Transcript Memory: The Long and Short of it

Brain Span =‘s Life Span
James Siberski MS,CMC
Assistant Professor
Misericordia University
[email protected]
Defining the problem!
Can we handle the BOOMER’S
Boomers
+ today's cohort of older people =‘s $$$$$$$$$
A hypothetical intervention that delayed the onset of AD
dementia by 5 years would result in a 57% reduction in
the number of patients with AD dementia, and reduce
the projected Medicare costs of AD from $627 to $344
billion dollars
Everyone - religious organizations , big business,
Government, ……… to have a prayer of meeting the needs
Aging healthy it has not changed that much?
Roger Bacon (c. 1220-1292)
•Franciscan friar
•English philosopher
•Oxford professor
•Old age could be thwarted off by:
eating a controlled diet
proper rest
exercise
moderation in lifestyle
good hygiene
inhaling the breath of a young virgin
(Kind David…sleeping between 2 virgins)
Memory Processes
Rehearsal
Sight
Elaboration
and
Organization
Smell
Sound
Sensory
Memory
Attention
Short-Term
Memory
Long-Term
Memory
Retriev al
Taste
Touch
Lost
Lost
Memory
Memory is the basis for knowing your friends,
your neighbors, the English language, the
national anthem, and yourself.
If memory was nonexistent, everyone would be
a stranger to you; every language foreign; every
task new; and even you yourself would be a
stranger.
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The Phenomenon of Memory
Memory is any indication that learning has persisted
over time. It is our ability to store and retrieve
information.
BRAIN HEALTH IS IMPROTANT
BRAIN SPAN NEEDS TO = LIFE SPAN
NOT MATTER
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Reserve Function
Excess Capacity (Developed)
Reserve Function
Reserve Function
Basal Capacity
Age 40
Basal Capacity
Age 80
Memory Health
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How healthy your memory is depends quite a bit on how healthy you are. We all
notice fluctuations in our ability to remember from time to time. Your memory
might seem less efficient when you are very sick, emotionally stressed or
excessively busy.
Take the time to run through this memory health check:
Are you taking any medication, and if so, do you know if it can affect your
memory?
Is your vision or hearing impaired in any way?
Do you have chronic pain?
Is your sleep disturbed?
Are you experiencing a high level of stress or anxiety?
Could your hormone levels be altered at the moment?
Do you think you might be depressed?
Is your workload to heavy?
Do you drink too much alcohol, or use drugs to excess?
If you are worried about your memory and you answered yes to any of these
questions, it might be time to take action.
Brain Myth #1: You can't change your brain.
• Your brain is constantly changing in response to your experiences, and it
retains this basic "plasticity" well into old age.
• Everything we do and think about is reflected in patterns of activity in our
brains.
• Scientists can see these patterns in brain-imaging scans that show which
parts of the brain are functioning during specific tasks.
• Changing our thinking or changing the way we behave causes
corresponding changes in the brain systems involved.
• This is why therapy that teaches people to alter negative patterns of
thought and behavior (like cognitive therapy, for example) can be effective
in treating some mental disorders.
Brain Myth #2: People lose brain cells every day and
eventually just run out.
• Actually, most regions of the brain do not lose brain cells as
you age.
• While you may lose some nerve connections, this is not
necessarily a bad thing. It can be part of the reshaping of the
brain that occurs with experience.
• It's also possible that you can even grow new brain cells and
create new connections, or prevent the ones you have from
withering, if you exercise your brain
Brain Myth #3: The brain doesn't make new brain cells.
• This myth was widely believed for generations, but
has recently been proven false.
• We now know that certain areas in the brain—
including the hippocampus (where new memories
are created) and the olfactory bulb (the scentprocessing center)—regularly generate new brain
cells.
• Many of these cells go on to become working parts
in brain-cell connections.
Brain Myth #4: Memory decline is inevitable as
we age
• Many people reach very old age and are still sharp as ever. Genetics clearly
plays a role in "successful aging," but how we live our lives on a day-to-day
basis is also critical.
