S2E47. Guest Blogger: Sally!

Have you ever wondered what it’s like to live with someone who is semi-obsessed with brain health? Although she didn’t sign up for that job when we re-connected after 41 years in 2011, Sally has found herself in just that position over the course of the past two years. Although skeptical of my latest career tangent, she has shown amazing flexibility and acceptance of the path I’ve led us down. So I asked her if she’d like to write an episode of what it’s like to ride shotgun with me. Here’s what she had to say:

“who knew that wayne’s changing his behavioral and mental approach to brain health would have so many real benefits for my health, too?  

a once “i’ll-never-eat-that” food option is now one of my favorite side dishes. i’d previously tried kale in various iterations but never found it palatable. but that was before wayne discovered the magic of massaging it with a little salt and olive oil. what a difference! 

and then there’s quinoa, for which my attitude had always been: “just not gonna happen.” but lo and behold, now i really enjoy the nutty flavor and look forward to it in many dishes.  

kefir? it took me years to eat yogurt and this was a step beyond that. when wayne told me what it was, my gut reaction was: “no way.” it had no appeal for me whatsoever. but then he made some and now i eagerly enjoy it every night as our after dinner drink.   

we are on this journey together. as you know, his change in habits goes well beyond food. we’ve lowered the night temperature in the apartment, constantly evaluate the air for impurities, and have adjusted the darkness in our bedroom so as to promote better sleep.    

his recent experiment to change his circadian rhythm was so funny to watch! he religiously went to bed an hour earlier than the night before until he was going to sleep at 6pm and waking up at 2am. goodness! i would just shake my head and laugh as he said good night when it was still light out. luckily, my reading didn’t bother him and his turning all the lights on at 2 am didn’t bother me (i was in the bedroom and he in the living room). the reviews are mixed as to whether it was a successful venture, but it proved to me that this man will try almost anything to better his health and mind and soul.  

i never envisioned these kinds of changes in lifestyle but it’s about damn time!  exercising and eating healthy foods just makes good sense. and i love this man so i know we will continue to explore how to be healthy for as many years as we have left to us.” ***

Thank you…and back at ya!

But regarding the question of how many years we have left to us, she’s known my thoughts about that since our first date after re-connecting. We were both 60 at the time, and I asked her what she was planning on doing for the next 60 years. That makes it 11 down and 49 to go! She’s done well adapting to quinoa and kale, but I don’t think she’s quite wrapped her head around the idea of celebrating our 120th birthdays together!

*** Note: No, those are not typos in Sally’s essay. She has eschewed the use of capital letters ever since reading e.e. cummings when she was fifteen….and that was something I had trouble wrapping my head around when I was a freshman at Brown and reading her letters from home!

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S2E46. What Will I Remember?

About 25 years ago, when I was in my late 40s, my wife and I spent a week in Venice. Reflecting back on that trip, though, I only have a handful of memories…certainly not a week’s worth. Which makes me wonder: How much of our just-completed 12-day journey will I remember 25 years from now, when I’m 96?

I slept well every night with a lot of dreaming both on the trip and the week after, and I didn’t experience any anxiety or depression, so my brain has no excuse for not consolidating a lot of memories. 

I’m pretty sure I’ll remember that we visited Greece, Montenegro, Croatia, Slovenia and Italy, but the names of the ports are already eluding me. Without looking at the itinerary, I can name Athens, Santorini, Corfu, Dubrovnik, Zadar, Koper and Venice, but I already need help to fill in Katakolon and Kotor. I’ll be happy if I can recall 5 out of 9 a few years down the road.

One thing I know that I am certain to remember is tasting the fruit of a cactus that was growing alongside a cobblestone street. I picked one pod from a cluster and split it open with my thumbs to reveal its juicy, bright purple meat. It tasted bitter so one taste was enough. After dropping it on the ground, though, I noticed a smear  of juice on my hand and so I licked it.

BIG MISTAKE!

Immediately, I felt the prick of a hundred tiny needles all around my tongue and the inside of my mouth. Unseen by me, the fruit was protected by a legion of tiny spikes that had come off in my hand when I opened it. That one lick transferred most of them to my tongue. Lesson learned…and never to be forgotten! (On the walk back to the bus, our tour guide identified the plant. It was an aptly-named prickly pear cactus!)

On the other hand, I already can’t remember on which excursion it happened. 

I probably won’t forget the olive trees, which I had never seen before, that were as ubiquitous in Greece and Croatia as are vineyards in France and corn fields in rural Pennsylvania.

I tried to replay in my mind our tour of Lubljana, Slovenia, and did pretty well. Sally was impressed with the detail of my recollection. But I’m unable to recall the other excursions with as much certainty. A few images pop up, but I know that there is a lot I’m forgetting, and I have trouble connecting the images to the locations. Reminiscing with Sally should help remedy some of that.

Telling friends about our adventure should foster preservation of some memories. It will be interesting to see which experiences emerge as important enough to share.

The pictures we took will also help, but only if we look at them from time to time. The photos I’ve posted to the blog’s web site are the one’s I’m most likely to recall in the future because of their association with the blog in addition to the visit itself.

