Cross Train Your Brain - Brookdale Senior Living CEU Professional Development
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At Brookdale, we're proud to provide healthcare professionals an opportunity each month to earn Continuing Education Credits (CEU). In a CEU webinar earlier this year, Carol Cummings, RN, BSN, the Sr. Director of Optimum Life Engagement, reviewed the top ways seniors can improve overall brain health. View her presentation here for a peek into the program
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Cross Train Your Brain - Brookdale Senior Living CEU Professional Development
- 1. Cross Train Your Brain Carol Cummings, BSN, RN, CWC Sr. Dir. Optimum Life Engagement
- 2. Objectives • Name the six dimensions of wellness and how they relate to healthy brain function. • Identify normal versus pathological changes associated with brain aging. • Identify the modifiable risk factors for dementia. • Create and apply a personal plan for brain health.
- 3. Stroop Test Quickly! Say aloud what color you see in every word, NOT the word you read.
- 4. Brain Functions Frontal lobe: “The Boss” Decision, judgment, planning Prefrontal cortex: focus, attention Temporal lobe Hippocampus: “librarian” Receptive language Parietal lobe Touch Pain Spatial relations Occipital lobe Visual - perception Reading Cerebellum Balance and equilibrium Coordination of movement
- 6. Are you living your Optimum Life?
- 7. Emerging Brain Research • The brain is flexible (neuroplasticity) • Re-wired rather than hardwired • Neurogenesis: new brain cells! • BDNF: important for neuron survival and growth (Miracle-Gro for the brain) • Exercise spawns neurons; environmental enrichment helps them survive
- 8. Three Important Terms 8 Neural Plasticity The brain is “plastic” and can continue to grow and change throughout life- forming new brain cells and new connections between existing cells. Neurogenesis The development of new brain cells when the brain is stimulated. Brain Resilience A brain that has many brain cells and connections is resilient and can delay onset of dementia symptoms.
- 9. 9 Brain Aging Aging Oxidative Stress Ischemia Aging Oxidative Stress Ischemia Neuron Dysfunction Neuron Dysfunction Neuron Preservation Neuron Preservation Neuron LossNeuron Loss Environment stress, trauma Environment stress, trauma Genetic Factors Beta-amyloid Genetic Factors Beta-amyloid Neuronal Injury Repair Response Neuronal Injury Repair Response Adapted from L.J. Ball, S.J. Birge, Clin Ger Med 18 (2002) __________________ __________________
- 10. Normal changes – Brain shrinks-especially the hippocampus where new learning occurs. – Word finding is slower. – Retrieval of information is slower. However… – Memory loss is not a normal part of aging The Brain and Aging
- 11. Memory and Aging Normal changes – Loss of pure, raw memory – Things in context preserved – Focus and concentration difficulties – Do not interfere with daily living activities
- 12. Raw Memory vs. Context • Car • Man • Park • Store • Cart • Antique • Drug
- 13. Dementia • A syndrome of decline in memory and other cognitive functions sufficient to affect daily life. • Alzheimer’s disease is the most common type • Consider the “look alikes” • Progressive and disabling • NOT a normal aspect of aging • Different from normal cognitive lapses
- 14. Warning Signs • Memory loss • Difficulty performing familiar tasks • Problems with language • Disorientation • Impaired judgment • Problems with abstract thinking • Misplacing items • Changes in mood or behavior • Personality changes • Loss of initiative
- 15. Cancer Stroke Heart Disease Diabetes Which Disease Are You Most Afraid of Getting? MetLife Foundation Alzheimer’s Survey, 2006 Alzheimer’s
- 16. Alzheimer’s disease • Uncommon before age 65. • Prevalence doubles every 5 years after age 65: – 1-2% at 65 – 2-4% at 70 – 4-8% at 75 – 8-16% at 80 – 16-32% at 85 – Incidence continues to increase after 90
- 17. Alzheimer’s Demographics • 5 million in U.S. currently • 15 million in U.S. by 2050 • Every 70 seconds, another American is diagnosed with AD. • My mid-century, another case every 30 seconds
- 18. Normal vs. Alzheimer Brain
- 20. 20 Functional MRI: Memory Task
- 21. 21 Functional MRI: Visual Task
- 22. 22 Functional MRI: Earlier Diagnosis of MCI and AD
- 24. Dementia Economics • Over $200 billion annually for care and lost productivity. • Only partial coverage provided through Medicare, Medicaid, private insurance. • Families bear greatest burden of expense.
