Booster Shots

Oddities, musings and news from the health world

Category: memory

Book Review: 'The Winner's Brain' by Jeff Brown and Mark Fenske with Liz Neporent

May 29, 2010 |  6:48 pm
Winner

Why are some people highly successful in life, while others just get by? Authors Jeff Brown and Mark Fenske say the difference between the high-achieving and the merely average is due not to IQs, life circumstances, financial resources, social connections or luck but to the workings of the brain. 

In "The Winner's Brain," Brown, a Harvard cognitive-behavioral psychologist, and Fenske, a neuroscientist, present evidence showing that the brains of the high-achieving operate differently from those of the average person. Brain scans measuring neutral activity show these processes at work, they say.

The good news, according to Brown and Fenske, is that the brain can be reshaped and rewired by employing the strategies successful people use to overcome obstacles and reach their goals. 

"The brain is active and subject to change no matter what you do -- this is one of the key discoveries of modern neuroscience," they write. "What sets the owner of a Winner's Brain apart is the desire and the know-how to take charge of the process."

Brown and Fenske say that transforming your thinking, emotions and behavior as well as the physical structure of your brain is not unlike doing bicep curls to reshape and add inches to your arms. 

The authors have identified five "brainpower tools" commonly used by successful people: seeing opportunity where others don't, accurately gauging and being willing to take risks, being able to stay focused on a goal, possessing the energy to take action and being able to accurately assess one's strengths and weaknesses.

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Driving dementia patients off the road: Neurologists weigh in

April 13, 2010 | 10:51 am

Taking the car keys away from an aging parent or spouse whose mental faculties are slipping is one of the most difficult decisions a loved one confronts. But sometimes, it must be done. And knowing what checklist neurologists use might help both to back up your judgment and take some of the sting out of the decision for all parties.

Fortunately, the American Academy of Neurology has just issued new practice parameters for physicians that take account of the most recent findings on cognitive impairment and driving. This is the group's first update of the document in a decade.

Among patients who have recently been diagnosed with mild dementia, 76% can still pass an on-road driving test. Clearly, some with mild dementia can continue for some time to drive safely, but not all.  

The stakes for guessing which ones should not are high. But "there is no test result or historical feature which accurately quantifies driving risk," the academy says. The neurologist's most useful tool for gauging dementia is called the mini-mental state exam, but a patient's score on that test alone is not a good predictor of an older driver's ability to drive safely.

The academy recommends that, beyond a patient's performance on the mini-mental state exam, a physician should consider the patient's past driving record, his or her level of aggressiveness and impulsiveness, and whether the patient acknowledges avoidance in his or her driving patterns -- reporting, for instance, that he stays away from driving on highways or at night. When the driver acknowledges such avoidance behavior, that's a more useful clue than when she doesn't; some patients don't respond to declining driving performance by scaling back.

In the same vein, eliciting a caregiver's view of a patient's driving safety is most useful to a physician in cases where the caregiver rates the patient's driving as marginal or unsafe. Recent research suggests that caregivers routinely overestimate the driving performance of a loved one with dementia -- a fact that loved ones should consider when they begin to have doubts. 

And taking a patient's word for it is clearly not useful. The practice guidelines took note of research finding that in a group of patients with mild Alzheimer's disease, 94% identified themselves as safe drivers, while only 41% could actually pass an on-road driving test. Another study found of drivers diagnosed with mild Alzheimer's found that all of those who had failed the on-road driving exam had rated themselves as good drivers. 

Sadly, there are no proven interventions -- classes, medications, strategies -- that can reduce driving risk for those with dementia. One study suggested that requiring those over 85 years of age to come in and apply for a license in person reduced fatal crashes among this population.

Are you facing this difficult decision? Here's a very useful article on the subject, and here's a state-by-state list of alternative transportation available to seniors and patients with disabilities.

-- Melissa Healy


By any other name, Mediterranean diet protects the brain

April 12, 2010 |  4:48 pm

It's sounding increasingly familiar, but a new study suggests that the dietary advice at the heart of the Mediterranean diet bears repeating, in any accent that suits you: eating lots of leafy green and cruciferous vegetables, nuts, fish, poultry and fruits (including tomatoes) is the best way to preserve the health of mind and body.

In this case, it's the brain that appears to benefit from a diet that uses saturated dairy fats and red meats sparingly, relying more heavily on lean protein, plant-based foods and the kind of polyunsaturated fats you find in olive and canola oils. An article released early, but slated for publication in June's issue of the Archives of Neurology, found that older adults who consumed lots of salad dressing, nuts, chicken and fish, fruits and vegetables were less than half as likely as those whose diets were heaviest in meat and saturated fat to develop Azheimer's disease.

