Aging
Preventive Maintenance for the Brain

Dr. Molly V. Wagster, Ph.D.
Program Director for Neuropsychology of Aging research of the Neuroscience and Neuropsychology of Aging Program at the National Institute on Aging (NIA), National Institutes of Health (NIH)
Tuesday, February 21, 2006 12:00 PM

If it seems you're forgetting more as you grow older, you are. Like most other organs in the body, the brain gets smaller as we age, leading to a decline in memory, decision-making ability and verbal skills. That doesn't necessarily mean that you're on a steep downhill slide toward certain dementia, say experts. Growing evidence suggests there are steps you can take to better the odds of preserving your brainpower and protecting it against disease. (Read More.)

Dr. Molly V. Wagster, Ph.D. of the National Institute on Aging (NIA) was online Tuesday, Feb. 21, at noon ET to examine aging well and preventive maintenance for the brain.

Wagster is Program Director for Neuropsychology of Aging research of the Neuroscience and Neuropsychology of Aging Program at the National Institute on Aging (NIA), National Institutes of Health (NIH), Bethesda, Md. Wagster manages a portfolio of research in mechanisms of cognitive (memory, learning, attention, language) change with age that spans research from molecules to behavior. Wagster came to the NIA from the Department of Pathology, Division of Neuropathology, at The Johns Hopkins University School of Medicine. For more than a decade, Wagster investigated neural mechanisms of learning and memory changes with age in animal models and studied changes in neuroreceptor mechanisms in relation to cognitive decline in neurodegenerative diseases such as Alzheimer's disease and Huntington's disease.

The Transcript follows.

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Dr. Molly V. Wagster, Ph.D.: For additional information regarding the topic of today's forum, see the Alzheimer's Disease and Education Referral (ADEAR) Office at www. alzheimers.org or contact the ADEAR office at adear@alzheimers.org or 1-800-438-4380 [8:30-5 ET Mon-Fri]. Other resources of information can be found at the National Institute on Aging Web site at www.nia.nih.gov.

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Leesburg, Va.: What kinds of mental decline can be reduced or prevented altogether by diet, exercise, social interaction, or other environmental factors?

Dr. Molly V. Wagster, Ph.D.: While research findings are mounting in this area, it still is too soon to know specifics about whether certain types of cognitive function are influenced positively by specific lifestyle factors. One area where we do have some specific information is in the area of exercise. One small trial in humans indicated that modest exercise such as walking several times a week improved executive function in older, previously sedentary adults. Executive functions are those cognitive functions involved in switching easily from one task to another, inhibiting irrelevant information so that one can attend to the relevant information, planning and sequencing activities.

Increasing evidence from animal studies indicates that older animals can show improvement in cognitive function when their diets are supplemented with fruits and/or vegetables high in antioxidants.

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Rockville, Md.: If you're just turning 60 and are noticing that your short term memory is starting to make you a little forgetful--is this "normal" or the beginning of something worse? Is there anything you can do to prevent if from getting worse? (For example, you put laundry soap in the washing machine, and then a minute later can't remember if you did or not.) Also, does hardening of the arteries cause memory problems or dementia? Thanks.

Dr. Molly V. Wagster, Ph.D.: Most adults will experience normal cognitive changes with age. These types of changes can include: difficulty doing more than one task at a time, being slower to retrieve information from memory, being slower to learn new information, having difficulty remembering names or specific nouns (tip-of-the-tongue phenomenon). These types of changes, while annoying, are not of the level that they are interfering with one's ability to do one's job, take care of a household, take care of everyday activities.

We don't have a specific "prescription" yet for factors that will help prevent cognitive decline with age but mounting evidence from animal studies and large observational studies point to aerobic exercise/physical activity, control of hypertension and other forms of cardiovascular disease, diets rich in fruits and vegetables, social engagement, and mental engagement (reading newspapers, working puzzles, playing games, etc.) as being linked to better cognitive function with age.