- 25. Risk Factors Age Family history Education Head injury Lack of exercise Oral hygiene Smoking Excess alcohol Obesity Hypertension Diabetes Hyperlipidemia Social isolation Stress/depression
- 26. The Big Question Can Dementia Be Prevented?
- 27. Dimensions For Brain Health 27 • Physical • Emotional • Purposeful • Social • Spiritual • Intellectual
- 28. Physical - Nutrition Antioxidants: Help to combat cellular damage •Fruits and vegetables – Eat a variety, all colors – Apples, blueberries, and cranberries rich in quercetin, an antioxidant that protects brain cells •Coffee •Tumeric (curcumin) •Red wine
- 29. Physical - Nutrition Omega-3 Fats: Remember the brain is 60% fat. Sources: – Fatty fish such as tuna, salmon, mackerel – Flax seed, grind and sprinkle on food – Nuts-walnuts, almonds – Oils: Flax, olive
- 30. Who would like to reduce their risk of Alzheimer’s disease by more than 50%?
- 31. MIND Diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) • Green leafy vegetables (like spinach and salad greens): At least six servings a week • Other vegetables: At least one a day • Nuts: Five servings a week • Berries: Two or more servings a week • Beans: At least three servings a week • Whole grains: Three or more servings a day • Fish: Once a week • Poultry (like chicken or turkey): Two times a week • Olive oil: Use it as your main cooking oil. • Wine: One glass a day
- 32. MIND Diet: Avoid or Reduce • Red meat: Less than four servings a week • Butter and margarine: Less than a tablespoon daily • Cheese: Less than one serving a week • Pastries and sweets: Less than five servings a week • Fried or fast food: Less than one serving a week
- 33. Physical – Exercise 30 minutes per day • Benefits – Reduces the risk of developing Alzheimer’s – Improves blood flow to the brain – Elevates mood – Reduces stress – Promotes new brain cells – Reduces other risk factors
- 34. Quiz Question What physical activity demonstrated the greatest benefit in reduction of risk for Alzheimer’s Disease and other dementias? Source: Einstein Aging Study
- 36. • Chronic stress leads to elevated cortisol levels. • Sustained cortisol elevations are toxic to neurons in the hippocampus. • Depression can be associated with cognitive impairment. Emotional Stress
- 38. Reducing Stress • Exercise!!! • Music • Yoga • Tai chi • Meditation • Purposeful pursuits
- 39. Spiritual-Your Brain on Meditation 39
- 41. Social and Civic Engagement • Isolation associated with higher dementia risk. • Creative community projects are a rich source of mental challenge . • Dr. Cohen’s study: those participating in a community-based arts program: – Made fewer visits to the doctor – Fell less often – Used less medication – Were less likely to be depressed
- 42. Sleep • Sleep necessary for normal neuron function. • Too little sleep impairs concentration, memory, physical performance, ability to carry out math calculations. • Profound sleep deprivation can lead to hallucinations and mood swings. • Sleep allows neurons used while we are awake a chance to shut down and repair themselves.
- 43. Intellectual Stimulation Effects of Cognitive Training in Older Adults Significant percentages of older adults who trained for five weeks improved their memory, reasoning and information processing speed. Einstein Aging Study Conclusion: those who participated at least twice weekly in reading, playing games, playing musical instruments were significantly less likely to develop dementia.
- 44. • Forming new connections happens when we challenge the brain. • Learn something new and difficult: – Play an instrument – Take up a new creative hobby – Learn a new language Intellectual Learn New Things 44
- 45. Internet Searching and the Brain Small et al. Am J Geriatr Psychiatry 2009
- 46. Your Brain on Google TextText InternetInternet Net NaiveNet Naive Net SavvyNet Savvy
- 47. Brain Games To be effective they should include these three elements: • Novelty-learning new things forms new connections • Variety-challenging many areas of the brain • Challenge-should be difficult but not stressful
- 48. Which Way Is The Bus Heading?
- 49. What Do You See?