I’ll remember that the former Yugoslavia broke into 6 nations: Montenegro, Croatia, Slovenia, Macedonia, Serbia and Bosnia-Herzegovina. All 4 of the tour guides we had in the first 3 of those countries mentioned it and I realized that I was completely ignorant of that recent history, so I made an effort to commit it to memory.

I sat agape watching people walk by at the port in Kotor, Montenegro, stunned at their height. It turns out that they have the 3rd tallest population in the world. I felt like Gulliver in Brobdingnag…which should be unforgettable.

I’ll remember the rubbing alcohol taste and spreading warmth throughout my chest from drinking grappa. I won’t remember any of the paired wines from our gourmet on-board dinner.

I’m pretty sure I’ll recall the glass-making demonstration in Murano. We bought an art glass paperweight that is sure to remind us.

In all likelihood, though, I’ll forget the vast majority of the experience. Like my Venice trip a quarter of a century ago, there will probably be fragments, but not enough to conjure up the full 12-day trip.

Already—just a week since our return—much has faded. Memories are mischievously mingling and blending with one another, so I have difficulty sorting out what happened when and where.

But I’m going to try my level best to preserve the humbling awe I felt as I beheld the elegant majesty of the Parthenon, and the quiet thrill that surged through me as I stood on the starting line for the foot races at the original Olympic stadium where the games were held for more than a thousand years. 

I believe in the maxim that it’s not the destination, but the journey that matters. I’d like to augment that sentiment by suggesting that it’s not the memories (which can fade) but the experience (knowing that you did it) that really matters. And so I’m hopeful that a quiet warmth will still well up within me when I’m 96 and someone mentions Montenegro—even if I can no longer picture it in my mind’s eye—and I’ll smile.

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S2E45. Home Again, Home Again!

Greece, Montenegro, Croatia, Slovenia, Venice, West Chester, Pennsylvania!

As wonderful as the accommodations were on our trip, it was great to sleep in our own bed last night, especially after having woken up at 4am in Venice to begin the journey home.

4am in Venice. That’s 10pm in West Chester. It’s just mind-boggling that I had to get up at exactly the same time that I would normally be going to bed. 

The flights home were quite the challenge. Did you know that Venice airport is a ‘silent’ airport? No announcements over the public address system until you get to your gate. It was borderline serene walking through the terminal.

Our first flight was a 2½ hour hop to Heathrow Airport in London. We arrived on time, but due to a labor shortage, there was no one to connect the walkway to our plane, so we sat on the tarmac for half an hour…which resulted in our missing our connecting flight to Philadelphia.

Heathrow is a sprawling city. Once we got into the terminal, we had to take a bus, a tram, an elevator, 2 escalators and then walk about a quarter mile to get to our gate. The security lines were long and the technology to move through the various passport and boarding pass checkpoints confusing. Fortunately, though, signage was clear and we muddled our way through in our sleep-addled state.

Once aloft, I decided to sleep as much as possible on the 8-hour flight while Sally decided to stay awake the whole time. We arrived in Philly around 5pm and we both went to bed at 9pm. It will probably take us 2-3 days to get back into our normal routine.

Reflecting back, the journey was both a feast and an assault on our senses, cognitive abilities and biological rhythms. Just the thing the doctor ordered for dementia prevention!

The sights and vistas were breathtaking across the 5 countries we sampled, topped off by the 27-hairpin turn climb to the 3,000 foot view from a mountain top in Montenegro back down to our ship in the turquoise harbor below.

We discovered that sunrises and sunsets don’t get old, no matter where or how often they are viewed.

The various on-board lectures and tour guide narratives filled our heads with new information about the last 4,000 years of history across the region. By the time we did the tour of St. Mark’s Basilica in Venice, I just couldn’t absorb another byte of information. Fortunately, it was our last day.

Food was a ceaseless adventure. Between the on-board options (ranging from buffet to gourmet with paired wines) and the tastes of local cuisines on land excursions, our taste buds joyously put in a lot of overtime. 

Music was everywhere, from the guitarist in the nightclub to the Beatles songbook in the theater to the violin and cello duo in the atrium to the pianist in the lounge to the string septet concert in a 15th century church on the lagoon in Venice.

I’ve already described in depth the assault on our circadian rhythms as we adjusted to time zone changes. Add to that the assault on my gut biome that I believe was precipitated by my drinking caffeinated coffee every morning. After a few days, I was able to restore a bit of routine to my diet by replacing my usual breakfast granola with muesli and a plate of fruit. On the other hand, I continued to consume more sugar, flour, butter and bread than I had in months.

We didn’t have to worry about performing a lot of mental arithmetic to convert currencies as the euro and dollar are at parity right now. I was surprised, though, at the wide varieties of credit card readers that I confronted. Sometimes it took me a while to figure out whether to tap, swipe, scan or slide and where on the device to do it. Cashiers, though, were more than willing to guide me through it.

All in all, it was quite the adventure. We didn’t get lost during any of our free time (which surprised us) and we managed to muddle our way through every situation we confronted, even if it took us 2 or 3 passes to get it right.

To be honest, I’ve had enough neural stimulation in the last two weeks to last me for a while. I’m definitely looking forward to re-establishing my hum-drum routine and sticking with it…until the next time!

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S2E44. Greece!

