Authors: Majid Fotuhi
Other studies have shown similar results in people who become highly proficient in other activities. Basketball players, for example, experience growth in the parts of the cerebellum associated with eye–hand coordination and balance, mathematicians’ parietal lobes are larger than their peers, and novice golfers experience an increase in the sensorimotor areas of their cortices as they learn to golf. In fact, in the case of the golfers, a visible increase in brain size was noted on MRIs after just forty hours of training in the sport.
8
If You Use It, You Won’t Lose It
It probably doesn’t surprise you to hear that cognitive stimulation throughout life can help stave off late-life dementia. Anecdotal evidence has long existed. There’s the ninety-year-old who continues to go to work every day and credits his hours in the office with keeping him sharp. Or the eightysomething who says daily crossword puzzles have kept her mentally nimble.
Not all intellectually stimulated people avoid dementia, but research supports the notion that staying mentally engaged—playing board games, reading, playing a musical instrument, or dancing—is associated with a reduced risk of developing dementia and improves cognitive function late in life.
9
We now know people engaging in such activity are protected against Alzheimer’s disease because they’ve built brain reserve throughout their lives, making their brains bigger and stronger.
Perhaps one of the more interesting studies on this topic, though, is being done by my colleagues at Johns Hopkins University, in Baltimore. This research grew out of a program called Experience Corps, which got its start in 1988 when former Secretary of Health, Education, and Welfare John Gardner drafted a concept paper on his idea to pair senior citizens with grade school children—for the betterment of both. The idea was simple: put to use the wisdom, time, and talent of older adults in order to help children at a critical juncture in their educational lives.
The elderly would volunteer in schools, primarily in low-income areas. For the kids, having one-on-one time with an adult who could act as both mentor and tutor would surely lead to higher achievement in school. For the adults, making a commitment to get up and out to “work” several times a week would increase physical activity and social interaction, not to mention offer the psychological reward of helping others and putting to use the knowledge they’d acquired over a lifetime. It would be, Gardner believed, a win-win.
Gardner’s plan led to a pilot program that launched in 1996 in five U.S. cities. Volunteers had to commit to being in school fifteen hours a week and spend their time with the same teacher and students for the duration of the school year. The pilot was a success, and by 1998 it had been expanded to other cities.
From the start, the pilot program had included a team of researchers at Johns Hopkins’s School of Medicine and Bloomberg School of Public Health, including my colleague Dr. Michelle Carlson. The team’s job was to help design the program and then to study its impact.
When it came to the students, Experience Corps was clearly a win. Third-graders in the schools with Experience Corps volunteers scored significantly higher on a standardized reading test than children in the control groups; plus, they had fewer behavior problems. Volunteers, meanwhile, reported being more socially and physically active. And there was something else. “I got a lot of feedback saying ‘this really removed the cobwebs from my brain,’ ” recalls Dr. Carlson, an energetic and inquisitive researcher who is also associate director of Johns Hopkins’s Center on Aging and Health. “They were saying it without any prompting from me.”
The elderly study subjects weren’t imagining it either. When their cognitive skills were tested, those who’d taken part in Experience Corps exhibited improvements in executive function and memory over the study period.
10
In fact, those who’d started the program with the poorest executive function showed gains of up to 51 percent in executive function and memory after six months. Members of the control group who were similarly impaired at the start of the study actually showed declines in decision making (which you’d expect, given the normal course of aging).
But what exactly was going on in the brains of those who’d volunteered? To find out, Dr. Carlson and a group of colleagues recruited eight volunteers to take part in Experience Corps and nine age-matched controls who were waitlisted to take part the following year. The volunteers underwent fMRI scans before being placed in a school. Then they went through training and got to work tutoring and mentoring students in kindergarten through the third grade.
After six months, a new round of fMRIs offered proof that experience significantly changes the brain: those who participated in Experience Corps showed measurably increased activity in their left prefrontal cortex and anterior cingulate cortex as they performed a cognitive test.
11
The Experience Corps volunteers also did better on tests of executive function.
Why? Taking part in the program required cognitive stimulation. Planning how to get to school every day, for example, kicked the frontal lobes into gear, as did working as part of a team of volunteers in order to complete tasks and adapting to the needs and abilities of children in the classroom. The program also offered a “workout” for memory: volunteers had to learn or relearn the Dewey decimal system so that they could lend a hand in school libraries. And they had to familiarize themselves with learning materials and remember the names and faces of the students and teachers they interacted with. Finally, being part of Experience Corps offered regular opportunities for social interaction, which requires the use of various cognitive abilities (as you’ll soon read).
That they’d offset at least some of the effects of aging by taking part in Experience Corps offers a compelling argument that cognitive stimulation is a worthwhile pursuit at any age. This is tremendously exciting news for everyone but particularly for anyone past midlife who wants to sharpen his or her mind—and keep it sharp longer. It’s the reason I make cognitive stimulation a critical part of my brain fitness program, and why you’ll need to make it part of your plan to grow your brain. Practice
does
make cortex.
Building Brain Reserve One Thought at a Time
I’m going to give you guidance at the end of this chapter on different types of cognitive stimulation you can try. But while you need to take part in scheduled activities, just as you do for exercise, I also advise making mental gymnastics a part of your every day.
Dining out and ready to sign your credit card slip? Instead of whipping out your phone to calculate the tip, do the calculation by hand or in your head. Make a practice of remembering phone numbers rather than just programming them into your phone. Use your GPS, but read a map too. Predict the total of your grocery bill before the cashier rings it all up. Think! Whenever you can, think.
Practice . . . but What?
