Would You Break a Sweat to Save Your Brain?

Tis the season to begin thinking about new year's resolution and for sure, many will hit the gym, the pool, and the neighborhood pavement for a few months.

What if I could offer greater motivation, perhaps enough to start today in December?

As we become older adults, our brains begin to shrink or "atrophy" at a rate of 1-2% per year.  Scary, yes, but there may be something we can do about it.  We will focus on the hippocampus, the part of the brain "critical for establishing new memories, part of the brain most vulnerable in Alzheimer's Disease (AD) and vulnerable to aging."

As discussed in a very informative lecture by Professor Frank Longo, MD, PhD, Chairman of Neurology and Neurological Sciences at Stanford University, it is possible to grow your brain with daily exercise.

Dr. Longo cites a 2011 Prospective Randomized Controlled Trial (RCT) by Erikson et al. entitled 

"Exercise training increases size of hippocampus and improves memory."  RCTs are the gold standard in research trial design, showing cause and effect, not just association (or correlation) of factors.

Dr. Longo then imagined out loud how this good news may play out when speaking with a patient at his Stanford clinic:

"I have this new drug out, it's is going to reverse the shrinkage of your hippocampus- I know that sounds like science fiction- we have this drug that will reverse brain shrinkage... here are the side effects of this 'drug': less hypertension, less diabetes, and less depression... so you'd say write me a prescription, I'm ready. I'd tell you you need to do brisk walking, or some form of exercise, 30 minutes a day 5 days, you'd be really disappointed and probably wouldn't take it."

This, no doubt, will not stop Dr. Longo from offering the findings and encouragement. Of course, we should all still try to spread the news of the potential benefits of exercise. Will you make that difference?

I hope you consider this study and start lacing up your tennis shoes. Please do not see this as an all or nothing proposition.  If you can exercise 3 days a week, that is better than nothing. I'll post more research on prevention. The best way to find Peace with Dementia is to take steps to avoid developing it. Be well!

A special thanks to Dr. Longo for this presentation and Dr. Erikson and team for this important work.

Action Items:

• Decide if you want to reduce risk of hypertension, depression, diabetes, and dementia.
• If yes, find a cardiovascular activity that you enjoy doing - swimming, walking, cycling, etc.
• Add a comment or question. 
• Share, Like, and +1 this article.
• Like us on FB and visit our website for a list of support groups and services.

Matt Estrade, MBA, CAPS is the Founder and Chief Mentor at Care Partner Mentoring, LLC in Covington/New Orleans, LA, USA. A more extensive biography can be found here.

PubMed Citation of Study Discussed:

Proc Natl Acad Sci U S A. 2011 Feb 15;108(7):3017-22. doi: 10.1073/pnas.1015950108. Epub 2011 Jan 31.  Exercise training increases size of hippocampus and improves memory.
Erickson KI1, Voss MW, Prakash RS, Basak C, Szabo A, Chaddock L, Kim JS, Heo S, Alves H, White SM, Wojcicki TR, Mailey E, Vieira VJ, Martin SA, Pence BD, Woods JA, McAuley E, Kramer AF.

Individualized Music in Preventing and Soothing Agitation in Dementia

They say that music is the soundtrack of our lives. Most probably, this strikes a chord with you. Do you ever hear a song on the radio or television that for a moment transports you back to a distant place and time? Perhaps the memory is pleasant and reminds you of event like courting your spouse or your wedding.  A song may also bring back a painful memory such as a bad relationship or breakup. It could even be bittersweet, reminding you of a loved one who is no longer physically in your life. This blog post will tell you how music can create Peace with Dementia. As always, I offer some action steps if you are committed making Peace.

Music is a powerful thing.  According to Professor Linda A. Gerdner at the Stanford Geriatric Education Center, music can be used to sooth persons with dementia when they are agitated.  Agitation is a term used to describe "inappropriate verbal, vocal, or motor activity that is not explained by needs or confusion per se" (Cohen-Mansfield & Billig, 1986, p.712) as documented in Dr. Gerdner's presentation mentioned in the next paragraph.  When someone has a dementia, their "stress threshold" is lower, meaning that it takes even less distraction and disruption to become agitated (Richards-Hall & Buckwalter, 1987) as documented in Dr. Gerdner's presentation. Where you and I today may have a strong ability to keep our cool,  we will generally be set off more easily if we have dementia.  Using music in the proper way can help prevent agitation and also help calm someone down when agitated.

Dr. Gerdner has been studying the benefits of music for persons with dementia for 25 years. In 1996, she published her original evidence based guidelines which is in its 5th edition. In early 2015, Stanford uploaded this Dr. Gerdner presentation that you will enjoy.  I highly recommend viewing the presentation and focusing on these key points from Dr. Gerdner's research:

• It is important to know this a "music intervention" that can be used by family members and staff who follow Dr. Gerdner's evidence-based guidelines. This is not "music therapy" that is offered by therapists. 
• For music to effectively create peace, select songs and artists that you know are special to the person with dementia.
• Dr. Gerdner has developed two (2) assessments to assist you in exploring song selection.
• One (1) assessment is for persons in the early stages of dementia - Page 16 of the guidelines
• One (1) assessment is for a family care partner and/or professional care partner- Page 18 of the guidelines.
• Prevention of agitation is optimal. Dr. Gerdner recommends playing music 30 minutes prior to the time of day when it appears.  This takes looking for patterns and sources of agitation. 
• The only way to know if this will work for your loved one or a client is to try the selected songs and takes notes on progress.  When a songs works, write that down. When a song does not work, write that down. Discontinue songs that create more agitation.  The person with dementia is the expert from whom we take our cues.
• If music from a music player bothers other people, try comfortable headphones with a safe volume. Remember the person will like have different hearing ability as you, and not necessarily worse if they have a hearing device.
• Dr. Gerdner's research also discuss ethnic music that can be very powerful if they have not heard it in a very long time. Her above presentation includes two powerful examples of this.
• Naomi Feil, creator of Validation Therapy, is seen on this popular video of utilizing music to communicate with someone in repetitive motion and non-verbal.
• Here is a popular example of a gentleman coming alive with the help of his favorite music.

Action items for you to create Peace with Dementia:

• Review the PDF of Dr. Gerdner's Evidence Based Guidelines.
• Visit her Stanford page.
• Consider the idea of using individualized music to communicate with your loved one or client.
• Add a comment or question. 
• Like us on FB and visit our website for a list of support groups and services.

Matt Estrade, MBA, CAPS is the Founder and Chief Mentor at Care Partner Mentoring, LLC in Covington/New Orleans, LA, USA. A more extensive biography can be found here.