To Avoid Dementia, Stay Mentally Active Throughout Lifetime

2013-07-09

By Maia Szalavitz

The key to staying sharp in old age is to exercise your brain throughout life. Now the latest research shows that such activity may actually slow cognitive decline and, if you do develop dementia, shorten the time you spend living with it.

The new study, which was published in Neurology, involved nearly 300 older people, about half of whom developed dementia or mild cognitive impairment (often a precursor to dementia), over the course of six years. At the start of the study, participants reported on how frequently they engaged in mentally stimulating experiences throughout life such as extracurricular activities while in school and, more generally, reading books, writing letters, reading the newspaper and visiting libraries. (Because the research started over 20 years ago, internet related activity was not common.)

By studying brain autopsies after the participants died, the scientists found that 14% of the variability in mental decline could be attributed to the amount of intellectual activity in which people participated, both early and late in life. And that effect was seen even after the researchers accounted for other factors that influence dementia like age and education.

They also adjusted for the effect of brain changes due to diseases such as Alzheimer’s, stroke and Parkinson’s disease, which the research team said accounted for about a third of the differences in people’s cognitive decline before death. By comparison, cognitive activity accounted for nearly half as much as such pathology.

The people who were most active in late life showed a 32% slower rate of decline compared to those who maintained an average level of mental activity. And those who were the least active had a 48% faster fall into dementia.

“The beauty of this study is that they tested people at different points and followed them [through to] autopsy,” says Prashanthi Vemuri, an Alzheimer’s researcher at the Mayo Clinic who wrote an editorial accompanying the study, but was not otherwise associated with the trial. “People need to know [this] and be aware that it is possible to slow down the decline of dementia,” Vemuri says.

That’s important knowledge, given that nearly half of people over age 85 develop Alzheimer’s and the baby boom generation is rapidly approaching the age at which risk starts to increase; the lifetime risk of Alzheimer’s for women is 17% and for men is one in ten. By 2050, the Alzheimer’s Association estimates that the prevalence of dementia will double due to the increased proportion of the elderly in the population.

“Anything having to do with reading and writing counts in spades,” says the study’s lead author Robert Wilson, senior neuropsychologist at the Rush Alzheimer’s Disease Center at Rush University in Chicago. Sending emails or reading news online, he suspects, would have similar effects. “There’s no reason to think they wouldn’t be as mentally stimulating.”

How early does the mental activity have to start? Earlier research found that childhood intelligence can account for some of the differences in the brain once attributed to later-life cognitive activity. But whether it does so by increasing lifetime cognitive activity— people who grow up reading, for example, tend to be life time learners— or through some other means is not clear. The new study found that both early childhood cognitive activity and such activity in middle age were linked with slowing mental decline.

Vemuri says brain aging is similar to having money in the bank— people who are intelligent are cognitively “richer” and therefore have more reserves upon which to draw when brain function starts to decline. Consequently, it takes longer to “bankrupt” these resources. And cognitive activity throughout a lifetime can increase this “wealth.” But this study shows that greater cognitive activity not only adds funds, but actually slows the rate at which you lose intellectual resources— and that helps no matter how much you start out with.

Research also shows that engaging in more intellectual activity shortens the time during which someone is actually demented if they do get ill— meaning that it not only delays active disease, but shortens the worst part of it. “Reading, writing playing music, playing games [all of these] could be good,” says Vemuri, “I don’t want to pinpoint specific activities: keeping your brain mentally stimulated and active is what is primary.”

And it’s not just intellectual stimulation that may be important. Social engagement also seems to be crucial. “We’re finding in our studies that social interactions and group activities seem to help,” she says.

“The more, the better,” Wilson says. “But it’s not like physical exercise, [where it’s] ‘no pain, no gain.’ The metaphor should be ‘a hobby.’ In order to change structure and function, the activity needs to be sustained and to be sustained, it needs to be enjoyable. Hobbies like quilting or photography, acting and theatre, book clubs: those sorts of things. There’s no product that needs to be bought and one size won’t fit all.” What is important, he says, is that the activity is intellectually stimulating, and interesting enough to keep you occupied for more than one or two sessions.

When does your mental health become a problem?

2013-07-03

People often experience sadness in response to difficult life events, but when does this become a mental health problem?

One in four people are expected to experience a mental health problem, yet stigma and discrimination are still very common. Myths such as assuming mental illness is somehow down to a ‘personal weakness’ still exist.

How do we define mental health?

A person who is considered ‘mentally healthy’ is someone who can cope with the normal stresses of life and carry out the usual activities they need to in order to look after themselves; can realise their potential; and make a contribution to their community. However, your mental health or sense of ‘wellbeing’ doesn’t always stay the same and can change in response to circumstances and stages of life.

Everyone will go through periods when they feel emotions such as stress and grief, but symptoms of mental illnesses last longer than normal and are often not a reaction to daily events. When these symptoms become severe enough to interfere with a person’s ability to function, they may be considered to have a significant psychological or mental illness.

Someone with clinical depression, for example, will feel persistent and intense sadness, making them withdrawn and unmotivated. These symptoms usually develop over several weeks or months, although occasionally can come on much more rapidly.