- 50. The Power of Purpose
- 52. Unproven Therapies • Gingko biloba • DHEA • Chelation
- 53. Action Steps • Diet rich in antioxidants, omega-3 fatty acids • Keep physically active • Get a good night’s sleep • Ballroom dancing may help you to be both intellectually stimulated and physically active • Remain intellectually stimulated and socially engaged • Control stress • Live life with purpose
- 54. Quiz Steps can be taken to improve one’s brain function in the later years of life. The brain has a limited capacity to form new brain cells. False Exercise is a valuable aid to learning. True Difficulty with concentration and focus are common with aging of the brain. True True
- 55. Quiz False False True False Normal age-related memory loss interferes with daily living activities. Dementia is normal with advanced age. Alzheimer’s disease is the most common type of dementia. Dementia can always be prevented.
- 56. Memory is a way of holding onto the things you love, the things you are, the things you never want to lose. -The Wonder Years
- 57. Resources • The Alzheimer’s Prevention Program, G. Small • Spark, J. Ratey • The Alzheimer’s Action Plan, P. Doraiswamy • Exercise and Physical Activity: Your Everyday Guide from the NIA – www.nia.nih.gov – 800-222-2225 • Alzheimer’s Association – www.alz.org – 800-272-3900 • For Caregivers: Take Your Oxygen First, Gibbons, Huysman, Laird
Editor's Notes
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- Explanation: The Stroop test is used in neuropsychological evaluations to measure mental vitality and flexibility. Performing well requires strong attention and self-regulation capability. You have to say the color of the word not the word itself. Have the audience do this along with you and say the colors out loud. It helps if you have a laser pointer or other way to point to each word. Have fun with it. Everyone will be laughing by the end.
- This is a very simplistic view of what is a very complex organ. It shows the major lobes of the brain and gives a general explanation of their function. Buried in the temporal lobe is the hippocampus-the site of new learning and memory. In reality, the brain is very, very complex and not completely understood. What we do know is that every part of the brain has a known function. The old idea that humans only use 10% of their brains is not true. Here are a few brain facts. Your brain weighs 2 to 4 pounds, Your brain is composed of 60% fat 25% of blood from each heartbeat goes to the brain The last part of the brain to mature is the frontal lobe which controls judgment and planning. As many of you know from raising children, our brains don’t fully mature until around age 25! That explains a lot about teenage risk taking and bad decisions. Much of what we have learned about the different areas of the brain, have been learned from others misfortune. Through studying those with some form of brain damage, we’ve learned a lot about the different areas of the brain. When a stroke or traumatic brain injury (such as a car accident) occurs, damage to a particular area can cause loss of function or ability. For example, damage to the temporal lobe, can cause a person to be unable to understand what other’s are saying to them. And, damage to the left side of the brain can cause a person to be unable to control the right side of their body. There is a part of the brain known as the fusiform gyrus which, if damaged, has caused people to be unable to recognize faces.
- This is a graphic of the building block of the brain-the Neuron or brain cell or nerve cell. Your brain has about 100 billion neurons. Each neuron connects with the next neuron through the finger like projections called dendrites. The lit area in the slide depicts how one neuron connects to another neuron. Through a small gap or “synapse” the brain cells communicate and pass messages along at lightening speed. Each neuron has anywhere from 1,000 to 10,000 connections. 100 billion neurons X 10,000 connections: That adds up to a number too big for the average person to calculate. Messages are sent through electrical impulse. In fact while you are awake your brain generates between 10-23 watts of power-enough energy to power a light bulb. New connections between brain cells are formed when we use the brain in new ways. Optional exercise-tell the audience to fold their arms. Then tell them to unfold and redo it but with the opposite arm on top. This is hard for most people because it is asking the brain to do something a new way. They just formed a new connection! Background and optional information to discuss: Each nerve cell connects with many others to form communication networks. Groups of nerve cells have special jobs. Some are involved in thinking, learning and remembering. Others help us see, hear and smell. The number of connections between neurons varies throughout life. Children, ages 2-4, have more connections between neurons. As we mature, selective pruning helps the brain to mature. Pruning involved getting rid of unneeded or unused connections. To do their work, brain cells operate like tiny factories. The brain cells (or neurons) receive supplies, generate energy, construct equipment and get rid of waste. Cells also process and store information and communicate with other cells. Keeping everything running requires coordination as well as large amounts of fuel and oxygen. Scientists believe Alzheimer's disease prevents parts of a cell's factory from running well. They are not sure where the trouble starts. But just like a real factory, backups and breakdowns in one system cause problems in other areas. As damage spreads, cells lose their ability to do their jobs and, eventually die, causing irreversible changes in the brain.
