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Train Your Brain: A Holistic and Empirically-Based

Approach to Brain Health

Dr. Rob Winningham

Western Oregon University

© 2014, Dr. Rob Winningham All

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Today’s Presentation

• We will take a very holistic and interconnected approach, discussing a myriad of factors that affect cognition as we age (e.g., cognitive exercise, physical exercise, social support, and nutrition).

• We will discuss numerous and practical ways older adults can maintain their cognitive and social well-being.

• Bottom line is that numerous behavioral and lifestyle interventions seem to have a significant impact on the likelihood of developing dementia.


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A Holistic Approach

Besides age, what determines whether or not we have good memory abilities in older adulthood?

• Genetics (~50%)

• Cognitive stimulation

• Other health conditions (e.g., diabetes, obesity, depression)

• Stress (Stawski et al., 2006)

• Good sleep (Campbell et al., 2005)

• Social support and engagement

• Proper nutrition (Karr et al., 2010)

• Adequate physical exercise (Nagamatsu et al., 2012; McGough et al., 2011)


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Dementia Prevalence is Declining

• Matthews et al. (2013) reported in the

journal Lancet that dementia rates

among people 65 and older have

plummeted by 25 percent over the past

two decades, to 6.2 percent from 8.3

percent, a trend that researchers say is

probably occurring across most

developed countries. Why?


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Dementia Prevalence is Declining

• Possible reasons for the 25% reduction:

– Controlling cardiovascular risk factors

• Cholesterol

• Blood pressure

– Better education and possibly more cognitive stimulation

– Greater awareness of the importance of physical exercise


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2013 Article in the Journal

Neurology

• Wilson et al. found that people who

participated in more mentally stimulating

activities had a slower rate of decline in

memory. Mental activity accounted for

nearly 15 percent of the difference in

decline beyond what is explained by

brain changes associated with

dementia.


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Computer Based Cognitive Stimulation Led to Significant Improvements

• Lee et al., (2013) published a paper in

PLOS ONE describing the results of an

8 week (24 session) computer training

intervention relative to a wait list control

group. Significant improvements in:

– Immediate memory

– Attention

– Visual spatial memory


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More Empirical Evidence for

Memory Enhancement

• Participants in 7 different communities were tested on many different memory and mental tests. Then 1/2 of the participants engaged in the cognitive enhancement

program and the other 1/2 (the control group) did not.

Three months later all participants were retested on the same tests. Changes over the three months were analyzed.


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Memory Ability Increased after Three Months of Cognitive Enhancement Training

RiverMead Behavioral Memory Test

(Extended)

40

45

50

55

60

65

70

Time 1 Time 2

Time of Testing

Score o

n R

BM

T-E

Cognitive Enhancement

Control Group


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Empirical Evidence for Memory

Enhancement

• “If older adults can maintain their cognitive ability, they will require less care and possibly delay or even eliminate the need to go to a nursing home. Cognitively stimulating activities may also postpone symptoms of dementia, which could also delay the need for more intensive care.”

Dr. Winningham, Journal of Mental Health and Aging


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Cognitive Stimulation


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Great Resources

• www.robwinningham.com

Click on “Crossword Puzzles Are Not As Good as Sudoku Puzzles…” to download mini-sudokus and get access to hundreds of 9 X 9 puzzles.


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• iPads – Many high quality cognitive stimulation apps.


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Recommended Apps for Cognitive Stimulation

• Fit Brains

• Lumosity

• Tetris

• Sudoku2

• Memory Block

• Stroop Effect

• Visual Attention

• Brain Lab


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Recommended Apps for


• Word Search+

• Word Jigsaw

• Brain Challenge

• Words Chain Challenge

• Chain of Thought

• This is to That

• Watch That!


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Apps for Cognitive Stimulation

Do you have other app ideas?

– Please post them on the website

www.robwinningham.com

– Under the post titled “Apps for Cognitive

Stimulation”

– You can also find much more information

about our experience using iPads and even

download a powerpoint file

Exercise and Cognition

• Colcombe and Kramer (2003) reported

the results of an 18-study meta-

analyses on the effects of exercise on

cognition.

