Finding New Pathways to Cognitive Resilience

Imagine a woodland, blanketed with knee-high snow. On foot, you need to cross. Those first few crossings are tough, lifting your feet high, then crushing the snow underneath. With repetition, you’ve built a path and your crossing is made faster and easier. One day an interesting birdsong catches your attention and you stray from your worn path, starting a new one. 

For several days, you follow the new path hoping to catch a glimpse of the elusive bird. Now you have two worn paths. Every so often, exploring the reaches of the woodlands, you create and then retrace new paths. A large tree breaks under the weight of the snow, completely blocking your first, main path. Because you branched out, explored new areas, you have options.

Applied to the brain in a general way, this scenario represents the real-world value of neuroplasticity. Our brain function relies on fast and accurate communication of sensory inputs and responses, traveling through chains of brain cells (neurons) where chemical neurotransmitters serve as the language of that communication. Well-used neuron chains are in effect the snow-packed paths in the woodland.

Neuroplasticity describes how experience and environment trigger the brain to form new connections and pathways. Should a brain injury occur - stroke, trauma, or other - neuroplasticity allows for workarounds that can compensate for impaired function.  This capacity is crucial to rehabilitative therapies. 1 

But neuroplasticity is also key to managing risk and slowing the progression of neurocognitive disorders, including those resulting in Dementia.  New and novel experiences, no matter the type, lay down new pathways connecting different areas of the brain. These pathways allow for learning a new task or committing to memory the sights, sounds, and sensations of a new destination. They open up a network of routes for neuro-communication that can be used for a range of functions much broader than the original task or experience would suggest.

While repetition builds stronger pathways, a recent investigation suggests that prolonged experiences such as physical exercise or stress can change the language of communication between neurons, substituting one neurotransmitter for another. 

A study of mice running in a wheel demonstrated both the switch-up in neurotransmitters and an overall improvement in coordination and motor learning.2 Not only did they run faster, but the mice also had an improved ability to walk a tightrope and balance on a rotating rod. 

This process, the neurotransmitter switch, is of interest to researchers examining mechanisms behind stress-induced diseases. It will also be important as we learn how targeted exercise might be used as a treatment for other diseases. 

Another related area of study with great potential is neurogenesis- the creation of new neurons.  Neurogenesis is regulated by neurotransmitters – think of the study of mice in the running wheel. While neurogenesis is slowed by stress and aging, rates can be accelerated by physical exercise and brain exercise, for example learning new concepts or skills. Of course, many other molecular mechanisms also affect the process of neurogenesis.3  

Neuroplasticity is as complex as it is crucial to our cognitive health. A technical summary would be that curiosity, physical activity, and novel experiences enhance neuroplasticity through mechanisms such as the neurotransmitter switch and neurogenesis. A practical summary though - while the main path may be easy, it would serve us well to tread more paths. Even better, use different tools like skis, snowshoes, or crampons, and skills like using a bird guide, binoculars, and journaling your experiences. 

1 Ackerman, Courtney E., MA. What is Neuroplasticity – A Psychologist Explains. Accessed 4/15/2020 from https://positivepsychology.com/neuroplasticity/

2 University of California Television. 30 June 2017.  “Neuroplasticity: Our Adaptable Brain with Nick Spitzer”. [Show ID: 32521] Accessed 15 April 2021 from https://www.youtube.com/watch?v=DXA_iTG3XSM

3 Ming, Guo-Li, and Hongjun Song. “Adult neurogenesis in the mammalian brain: significant answers and significant questions.” Neuron vol. 70,4 (2011): 687-702. doi:10.1016/j.neuron.2011.05.001 Accessed 15 April 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3106107/

Contributor: Karen R. Ogden, team member, Dementia Society of America.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Do You Remember When?

 

“I see trees of green- Red roses too, I see them bloom- For me and for you... “

“You may say I'm a dreamer, But I'm not the only one…”

"Almost Heaven, West Virginia. Blue Ridge Mountains, Shenandoah River…"

“Bye, bye Miss American Pie- Drove my Chevy to the levee but the levee was dry... ”

“Born down in a dead man's town -The first kick I took was when I hit the ground…”

“Woah, we're halfway there -Woah, livin' on a prayer -Take my hand, we'll make it I swear… "

Surely while reading these lyrics, you experienced a trickle or a flood of memories or maybe the tingle of emotion not born of the present moment.  You may recall a moment in time - where you were, who you were with, and what was going on. Or you may be transported back to a period in your life filled with joy, romance, frustration, even grief. How does this happen, and how can we harness that power to enrich and enliven lives those living with Dementia?