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Gaithersburg, Md.: I've started doing word search puzzles and crossword puzzles daily before bed. Are these good for "brain exercise"? Are there other ones I could do as well?

I am only 31, but losing my faculties scares me. I already feel like I have a sieve of a brain!

Dr. Molly V. Wagster, Ph.D.: Staying mentally engaged doing activities that "challenge" our minds appears to be related to better cognitive function with age. However, we do not have definitive research evidence from human studies of what this would mean for each individual. Animal studies, where better control over the lifetime activities of the animal can be performed, indicate that enriched or novel environments can not only improve cognitive performance but can impact positive changes in the brain as well, even in older animals.

Do the puzzles only if they are enjoyable to you. And don't be too dismayed about forgetfulness - even at 31. Different times of our lives bring about different stressors of job, family pressures, lack of sleep, multi-tasking that can temporarily cause us to feel as if we aren't at our mental best. Unless the cognitive difficulties are affecting your ability to do your job, take care of yourself or your household, you probably are experiencing the same lapses as everyone else!

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Jupiter, Fla.: How can one be tested to determine the on-set of Alzheimer's?

Dr. Molly V. Wagster, Ph.D.: One should contact one's physician for a referral to a doctor experienced in assessing individuals for memory disorders. This individual might be a psychiatrist, a neurologist, or a psychologist (neuropsychologist). However, it is important that the doctor be someone who does these types of assessments routinely. He/she will be better able to distinguish between the different types of memory disorders and whether the disorder is something that could be reversed.

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Washington, D.C.: Hi, I have sustained several minor concussions that have lead to postconcussion syndrome (PCS). While I seemed to have mostly recovered from that, I haven't found much information about the effects of concussions on the brain as I age. Are there any correlation with concussions or minor brain trauma with increased risk of neurodegenerative diseases, such as Alzheimers, Parkinsons or other mental declines? While I'm happy that the short-term effects of PCS has finally become recognized by the medical field, I'm still frustrated and worried by the lack of information available about my long term prognosis. Concussions are very common, but I don't think much attention is paid to them if you don't have severe acute symptoms.

Dr. Molly V. Wagster, Ph.D.: There have been some observational studies linking head injuries with increased risk for Alzheimer's disease and other neurodegenerative diseases. However I, like you, am not aware of a body of literature examining whether there is a relationship between mild concussion and risk of Alzheimer's disease. You might be able to gain additional information or be pointed to a new resource by contacting the ADEAR Center (1-800-438-4380) mentioned in the opening statement.

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Rockville, Md.: Alzheimer's happens to run in my family. My great-grandmother had it. My grandmother, age 79, was diagnosed a year or so ago.

My mom, 49, is convinced she already shows signs of Alzheimer's, because she occasionally misplaces things and forgets details.

I try to tell her that she's only making these slips because of the huge amounts of stress she's under, caring for two elderly relatives, teaching 6th graders and holding together a family. There's just no convincing her!

She's been good about exercising, eating right and staying mentally active.

How do I get her to understand that she doesn't have to worry about Alzheimer's for quite a few years?

Dr. Molly V. Wagster, Ph.D.: It sounds as if your mother is doing all the right things for her health, except for avoiding the unavoidable stressors in her life. Perhaps everyone could pitch in to help relieve her of some of these stresses!

Having a family history of any type of disease often heightens individuals' sensitivities to warning signs. If your mother's concerns continue, and obviously they worry her, then she may wish to speak with her primary care physician and inquire about a cognitive assessment. The positive results just might put her mind at ease!

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Washington, D.C.: What is the value/correlation of Omega-3 fatty acid and is it a suggested part of the daily diet?

Dr. Molly V. Wagster, Ph.D.: Consumption of Omega-3 fatty acids, found in foods such as oily fish and walnuts, has been linked to protection against cognitive decline. There also are some studies in animals that have been genetically engineered to carry a gene for development of Alzheimer's disease that show that these animals show protection against the brain pathology of Alzheimer's disease when they are given omega-3 fatty acids.