We made it! We’ve spent the last several days island-hopping around Greece and as I write this we’re docking in Dubrovnik. I’ll be honest: I haven’t focused much (if at all) on brain health. I’ll assume you can understand why. Nonetheless, I’ll try to put together a few thoughts before heading out on our next excursion.

I felt I was prepared for the flight last Friday, having adjusted my sleeping and eating rhythms to accommodate 5 of the 7 hours we would cross during the flight. Serendipitously, Greece set its clocks back by one hour for daylight savings time the night we arrived, so I was gifted one more hour of transition time. What was left to absorb, then, was minimal: just 1 hour, or the equivalent of flying from Chicago to New York.

Unfortunately, I wasn’t able to get much sleep on the plane. I used a neck pillow, lavender oil, loose-fitting clothes, and I ate a banana, but all to no avail. The engine noise, fellow passengers conversing loudly, and the impossible task of getting comfortable all conspired against me. Consequently, I was not a happy camper the next morning when we landed in Athens.

The good news, though, is that I don’t think I felt any effect of the time zone changes. Once I caught up on my sleep, I was fine.

Sally, on the other hand—having not made any effort at all to prepare for the time-shift—was…fine!

It seems that for both of us, the quality of the previous night’s sleep was far more impactful than the 7 time zones we had crossed.

Traveling is a brain-healthy activity because it presents a variety of unique cognitive challenges. Going on a cruise provides those opportunities in spades.

First off, there’s getting oriented on the ship. It took me several days to figure out how to find the important locations: our room, the different restaurants, and the theater. Oh, you could find your way around by reading the signage, but I wanted to be able to do it on my own.

First, I figured out that the various restaurants, although they were on different decks, were all at the back of the boat while the theater and the main lounge were at the front. These landmarks replaced north (theater) and south (restaurants) in my personal navigation system. Then I noticed that the even numbered rooms were ‘west’ and they got higher as you traveled from ‘north’ to ‘south.’ So as long as I could keep an image in my head of where the theater was (‘north’), I could figure out where anything else was whenever I emerged from an elevator.

Conversely, after only 2 days, Sally just knew which way to turn to get to where we were going.

Then there are the excursions with guides who present volumes of information along the way, on-board lectures, adjusting to at least a dozen different accents spoken by members of the crew, and absorbing the sights and vistas themselves. Add to that sampling new foods and meeting new people and you’ve created an intense synapse-stimulating environment.

On the other hand, maintaining a brain-healthy diet just ain’t gonna happen! I’ve been like a kid in the proverbial candy store pigging out at the buffets on sweets, pastries, carbs, meat and more alcohol than I’d consumed in a very long time. Leafy green vegetables? Nope. On the positive side, I am eating a boatload of fish and I’m making an effort to dose myself with fruits every morning at breakfast. I’m not at all looking forward to stepping on the scale when we get home.

We walk a lot on our daily excursions. Even though I don’t find myself breathing hard, I’ll assume that I’m getting my 30-minutes of cardio every day. There is a ¼-mile jogging track around the boat and a fitness center with treadmills and resistance machines, but I’m tired enough at the end of the day without pushing my limits with intentional exercise.

So I hope you’ll excuse me if I leave it at that for now and get back to the task of thoroughly enjoying this trip. I know…it’s a tough job…but somebody has to do it!

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S2E43: Three…Two…One…Liftoff!

Undaunted, I stumbled forward with a mild case of sleep deprivation into my 3rd week of attempting to reset my circadian rhythm to accommodate the 7-hour time difference I will experience when the plane lands in Athens tomorrow.

I took a closer look at our flight itinerary and saw that the flight leaves at 5:50pm eastern on Friday and arrives at 10:10am Saturday morning (9 hours in flight plus 7 time zones). It occurred to me that it would be wonderful if I could fall asleep right after boarding and get a full 8 hours of sleep during the flight, but, as we all know, sleeping on an airplane is spotty at best. What to do?

It turns out that Sally has a prescription for medical marijuana to help her sleep at night and so I thought it might work for me, too. The idea was that I would take one of her gummies as the plane was taking off and, hopefully, it would knock me out for the next 7-8 hours.

But what if it didn’t work? I was terrified at the thought of being seat-bound at 39,000 feet for 9 hours while high! My god, it would feel like all eternity before we landed!

So I decided to give it a test run this past Saturday night. Since it takes about an hour to kick in, I took it at 6pm and got in bed at 7pm, hoping to sleep through to 3am. 

Wow…was that ever a mistake! Oh, I fell asleep quickly enough, but it was a nightmare the rest of the way. Every time I started to dream I would be shocked into awareness by the intensity of the dream. Sometimes it was just the vibrancy of the colors; sometimes it was the emotional content. Once awake, I became hyper-aware of my body which seemed to be making a lot of noise. I have no idea what that was about, but the bottom line was that it was keeping me awake. To make matters worse, I would check the clock after I thought I had gotten some sleep only to discover that not even half an hour had passed.

It was a long night, indeed.

I got out of bed at 3:30am feeling exhausted and a little wobbly on my feet. I bailed out on exercising and then slogged my way through the day.

Remind me never to do pot before going to bed!

So although taking a little something to help me sleep on the plane was a good thought, it definitely wasn’t going to work for me. As miserable as I was, I was thankful that I had done the experiment now rather than trying it for the first time on the flight.

