speedy progression past that even though he’d not seen any of hisstage of fear and anxiety, a time when he family since leaving England in 1965. Andseemed to know something was wrong but then, tired by the effort of keeping himprobably no longer remembered what it comfortable, I agreed to his suggestion he’dwas. I comforted myself with the thought like a walk along the beach. Like an idiot, Ihe’d forget his distress, and forget I’d been blithely watched him head along the sandthere. But I’m not sure it works that way. from the balcony of the apartment, and I’d sensed something was wrong when his suddenly realised what I’d done: he’d neverlandlord called me about late payments of remember where he’d come from. So I ranrent. He’d simply forgotten to make them. after him, and eventually found him by aProblems handling money are often the nearby road.first signs of dementia. We moved him into That was about eight years ago. He’snew accommodation where he didn’t have long forgotten my name, or how to speak.to worry about money, but that proved These days he spends much of his timehopeless too. sleeping. He can no longer eat by himself, He’d unscrew the light to turn it off, so on one recent visit I fed him instead of Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
the nurse. He hadn’t lost his appetite, atleast. But inside his head, the brain hadbeen shrinking, the neurons dying, and thepathways clogged. ON THE BRINK • Might he have been helped by usinghis brain more, a new hobby, even by Even if your brain can bench-press a Mackarithmetic and reading aloud? For my truck and arm-wrestle a supercomputer,father, it’s too late to know, but for others it can’t stop Alzheimer’s disease progressing if itsome doctors believe there is hope. starts. The only real protection is to halt the spread Neuropsychologist Nicola Gates of dying brain cells- and a group of Melbourneis one of them. An absence of long- scientists think they may have found a way.term trials proving that brain training “If you’re a mouse [with Alzheimer’s-typecan ward off dementia hasn’t stopped dementia], we can basically make you normal now,”her opening a brain gym in Sydney’s says Professor Ashley Bush. For humans it’s more uncertain. But within a few months Bush and theMosman. HeadStrong Cognitive Fitness team from the Mental Health Research Institute ofis bankrolled by investors who see a strong Victoria should have a pretty good idea if they’vemarket in Sydney’s well-heeled but ageing hit on one of the great medical breakthroughs.suburbs, and fronted by Gates who brings Melbourne firm Prana Biotechnology, with Bushthe professional experience and academic as chief scientific adviser, is set to trial a newtraining. In her late 30s, Gates has been drug called PBT2 in people in the early stagesworking with brain injury victims for the of Alzheimer’s disease in Europe after seeingpast 13 years, citing that as proof the brain sensational results in mice genetically engineeredcan rebuild. to be comparable to a human with Alzheimer’s. The first clients begin their mental “It was breathtaking,” says Bush. “The mice getexercises this month. Gates insists her returned to absolutely normal behaviour withincomputer-based exercises are grounded days, so it really looks like a detoxification. Gettingin scientific research and backed by New them to recover ... was not really contemplated as being possible.”York specialist Dr Elkhonon Goldberg, apioneer of brain gyms. “You go in and The mouse studies showed PBT2 can blockcomplete tasks that target brain function and even reverse the disease, “but even more importantly it can dramatically improve the memorysuch as processing speed, verbal fluency, and cognitive function of the mice.”and new learning capacity,” she says. Gates says until recently doctors Bush’s theory on the cause of Alzheimer’s has been 16 years in the making but is not shared bybelieved the brain could not regenerate, most international experts. He and other Australianand that advancing years meant inevitable scientists working on the project argue it’s thedeterioration. “Now you can increase result of a failure of a protein called amyloid toyour functioning rather than accept that properly manage key metals zinc and copper inwith age you’re going to be slower, more the brain.forgetful,” she says. “In fact, there’s a lot to be said for olderbrains that has been missed in our generalcelebration of youth.” All that accumulatedknowledge means older people can Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
solve problems at a deeper level, and that is the same sort of high-fat while being less impulsive and menu that has produced a surge of better focused. She acknowledges obesity and Type 2 diabetes. Valenzuela’s point that mental So significant are the risks exercise is not enough, and says her from high blood pressure and clients will also be asked about diet cardiovascular disease that and exercise, and may be directed Professor Ralph Martins, director to a dietician or local fitness gym. of the Centre of Excellence for But how can she be sure it will keep Alzheimer’s Disease Research and dementia at bay? “That’s what the Care in Western Australia, believes research consistently indicates,” she physical exercise may be more insists. “The question is not whether beneficial than mental gymnastics. to do it; the question is how often One theory, since the brain is a to do it, and how much benefit.” voracious consumer of oxygen in the blood, is that better blood flow just makes for healthier brain cells. But Martins says it is more complicated. He is now studying four groups of people - those who increase physical exercise, those who