• They found that, on average, exercise

programs lead to a .5 standard

deviation increase in cognitive abilities

(e.g., I.Q. of 100 versus 108).


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• Kramer et al. (2001) found that participating in a six month walking program led to increased attention in 60-75 year old adults.

• Colcombe & Kramer (2003) found that executive functioning improved more than straight memory functioning.

• The ability to pay attention to relevant stimuli is correlated with cognitive ability in older adults. It appears that exercise affects this ability.


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• The ability to pay attention to relevant stimuli is correlated with cognitive ability in older adults. It appears that exercise affects this ability.


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• Scarmeas et al., (2009) found that older adults (mean age 77 years) who were in the top third in terms of getting physical exercise were 61% less likely to get dementia


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What type of exercise is best?

• A mixture of aerobic and strength (or resistance) training is best.


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• Liu-Ambrose et al. (2010) reported that either once-a-

week or twice-a-week resistance training sessions for

12 months led to improvements in older adults’

cognition and attention.

– 11% improvement for once-a-week

– 13% improvement for twice-a-week


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• Nagamatsu et al. (2012) found that twice a week resistance training in 70 to 80 year old women, with Mild Cognitive Impairment, led to significant improvement in attention and memory ability.


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Nutrition and Cognition

• Fats

• Antioxidants


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“Good Fat”

• Omega-3 fatty acids or “good fat” has been

linked to improved cognitive functioning in older

adults.

• Fish, nuts, olive oil, canola oil, and green leafy

vegetables are high in Omega-3 fatty lipids.


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Research• Research has found a positive

correlation between Omega-3 fatty

acids levels (e.g., DHA) and cognitive

functioning in older adults.

• Individuals with dementia often have

lower levels of DHA than non-demented

controls.

• The more fish people eat, the less likely

they are to show signs of Alzheimer’s

Disease. © 2014, Dr. Rob Winningham All

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The American Journal of

Clinical Nutrition (2009)

Albanese et al., (2009) studied 15,000

people in Latin America and Asia found

that those who ate fish nearly every day

were 20% less likely to get dementia as

compared to those who ate it only a few

times a week. Those that ate fish a few

times per week were 20% less likely to

get dementia than those who rarely ate

fish. © 2014, Dr. Rob Winningham All

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Research

• Recent research has also shown that

fish oil tablets can decrease the number

of depressive symptoms in people

diagnosed with major depression. Some

studies have found that fish oil tablets

are as effective as modern

antidepressants.


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Research

• The omega-3 fatty acids might reduce

inflammation in the brain. Inflammation

might be one of the causes of

Alzheimer’s disease.

• It also may be that myelination of the

axon is affected by our dietary intake of

fat.


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Myelin Increase the Speed and Efficiency

of Neuronal Transmission


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Social Engagement is

Stimulating

• July, 2008 - Berkman and colleagues

reported findings that showed older

adults who are most socially engaged

have the least memory problems.

– Researchers controlled for age, health, and gender

– Those with the least formal education had the greatest gains from social engagement


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Social Engagement is

Stimulating“The working hypothesis is that social engagement is

what makes you mentally engaged,'’ said Lisa F.

Berkman, the study’s senior author and director of

the Harvard Center for Population and Development

Studies. “You can’t sit and withdraw if you’re

constantly talking and working on things and figuring

out problems in your daily life. It’s not just completing a crossword puzzle, it’s living your life.'’

From: http://well.blogs.nytimes.com/2008/06/04/socializing-appears-to-delay-memory-problems/


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Summary• Participation in cognitively stimulating activities is

associated with decreased likelihood of developing dementia.

• Cognitively stimulating activities may delay the need for more intensive care.

• Proper food and exercise is good for the brain and memory.

• Social support and social engagement is important for physical, cognitive and mental health.


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Contact Information

Dr. Rob Winningham

Professor & Chair of Behavioral Sciences

Western Oregon University

Email: [email protected]

You can find cognitive stimulating activities, training opportunities, and other resources at:

www.robwinningham.com

ReferencesAlbanese, E., Dangour,, A. D., Uauy, R., Acosta, D., Guerra, M., Gallardo-Guerra, S. S., & Jacob, K. S.