I googled ‘sleeping on a plane’ to see if there were any helpful hints and, indeed, I found several in a nicely researched article (https://casper.com/blog/how-to-sleep-on-a-plane/). I’m pretty sure I’ll go with its recommendations to wear socks, dress in light layers, eat a banana, keep my legs uncrossed and wear a dab of lavender oil. I’ll also forego my morning green tea that is caffeinated. 

My experience on Sunday night could not have been more profoundly different…or more welcome! I got in bed at 7pm and slept straight through until half-past three. More than 8 hours of sleep…it was glorious! I woke up bright and alert and couldn’t wait to hit the hall for my half-hour walk and then go down to the fitness center for another half-hour on the resistance machines.

I was a little surprised to find another resident in the fitness center at 4:30am, but then again, people work all kinds of schedules. Another resident showed up at 5am and headed for the treadmill. He lives on the same floor as I do and I had passed him every day I walked the halls as he made his way down to the fitness center.

I couldn’t wait to tell Sally about my sleeping triumph, but drowsiness overtook me a little while after she woke up. I unexpectedly found myself napping at 8am. What was up with that?

Doing the math, I realized that 8am eastern was 3pm in Athens. Knowing that my natural napping window was between 1pm-3pm gave me cause for celebration: although I still had 4 more nights to complete my adjustment, my napping schedule had already made the transition. This was certainly a good sign, no?

On Tuesday night, I went to bed while it was still light out (6pm) and got up at 2am the next morning. In case you were wondering, no, there was no one else working out in the fitness center at 2:30.

On Wednesday, the roll-on lavender oil I ordered arrived and I applied it to my temples before getting in bed. It smelled ok and I fell asleep without any trouble and I slept well. There’s no way to tell if it actually helped, though, but since nothing bad happened, I’ll use it on the plane today.

Reflecting back, making that first 2-hour time shift was brutal and my circadian rhythm fought me every minute of the day for several days, but the shift from going to bed at 8pm to 6pm was a breeze. Is it possible that my suprachiasmatic nucleus (which controls the circadian rhythm) has learned a new trick?

So that’s it. I’ve transitioned 5 hours out of the 7-hour time difference. I’m ready. I’ve trained hard. I can do this. 

Look out, Athens, here I come!

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S2E42. Time Zones: Week 2

I’m sorry to foist this on you, but my experiment in preparing for a 7-hour time zone shift prior to our cruise is pretty much consuming my waking hours. And my sleeping hours, too, come to think of it.

This week was really rough on me. The good news is that I got into a rhythm of waking up at 4am as opposed to my normal 7:30am routine. But that was leaving me sluggish and pretty much wiped out during the day, even when I took a nap around noon.

It really had me perplexed because it was only 12 years ago that, following my first wife’s passing, I was on a regular schedule that had me getting up at 4:30am, working out on a treadmill and weight machine in my basement for an hour before showering and going to work. And I would feel physically fine and cognitively alert the whole morning (I had to be as I was a clinical psychologist on an acute care inpatient unit). Then I would take a nap in my office at noon and finish out the day, even putting in an extra hour or two at times.

So why was this so difficult? It appears that our circadian rhythms get a little cranky and less flexible as we age, but I didn’t think the difference between being 59 and 71 would have such a dramatic effect. Apparently, it does on me.

My new routine has me waking up at 4am and immediately walking for half an hour at a brisk pace. I moved my workout to first thing after waking up because I found I was too tired later on in the day to convince myself to do it.

Luckily for me, the new management company for our apartment building is renovating. They are painting the hallways a lighter color and changing the lighting so that it is like daylight out there…and early morning light is exactly what is called for when trying to fool your sleep-wake system into re-setting itself.

So my morning exercise of walking the halls (where 1 lap around is about 200 yards) is serving a dual purpose. If the hallways weren’t so fortuitously bright, I’d probably have to buy a light box and sit in front of it for a while after waking up. Thank goodness I lucked out and avoided that fate!

After my walk, I sit down with my computer, turn the brightness up full, and do The New York Times crossword puzzle, Spelling Bee, Wordle and Nerdle. It’s about then that Sally wakes up and I make her coffee and my tea to initiate our normal morning ritual. By then, the sky is starting to brighten and it feels like things are almost back to normal.

Sally is not all that enthusiastic about my attempt to prepare my body for Athens. Her natural rhythms would have her going to sleep around midnight, but she also likes to go to bed when I do, so my new hours have thrown a major monkey wrench into her routine. She reminds me that we went to Paris a few years back (6-hour time difference) and really didn’t do anything to fend off jet lag and neither of us can recall any severe effects. She has a point.

By 11am, I’m getting groggy and thinking about taking a nap. It takes me a while to appreciate the fact that I’ve already been up for 7 hours and I’ve worked out, so napping at 11am isn’t such an off-the-wall idea.

I’m eating dinner a little earlier than before (around 5:00pm instead of 6:30pm. After all, it’s not just your sleep but your hunger/digestive rhythms that need to adjust, as well.