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To help your brain age well, you can:
Perform physical exercise (especially aerobic exercise)
Engage in intellectually stimulating mental activity
Eat a healthy diet
Maintain social connections (spending time with friends and family
members, for example)
Learn to manage stress
Develop a positive attitude toward yourself and your world
Ginkgo biloba
• Ginkgo biloba is the oldest species of tree known, dating back 300
million years.
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In Europe physicians write over 1.2 million prescriptions per month
for ginkgo to help improve cerebral circulation, mental alertness,
and overall brain functioning.
• Numerous human studies on ginkgo have been published, which
show that ginkgo leaf works by increasing blood flow throughout
the body and brain.
• It has been shown to be helpful with many of the complaints of the
elderly such as short-term memory loss, slow thinking and
reasoning, and dizziness.
Fish oil/DHA/EPA
• The omega-3 fatty acids EPA and DHA are the
preferred brain fats. Essentially the only place you
can obtain these fatty acids is by eating fish and
other seafood.
• The saying, “Fish is brain food” is correct: if you
don’t eat fish and consume other less desirable
fats such as the trans-fats found in margarine or
heated rancid fats such as are typically found
when food is deep fried, your brain incorporates
these fatty acids into its infrastructure(!)
L-glutamine
• L-glutamine is an amino acid that serves as an
important source of energy for the brain.
• Supplementation with l-glutamine has been
found to help improve mood, mental
performance and both long- and short-term
memory.
• What can be done to improve, maintain our
memory ?
1st do not:
Compared with the brain of an individual with no history of inhalant abuse (A), that of
a chronic toluene abuser (B) is smaller and fills less of the space inside the skull (the
white outer circle in each image).
2nd Do stimulate your whole brain
Why am I optimistic?
The defective, right side of three-year-old brain which was removed during surgery for
Rasmussen's encephalitis, a condition that causes seizures every few minutes. The
right side of brain typically controls the muscles on the left side of the body and is
more dominant for processing music and visual imagery
The 3 key principles for good brain exercise We need
to know and teach:
• Novelty: you need to try new things, including things you
aren’t good at.
• Variety: given that the brain is composed of a variety of
functionally distinct areas, you need to ensure a complete
mental “workout circuit” to maintain sharpness in all areas.
Excessive specialization is not the best strategy for our longterm Brain Health.
• Challenge: you need to be exposed to increasing levels of
challenge, so the task is never too easy.
If you can only do one thing, learn something new every day,
no matter how small.
Neuroplasticity
• The hope of many scientists researching
neuroplasticity is that humans will be able to combat
things such as ID, addiction, dyslexia, and more by
harnessing the brain's inborn ability to change.
• One way to harness the power of neuroplasticity is
through the use of Brain-computer interfaces
Brain Plasticity
• Brain reacts and adapts in response to
challenge.
• Recent brain imaging technologies show as we
receive input through our senses with
frequency, intensity and duration, the brain
physically changes its structure.
• New connections and neurons sprout.
• Once structure changes, function can change.
Alzheimer’s –Dementia
Today
Tomorrow
Alzheimer’s
MEDICATION AND
TREATMENT
TESTS
WILD CARD
EARLIER TREATMENT
BETTER
MEDICATIONS
BETTER - TESTS
WILD CARD
WILD CARD (all of you!)
YOU
TECHNOLOGY
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YOU HAVE TO GO TO DOCTOR
YOU HAVE TO HAVE ASSESSMENT
YOU HAVE TO ALTER LIFE STYLE
YOU HAVE TO PLAN
YOU HAVE TO POSTPONE
YOU HAVE ……………..
