Brain Training Prevents Mental Fragility And Falling

Every day, I see many elders in my practice. Some of them are experiencing the usual mental difficulties of old age, like forgetfulness or poor attention span. Yet others somehow manage to remain mentally sharp, even well into their 80s.

I call these people “superagers”; those whose memory and attention is well above average for their age, on par with healthy, active 20 and 30-year-olds.

So, why do some elders remain mentally agile while others descend into dementia?

There are several reasons:

• As a person gets older, changes occur in all parts of the body, including the brain. Certain parts of the brain shrink (such as the prefrontal cortex and hippocampus); both areas are important to learning, memory, planning, and other complex mental activities.
• In some people, structures called plaques and tangles develop outside of and inside nerve cells of the brain, which in large amounts, can result in dementia (such as Alzheimer's disease).
• Lastly, as people get older, research shows that people tend to avoid unpleasant situations, such as any discomfort or frustration associated with mental exertion. If people consistently sidestep the discomfort of mental effort, it can be detrimental to the brain. All brain tissue wastes away from disuse. If you don't use it, you lose it.

Can Brain Activity Lead to Falling?

Aside from memory problems, changes in brain activity can influences one's chances of falling:

• The ability to keep balance and avoid falling depends not only on leg strength, but also on complex and simple reaction times, known as ‘brain speed'. The faster one's brain can move between events (identifying a loss of balance and executing a safe alternative to maintain balance), the better off people are in avoiding falls. In other words, when some people fall, their brains may not be keeping up with what is happening and unable to quickly recover from a loss of balance.
• People whose brains work hard when trying to complete complex activities (such as walking and talking at the same time) may have a higher risk of falling than those individuals who do both tasks with ease. When elders perform any cognitively demanding task, their brains become more active to handle the challenge. Walking and talking at the same time requires greater attention. Thus, more brain effort is expended, which in some individuals can lead to falling.
• Alzheimer's disease (AD) is a disease associated with a loss of memory and intellectual abilities. The risk of developing AD increases with advancing age and gradually gets worse over time. One of the most common safety problems in persons with AD is that of falling. It's estimated that up to 60% of persons with AD experience one or more falls annually because of poor mobility, which includes the ability to walk safely and maintain good balance. Persons with AD tend to exhibit marked impairments with both. This places them at increased fall risk.

Brain Training

Which activities will increase your chances of remaining mentally sharp and fall-free into old age?

Stay Active

• Enjoy regular exercise and physical activity. Exercise helps counter normal cognitive decline; it can also assist in managing and preventing conditions like high blood pressure and depression that are associated with poor brain health.
• Exercise pumps blood to the brain and encourages the growth of new brain cells.
• Regular aerobic exercise (such as walking, cycling and swimming) for 30 minutes a day reduces brain cell loss.
• Exercise changes how the brain processes movement, resulting in improved mobility.

Engage Your Brain

• Just like physical exercise, mental exercise is good for you. Mentally stimulating activities help preserve brain function. Keeping your mind engaged increases the brain's vitality and helps build its reserves of brain cells and connections.
• Do stimulating activities that you enjoy; read, write, put together a jigsaw puzzle, work on crosswords, etc.

Any mentally challenging activity will keep your mind sharp.

• Critical brain regions are stimulated by engaging in physical and mental tasks requiring effort. In other words, vigorous exercise and strenuous or challenging mental effort (such as swimming daily and learning a foreign language or taking an online college course), helps keep the brain youthful and sharp.

Eat Healthy

• Free radicals are a normal by-product of the body's metabolism. Normally, free radicals serve important functions, such as helping the immune system fight off disease. However, free radicals can also damage the brain and contribute to memory loss.
• Eating a healthy diet helps maintain brain health. For example, eating fruits and vegetables (that have high levels of disease-fighting antioxidants) helps counteract disease-causing free radicals throughout the body, including the brain.

Stay Social

• Connect with family, friends and your community. Isolation can be a threat to brain health. Staying engaged with family and being active in your community can keep your brain active. The more social connections someone has, the better they are at preserving mental function and memory.
• Social interaction engages areas of the brain that are involved in memory and attention, the same mental processes that are used in many cognitive tasks.

Get a Check-Up

• Take care of your health. Certain conditions can affect brain health including diabetes, stroke, vitamin deficiency, thyroid disease and high blood pressure. Controlling risk factors for chronic disease (such keeping blood cholesterol, blood pressure at healthy levels and maintaining a healthy weight) is good for brain health.
• Certain medicines, such as sleep and anxiety drugs can also affect mental ability. Ask your doctor to review all your medications on a regular basis.

Rein Tideiksaar Ph.D., PA-C is the president of FallPrevent, LLC, Blackwood, N.J., a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr. Tideiksaar is a gerontologist (healthcare professional who specializes in working with elderly patients) and a geriatric physician's assistant.