Bedtime is the biggest problem. Early to bed means I can’t watch most of the Phillies games in the playoffs. Bummer! My compromise has been to get in bed around 9ish so I could at least watch a few innings. But that only left me the potential for 7 hours of sleep and, with the usual time it takes to fall asleep and the usual number of nighttime awakenings, I was only getting about 6 hours of actual sleep…and that just wasn’t enough for me, even with a mid-day nap.

So on Wednesday of this week, I moved my bedtime back to 8pm…and it worked like a charm! I got a good 7 hours of sleep and I felt fine the rest of the day. Now I know that I need to lock-in 8 hours in bed, no ifs, ands or buts!

As of today (Friday), I’ve got just 7 more days available to adjust. I’ve picked up half of the 7-hour transition I’ll be making, leaving a 3½-hour difference. I know I won’t be able to get all the way there, but I think I’d like to transition 1 more hour before we board the plane. That would be a 7pm bedtime and 3am awakening. Somehow, doing that never made it onto my bucket list!

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S2E41. Time (Zone) Travel

No sooner had I finished writing last week’s blog about sleep than it dawned on me that I had to start preparing for our upcoming Mediterranean cruise. We fly to Athens on October 29th which means that we have 3 weeks to adjust our sleep patterns to compensate for the 7 hours we’ll lose on the flight.

We booked the cruise months ago and I have been eagerly looking forward to it, but now all of a sudden it is imminent, and now, also, I am acutely aware that having my circadian rhythm out-of-joint for a week while I adjusted 1 hour per day was not the best way to get the most out of the trip. So I began the transition this week.

The task before me is pretty daunting. I normally go to bed around 11:30pm and get up at 7:30am. But in Greek time, that would be like going to sleep at 6:30am after pulling an all-nighter. Not good.

It’s my understanding that the kinder-and-gentler way to prepare for a trip like this is to start several weeks before the flight by going to bed 15 minutes earlier every night and waking up 15 minutes earlier until you are on schedule in your destination’s time zone. Compensating for the 7-hour difference, then, would take about 28 days using this system. I only had 21 days left until departure, though, so I figured I had to accelerate the pace a little.

The first night, I got in bed at 10:30pm and got up at 6:30am. Unfortunately, I had a lousy night’s sleep and was miserable most of the day. The good news here, though, is that since I’m retired, I can just take it easy and nap when the spirit moves me, which is what I did.

Then we went to the Jersey shore for two days. We picked the time to coincide with the October full moon. We thought it would be fun to watch it rise over the ocean, so we got a beachfront hotel room with a balcony on the 3rd floor with a pristine view of the ocean.

The sky was cloudless and the view of the red moon hurdling over the horizon at about 6:30pm was spectacular. It was shortly thereafter that I realized, “Hey…we can watch the sunrise tomorrow morning, too!”

Which is what we did. I only needed to get up by 6:00am to see it, but I happened to wake up at 4:30am and decided not to go back to sleep. Bundled up and sitting on our balcony, I was treated to the full spectrum of the sunrise. It began around 5:30am with a deep red-violet glow at the horizon that gradually brightened to a red-orange wash as the sky above it lightened to turquoise. The light show went on for an hour before the sun finally crested onto an already day-lit sky. Just beautiful!

And I did it again on Tuesday morning, going to bed at 9:30pm that night, and getting up at 4:30am on Wednesday. 

We were back home in the apartment by then, so I turned on all the lights in an attempt to fool my body clock into believing that it was time to get up. I turned the brightness on my computer screen up as high as it would go and did crossword puzzles while waiting for the sun to rise. The view isn’t nearly as spectacular from the apartment balcony as it was from the shore, but the colors are just as rich and they provide a modicum of reward for the abuse to which I’m subjecting my body.

Getting up at 4:30am isn’t really agreeing with me…yet. I have to believe though, that it will get better with each passing day. I’ve made up nearly 3 of the 7 hours I’ll lose, so at least there’s that. I’ll admit, though, that I can’t really imagine myself going to sleep at 4pm (11pm in Greece) by the end of the month and feeling good about it. 

And then there is the issue of food. I also have to change the times that I’m eating so that I’ll want breakfast and dinner at the right times while on the cruise. 

For now, I’m feeling ok for about 4 hours after I get up, but then I fade fast. I’m eating whenever I get hungry, which now seems to be most of the time. I have no energy to exercise, but I at least try to take a walk every day. The fitness center in our apartment building is open 24/7, so maybe I can try to work out in the wee hours. It might be worth a shot. Bottom line: once your sleep rhythm is out of wack, it’s really hard to maintain a brain-healthy daily schedule.

Playing with all of my bio-rhythms at the same time is a strange experiment. I suppose it’s better to get all of this discomfort out of the way now rather than to find myself walking around in a fog as we visit the ancient empires of the eastern Mediterranean. 

Lord, I hope so!

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S2E40. Going Back To Sleep

It was just 9 weeks ago that I posted a blog about sleep (S2E31. Sweet Dreams Are Made Of This) in which I described my lifetime relationship with sleeping and napping.

I thought I had said all I needed to say about sleep’s importance as one of the five pillars of preserving brain health, but The Universe seemed to have a different idea. All of a sudden my inbox and social media feeds were full of articles about sleep and sleep hygiene…and it wasn’t even National Sleep Awareness Week!

