Jogging the Brain

The idea of systematic cognitive exercise as a way of improving mental functions is not new. For decades, people who suffered head injury or stroke have been treated with cognitive therapy as a way of restoring mental functions lost to brain damage. Today we are on the threshold of a conceptual leap from treatment to prevention. A growing number of scientists, physicians, and psychologists believe that vigorous and diversified mental exercise may help in the battle against the decline of mental functions, which ultimately may take the form of dementia. From treatment to prevention—this is the dominant theme of modern medicine, and it is becoming an important theme in the battle against cognitive decline.

The theme has gained currency as the general public is made increasingly aware of the ravages of dementia. Earlier, mental deterioration was assumed to be a normal and inescapable product of aging, “Becoming sclerotic,” “getting senile,” “losing one’s marbles” were the standard popular terms for referring to such “inevitability.” But recent scientific research has shown that a large portion of the elderly population never loses mental acuity through gradual, inexorable decline. Instead, scientific research suggests that a “bimodal” picture, a distinct difference between those who lose their cognitive powers with age and those who do not. In their influential book Successful Aging, John Rowe and Robert Kahn make the point with impressive clarity. From this it follows that cognitive deterioration is not an obligatory part of normal aging; it is a disease of aging that affects some, perhaps many, but not all. The disease is called “dementia” and several types of dementia exist, each representing a different type of illness afflicting the brain. Therefore, we usually talk about “dementias” rather than “dementia.”

A preordained, inexorable progression toward “senility” is a myth. This is the good news. The bad news is that while not inevitable, dementias are very common. Alzheimer’s-type dementia is the most common among them, accounting for more than 50% of all dementias. By the age of 65, more than 10% of the population is afflicted with one form of dementia or another. According to the American Medical Association, by the age of 85, some 35% to 45% of people have it to at least some degree. It is estimated that dementias are likely the fourth or fifth most common cause of death in the United States.

The high rate of dementia means that something must be done to treat it, and preferably to prevent it. Unfortunately, mental illness (and dementia is a form of mental illness) has been traditionally associated with stigma. People are more open about their “physical” ailments than they are about their “mental” ailments. Stigma means silence and the illusion of absence. Therefore, the taboo imposed by tradition on the discussion of mental illness has hindered society’s ability to grasp its full scope and dimension and thus to assign the battle against it the priority it merits.

Fortunately, attitudes are rapidly changing. With the development of science and public awareness, the distinction between “physical” and “mental” ailments is becoming increasingly obsolete. Until recently, the general public was under the blissful assumption that while the body is frail and subject to decay, the mind is forever invulnerable. Today most people understand that the “mind” is a function of the brain, which is very much part of the “body.”

How can dementias be fought? The thrust must be two-pronged: treatment and prevention. A concerted effort has been launched by scientists and the pharmaceutical industry to develop dementia-treating drugs. Little of immediate clinical utility has been accomplished, but the battle has been joined and the resources mobilized, and there is good reason for optimism in the long run.

By contrast, the concept of prevention of cognitive decline is only beginning to take shape in the minds of the scientific community and to enter public consciousness. Over the last few decades, the concept of physical exercise as a way of extending one’s physical well-being with age has taken a firm hold in American culture. Today, the notion of cognitive exercise as a way of extending one’s cognitive well-being with age is becoming increasingly accepted by scientists and is beginning to connect with the general public. In the last few years we have witnessed a sea change in the public attitude toward the notion of cognitive fitness.

While the concern about cognitive decline and how to prevent it naturally increases with age, it need not be limited to the elderly. A certain decline of cognitive powers is already evident at the age that we usually associate with the zenith of our lives and the pinnacle of our careers: 40s, 50s, and 60s. A green youth is usually more adept at learning a foreign language, computer language, or a complex game like chess than is a corporate or political leader at the height of his or her power and societal influence. We begin to notice subtle memory slippage long before our confidence in ourselves becomes eroded in a global sense. Is this inevitable?

Middle-aged people engage in physical exercise to improve the odds against having a heart attack, whereas young people exercise to improve their social attractiveness. The criteria of social attractiveness reflect the attributes critical for competitive success, which in turn change through the history of human civilization. The criteria of physical attractiveness reflect the markers of physical fitness, which has been, and will remain, an important ingredient of success. For centuries the definition of attractiveness has revolved mostly around physical attributes.

This attitude is changing. We are entering an unprecedented era in the development of human society ruled overwhelmingly by information processing. Bill Gates refers to this as the advent of the knowledge-based society. As we move into the twenty-first century and beyond, the attributes of social attractiveness will reflect the prerequisites of success in an increasingly information-driven society. Sharp will be beautiful. Being perceived as “dumb” will be more socially damning than being perceived as “ugly.” In this social context, any credible approach to the preservation of cognitive well-being will be met with a public sense of approval and urgency.

Extract (c.800w) from Chapter 13 “What Can You Do For Me?” pp.240-244 ‘Jogging the Brain’ from “The New Executive Brain: Frontal Lobes in a Complex World, Revised and Expanded Edition” by Goldberg, Elkhonon (2009)
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By permission of Oxford University Press, Inc

Don't miss Dr. Goldberg’s Tri-Cities presentation on June 11.

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