Much academic study has focused on how background music affects cognitive processing. Because listening to music elevates arousal (or physiological activity), mood, and the listener’s enjoyment, cognitive performance is also increased.(2) Working memory is tasked with interpreting a series of sounds into the rhythms and melodies that make it music. This helps explain why memories associated with particular songs are often permanently etched in our brains – our cognitive processing was on overdrive when those memories were being recorded and transferred to long-term memory. 

Music and emotion are intertwined. Not only does heightened arousal fortify memories made while listening to particular pieces of music, but the same is also true for emotions. Increased blood flow to areas of the brain involved in generating and controlling emotions activates the functions of emotion, attention, and memory.(4) Further, consider how rhythm compels us to move. A slow dance with your partner, or the exuberance of singing and dancing with friends. We, as humans, are moved emotionally by music.(3)  

Early adulthood is filled with new emotions and experiences gained as we move towards independence- these experiences are a big part of how we see our “selves”.  So it is not surprising that people most prefer and are most stimulated by music that was popular when they were young adults.  Past romantic relationships and experiences with friends and family are most often recalled with the replay of music.(1)

As Dementia progresses, using music to help individuals remember their vibrant, youthful “selves” can bring joy to caregivers and patients alike. When one hears a piece of music from years gone by, the pleasant memory and emotion can be experienced again and again. Recognizing that "remembered joy" in your loved one living with Dementia can be just the uplifting moment a caregiver needs. Dementia or not, you can transport back to happy times through music is a reprieve from everyday stresses and frustrations. It's free. It's easy. It’s fun.

Do you remember when- we used to sing Sha la la la la la la la la la la te da, la te da?

1  Baumgartner, Hans. 1992. Remembrance of Things Past: Music, Autobiographical Memory, and Emotion, in NA - Advances in Consumer Research Volume 19: pp. 613-620. Accessed September 22, 2020 at https://www.acrwebsite.org/volumes/7363/

2  Bottiroli, Sara et. al. Frontiers in Aging Neurosci., 15 October 2014. The cognitive effects of listening to background music on older adults: processing speed improves with upbeat music, while memory seems to benefit from both upbeat and downbeat music. Accessed September 22, 2020 at https://www.frontiersin.org/articles/10.3389/fnagi.2014.00284/full

3  Proverbio, A. M. et al. The effect of background music on episodic memory and autonomic responses: listening to emotionally touching music enhances facial memory capacity. Sci. Rep. Accessed September 22, 2020 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606564/

4  Lutz, Jäncke. Music, memory and emotion. J Biol. 2008; 7(6): 21. Published online 2008 Aug 8. Accessed October 5, 2020 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776393/

Contributor: Karen R. Ogden, team member, Dementia Society of America.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor. www.DementiaSociety.org

Understanding Memory and Language

In the broadest sense, memory is the ability to retrieve information from specific areas of the brain. Types of memory fall into two categories – long-term memory and short-term memory. The kinds of information associated with long-term memory are the names, places, and dates that compose our personal history. Long-term memory also includes such things as the skills we have learned as well as the acquisition and use of language. 

When Dementia damages our long-term memory banks, we forget such things as our address and birth date, and may no longer remember how to drive the car or to use the washing machine.

When we lose access to our collection of learned information and built-in skills, we require assistance to live safely at home. Short-term memory, or working memory, is the ability to retain small bits of recently learned information, such as phone numbers, login codes, and street addresses.

People who have short-term memory deficits may not remember they have already taken their medication or, just an hour ago, ate lunch.

The ability to recall and use language is one of many ways to assess the progression of Dementia. In addition, specific kinds of language difficulties can help clinicians differentiate Frontotemporal Dementia (FTD) from other types of Dementia such as Alzheimer’s disease.

Language difficulties most often associated with Alzheimer’s disease are difficulty in finding the right words, describing objects rather than calling them by name, repeated use of familiar words, relying on gestures to express ideas, and reverting back to speaking a native language.