Those components are indeed the central pillars of the Mediterranean diet, which has been linked to improved cardiovascular health and lower cancer rates. And the same Columbia University researchers who conducted this study have found before that adherence to a Mediterranean diet appears to protect against Alzheimer's disease. But in this study, they wanted to explore whether consumption patterns that may not look Mediterranean, but which share some of that region's dietary features, might also protect against Alzheimer's.

Researchers followed a total of 2,148 cognitively health New York City residents over age 65 for about four years, assessing each subject for cognitive deficits at least three times. At the same time, the researchers broke down their dietary reports to gauge their intake of seven nutrients: saturated fatty acids; monounsaturated fatty acids; Omega-3 and Omega-6 polyunsaturated fatty acids; vitamin E, vitamin B12 and folate.

Of the one-third (749) of subjects whose diets ranked highest in saturated fats and B12 (nutrients richly represented in red meat and organ meats, butter and high-fat dairy products) and lowest in monunsaturated and polyunsaturated fats, vitamin E and folate, 117 subjects (16%) developed Alzheimer's disease during the four year study.

Of the 682 subjects whose diets ranked in the top third of the group in intake of vitamin E, folate and poly- and monounsaturated fats (nutrients found in poultry, fish, vegetables and most nuts and vegetable oils), just 50 subjects (or 7%) developed Alzheimer's disease. (Of the 717 in the middle, 86 subjects--or 12% developed the degenerative disease of memory.)

Just remember, you don't actually have to live on the shores of the Mediterranean--or to eat and drink like the coastal Spaniards, southern French, Italians or Greeks do--to live a long and memorable life.

-- Melissa Healy


Book Review: 'Eat Your Way to Happiness' by Elizabeth Somer

February 27, 2010 | 10:14 am
EYWTH

Battling the blues? Put down that Prozac prescription and head for the pantry, says Elizabeth Somer, author of the new book "Eat Your Way to Happiness." It's time for a diet makeover.

Changing what and how you eat can dramatically improve your life, without the negative side effects of antidepressants, writes the registered dietitian and frequent morning TV show guest.

Somer says people who followed diet advice she gave in her 1995 book, "Food & Mood," have told her they've seen their energy increase, their memories improve, their PMS symptoms vanish, their extra weight drop off and even their depressions lift. (She emphasizes that people should always seek medical help for depression that lasts more than a month or is accompanied by other symptoms.)

In her new book, she shares some of their stories and offers updated nutritional information.

Included in "Happiness" is advice we hear from many quarters today: Eat a good breakfast; cut back on sugar, white flour and saturated fats; choose real food over processed food most of the time; exercise daily. But she also goes further, quantifying what we should aim for and including research to back up her claims.

For example, Somer writes that sugar today makes up 25% of calories in most American diets -- much of it coming from processed foods. But a diet in which even 9% of calories are from added sugar is a red flag for weight and health problems, she says, and too much sugar offers a temporary "high" that can end in fatigue and depression. The good news is that cutting back can bring immediate weight loss, mood improvements and increased energy. She says we should aim for no more than 6% of our calories from added sugar -- 30 grams, or 7 1/2 teaspoons, a day on a 2,000-calorie diet. (This doesn't include the sugar found in naturally sweet foods such as fruit.)

Somer lists a dozen "super mood foods" to include in our diets whenever possible. Nuts are in the No. 1 spot, and she recommends an ounce a day to raise metabolism, take the edge off hunger and help regulate blood sugar. Other must-eat foods include soy (a memory booster, she says), milk and yogurt, dark leafy greens and dark orange vegetables, broth soups (which help dieters feel satisfied on fewer calories, a secret to permanent weight loss), legumes, citrus and tart cherries (they contain melatonin, a hormone that helps regulate sleep).

She spells out potential brain- and mood-boosting benefits of eating omega-3 fats, especially DHA, found in fatty fish ("Prozac from the sea"). She also goes into the downside of eating fatty fishes -- the mercury they may contain -- and gives DHA-fortified alternatives.

Somer offers tips for how to eat to sleep better (one is to eat a light dinner no less than three hours before bedtime) and work with, rather than fight, cravings. She discusses supplements, beverages and the right vices in which to indulge (good news for dark chocolate lovers). She outlines an ideal diet -- think fresh fruits and vegetables, whole grains, milk and soy, lean protein. Her book also includes recipes and a two-week kick-start diet plan.