- Research over the past 20 years has shown us some very exciting things. We used to think that we had all the brain cells we would ever have when we were born. We now know that the brain can change and grow, forming new brain cells and new connections throughout the life span. It does not matter how old you are. Neural Plasticity is why adults are able to recover and re-learn skills after a stroke or other injuries to the brain. Plasticity is the brain’s ability to change and grow throughout life. When we learn new things, we’re forcing our brain to make new brain cells and new connections between brain cells. Our brain’s ability to create new brain cells is called neurogenesis. Most neurogenesis occurs in-utero (before we’re born), but creating new brain cells can happen throughout life. A brain that is resilient looks like a jungle. If you took a weed whacker to a jungle-you really would not make a big dent. The weed whacker represents the damage that a disease like Alzheimer’s can do. A resilient brain has reserves and may be able to delay the onset of symptoms. This is why keeping your brain active and learning may help slow-down the onset or help to prevent the development of Alzheimer’s.
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- As we age, our brains change. The aging process is associated with several structural, chemical, and functional changes in the brain as well as a host of other changes. Recent reports suggest that as organisms age, there are distinct changes in the expression of genes in our DNA that causes these changes. Through looking at brain images using CTs and MRIs, studies have reported age-related decreases in the size of different areas in the brain. Some brain regions shrink at a rate of up to 1% per year, while others remain relatively stable until the end of life. The shrinking of the hippocampus is why learning new things becomes more difficult as we age. Also by looking at brain images, we’ve learned that the part of the brain responsible for word retrieval matures then declines earlier than other parts of the brain. This is why word-finding becomes more slow as we age. From other studies, we’ve learned that the number of dendrite spines (or connections to other neurons) decrease in size and number. This explains why retrieval of information becomes slower after age 50.
- This is an exercise that utilizes a new tool to help with remembering a list. Memorizing a list of words can be difficult. Ask the audience to look at this list for 30 seconds. Then click-the list will disappear. Ask if anyone remembers the list. Some will have a few words but none will have them all. Explain that when you make a mental image-it helps you to remember because it uses other parts of the brain. Then click to have each of the images come up. A young man drove his antique car to a local drug store. When he tried to park, he accidentally bumped into a shopping cart
- GRAPHICS NOTE: Title should be Georgia 32. Text font should be Segoe UI. Adjust font size and position on all text as needed.
- GRAPHICS NOTE: Title should be Georgia 32. Text font should be Segoe UI. Adjust font size and position on all text as needed.
- GRAPHICS NOTE: Title should be Georgia 32. Text font should be Segoe UI. Adjust font size and position on all text as needed.
- GRAPHICS NOTE: Title should be Georgia 32. Text font should be Segoe UI. Adjust font size and position on all text as needed.
- The answer to this question is no-however… we can reduce the risk through holistic lifestyle choices.
- Optimum Life is Brookdale’s philosophy of wellness-incorporates six dimensions- physical, emotional, purposeful, social, spiritual and intellectual- that enlightens everything we do. You can remember the dimensions with the acronym PEPSSI This holistic philosophy is at the heart of all we do at Brookdale. The brain health program is designed around these six dimensions as there are things we can do in each dimension to improve brain health and also to impact overall well-being.
- There are basically two “buckets” of brain healthy foods. The first is antioxidants-these help to combat cellular damage that is happening all the time due to normal metabolism and aging. Eat a colorful diet with many fruits and vegetables. Apples, blueberries and cranberries are rich in a substance calle quercetin that helps to protect brain cells. Coffee and tumeric (a spice) also have shown to have benefit. Red wine in moderation is also good (1 6 oz glass per day for women and two for men) Optimum Life Cuisine at Brookdale Optimum Life Cuisine is a delicious way for residents to meet their healthy eating goals. It is abundant in whole grains, meats, poultry and fish, low fat dairy and includes a wide variety of fruits and vegetables. In addition, healthy fats, fresh herbs, spices and other low sodium seasonings are used in meal preparation. These elements are all found in the Mediterranean diet which has been shown in research to support good health, including good brain health,
- The second “bucket” is omega 3 fats. These fats are especially good for the brain. Remember the brain is 60% fat. Cold water fish like salmon, mackerel and tuna are great sources of Omega 3 fats. Flax seen, nuts and good oils are also sources. Fish oil supplements are used by many , but their benefit has not been proven. Talk to your doctor before taking supplements.