Unlike Alzheimer’s disease, people who have FTD often have difficulty in using and understanding spoken and written language. Language problems include repeated mispronunciations, such as “sork” for “fork” and the inability to make appropriate associations between names and objects. If your parent is not able to associate an object with a word, he or she may point to a sandwich and call it a baseball. People who have FTD are not aware of how they have changed.

Using words and phrases such as “this,” “that” and “over there” in the place of specific nouns and descriptions are language deficits typical of many types of dementia.

Memory loss and language difficulties often make communication awkward, difficult, and frustrating. It doesn’t take long before “never mind” replaces your efforts to engage in conversation.

Here are a few tips you can use to improve communication between you and your loved one. As you will read, most are expected norms of polite conversation.

· Give your loved-one the time to formulate a response
· Engage in one-on-one conversation
· Converse in a quiet space with few distractions
· Maintain eye contact
· Avoid criticizing or correcting misinformation
· Listen
· Avoid arguments
· Speak slowly
· Give step-by-step instructions
· Use written notes to prevent the frustration and confusion of remembering details.

Contributor: Janet Yagoda Shagam, PhD, is a freelance medical and science writer and the author of “An Unintended Journey: A Caregiver's Guide to Dementia.” Available through Amazon.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.

Stay Sharp for Safe Driving

The fitness of your mind and body must work together in order to drive safely. Follow these tips from AARP to keep yourself sharp, healthy, and ready for the road.

Your eyesight is key to all aspects of driving, but you may not realize how complex vision actually is. Good vision, both near and far, is needed to identify road hazards, road signs, and view your dashboard.

Visual acuity is how clearly or accurately you can see. There are many conditions that affect visual acuity, especially as we age. Here are a few conditions to keep watch for:

• Colorblindness and cataracts may cause problems when identifying traffic signals or brake lights of other cars while driving.
• Decreased contrast sensitivity is the visual ability to see objects that are not outlined clearly or do not stand out from their background. Examples are difficulty seeing pedestrians and road signs, especially in poorly lit roads or in fog.
• Decreased useful field of view refers to the amount of visual information that can be processed in a brief glance using both eyes. The ability to process information slows with age, particularly for situations in which the environment is very complex, e.g., a busy roadway.
• Decreased depth perception and peripheral vision is the ability to judge the distance of objects in relation to ourselves and the ability to see outside our immediate field of view.  Both tend to decrease with age and are essential in everyday driving situations, such as judging the distance and speed of approaching cars when merging or seeing a car approaching you from either side.

With that in mind, it is incredibly important to get regular eye exams to maintain good eye health.

Over time, we can lose the ability to quickly assess and react appropriately to the demands of driving. From something as simple as fatigue to minor memory loss to something as complex as Dementia, our brain health, and overall mental well-being are crucial to the task of driving.

Your ability to carry out the following processes should be gauged in assessing your driving fitness:

• Attention and reaction time
• Concentration (paying attention to changes in your driving environment)
• Ability to process information quickly and accurately
• Problem-solving skills (how to get help if you have a flat tire)
• Memory (how to get to the doctor’s office)

Stimulate your brain by trying new activities. Try testing your memory and problem-solving skills; it can be something as simple as taking a new route to a familiar location. A study by the National Institute of Health recently found that people who had cognitive training for memory, reasoning or speed of processing had 50 percent fewer car accidents than those in the control group.

Driving is a demanding activity that requires your full attention to many things at the same time. Eliminate distractions inside the vehicle and minimize activities that require you to take your eyes off the road or take both hands off the wheel, especially in heavy traffic. Some suggestions:

• Put your cell phone on silent and tuck it away so you are not tempted to answer a text or phone call while driving.
• Pre-set your radio with your favorite radio stations. That way you won’t have to look away from the road to change the station.
• Don’t eat, drink, or smoke while driving.

These important tips will keep you sharp and ready to drive. Driving is demanding, so take measures to ensure good vision, brain health, and reduce distractions while on the road.

Source: AARP

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse or guarantee products, comments, suggestions, links, or other forms of the content contained within blog posts that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice. Please consult your doctor.

Repeat Names Three Times

Memorizing names can be a serious challenge for some people. The world is rife with all kinds of tricks for putting faces with names and the like. Most of them have various degrees of success. In a certain light, saying someone’s name three times during your first meeting can essentially be a type of brain game.

