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One of the most important things I do for patients with memory problems isn’t giving them medicines. It’s actually taking them away.
Some common medications, even those that you can buy without a prescription, can have a negative effect on your memory and alertness. And some medicines that are completely safe in younger people have bad effects in older persons. One of the best things you can do for your memory is go over your medications with someone who knows about medicines and how they affect older persons.
Medications that may have a negative effect on memory are those that have anticholinergic effects. They act to decrease the effectiveness of a brain chemical called acetylcholine. Acetylcholine is a brain chemical that is essential in memory. The part of the brain with the most nerve cells that use this chemical is one of the first affected when someone has Alzheimer’s disease.
Probably the most commonly used medication used by older persons that has anticholinergic effects is the antihistamine Benadryl,® It’s a perfectly good medicine, but in its generic form diphenhydramine it’s in many over-the-counter sleep medicines. If you have memory problems and take this medicine regularly, you might want to try stopping it and see how your memory functions without it.
Another group of medications that can affect memory are the benzodiazepines. These are commonly-used medicines for anxiety and sleep such as Xanax,® Ativan,® Klonopin,® and many others. They can affect memory in a different way from diphenhydramine. If you’re taking one of these medicines regularly, it usually isn’t a good idea to stop taking it suddenly. You might want to talk to your doctor about alternative medicines for anxiety and sleep.
“Useful field of view” is a concept that on the surface may not immediately make sense. It means how much of what you see can be acted on. If the focus of our attention becomes more narrow as we age, then our useful field of view may get smaller, too. Useful field of view, or UFOV, is related to driving skills in older persons, and some people believe that it can be trained. Dr. Karlene Ball and her colleagues at the University of Alabama have developed a computer program for training UFOV and shown that it is effective in helping older persons develop better attention skills. Some research suggests that the training can improve driving skills, too.
Now the insurance company Allstate has weighed in on the subject. According to a press release on the Posit Science website, Allstate and Posit are partnering to provide UFOV training to some of the people Allstate insures. Allstate may be giving people a break on their insurance rates, so they are taking the issue seriously.
The UFOV task is part of a software package available as part of the Miami Brain Fitness program. Interested persons can arrange for a consultation with me by calling 305-243-4082. We’ll be happy to show you the software and give you an individually-tailored set of recommendations for improving your brain fitness.
A recent study reported in the journal Neurology once again gives us more evidence about how important exercise may be for keeping your brain healthy.
The study looked at how fit two groups were. One group included people without memory problems and had an average age of about 72 years. The second group included people with Mild Cognitive Impairment and early Alzheimer’s disease. Their average age was about 74 years (this difference wasn’t statistically significant). Both groups included about the same number of men and women and were well-educated (many had at least some college-level education).
The researchers looked a measure of how well the lungs can use oxygen that’s referred to as “VO2 max.” It’s an index of how well the heart and the lungs work during exercise.
They looked at the brains of people in each group using magnetic resonance imaging (MRI). From this, they could calculate how big several parts of the brain were.
They gave all the participants a battery of neuropsychological measures that assessed their thinking and memory abilities.
The researchers showed that for the people with memory problems (those with mild cognitive impairment and early Alzheimer’s disease) there was a relationship between fitness and how big the brains of the patients were. People who were more fit had bigger brains. They had more gray matter – that’s the part of the brain that includes nerve cells. (White matter has the fibers that connect the parts of the gray matter.)
For the people who didn’t have memory problems, there wasn’t a relationship between the size of the brain and fitness. But in this group, there was a relation between fitness and how well they did on the neuropsychological tests.
This study shows two things that are important. First, it confirms that people who are more fit do better on test of memory and other thinking skills. Since other studies have shown this, this isn’t new. Second, it shows that the size of the gray matter in the brain in people with early stages of memory loss is related to fitness. This is new, and gives us a clue about why physical fitness might be related to brain fitness.
One warning: like many studies about risk factors and memory loss, this study is only looks at the way two things are related. Researchers call this kind of study correlational, because it looks at the relation between two things using a statistical measure called correlation. It’s important to remember that in this kind of study, we don’t know which way the two things are related.
It may be that better fitness causes people to have more nerve cells. On the other hand, it may be that people with more nerve cells exercise more. So although this study continues to emphasize the importance of fitness, we should interpret it with a little bit of caution.
The study appeared in the journal Neurology, 71, 210-216 (July 15, 2008)
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- Meditation as Brain Training
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Mindfulness meditation as practiced over a long period by experts makes clear changes in someone’s brain function. But what about those of us who don’t have a few years to sit in a monastery in the Himalayas? A new study shows that even brief meditation practice can improve attention.
I saw an interesting blog post yesterday evening on the site of the Huffington Post about the potential benefits of meditation – or at least about what one woman thinks might be the benefits. (more…)
Although many people are excited about the potential for using computers to train their brains, we shouldn’t forget that other techniques have been used to the train the brain for many centuries. I’m thinking about the large number of techniques for meditation. While free computer software still requires an investment in a computer, meditation only asks you to sit or lie quietly and focus your mind.
A recently-published study shows parts of the brain in long-term meditators are larger than the same parts of the brain in people who don’t meditate. The article by Eileen Luders and her colleagues appeared in a recent issue of the journal Neuroimage (Vol. 45, No. 3, pp. 672-678, April 15, 2009). The study showed that portions of the orbitofrontal cortex and the hippocampus were larger in persons who had been regular meditators for 5 or more years. The study is interesting because the parts of the brain that were larger are often thought to be important in helping people keep themselves emotionally balanced.
A number of strategies are likely to be helpful for meditators. There has been a great deal of interest over the last several years in mindfulness meditation. Researchers have studied how it can be used in reducing anxiety and depression. Mindfulness is based on Buddhist meditation (for a brief article, click here) but you don’t have to be a Buddhist to practice meditation. In fact, one of the most important persons who has promoted mindfulness is Jon Kabat-Zinn, a researcher at the University of Massachusetts. You can see a video presentation by him on YouTube by clicking here.