Brain Savers

By A.J. Mann

Literary biographer Leon Edel used to keep a small painting by Bloomsbury artist Duncan Grant hanging just inside the doorway of his home office in Honolulu. "Grant painted that when he was 90," Edel, then 72, told an interviewer. "I keep it there to remind myself that a man can be productive at 90."

By the time of his death, Edel had edited his Pulitzer prizewinning biography of Henry James from its original five volumes down to two and then to a single volume and had written four more books, including his war memoirs. He died four days short of his 90th birthday.

William Paley was still running CBS at 89. Picasso turned out 140 canvases at 88 and was still painting when he died at 92. Great minds aside, how long is a good mind good for? And what can the rest of us do to keep our minds alert and active, to safeguard our gray matter from the inevitable cognitive decline associated with aging?

Experts say this decline--starting with intermittent "senior moments" and potentially progressing to full-blown Alzheimer's disease--is due to myriad factors, with things like genetics and lifestyle choices determining how far down the forgetful road we go. And those choices can be every bit as powerful a positive force as genetics can be a negative one.

Take the case of the identical-twin 81-year-old sisters reported by Dr. Gary Small in The Memory Bible: An Innovative Strategy for Keeping Your Brain Young (Hyperion), due out next month. One sister lived a "hard life," smoking, drinking heavily, eating a high-fat diet and exercising little, if at all. She started experiencing mild forgetfulness at 77, followed by difficulty balancing her checkbook, completing crossword puzzles and addressing Christmas cards. Soon she developed Alzheimer's. The other twin was a social drinker who never smoked, adhered to a diet low in starches and animal fats, and exercised. She too began experiencing mild forgetfulness in her 70s but didn't decline further.

Some of us will go beyond the level of the second twin, to what is known as mild cognitive impairment, and some all the way to dementia, the most common form of which is Alzheimer's. But most of us won't--and need not. "People used to think that senility was a normal part of aging," says Small, a professor of psychiatry and aging at the University of California, Los Angeles. "Now we see it's a disease. If we all lived long enough, we'd all get Alzheimer's disease if we did nothing about it." The good news: we can do something about it.

The new strategies are based on recent research findings. The most striking are those showing that, where the brain is concerned, the familiar exhortation is right: use it or lose it. The Religious Orders Study, headed by Dr. David Bennett, director of the Rush Alzheimer's Disease Center in Chicago, looked at 700 elderly, dementia-free Roman Catholic nuns, priests and brothers. Each was asked about time spent on various activities, among them viewing television; listening to the radio; reading newspapers, magazines and books; playing games such as cards and checkers; doing crossword puzzles; and going to museums.

Engaging in all these activities was found to protect against Alzheimer's and resulted in lower rates of decline in short-term memory and perceptual memory--a person's ability to perceive new information. "We're not in a position to recommend one activity over the other," says Bennett. "As far as we can tell, it's the variety--doing a bunch of different things--because you're stimulating different parts of your brain."

While mental exercise is getting new emphasis, physical exercise remains vital too. "The Romans said it ages ago: A sound mind and a sound body," says Dr. Robert Butler, president of the International Longevity Center in New York City. At the University of Illinois, Dr. Arthur Kramer pitted aerobic exercise against weight lifting and toning in 124 very sedentary elderly men and women without dementia--"couch potatoes," as Kramer calls them. Half were assigned to an aerobic-fitness schedule consisting of progressively longer walks; the other half did strength and flexibility exercises.

"We speculated that aerobic training would increase performance in skills that have to do with executive control--planning, scheduling and/or multiple tasking," says Kramer. "And that's essentially what we found--but not for the nonaerobic group." Besides increasing the flow of blood to the brain, aerobic exercise is believed to stimulate the production of new neurons in the brain and a protein called bdnf (brain-derived neurotropic factor), which helps maintain the health and efficiency of neurons.

The mind, it turns out, can be nourished by certain foods just as much as the body, particularly foods high in antioxidants. When brain cells burn oxygen for energy, molecules called free radicals are created to eliminate harmful toxins. But when free-radical levels get too high, the free radicals start damaging neurons. Antioxidants keep these levels down.

Dramatic proof was found by Dr. James Joseph at Tufts University's Human Nutrition Research Center on Aging, in a study of 40 elderly rats with dementia. Thirty of the rats were fed high-antioxidant extracts from blueberries, strawberries or spinach. All showed improvement in working memory compared with the 10 rats that were not fed supplements. So it makes sense to load up on antioxidants (which are also found in prunes, plums, raisins, cranberries, raspberries, Brussels sprouts and broccoli) as well as beta-carotene (in carrots and cantaloupes) and vitamins A and C.

You should not overlook folic acid (found in meat and leafy green vegetables such as spinach) or vitamins B6 and B12. They reduce high levels of the amino acid homocysteine, which is believed to contribute to Alzheimer's. "It makes sense to have a diet that's rich in folic acid, fresh fruits, legumes and vegetables," says UCLA's Small. "And it can't hurt to take a multivitamin, which has 0.4 milligrams of folic acid and some B6 and B12."

While you're at it, add some fish to your menu too. The omega-3 fatty acid docosahexaenic acid, or DHA, which comes from fish oil, has been shown to improve memory in Alzheimer's patients and is, like other antioxidants, believed to protect against the ravages of oxidation.

What all these new findings come down to, suggests Dr. Molly Wagster, program director of neuropsychology of aging research at the National Institute on Aging, is some of the oldest and simplest truths we've known from childhood. If your short-term memory is failing you now, she says, "try to remember your parents telling you to read a book, eat your fruits and vegetables, go outside and play, and get a good night's sleep."