Richard G. Petty, MD

Brain Training and the Paradox of Aging

For centuries, people in cultures throughout the world have believed that increasing age is associated with increasing wisdom. Not just knowledge and experience, but wisdom. Is this an old wives’ tale, or is there something to it?

There is growing evidence that as we age our brains actually become stronger. Everyone missed it, because the emphasis was on memory, concentration and thinking speed, and those may all deteriorate with age. What changes is that as we age we become more efficient at making associations rather than thinking linearly. we also recruit regions of the brain that may have lain dormant for years. At the same time, different types of mental training, including meditation, can improve many aspects of our cognitive abilities, and may also enrich and even grow appropriate regions of the brain.

Some new data from a study being conducted at Wake Forest University Baptist Medical Center in North Carolina suggests that it is possible to use a fitness program for your brain that can improve thinking skills, attention and concentration as reliably as lifting weights can increase muscle strength.

Preliminary findings from the study, which used functional magnetic resonance imaging (fMRI) to record brain activity, were presented last week at the Organization for Human Brain Mapping conference in Chicago.

As we age, we do experience changes in how we perceive the information that our senses gather from the environment. As I mentioned older adults combine information from the different senses more readily than do younger adults. This is known as sensory integration, and the down side is that it can lead to difficulties in blocking out distracting sights and sounds while still maintaining focus on important information. You are probably familiar with the “Cocktail Party Phenomenon.” You are in a loud room, but because someone is saying something interesting, you are able to block out uninteresting information. This technical term for this is cortricofugal inhibition. As we get older it gets more difficult to do the inhibiting.

The Brain Fitness in Older Adults (B-fit) study has been designed to establish whether eight hours of brain exercise can improve the ability of healthy older adults, ages 65 to 75 years, to filter out unwanted sights and sounds.

The B-fit study uses fMRI to visualize blood flow and brain activity to determine how attention training affects brain function. The training involves either a structured one-on-one mental work-out program or a group brain exercise program. During the one-on-one sessions, the volunteers were asked to ignore distracting information and tasks get harder as the eight-week training progresses. For the group sessions, participants learn new information relevant to healthy aging and are then tested on their ability to apply the new information.

All participants had an fMRI scan during a distraction task. They had to look for target words or numbers while ignoring distracting sounds. The scans showed brain activity in areas related to both sight and sound. Follow-up fMRIs showed that in the group receiving the one-on-one training, activity related to sight was increased, while activity related to sound was decreased. In addition, performance on the task was improved.

So the data do indeed suggest that attention training is a way to reduce
older adults’ susceptibility to distracting stimuli and therefore help improve

And what about wisdom?

I have written in Healing, Meaning and Purpose that “Wisdom is the integration of understanding:” making more new associations and drawing conclusions based on a new perspective is a gift of aging. The training enables us to make sense of and communicate our conclusions.

When it comes to the brain, use it or lose!

Resilience, Misfortune, and Mortality

Much of the development of the ideas of Integrated Medicine has been driven by the idea that a truly effective holistic medicine does not simply integrate different modalities to achieve health and wellness, but is also aimed at integrating all the different aspects of a person into a coherent whole. That was the real reason for choosing the term “Integrated” medicine in the United Kingdom, though “Integrative” and “Integral” medicine are ultimately all aiming for the same thing.

This is quite different from simply adding some acupuncture, an herb or some relaxation therapy to a conventional medical program. Its aim is not so much getting someone better, as to give the whole person – physical, psychological, social, subtle and spiritual – what he or she needs to be able to get themselves back on an even keel, so as to be able to deal with future challenges as they arise. And not just deal with them, but to use challenges as springboards to growth and development.

The whole idea of this system of medicine included an extra dimension that had often been left out: the interaction between the person in trouble and the practitioner. We are social animals, but even more than that it looks as if we are highly interconnected from cell to soul. We have to take into account the impact of a therapeutic interaction on the clinician, as well as the influence of the clinician’s psychological, subtle and spiritual makeup on the individual.

