This is Part I of a two-part series on how to keep your brain healthy. There is a little bit of history, some pithy observations, and hopefully, information that will help you stay engaged cognitively! Look for Part II next week.
Not too long ago I was able to remember endless bits of information. Nowadays I make lists. I used to make fun of people who made lists until I read Atul Gawande’s book about how list making actually saves lives in the operating room (The Checklist Manifesto). I figured if it was good enough for a surgeon, it was good enough for me.
I have recently been involved in an office renovation. This has required me to go through drawers and clean out things. Among the many things I came across were lists my mother made in her later years. She, too, found lists helpful. There was a bittersweet quality to finding the lists she made, marking as they did, her slow decline into mild cognitive impairment and then dementia.
Lists are like exit signs on the highway. The list tells me which turnoff to take. Taking this analogy a step further, once on the familiar road, I can figure out where I am going and usually find my way around my memories and recall things pretty well. But if I miss the exit, I can get lost and need extra time to find my way back. There are many reasons for missing the turnoff – anxiety, lack of sleep, poor nutrition, substances and pharmaceuticals, all interfere with the brain’s ability to function. Oh yes, and then there is dementia.
I suspect that I am not alone these days in worrying that my memory problems are signs I have dementia. There are times when my brain feels like molasses. Words need to be searched for instead of tripping off my tongue as they once did. When I am discussing a familiar topic, ideas come easily. When I am recalling things not so familiar, it can feel like searching in a basement filled with cobwebs, dust, and desiccated remains in the dark corners. Eventually I get to the word or concept, but not as quickly as I used to. Now I am making lists, just like my mother did. But what is actually happening to me?
Neuroscientists are constantly coming up with new metaphors to describe how our brains work. Back in the day when I was teaching psychology to college freshmen, one of the main descriptions was that memory was like a filing cabinet. Diagrams with storage bins were found in textbooks. These seemed logical and were a useful visual to understanding this complex process. Current metaphors include computer references such as encoding, storage, retrieval, and dual-processing. 
In actuality, we really don’t know how memories are made, where they are “stored”, or how we bring them back to awareness. We have evidence and have identified specific processes, but there is still much that confounds science! And we don’t know because we don’t have the technology that can look inside our brains in real time and give us the answers. How frustrating!
Instead, we rely on systematically testing out ideas and seeing if they hold true. This takes time and money and really dedicated researchers who are willing to spend a lifetime just looking at one small aspect of how our brains function. We work with people who have exceptional memories and people whose brains have been compromised. We work with self-reports and long-term observational studies. This information is gathered, discussed, and shared at conferences all around the world. Much of the time our theories are wrong and we have to go back to the drawing board. This is what has been true for most research on Alzheimer’s.
Using the cutting edge technology of his times, Alois Alzheimer systematically investigated brains of people who had been acting strangely before they died. These people, he was told, seemed to not be able to remember or recognize things and eventually they even forgot how to do basic things like button a shirt, comb their hair, and recognize loved ones. What Alzheimer discovered using his microscope was what he called “plaques” and “tangles”. 
While they were found in different parts of the brain, what was consistent was that the people who had these plaques and tangles all had memory issues. From that time on, scientists focused their efforts on understanding how plaques and tangles caused memory loss and what became known as Alzheimer’ Disease (AD). That was back in the early 1900’s. Today we have different technology and we have found out some interesting things.
While all people who are diagnosed with AD have plaques and tangles in their brains, many people who do not have AD also have plaques and tangles. We now understand that some people are more vulnerable to the symptoms of AD, which include memory issues (forgetting), difficulty naming objects, planning and executing plans, and destructibility. These folks may have a genetic predisposition to AD, although there isn’t just one AD gene that covers all these brain functions. We also know that injury to the brain such as concussions may result in damage that shows up in behaviors like forgetting, difficulty recognizing objects, planning and executing plans, and impulsivity.
While it doesn’t appear that AD can be cured or reversed at present, there are things that seem to slow it down. These are protective factors. Based on my reading and understanding of findings, these can be grouped into three areas: exercise, nutrition, and attitude. Exercise includes the physical (walking, swimming, dancing, weights, sex), nutrition includes lots of green leafy veg and brightly colored fruits, and attitude includes managing anxiety, stress, sadness and loss, and outlook. 
I’ll take a deeper look at each of these three areas in next week’s blog.
If you are interested in participating in brain research, you can sign yourself up at Brain Health Registry, where they have an exciting study going on by researchers at the University of California-San Francisco. It’s free and will make a difference in how quickly scientists are able to find ways to keep our brains healthy over the lifespan.
In the meantime, I have to go over my list and get ready for my sabbatical. Now, what am I forgetting?