Mental health problems are defined and classified to help experts refer people for the right care and treatment. The symptoms are grouped in two broad categories – neurotic and psychotic.

Neurotic conditions are extreme forms of ‘normal’ emotional experiences such as depression, anxiety or obsessive compulsive disorder (OCD). Around one person in 10 experiences these mood disorders at any one time. Psychotic symptoms affect around one in 100 and these interfere with a person’s perception of reality, impairing their thoughts and judgments. Conditions include schizophrenia and bipolar disorder.

Mental illness is common but fortunately most people recover or learn to live with the problem, especially if diagnosed early.

What causes mental illness?

The exact cause of most mental illnesses is not known but a combination of physical, psychological and environmental factors are thought to play a role.

Many mental illnesses such as bipolar disorder can run in families, which suggests a genetic link. Experts believe many mental illnesses are linked to abnormalities in several genes that predispose people to problems, but don’t on their own directly cause them. So a person can inherit a susceptibility to a condition but may not go on to develop it.

Psychological risk factors that make a person more vulnerable include suffering, neglect, loss of a parent, or experiencing abuse.

Difficult life events can then trigger a mental illness in a person who is susceptible. These stressors include illness, divorce, death of a loved one, losing a job, substance abuse, social expectations and a dysfunctional family life.

When is someone thought to be mentally ill?

A mental illness can not be ‘tested’ by checking blood or body fluids. Instead it is diagnosed, usually by an experienced psychiatrist or clinical psychologist, after studying a patient’s symptoms and monitoring them over a period of time.

Many different mental illnesses can have overlapping symptoms, so it can be difficult to tell the conditions apart.

To diagnose a mental health condition, psychiatrists in the UK may refer to the World Health Organisation’s International Classification of Diseases (ICD) system. This lists known mental health problems and their symptoms under various sub-categories. It is updated around every 15 years.

Some experts argue that the current system relies too strongly on medical approaches for mental health problems. They say it implies the roots of emotional distress are simply in brain abnormalities and underplay the social and psychological causes of distress.

They argue that this leads to a reliance on anti-depressants and anti-psychotic drugs despite known significant side-effects and poor evidence of their effectiveness.

Breast-Fed Babies Achieve Higher Social Status

2013-06-26

By Alexandra Sifferlin

Studies suggest that breast-feeding can be good for a baby’s health, and now there’s fresh evidence that it may help children to climb the social ladder as well.

What does breast-feeding have to do with social status? According to the researchers from University College London, who reported their findings in the journal BMJ, breast-feeding can impact cognitive development, and that accounted for just over a third of nursing’s effect on improvements in social status. What’s more, the practice also seemed to lower the chances of downward mobility.

To assess the impact of breast-feeding on later social status, the researchers compared two cohorts of people, including more than 17,400 individuals born in 1958, and over 16,700 people born in 1970. When their kids were about 5 years old, mothers in both groups were asked if they had breast-fed their children. The researchers used the children’s fathers’ income and job to determine the youngsters’ initial social status when they were about 10 to 11 years old and compared this with their social status decades later, when they reached age 33 or 34. And to get some idea of the way in which breast-feeding might be influencing social status, the scientists also evaluated the children’s cognitive skills and stress responses when they were about 10 or 11.

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Talk Therapy or Antidepressant? A Brain Scan Predicts Which Works Best for Your Depression

2013-06-24

By Maia Szalavitz

There hasn’t been much in the way of hard science to help doctors or patients decide on the best treatments for depression — until now. For the first time, brain imaging may be able to help determine who will get better in therapy and who improves more on medication.

Depression affects an estimated 1 in 5 people over a lifetime, and talk therapies and antidepressant medications can help a significant proportion of those patients. But figuring out who will benefit most from which treatments remains a major challenge; while nearly 22 million Americans take antidepressants, 40% of people are not helped by the first treatment — drug or talk therapy — they try. And since it often takes weeks to relieve symptoms, choosing the wrong first treatment can lead to extra months of suffering.

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Are You Happy or Horny? A Brain Scan Can Tell

By Maia Szalavitz

What are you feeling?  For the first time, a brain scan might be able to answer that question.

It’s not exactly mind reading, but a new program can identify emotional states— from happiness to sadness, lust to disgust— simply by analyzing brain activity, according to a recent study.

The technique isn’t just a parlor game; since emotional disturbances lie at the center of most psychiatric problems, a reliable way to detect feelings from brain scans could help researchers to better understand what goes wrong in cases of depression, autism, schizophrenia, anxiety disorders and many other conditions, as well as offer new insight into how emotions work.

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How Money Makes You Lie and Cheat

2013-06-20

By Maia Szalavitz

Money corrupts, they say, and now there’s a study that shows why people get so sneaky when it comes to making a profit.

The research, which was published in the journal Organizational Behavior and Human Decision Processes, revealed that people doubled the number of lies they told in order to earn extra cash if they were first prompted to think about money. The study involved more than 300 business students who participated in several experiments, all of which showed that cuing people to consider money increased either unethical intentions or actions.

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