- There is a great deal of research related to the benefits of exercise. This is probably the single most important thing to do for brain health and over all health. It has many benefits, including producing a substance that helps to spawn new brain cells. You should get 30 minutes of moderate intensity exercise on most days of the week. Also, stay generally active throughout the day. Brookdale Fitness-B-Fit Brookdale’s signature exercise program At all Brookdale locations Based on the recommendations of the American College of Sports Medicine Includes brain healthy exercises, Tai Chi and relaxation
- The Einstein aging study is the landmark study that showed that leisure activities at least twice per week are beneficial for dementia risk reduction.
- Ask the audience why you think this is the case? Ballroom dancing is social, mental (have to memorize the steps), and fun! All things that are good for the brain.
- To begin with, stress is regulated by three components: the hypothalamus, the pituitary gland, and the adrenal gland, each working in tandem with the other. When the brain senses stress, the brain stem alerts the adrenal glands to send out sugar into your bloodstream, giving you that hyperactive feeling when stress kicks in. Additionally, your hypothalamus sends signals to your pituitary gland, telling it to release a hormone called cortisol in order to keep up the high amounts of sugar in your body, prolonging your stress time. Although the injection of these hormones into our bodies helps us overcome whatever causes our stress, there are, in fact, long term negative effects to prolonged periods of stress.
- Stress hormones are toxic to brain cells so stress reduction is a very important brain health strategy . Meditation helps to “turn down” the emotional part of our brain and relieve stress.. This image shows a scan of a brain before and after 10 minutes of meditation. Meditation has many benefits to the brain. Numerous studies have shown that meditation changes the brain and also helps with depression. Many other spiritual practices are good for the brain as well- such as prayer, gratitude, forgiveness, and attendance at worship services
- Many studies show the importance of social interaction for healthy aging Social support helps reduce dementia risk Relationships help to provide meaning and stimulate the brain. Residents at Brookdale are free to engage in as many social activities as they choose! This is one of the most beneficial and important reasons to live in a Brookdale community. Our goal is to provide a variety of interesting activities for ALL residents and to help them connect in ways that are meaningful to the resident.
- Keeping your brain ‘moving’ is a way to keep it healthy! Studies have shown that people who keep mentally active are less likely to develop Alzheimer’s. You can ‘stretch’ your brain by learning things such as: How to play an instrument Learning to paint or draw Learning a few phrases (or more) in another language Or even trying to write with your non-dominant hand
- Three factors associated with the least cognitive decline: education, exercise, and self-efficacy. Rush University: Those with a lesser sense of purpose were twice as likely to develop Alzheimer’s disease. UMichigan Institute for Social Research: those who assist others live longer.
- 1,238 older adults already participating in the Rush Memory and Aging Project and the Minority Aging Research Study. Participants averaged 78 years old and were dementia-free. People who reported a greater level of purpose in life were about half as likely to die over the follow-up period compared to people with a lower level of purpose. It doesn't seem to matter much what the purpose is. Dr Boyle: "What this is saying is, if you find purpose in life, if you find your life is meaningful and if you have goal-directed behavior, you are likely to live longer.”
- Memory is a way of holding onto the things you love, the things you are, the things you never want to lose. That’s why we’re here today. Our memories are precious --they give us an immense sense of satisfaction with our lives and provide a common bond with family and friends. A Met Life Foundation Survey in 2006 showed that outside of cancer, Americans fear Alzheimer's disease more than heart disease, stroke, and diabetes. Brookdale cares for over (90,00 number of) residents who are living with some form of dementia. This presentation is meant to help you learn: Some basic facts about your brain what you can do to slow the onset of dementia and how we here at Brookdale can help residents to live a brain healthy life
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