increase mental exercise, those who do both, and those who do neither - to see which is most effective. Some studies have shown aerobic fitness reduces the amount of shrinkage in the brain in old age. “There’s a lot to be said for older brains,” And Martins says there’s evidence says Nicola Gates. that increased physical activity Even if that is right, a sharp brain also boosts the production of high- doesn’t look like being enough. In density lipoprotein - HDL - which the past few years, poor physical mops up cholesterol from the blood. health and diet have come to be seen New evidence from his laboratory as direct contributors to memory suggests HDL may also lower the trouble. There are no magic foods, level of the main killer of brain cells although some experts recommend in Alzheimer’s, the amyloid protein. small amounts of alcohol - one to But how much exercise, and which three drinks a day, especially red type, remains uncertain. Martins wine - fish, Vitamins E and C, recommends walking 4-5km about folic acid, and anti-oxidants. More five times a week. important is what you shouldn’t eat,10 Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
C LEARLY, IT’S AN IMPRECISE increase activity in a wide area of business. And maybe, as the brain, that probably increases argued by US neuroscientist synapses, and increased numbers Timothy A. Salthouse of the of synapses probably protect youUniversity of Virginia, it’s more an against the amyloid and other“optimistic hope” than hard science. causes of Alzheimer’s.”In March, Salthouse published a long That’s gratifying, since Kawashimareview of the scientific papers on has been working me hard,the subject in the journal Perspectives counting how many syllables I readon Psychological Science. He found no each second, testing my memoryconvincing evidence that mentally of lists of words and numbers,stimulating activities prevented the and demanding I draw picturesbrain’s decline in older age. That of koalas and kangaroos on thewas his professional opinion, he screen. “What wonderful results!”wrote, but “my personal view is that his bouncing head tells me after apeople should behave as if it were particularly speedy bout of simpletrue”. Mental exercise did no harm, maths calculations. “I may start towas fun, and “if you can still do it, cry here!” He tells me my brain agethen you know you have not yet has come steadily down, after thatlost it”. rocky start, to below 40. Good, but Michael Woodward of the nowhere near the optimal 20.Heidelberg Repatriation Hospital And in any case, does my betteragrees there’s no absolute proof memory for lists and quickeryou can delay Alzheimer’s. “All that maths add up to anything otheryou’re hearing about prevention than exactly that? From his office- this mental and physical activity at Tohoku University, Kawashima- at this stage has not been tested,” is supremely confident that all thishe says. “It’s all just associations, so work is warding off Alzheimer’syou can’t be sure it’s preventive. It’s “100 per cent!” the 46-year-old tellsa chicken-and-egg phenomenon: me in an email. The evidence, heis it because people who are prone insists, is concrete.to Alzheimer’s are less likely to be Still, Kawashima’s own approachphysically or mentally active, or is it to life seems to back the idea that thebecause people who are physically best strategy for a well-buffed brainor mentally active are preventing is a broad range of activities, ratherAlzheimer’s? We don’t know the than hunching over a computeranswer.” screen. Does he play Brain Training? Still, he says playing more “No,” he says bluntly. “I am toomentally stimulating games makes busy to play games.”sense. “Games like the Nintendo do This article was written by The Weekend Australian’s staff writer Roy Eccleston. Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine 11
Mind your Mind®Alzheimer’s Australia’s dementia risk reduction programIn 2005, a panel of eminent geriatricians The Mind your Mind® program includes:and psychogeriatricians led by Associate Mind your BrainProfessor Michael Woodward examined When the mind is active, the brainthe national and international scientific is protected.literature to identify dementia riskreduction strategies. Mind your Body Exercise regularly – your brain will love it.Studies of large groups of people showedthat those who adopted ‘brain-healthy’ Mind your Dietlifestyles at mid-life may have a reduced A balanced diet promotes brain health.risk of developing dementia. Mind your Social LifeMind your Mind® aims to encourage An active social life is good for the brain.people to adopt healthy lifestyle habitsthat may protect against decline in Mind your Health Checksthinking and memory abilities as they age. Regular health checks are important for brain health.The simple brain-healthy habits in theprogram can improve your health and Mind your Habitslower your risk of heart disease, stroke, Stop smoking and don’t abuse alcohol.diabetes – and dementia. Mind your Head Wear a helmet when appropriate.What is dementia?Dementia is a general term to describe Alzheimer’s Australia gratefullyproblems with progressive changes in acknowledges the support ofmemory and thinking. Alzheimer’s disease The Australian News Ltd.is the most common type of dementia.Dementia can happen to anybody, but it For more information:becomes more common over the age of www.alzheimers.org.au65, and especially over the age of 75. National Dementia Helpline 1800 100 500Early signs may not be obvious – only adoctor or specialist can properlydiagnose dementia.
National Dementia Helpline 1800 100 500 www.alzheimers.org.auMind your Mind® is generously supported with funding from