If you’re like most of my patients, your next question will be a logical one: What
kind
of practice? People don’t usually stick with activities they don’t enjoy, so I always let them pick their own preferred pursuits when it comes to cognitive training. But I do offer some guidelines.
For starters, I recommend choosing an activity that allows you to cross-train different parts of your brain. Carpentry is a good example. If you’re building furniture, you’ll need to engage your attention and focus to figure out what materials you’ll need, what pieces you’ll create, and how they’ll fit together. You’ll use the parts of your brain responsible for mathematical calculations as you measure and calculate the sizes of each piece. And as you operate tools and manipulate the wood, you’ll rely on the parts of your brain responsible for manual dexterity, organization, and attention. All told, you’ve enlisted your frontal, parietal, and occipital lobes. Not bad for manual labor!
I also recommend regularly reaching outside of your routine to add new activities to your life. If you’ve always played bridge, you can consider it cognitive exercise (it is!), but you won’t get as much value for those three hours a week you play bridge as you will doing three hours of something new. Why? Learning something new is a fantastic brain grower, because it actually requires the development of new synapses, rather than merely the strengthening of existing synapses.
Finally, in addition to cross-training within the brain, I recommend cross-training your cognitive stimulation with exercise and social interaction. This multiplies the reward. To understand why, consider the benefit you get from riding a bicycle. It’s good exercise, which will help grow your brain. But joining a cycling group is even better, as it adds social interactions that work the mind. Even more bang for your buck: join a cycling group and take on the responsibility for planning the group’s routes. Your mapping efforts will give your brain a workout before you even climb aboard your bike, and interactions with your cycling friends add a brain benefit as well.
The Power of Engagement
Exercise and overt cognitive stimulation might seem like no-brainers when it comes to cross-training your brain, but the value of social interaction shouldn’t be underestimated either. In fact, it’s likely that social interactions are a vital part of the benefit recorded in some cognitive stimulation studies. In the Experience Corps program, for example, it’s difficult to tease out how much of the benefit came simply from being regularly engaged with other people. Dr. Carlson thinks the social aspect surely had an impact—and I agree.
Why would regularly engaging with people affect your brain structure and size? You may not realize it, but interacting with others actually requires a good deal of mental maneuvering. To understand why, imagine yourself standing amid friends at a cocktail party. As you mingle and chat, you may need to keep track of several conversations as well as information about those you encounter, making assessments about your relationships and tailoring your conversation appropriately. Remembering that the person to your right is a strong gun rights advocate, and the person to your left isn’t, you might decide to steer clear of the topic (or not, if you’re interested in a debate). Bantering with someone you don’t know well, you might resist the urge to tell a political joke—a sign your frontal lobes are in play.
Such mental gymnastics help us exercise various parts of our brains, building synapses, but they also likely aid brain growth in other ways. Interacting with others often brings us pleasure, which may lead to the release of endorphins or other neuropeptides, similar to the runner’s high we get from a long run. Taking part in social activities may also reduce our levels of stress and therefore reduce excess cortisol, which, as you’ll soon read, is a major brain shrinker. How much, we don’t yet know, but I consider social interaction to be an important component of cross-training the brain.
In addition to engaging in cognitive activities that cross-train, I recommend something else for all my patients: regular memory workouts to grow the hippocampus and improve skills of memorization. That’s because the hippocampus, you’ll remember, is one of the first areas of the brain to deteriorate as we age. Building it up will help offset that natural process, for benefits now and later. When I suggest memory training, though, I’m often met with a knee-jerk response: “But I have a terrible memory,” my patients will protest.
They’re not alone in thinking that. Easily 90 percent of my patients feel the same way. It is, in fact, the most common complaint I hear from patients (and from friends at cocktail parties). They are often shocked to learn that even people who perform tremendous feats of memory likely once felt the same way. It’s at that point that I tell them about my remarkable friend, Nelson Dellis.
A Champion’s Brain
On a crisp spring day near the end of March 2012, I strode onto a stage in the stately nineteenth-floor event room of Manhattan’s Con Edison building to face an audience of several hundred people. Though they varied greatly in age, race, and occupation, everyone in the room had one thing in common: they all had memory on their minds. They were here, after all, to witness—or participate in—the fifteenth annual USA Memory Championship, a competition designed to test incredible feats of recall. I was about to launch into a presentation detailing ways to increase brain size and improve memory too. For simplicity’s sake, I gave the audience just three pieces of advice: eat well, exercise, and make that brain of yours
work
.
I can’t get inside the minds of anyone in the room that day but I’m fairly sure that, at least for a certain subset of my audience, the admonition to put their brains to work didn’t come as much of a surprise. After all, they’d spent the morning doing just that, committing to memory the names of strangers, the order of a deck of cards, and long strings of random numbers, among other things.
The competition had kicked off at 8:45
A.M.
with the fifty-six participants—or as the competition founders like to say, “mental athletes”—spending fifteen minutes memorizing a series of names and faces. In the front row was Nelson Dellis, an affable six-foot-six twenty-eight-year-old computer scientist and reigning USA Memory Champion from Miami. Not far away, sporting a cowboy hat, was thirty-eight-year-old Texan Ron White, a two-time memory champ whose southern drawl and quick wit would liven up the proceedings throughout the day. Off to one side of the room sat Michael Glantz, an amiable eighteen-year-old who, despite his youth, had managed in 2011 to set a record in the poetry contest.
The names-and-faces challenge was followed by “speed numbers,” a test of participants’ ability to remember randomly generated digits in five minutes. By 10:45
A.M.
, the group had moved on to the especially challenging poetry competition, in which participants were asked to memorize a previously unpublished poem.