AD – DISEASE & AD - DEMENTIA
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Converging evidence from both genetic at-risk cohorts and clinically normal older
individuals suggests that the pathophysiological process of Alzheimer’s disease
(AD) begins years, if not decades, before the diagnosis of clinical dementia
The long preclinical phase of AD provides a critical opportunity for potential
intervention with disease-modifying therapy
A recent report on the economic implications of the impending epidemic of AD, as
the “baby boomer” generation ages, suggests that more than 13.5 million
individuals just in the United States will manifest AD dementia by the year 2050
A hypothetical intervention that delayed the onset of AD dementia by 5 years
would result in a 57% reduction in the number of patients with AD dementia, and
reduce the projected Medicare costs of AD from $627 to $344 billion dollars
AD would be optimally treated before significant cognitive impairment, in the
“presymptomatic” or “preclinical” stages of AD
This model postulates that amyloid beta (Aβ) accumulation is an “upstream” event in the cascade
that is associated with “downstream” synaptic dysfunction, neurodegeneration, and eventual
neuronal loss
Gammagard
• "If we have a patient who goes out to 18 or 24
months without changing, then we usually
begin to doubt that they have
Alzheimer's...but to have 4 patients, all of
whom received the same dose and who are
effectively unchanged after 3 years, is a
remarkable
It is given once every two weeks, with an estimated to cost a patient $2,000 to $5,000.
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Immunotherapy with intravenous immunoglobulin (IVIG/Gammagard, Baxter) appears to
stabilize symptoms of Alzheimer's disease (AD) over the long term
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At 36 months, IVIG slowed the rate of expected cognitive decline in all participants.
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But the most striking finding was that it stopped decline in a subset of patients who received
what proved to be the optimal dose of the immunotherapy for the entire study period.
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For this subset of 4 patients, measures of cognition, memory, daily functioning, and mood
were unchanged from baseline after 3 years of treatment.
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To put this in perspective, when we see patients in our clinic with AD who are untreated,
there's usually measurable decline below baseline in 3 to 6 months. If we treat them with the
currently available agents, they typically drop below baseline between 6 and 12 months.
Souvenaid, Nutricia/Danone)
• Medical nutrition product (Souvenaid, Nutricia/Danone) showed that
memory performance continued to improve in drug-naïve patients with
mild AD for up to 48 weeks.
• These latest OLE results immediately follow those of the double-blind,
randomized controlled Souvenir II study, published in the July issue of the
Journal of Alzheimer's Disease, which showed significant improvement in
memory performance compared with placebo over 24 weeks
• The bottom line is that we have now conducted 2 large studies with this
medical food that aims to restore the function of synapses in mild to very
mild Alzheimer's disease and have proven that it improves memory
Axona
• The bottom line is that we have now conducted 2 large
studies with this medical food that aims to restore the
function of synapses in mild to very mild Alzheimer's disease
and have proven that it improves memory
• Both coconut oil and Axona are high in calories and saturated
fat, but some research suggests that coconut oil neither
increases weight nor adversely affects lipid levels.[2,16,17]
Gastrointestinal adverse effects, particularly diarrhea, were
frequent causes of discontinuation in the phase 2 study.[3]
Coconut oil costs about $12 for 16 oz. Axona costs about $85
per month.
Memory/Brain Health Spa’s
#5
http://www.cognifit.com
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Inhibition
Planning
Eye-hand
Divided attention
Visual perception
Time estimate
Shifting Visual scan
Awareness
Wk Memory
Response ST
Memory
Spatial
Naming
#5
Waitlist
Inhibition
SO ID INDIVIDUALS CAN LEARN!
Planning
Eye-hand
Divided att
Visual perc
Time est
Shifting
Visual scan
Awareness
Wk Memory
Response
ST Memory
Spatial
Naming
Placebo
Inhibition
Planning
Eye-hand
Divided att
Visual perc
Time est
Shifting
Visual scan
Series1
Awareness
Wk Memory
Response
ST Memory
Spatial
Naming
Experimental
Inhibition
Planning
Eye-hand
Divided att
Visual perc
Time est
Shifting
Visual scan
Awareness
Wk Memory
Response
ST Memory
Spatial
Naming
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What the aging brain needs:
A pumped-up blood
flow
• Variety and Challenge
• Good Nutrition
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Lifestyle Choices for Lifestyle Recommendations Health
If you are 45 years old and do all of these (rather than
none) you will live longer.