-- Anne Colby

Photo: "Eat Your Way to Happiness," Elizabeth Somer, Harlequin, $16.95

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A couple of things to remember about that blueberry-juice study

January 22, 2010 |  8:52 am

Berries Antioxidants? Blueberries have them. Potentially beneficial phytochemicals? Ditto. Memory-boosting powers? Um...

Researchers at the University of Cincinnati compared nine elderly adults with "early memory changes" who drank blueberry juice every day with a group of similar adults who didn't. After 12 weeks, those who drank the juice performed better on learning and recall tests.

The researchers wrote: "The findings of this preliminary study suggest that moderate-term blueberry supplementation can confer neurocognitive benefit ..."

And from this comes the headlines "Blueberry juice may boost memory," "Blueberry juice could halt memory loss," "Blueberry juice could stave off dementia."

Earlier research in rodents had suggested blueberries might have a positive effect on memory, but ... nine people? A 12-week study? It's a starting place for further research. 

Eat blueberries if you like them, drink blueberry juice if you like it. But at this stage, a balanced diet is a smarter way to go than cramming yet another food stuff onto what is likely already a full plate.

Here's the abstract from the study, published Jan. 4 in the Journal of Agricultural and Food Chemistry. 

-- Tami Dennis

Photo credit: David Karp / For the Times


A cocktail to remember? Nutrient elixir shows promise against Alzheimer's

January 7, 2010 |  5:04 pm

Souvenaid sounds like a cool drink to be sipped while reading Proust in the garden. But new research suggests that the cocktail of nutrients soon to be marketed under that name may boost the production of brain cells lost in Alzheimer's and slow the loss of verbal memory in the disease's early stages.

A study published Thursday in the journal Alzheimer's and Dementia found that among 225 subjects diagnosed with early Alzheimer's disease, those who drank the nutrient cocktail twice a day for 12 weeks improved their performance on tests of verbal memory compared with newly diagnosed subjects who got a placebo drink. The study is the first to suggest that a "medical food" might be effective in stemming -- and perhaps reversing -- the cognitive tolls of Alzheimer's.

Souvenaid is expected to hit the American market in a test program as early as this spring, marketed by the French giant Danone, maker of Dannon yogurt, and its Nutricia subsidiary. 

The nutrient cocktail emerged from research conducted by Dr. Richard Wurtman, a neuropharmacologist and physician at the Massachusetts Institute of Technology. It contains a mix of nutrients all found in breast milk, and which are either produced naturally by the body or ingested in foods. Earlier research had found that the mix of nutrients -- uridine, choline and Omega-3 polyunsaturated fatty acids --  "synergistically" boosts the volume of proteins in the brain that give rise to synapses -- the branching structures that pass electrical impulses from cell to cell in the brain. 

The loss of synapses -- particularly in the hippocampal region, which is key to memory formation -- is one of several hallmarks of Alzheimer's disease. Wurtman said in an interview that if a mix of nutrients that so far have shown no side effects could stem or reverse that synamptic loss, it could become a valuable weapon in future physicians' arsenal against Alzheimer's. 

Nigel Hughes, head of Nutricia's North American unit, said in an interview that three other clinical trials are underway to test the effectiveness and safety of Souvenaid, and that a full market roll-out could begin in the U.S. by next year. Though the proposed Alzheimer's cocktail, as a dietary supplement, does not need  approval by the Food and Drug Administration before it can be marketed, Hughes said the company "is adopting the principles you would adopt for going to market with a pharmaceutical product," including clinical evidence that it works. As a "medical food," Hughes said the company anticipates that Souvenaid would be "taken under medical supervision."

Will Souvenaid become a voguish cocktail for aging smarties keen to hold off the cognitive decline that comes with age? Already, the Alzheimer's drug donepezil (marketed as Aricept) has been tested as a cognitive enhancement drug, and some consider taking it to be worth the risk. (The FDA, however, has pointedly declined to approve Aricept's marketing even for mild cognitive impairment, a loss of memory that is more serious than normal decline, but which leads frequently to Alzheimer's.)

One of the three large trials underway will test Souvenaid on European subjects with mild cognitive impairment. If that trial shows success, you can bet that the cocktail may be the next big thing among the middle-aged smart set.

--Melissa Healy  


Finally, evidence that cellphone radiation may be GOOD for you

January 6, 2010 |  3:01 pm

Poor cellphones. They get blamed for causing brain tumors, reducing bone density, prompting headaches and dizziness, and more. Though most rigorous research has exonerated the phones (not to mention the laws of physics), many people remain unconvinced.

Now comes a study from the University of South Florida that links cellphones to Alzheimer’s disease. But there’s a twist: The researchers found that radiation from the phones protected mice from the disease, and might even reverse the symptoms.