So I played along and watched a webcast of an interview with Matt Walker, Ph.D., a sleep scientist at the University of California-Berkeley (you can watch the 1-hour event here: youtube.com/watch?v=ZaxGiYyUcyI).

A lot of the information he presented was new to me, so I read his book Why We Sleep.

WOW…was I ever impressed! It was a real page-turner! He keeps his use of jargon and scientific terminology to a bare minimum and has a knack for selecting just the right analogies to make the research he details come to life. But it’s the content he covers that is truly mind-boggling. It was humbling to discover how little I knew about sleep.

Did you know that all creatures who live more than a day sleep? Including insects and worms?

Did you know that only one side of a dolphin’s brain sleeps at a time because it has to stay awake to surface and breathe?

Did you know that just one hour of lost sleep can significantly impair your cognitive abilities and possibly even kill you? Apart from all the laboratory studies that demonstrate this, we have an unintended real-life experiment that is run every year. It turns out that the day after daylight savings time goes into effect (and we lose an hour of sleep by turning our clocks forward), there is a spike in the number of fatal heart attacks and car accidents. Conversely, when we turn our clocks back in the fall (and gain an hour of sleep), there is a corresponding drop in heart attacks and traffic accidents. 

Fascinating!

Apart from fun facts to know-and-tell, the research he described was simply amazing. He would begin by asking what happens when we sleep, then progress to how it happens, and end up answering the ultimate question: why does it happen?

For the purposes of this blog, though, the meaty part of the book involves sleep’s effects on memory.

Dr. Walker explains that the hippocampus maintains traces of your experiences each day and then, during sleep, it empties itself by sending important information out to a variety of cortical areas where it is permanently stored in the form of memories. It’s kind of like downloading the contents of a thumb drive onto your hard drive and then erasing it from the thumb drive so it has its full capacity available for the next day. One stage of sleep is responsible for transmitting the data and a different stage of sleep takes on the task of cementing it in place by strengthening the synapses where the information is stored.

If your early sleep is disturbed enough, the information won’t be transmitted and you won’t remember much the next day. If your sleep later in the night is disturbed, the newly planted memory won’t be consolidated and you won’t remember much, either.

So if you want to be able to remember more about what happened today, you’ll need a good 7-9 hours of high-quality sleep tonight…and for the next couple of days, as well.

If you don’t get good early sleep, the hippocampus won’t empty out and it will have limited storage space available the next day. That’s part of the dullness you feel when you haven’t slept well and accounts for some of the difficulty you have learning new information that day.

Unfortunately, once we get into our 60s, our sleep patterns begin to change…and not for the better. We tend to sleep fewer hours and the quality of that sleep is compromised by more awakenings…all of which wreaks havoc on our memory, immune system, emotional reactivity and judgement. 

It also compromises the nightly cleansing of the day’s chemical detritus which includes beta amyloid and tau particles, the accumulation of which are associated with Alzheimer’s pathology.

The take-home message here is that it’s not true that we need less sleep as we age. We need the same amount of sleep that we needed when we were younger to allow all of these crucial processes to be executed every night. The problem is that we don’t get the sleep we need as often as we should.

Putting all this together, it’s no surprise that getting fewer than the recommended number of hours of sleep on a regular basis is a risk factor for dementia. The relationship is so strong that researchers are now exploring whether sleep patterns can be used to predict whether or not you will develop a dementia a few years down the road.

Dr. Walker ends the book with a listing of things you can do to maximize your chances of getting the sleep you need (spoiler alert: taking sleep medication is not one of them). Here’s a link where you can review them: https://www.nhlbi.nih.gov/files/docs/public/sleep/healthysleepfs.pdf

The one change I made after reading the book had to do with my computer usage. 

I’m usually on the computer right up until bedtime, but it turns out that that’s a terrible thing to do. You see, the LED screen of a computer emits strong light waves at the blue end of the spectrum. It is this wavelength of light that triggers your circadian rhythm which tells you when to wake up and when to go to sleep. 

By bathing myself in blue light late at night, I was telling my brain that it was still daytime and so it delayed sending out the signal to initiate the sleep cycle until after I turned off the computer and went to bed.

I thought about changing my end-of-day routine, but realized I’m pretty much addicted to my computer use. Fortunately, the people at Apple have provided a solution. There is a program built into their computers and phones that will change the color emitted by their screens in the evening, going from blue-white to a soft yellow-amber. Problem solved! The program is called ‘Night Shift’ and you can find it by clicking on the ‘Display’ icon in System Preferences or Settings.

Alternatively, you can buy glasses that block the harmful wavelengths.

I’ll close with one more snippet from the book:

So, you ask, why is it that our circadian rhythm is triggered by blue light and not by full-spectrum sunlight?

You might recall that we are descended from fish and their aquatic predecessors. The circadian rhythm was an adaptation that evolved while we were living in water. But water filters out the other wavelengths of natural light leaving only the blues and greens. Eons ago, then, our evolutionary ancestors lived in a world that oscillated from darkness to blue and back again. And that’s the light pattern that controls your circadian rhythm to this very day!

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S2E39. The 50th Reunion

We were 21 and 22 years old. It was our last semester at Brown University. There were 7 of us: 4 girls and 3 guys. We shared the left half of a duplex at 43 East Manning Street in Providence, Rhode Island. It was 1972.