(2009). Dietary fish and meat intake and dementia in Latin America, China, and India: a 10/ 66 Dementia

Research Group population-based study. American Society for Clinical Nutrition , 90(2), 392-400.

Campbell, S. S., Murphy, P. J., & Stauble, T. N. (2005). Effects of a nap on nighttime sleep and waking

function in older subjects. Journal of the American Geriatrics Society, 53(1), 48-53.

Colcombe, S., & Kramer, A. F. (2003). Fitness effects on the cognitive function of older adults: A meta-

analytic study. Psychological Science, 14(2), 125-130.

Ertel, K. A., Glymour, M. M., & Berkman, L. F. (2008). Effects of social integration on preserving memory

function in a nationally representative US elderly population. American Journal of Public Health, 98(7),

1215-1220.

Karr, J., Alexander, J., & Winningham, R. (2011). Omega-3 polyunsaturated fatty acids and cognition

throughout the lifespan: a review. Nutritional Neuroscience, 14(5), 216-225.

doi:10.1179/1476830511Y.0000000012

Lee T, Goh S, Krishnan K, et al. A Brain-Computer Interface Based Cognitive Training System for Healthy

Elderly: A Randomized Control Pilot Study for Usability and Preliminary Efficacy. Plos ONE [serial online].

November 2013;8(11):1-8. Available from: Academic Search Premier, Ipswich, MA. Accessed March 30,

2014.


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ReferencesLiu-Ambrose, T., Nagamatsu, L. S., Graf, P. Beattle, B. L., Ashe, M. C., & Handy, T. C. (2010). Resistance

training and executive functions. Archives of Internal Medicine, 170, 170-178.

Matthews, F. E., Arthur, A., Barnes, L. E., Bond, J., Jagger, C., Robinson, L., & Brayne, C. (2013). A two-

decade comparison of prevalence of dementia in individuals aged 65 years and older from three

geographical areas of England: results of the Cognitive Function and Ageing Study I and II. Lancet,

382(9902), 1405-1412. doi:10.1016/S0140-6736(13)61570-6

McGough E, Kelly V, Teri L, et al. Associations between physical performance and executive function in

older adults with mild cognitive impairment: gait speed and the timed "up & go" test. Physical Therapy

[serial online]. August 2011;91(8):1198-1207. Available from: MEDLINE, Ipswich, MA. Accessed January

4, 2014.

Nagamatsu, L., Handy, T., Hsu, C., Voss, M., & Liu-Ambrose, T. (2012). Resistance training promotes

cognitive and functional brain plasticity in seniors with probable mild cognitive impairment. Archives Of

Internal Medicine, 172(8), 666-668. doi:10.1001/archinternmed.2012.379

Scarmeas, N., Luchsinger, J. A., Schupf, N., Brickman, A. M., Cosentino, S., Tang, M. X., & Stern, Y.

(2009). Physical activity, diet, and risk of Alzheimer disease. JAMA: Journal of the American Medical

Association, 302(6), 627-637.


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ReferencesStawski, R., Sliwinski, M. J., & Smyth, J. M. (2006). Stress-related cognitive interference predicts cognitive

function in old age. Psychology and Aging, 21(3), 535-544.

Wilson, R., Boyle, P., Yu, L., Barnes, L., Schneider, J., & Bennett, D. (2013). Life-span cognitive activity,

neuropathologic burden, and cognitive aging. Neurology, 81(4), 314-321.

doi:10.1212/WNL.0b013e31829c5e8a

Winningham, R. G., & Pike, N. L. (2007). A cognitive intervention to enhance institutionalized older adults’

social support networks and decrease loneliness. Aging & Mental Health, 11(6), 716-721.

Winningham, R. G., Anunsen, R., Hanson, L. M., Laux, L., Kaus, K. D., & Reifers, A. (2003).

MemAerobics: A cognitive intervention to improve memory ability and reduce depression in older adults.

Journal of Mental Health and Aging, 9(3), 183-192.


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