CellphoneThese surprising results were not found by engineering tiny iPhones and holding them up to the rodents’ ears. Instead, researchers at the Florida Alzheimer’s Disease Research Center arranged about 70 mouse cages in a circle around a central antenna that emitted electromagnetic waves typical of what would emanate from a phone pressed to a human head. They were exposed to the radiation for two hours a day over seven to nine months. About two dozen other mice served as controls.

Some of these mice were normal, but most of them had a genetic mutation that caused them to develop the amyloid plaques that build up in the brains of Alzheimer’s patients. Among these mice, some were old enough to exhibit the dementia associated with Alzheimer’s and others were still young and healthy.

The researchers found that the memory problems of the older Alzheimer’s mice disappeared over the course of the study. Younger Alzheimer’s mice who were asymptomatic maintained their cognitive function, and the normal mice actually got a memory boost from the cellphone antenna.

It appears that the electromagnetic waves somehow broke down the beta-amyloid plaques in the mouse brains or prevented them from forming in the first place, the researchers said. It’s not clear how this happened, but they found that the temperature of the brains of the Alzheimer’s mice rose by more than 1 degree Centigrade when the cell antenna was turned on. The scientists speculate that the temperature increase caused the mice’s brain cells to release the plaques, which were then flushed from their systems.

The results “suggest that high frequency [electromagnetic field] exposure could be a non-invasive, nonpharmacologic therapeutic against [Alzheimer’s disease], as well as a means to enhance memory in general,” according to the study, which was published today in the Journal of Alzheimer’s Disease.

The researchers are now investigating that possibility, especially since Alzheimer’s has proven to be stubbornly resistant to pharmaceutical treatment.

William Thies, the chief medical and scientific officer for the Alzheimer's Assn., called the results "interesting though very preliminary."

"This idea deserves further study," he said in a statement. In the meantime, Thies advised Alzheimer's patients and other would-be memory boosters against "self-medicating" by spending extra time on their cellphones -- especially if they are driving.

Sound advice, to be sure. But if the Florida researchers succeed, perhaps someday your cellphone bill will be covered by health insurance.

Funding for the study was provided by the National Institute on Aging and the USF Health Byrd Alzheimer’s Institute.

-- Karen Kaplan

Photo: Mice were exposed to cellphone signals from a centrally located antenna. Photo credit: University of South Florida

Can the motion of water inside the brain signal the early signs of Alzheimer's disease?

January 6, 2010 |  1:01 pm

Doctors would love to find a way to look inside people’s brains and spot the initial changes that lead to Alzheimer’s disease, the mysterious and devastating disorder that robs patients of their memories and intellect. There is no cure, but treatments to preserve cognitive function are considered most effective when begun early.

MRI A team of Italian researchers reported today that a cutting-edge brain-imaging test can recognize memory decline in older adults who may be in the initial stages of Alzheimer’s.

The brain scan measures the random motion of water inside the hippocampus, which plays a key role in forming new memories. It turns out that in people age 50 and older, those with a higher measure of this motion did worse on simple tests that measure verbal and visual-spatial memory.

The study included 76 healthy people who ranged in age from 20 to 80. All of them took a battery of tests. In one, they were asked to remember a list of 15 words after a 15-minute delay. In another, they were asked to reproduce a complex line drawing from memory after a 20-minute delay.

Then the subjects got MRIs, which measured the total size of the hippocampus. As in some prior studies, the total volume of the hippocampus was not linked to memory performance. But using a type of analysis called diffusion tensor imaging, the researchers did find that subjects with a high level of “mean diffusivity” in the hippocampus had lower scores on the memory tests. The results were published in the journal Neurology.

The researchers said they weren’t sure why increased water diffusivity would affect memory, but they suspect it is a sign of “enlarged extracellular spaces.” That could be a sign of pathologic changes in the brain that lead to Alzheimer’s, they said.

In a related editorial, radiology researcher Norbert Schuff of the Center for Imaging of Neurodegenerative Diseases at the Veterans Affairs Medical Center in San Francisco called the study “eloquent” and said the test could become a valuable tool for detecting early cases of Alzheimer’s disease. (Of course, more studies are needed to confirm these results.)

“As better medications for [Alzheimer's] become available, it will be essential to identify individuals at high risk for the disease not only early but also as accurately as possible so that treatment interventions can be most effective,” he wrote.

-- Karen Kaplan

Photo: An MRI could someday be used to diagnose Alzheimer’s disease before patients have any symptoms. Photo credit: Genaro Molina/L.A. Times



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