Five of us got together on Cape Cod this past weekend for our 50th reunion. We came from Oregon, California, Massachusetts, Connecticut and Pennsylvania. On Friday, we zoomed with the 2 missing classmates who live in New York and California. Although various combinations of us had gotten together over the years, this was the first time we had all been together since graduation day a little over half a century ago.

It was remarkably easy being together again in a shared living space. We brought photos and journals and letters we’d kept. We reminisced about how our group formed during the first 2 years at Brown, about our time on East Manning Street, and about the years since.

We shared memory after memory of our days together. Some of the stories were new to me. No one remembered everything. Some remembered more than others. 

Some memories were pulled into consciousness from the deepest of slumbers. Others were made richer and more complete by hearing different perspectives of the same event. 

There was one memory that only I of those who were there remembered. It was a sunny, crisp fall day during our sophomore year and we decided to walk to the Seekonk River which wasn’t very far away. On that afternoon, ripe milkweed pods were opening and the breeze was lifting the seeds out of their husks. Hundreds floated in the air all around us. It was snowing milkweed! I had never seen anything like that before, nor have I since.

I filled my pockets with the feathery fliers even though I didn’t know at the time what I would do with them. A few days later, I found a clear wine bottle and pushed them into it with a pencil. It was a sculpture…a work of art! 

I kept that bottle through the years, brought it with me to the reunion, and told the story of how it came to be. As I sat looking at it, the Jim Croce lyric “If I could save time in a bottle” popped into my head and I realized that that is exactly what I had done.

I have no pictures from that period, so looking through the albums was, to me, astonishing. My visual memories were weak, faded, and in soft focus. Looking at those surprisingly unfaded color photos was like dusting off my own history, restoring it, and mounting it on the wall. I had forgotten how young we were.

Paraphrasing Hillary Clinton, it occurred to me that it takes a village to not only make a memory, but to preserve it.

In 2001—29 years after our time together and 21 years ago—I had occasion to try to capture our experience on paper. Here’s part of what I wrote:

“It was a time of passions expressed and passions denied; a time of independence, intimacy, intensity, and insufferable debate…but never, ever, indifference…Did any of us know that in that shortest of times we had permanently stitched ourselves into the fabric of each other’s lives?”

We toasted the good fortune that first brought our unlikely band together and we toasted the serendipity that allowed us to celebrate it a lifetime later. As we did so, we made more memories to carry with us to a future reunion: walking on the beach, avoiding poison ivy in the cranberry bog, making dinners, eating ice cream in an old schoolhouse, listening to oldies, doing a pot gummy, and visiting with 2 other classmates who were in the area.

And, of course, we took lots of pictures to share with the pair who could not attend and to fill an album that will help preserve these new memories for all of us.

I don’t think anyone wanted it to end. We joked about having a 75th reunion, but quickly realized we would be in our mid-90s, and so we decided we might want to do this again a little sooner than that.

In 1973, just one year after we graduated, Marvin Hamlisch wrote and Barbara Streisand sang ‘The Way We Were:’

“Memories

Light the corners of my mind

Misty watercolor memories

Of the way we were

Scattered pictures

Of the smiles we left behind

Smiles we gave to one another

For the way we were

Can it be that it was all so simple then?

Or has time re-written every line?

If we had the chance to do it all again

Tell me, would we?

Could we?

Memories

May be beautiful and yet

What’s too painful to remember

We simply choose to forget

So it’s the laughter

We will remember

Whenever we remember

The way we were

The way we were”

But we didn’t forget the painful parts. It was a unique combination of laughter and sadness and youth and intimacy and time and place that created the unbreakable bonds that we still feel so strongly today.

And to answer the song’s question, yes…I would do it all again. In a heartbeat!

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S2E38. Dementia Prevention: Brain Games

The notion that playing brain games on your computer can help prevent dementia is rooted in the research on neurogenesis and neuroplasticity.

Neurogenesis is the process whereby you can grow new brain cells at any age. Neuroplasticity is the process whereby you can grow new connections between neurons.

In theory, then, anything you do that (1) grows new brain cells, (2) increases the number of synapses between neurons, (3) strengthens cells and/or (4) protects them from harmful chemical interactions should all help slow down the process of cognitive aging. The recipe is pretty simple: bulk up your brain mass while minimizing the things that can cause it to atrophy. 

But it’s not just a theory. The research supports this view.

Exercise grows new cells, increases synaptic connections and strengthens the quality of transmission of electric impulses from cell to cell by thickening the axon’s myelin sheath.

A brain healthy diet provides nutrients that support neurogenesis as well as antioxidants that help clean up neuron-killing chemical detritus (e.g., beta amyloid and tau) that are residuals of your body’s immune response (i.e., inflammation).

Sleep expels toxins that accumulate on a daily basis and also increases the strength of neuronal connections (synapses) which form long-term memories.

When we engage in cognitively challenging activities—especially new and novel tasks—we create more connections. That is why reading a book, learning to play an instrument or to speak a new language, and navigating around a different environment (e.g., traveling) are all brain healthy activities.

But what about playing computer games? The evidence is spotty, but it seems that there might be something there. Enough, anyway, to justify millions of dollars of new research to try to nail down just what it can and can not do.