The development of this system of medicine had many parents. One was the American-born Israeli sociologist Professor Aaron Antonovsky who first generated the idea of salutogenesis: the study of the factors that support human health and wellness. He was one of the first to show that people who were relatively unstressed were far more likely to be able to resist illness, compared with stressed people. His interest was not just in what causes disease, but what are the roots of health.

He returned to and discussed, developed and applied an idea that had been around since the work of Sigmund Freud and Roberto Assagioli: that was that our experience of well-being constitutes a Sense of Coherence (SOC). He defined the sense of coherence like this:

A global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that one’s internal and external environments are predictable and that there is a high probability that things will work out as well as can reasonably be expected.

Two recent studies seem to indicate that this concept of coherence is fundamentally correct.

Researchers in Cambridge in the United Kingdom have reported a population-based cohort of 20,921 men and women completed a postal assessment of their lifetime experience of specific adverse events and a measure of their sense of coherence. Those with a weak SOC reported significantly slower adaptation to the adverse effects of life experiences, compared with those with a string SOC, and were more likely to die prematurely. Although the size of the effect was not large, the results suggest that SOC is a potential marker of an individual’s adaptive capacity to deal with social stress, which is predictive of mortality

The second study was a systematic review from Finland. I like the way in which the study was done, and it came to this conclusion:

“SOC seems to be a health promoting resource, which strengthens resilience and develops a positive subjective state of health. Salutogenesis is a valuable approach for health promotion.”

So what does this mean for you?

Developing a sense of coherence is a most critical factor in creating and maintaining robust health and ability to adapt to change, be it in health, stress, your relationship or at work.

How do you do that? Healing, Meaning and Purpose spends over a hundred pages or several CDs explaining the most up to date ways of doing exactly that using a process known as Creative Self-Integration.

I do hope that you take the opportunity to sample some of the techniques for yourself.

Integrated Health and Aging

An important principle of the emerging laws of health and healing is that anything helpful should help more than one system of the body at a time. So a diet that might help mitigate the effects of aging in the skin should also have beneficial effects on the major organs of the body.

So I was encouraged to see a new report indicating that cardiovascular health and a healthy lifestyle are associated with maintaining the health of our brains as we age. This is, of course, intuitively obvious, but it is always nice to see such things confirmed by empirical research.

The new report is from a multi-Institute collaboration of the National Institutes of Health (NIH) published online in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. The chair of the committee was Hugh Hendrie, the Scottish-born professor of psychiatry from the University of Indiana, and the committee members were many of the most eminent people in the fields of aging and Alzheimer’s disease.

What is encouraging about this new report is that many of the factors associated with cognitive decline as we get older are eminently remediable: we have within our reach a set of potential interventions that could significantly reduce our personal risk of developing cognitive problems later in life. These are the things that we need to work on if we want to reduce our risk of developing cognitive decline later in life:

  1. Hypertension: There is excellent evidence that inadequately treated hypertension correlates strongly with cognitive decline.
  2. Physical activity: There is good evidence that elders who exercise regularly are less likely to experience cognitive decline. This is over and above the general improvement in quality of life that accompanies regular exercise. The earlier in life that we start, the easier it is to continue.
  3. Increased mental activity throughout life, including learning new things and going through higher education may benefit the health of the brain.
  4. Moderate alcohol use and the use of vitamin supplements also seem to be brain protectors, though the report does not specify which supplements.
  5. Social disengagement and depressed mood are both associated with poorer cognitive functioning, so it is important to be alert to signs of depression, and to maintain a social network. I discuss this in more detail in my book Healing Meaning and Purpose.

There are doubtless some genetic and environmental factors about which we can do little. But the idea that we now have a list of things that we can do to protect our brains is very exciting.

This report also signals another important change. In recent years we have seen the growth of Positive Psychology, the study of how to improve ourselves rather than the constant focus on psychopathology. This report calls for the research community to study health maintenance of the brain with the same energy that it has brought to bear on the study of diseases of the brain. To which I would add, that we must not just focus on how to maintain the health of the brain, but how we can enhance it’s function so that we can all reach and exceed our full potential.

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