(men- 7 years, women-11 years)
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Sleeping 7-8 hours per night
Weight Control
Exercise
Limited Alcohol
Non-smoking
Eating Breakfast
Seldom Snacking
Belloc et al
Nutrition or A Waist is a Terrible Thing to Mind
Foods for Health
Lifestyle Recommendations
Dietary Reference Intakes
The National Academies
Press, 2005
Minaker et al
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Tea, green
1-6 cups
Coffee
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Fish
2-3 times/week
Cooked Tomatoes
10 servings/week
Fiber
> 25 gm/day
Nuts
> 5 oz/week
Chocolate
dark
Saturated fat < 10% total calories/day
< 1/3 of all fat intake
9. Fruit
> 4 Servings/day
10. Alcohol
1.5 oz/day- women
3 oz/day-men
Wine?
IF YOU DO STOP!
Cognitive Remediation of the Alzheimer Patient:
Client Disease Modification or Symptomatic Relief
Shore, R. 1997
Medication
Drug Side Effects Include Memory Loss
Drugs That May Interfere in Thinking and Memory:
• Antiarrhythmics: Digoxin (Lanoxin), disepyramide (Norpace)
• Antibiotics and antivirals: Acyclovir (Zovirax), ciprofloxacin (Cipro),
ganciclovir (Cytovene), metronidazole (Flagyl)
• Antihistamines: Chlorpheniramine (ChlorTrimeton), dimenhydrinate
(Dramamine), diphenhydramine (Benadryl Allergy)
• Antihypertensives: Clonidine (Catapres) and beta blockers, such as
atenolol (Tenormin), metoprolol (Lopressor), and propranolol (Inderal)
• Corticosteroids: Methylprednisolone (Medrol, Meprolone), prednisone
(Deltasone, Orasone)
• Cough and congestion medications: Dextromethorphan (Robitussin
Cough Gels), pseudoephedrine (Sudafed)
• Incontinence medications: Oxybutynin (Ditropan), solifenacin
(VESlcare), tolterodine (Detrol)
Drug Side Effects Include Memory Loss
Drugs That May Interfere in Thinking and Memory:
• Gastrointestinal medications: Cimetidine (Tagamet), diphenoxylate
(combined with atropine in Lofene, Lomotil), dicyclomine (Bentyl), glycopyrrolate
(Robinul), hyoscyamine (Anaspaz, Cystospaz), scopolamine (Scopace)
• Migraine medications: Naratriptan (Amerge), rizatriptan (Maxalt)
• Muscle relaxants: Cyclobenzaprine (Flexeril), orphenadrine (Antiflex)
• Painkillers: Codeine (generic); meperidine (Demerol), pentazocine (Talwin),
propoxyphene (Darvon)
• Parkinson’s medications: Amantadine (Symmetrel), levodopa (Sinemet),
selegiline (Eldepryl)
• Sleep medications: Eszopiclone (Lunesta), zaleplon (Sonata), zolpidem
(Ambien CR)
• Tricyclic antidepressants: Amitriptyline (Elavil), imipramine (Tofranil),
notriptyline (Pamelor)
Any intellectually challenging activity stimulates dendritic growth,
which adds to the neural connections in the brain.
The more mentally challenged sisters had more neural connections,
which allows them to reroute messages to the brain.
Counteracting the debilitating effects on the brain of dementia and
Alzheimer’s.
The phone has one pre-dialed number
If you want your brain span to equal your life span?
Conclusions!
• At any age:
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Enrich your environment - travel, games, dancing
Eat right - Med diet, H2O, supplements
Exercise - mind, memory and body
Education - learning new things everyday
Entertain - socializing
Evaluate - health, practice wellness, drugs you take
Estimate - quality of sleep
Examination - by MD and Dx. Memory issues
Expend – the effort to have memory span = life span
The End
IT WORKS FOR ME!