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Redwood City, Calif.: Are there effective therapies for a patient with significant loss of short-term memory (e.g., asking the same question several times in a conversation), but no other signs of significant mental deterioration?

Dr. Molly V. Wagster, Ph.D.: Individuals with any type of significant memory deficit should seek the advice of their primary care physician and perhaps seek a referral for someone who specializes in memory disorders. I know of no specific "prescription" for individuals with short term memory loss vs. other types of memory loss. Another resource for further information would be our ADEAR center (mentioned in the opening statement).

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Woodbridge, Va.: At what age should a person really start to think about brain health maintenance? Most of us are so concerned with  o verall physical health and appearance only and start regular body maintenance when we are in our twenties. It seems like this would be the perfect age to be concerned with brain health as well?

Dr. Molly V. Wagster, Ph.D.: Brain health maintenance should start as early as possible! However, there is some evidence from human and/or animal studies that even if activities (exercise, mentally challenging activities, diet rich in fruits, vegetables) are not begun until older age, cognitive benefits may be derived.

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Washington, D.C.: My father has been diagnosed with Alzheimer's Disease. He is still in the early stages, but he has noticeable trouble with his short term memory. He is currently taking Aricept. What are some other things my family can do to help him?

Dr. Molly V. Wagster, Ph.D.: Insuring that he has adequate sleep, that he engages (if able) in frequent aerobic exercise, that he eats a healthy well-balanced diet, and that he continues to have opportunities for rich social engagement may provide some help in maintenance of his cognitive function.

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Sterling, Va.: Have there been any studies linking occupation type to memory loss, i.e, the type of work one is engaged in and its effect on memory?

Dr. Molly V. Wagster, Ph.D.: There have been some studies that have examined the relationship between occupation and cognitive function. Generally, the more complex the work, the more positive the cognitive benefits. An authority on this topic is Dr. Carmi Schooler at the National Institute of Mental Health.

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Washington, D.C.: Some deficits that are usually taken to indicate deficits in cognitive ability in the elderly seem to have a large contribution from reductions in sensory processing with age. See, e.g., B. Schneider, M. Daneman, et al. (2000) Listening to discourse in distracting settings: The effects of aging. Psychology and Aging, vol. 15, 110 - 125. Do you have recommendations for sensory testing and remediation (e.g., hearing aids) as one way to improve the elderly's use of the information that impinges on them?

Thank you.

S. Parker, Dept of Psychology, American University

Dr. Molly V. Wagster, Ph.D.: I don't have any recommendations but I do agree that there are several lines of evidence linking sensory deficits to cognitive declines. The exact basis of this is not known but suffice it to say that it is important that individuals try to address seeing and hearing problems. Obtaining and using assistive devices (eyeglasses, hearing aids) may positively impact their cognitive function.

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washington, D.C.: Are there medications which affect memory or general cognitive function?

Dr. Molly V. Wagster, Ph.D.: There are any number of medications that could affect cognitive function. However, any given medication can affect individuals in different ways and although some might experience "fuzziness" others might not. If you feel that your medication(s) might be contributing to some problems in cognition or if you are concerned that a new medication might have this effect, speak with your doctor about it. Perhaps an alternative could be prescribed that would work as well for you but without an impact on your cognitive function.

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Rockville, Md.: A few years ago I read a book on the nun study in Minnesota, I think. One finding in the book was that women who had depression in their younger years were more likely to develop Alzheimers than those who did not. Is there any info on whether those who have depression, but it is treated with meds, lessen their chances of Alzheimers, or if it remains the same?

Dr. Molly V. Wagster, Ph.D.: There is observational evidence of a link between depression and development of Alzheimer's disease but we have no research to date that successful treatment of depression prevents Alzheimer's disease. However, there is some research that indicates untreated depression may negatively impact brain health.

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Dr. Molly V. Wagster, Ph.D.: Thanks for the opportunity to answer your questions. I am sorry that I was unable to get to all of the wonderful questions but hope that you will avail yourself of the resources I listed in the beginning.

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