Most brain games are simple exercises to help your brain work better. Saying someone’s name three times is as much about memorization as it is about developing conversational skills and working on associations.

I must admit that I’m not the best when it comes to remembering names. I’ve tried a lot of different tips and tricks over the years and very few of them ever really helped.

Saying someone’s name three times is a simple brain games you can do when you meet people (and they will never know it). The goal is to be subtle about it. You don’t want to shake someone’s hand and simply rattle off their name three times.

What you want to do when you first meet somebody: at the first handshake you want to repeat their name. For example, if I was meeting someone named Jason for the first time I would say, “Hello Jason, how are you doing?”

As the introduction and conversation flows naturally, I follow up with opportunities. “So tell me Jason, where do you live?” So, at this point I’ve already said his name twice. My brain is getting used to that and it’s associating that person’s face, his demeanor and everything in that environment at that particular time.

Within the next minute or so, create another opportunity to use their name again. Something along the lines of “So Jason, how many kids do you have?”

Not only are you repeating their name to put it into your memory, but you’re also creating associations that are relevant to them (i.e. where they live and how many kids they have).

Of course, there are a lot of different topics you could touch on. Family, hobbies, where they live, or what they do for a living are all common topics that help you learn more about them and create memorable associations that will stick in your mind the next time you meet them.

With regular practice, I think you’ll find that you can get to know a lot about people in a relatively short period of time. This is especially helpful if you’re involved in any kind of networking or social groups, where you’re trying to learn as much as you can about someone in a short period of time.

The key is to drop their name into the conversation. As you say the name, really try to emphasize your focus on their face or their demeanor. This could also include finding a similarity to someone you know that has the same name.

Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org

What is Neuroplasticity?

Put simply, neuroplasticity is the brain’s ability to change and grow throughout time, dependent on its environment. The brain is a sensory driven organism. This means that it thrives and survives and functions based on the input it receives. The brain essentially is a relay station, the information coming in influences the information going out. 
So we want to make sure our brain is wired in the best way possible.

There is a brilliant quote from neuroscientist Santiago Ramon y Cajal that said, “Any man can, if he so desires, become the sculptor of his own brain.”

Cajal said that at the turn of the last century when most everything we knew about the brain came from head to toe physical examination. In fact, Cajal was one of the first people to really study brain cells under a microscope. The conventional wisdom at that time was that your brain was hardwired and what you had at birth was how your brain would be the rest of your life.

In recent years we have learned that the brain is capable of change. Neuroplasticity is the key concept for everything we talk about in regards to brain training.

The picnic game exercise is just one of many examples. The game is played with two or more people. It starts out by the first person saying something like “I’m going on a picnic and I’m bringing an apple,” or something that starts with the letter A. The second person says they’re going on a picnic and they’re going to bring an apple and something else that starts with the letter B. 

The game continues on with each person reciting the items in the list and then adding an item that starts with the next letter of the alphabet. When you expand it out through the alphabet and you get to the letter Z it can actually be rather complicated.

There are two points to this game – improvement in working memory and short term memory, which are very well connected. Short term memory is where you hold onto a piece of information for a brief period of time. If that information is worth committing to long term memory, it will be based on repetition or importance. Repetition is somewhat obvious where you do something over and over again until it becomes learned (e.g. playing a guitar).

Importance is related to something happening that has significant impact. For example, if someone was hit by a car in a hit and run accident and they got the license plate number as the car drove off.  
The picnic game exercises primarily working memory and secondarily, short term memory. Working memory helps you hold onto small amounts of information while you are attending to something else, and is often the first aspect of memory impaired in certain types of dementia. 

Contributor Author: Dr. Michael Trayford is a Board Certified Chiropractic Neurologist and Founder of APEX Brain Centers in Asheville, NC. For more information, please visit www.ApexBrainCenters.com/memory.

The opinions expressed by contributing authors are not necessarily the opinions of the Dementia Society, Inc. We do not endorse nor guarantee products, comments, suggestions, links, or other forms of content contained within blog posts- that have been provided to us with permission, or otherwise. Dementia Society does not provide medical advice, please consult your doctor. www.DementiaSociety.org