In S2E29: Brain Training Is Hard Work! I discussed the intense effort I expended during my first week of working with the BrainHQ program. Now, 9 weeks later, I have some data I can report.

First, let me say that I over-did it. Playing these games for an hour each day was exhausting. However, it did allow me to quickly work my way through all 29 tasks covering 6 different functions: attention, brain speed, memory, people skills, intelligence and navigation. After 5 weeks, I dropped down to 30-minute daily workouts, which was much more manageable.

So how did I do?

The program provides you with a percentile ranking that shows how your performance compares to others in your same-age cohort. After 9 weeks, my scores have leveled off and I’m not seeing any more improvement. I placed at the 89th percentile overall among 71-year olds, with individual domain scores that range from the 86th to the 94th percentile.

What is valuable about this is that I now have a baseline measure of my mental status. Going forward, if I maintain my 89th percentile ranking relative to my same-age peers, it will mean that I am aging normally. If that number drops, it will mean that my cognitive decline is a cause for concern. If it goes up, it will be a cause for rejoicing as it will suggest that I am not experiencing the expected pace of cognitive decline.

That information has practical value, too. It appears that measurable and accelerating cognitive decline starts to appear about 6 years before a diagnosis of dementia is usually made. If I continue to play these games on a regular basis over the coming years, my scores should serve as an early warning system of any emerging cognitive problems.

The alternative, of course, is to get a full neuropsychological workup every year. Playing computer games is a lot cheaper and more fun, though.

The knock on using brain games to promote brain health is that, although you can get better at the games, your new learning does not generalize to everyday life and so it has no clinical or practical significance, even if your scores continue to improve.

This past Sunday, though, I actually had a real-life experience for which I directly attribute my success to one of the games I’ve been playing. 

In this game, designed to enhance your speed of visual processing, the computer screen is divided into 8 pizza slice shaped segments. Images of 11 birds are then briefly flashed all at once around the periphery. One of the birds, however, is different from the rest. For example, it might have a white body instead of a rust-colored body, or a white wing instead of a black wing. The task is to click on the slice of the screen where the odd bird appeared.

The more I played this game, the better I got. After a while, I was stunned at how accurate I was with only the briefest glimpse of birds on the screen.

Which raises the logical question: So what?

I’ll tell you what! Last Sunday, we were having breakfast at the home of Sally’s son and daughter-in-law. Tammy mentioned that she had seen a bird fly away from their backyard bird house, but couldn’t tell if it was a blue jay or a bluebird. 

As we stood around talking in the kitchen, out of the corner of my eye through the sliding glass doors I saw the flash of a bird in flight. It was only a flash of color that lasted less than a second, but I was able to process its shade of blue and size, realizing immediately that it was a bluebird.

Impressive, huh?

Then we moved outside to eat breakfast. While we were seated around the table, Sally’s grandson Ryan (who recently graduated from college) brought out a bottle of champagne to make mimosas. When he popped the cork, it rocketed through a gap in a vine-covered fence and landed on the lawn beyond. I was the only one who saw where it went. 

Pretty cool, eh?

OK. So it’s no big deal…but it does suggest that something good is happening inside my head thanks to my computer game playing. 

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S2E37. This Is Your Brain On Pot

In the interest of full disclosure:

I first tried pot at the end of my freshman year at Brown. The following semester was when I indulged the most. I was not considered a ‘head’ or ‘freak’ by any stretch of the imagination, but I would take a hit when offered and my longish hair and goatee fit the profile of those who merited an offer. 

I was terrified of getting busted, so I never bought any of my own, but always made contributions to the kitty. 

There was no real research about marijuana usage at the beginning of the 70s, just strong opinions based on folklore and urban legend. ‘Reefer Madness’ taught us that pot was a gateway drug to heroin, but whenever someone told me that junkies started with pot, I’d reply that pot users all started with milk. End of conversation!

I smoked enough to have a decent complement of weed stories to tell over the course of the coming decades, but I cut back dramatically during the second half of my sophomore year when I had a close encounter with depression and my therapist advised me to give it up.

I used pot sporadically over the course of my last two years at Brown as I settled on beer as my go-to party drug. In the 50 years since graduating, I think I’ve gotten high maybe 15 times, at most.

Which brings us from the 70s to my 70s where the marijuana world has changed dramatically.

Pennsylvania has legalized cannabis for medical use and so Sally got a prescription to treat her insomnia. For reasons unknown, edibles are not offered in PA, so we drive over to New Jersey where both medicinal and recreational pot is available, including edibles in the form of gummies. Would it surprise you to learn that we picked up some recreational edibles while we were there?

Getting high is different from what it was lo those many years ago. Don’t get me wrong. It’s still fun: music packs a strong emotional wallop, ripples on the surface of the pool are infinitely interesting, and the food is…well…you know!  Nonetheless, it’s different. It’s no longer part of a cultural movement. It doesn’t hold the same promise of self-discovery and revelation.

And some things just plain suck. For example, back in the day, you’d start to tell a story and then forget what you were going to say. That didn’t happen when you weren’t stoned and so it was really funny when it did. Now, though, I can lose my train of thought when I’m stone-cold sober, which is irritating enough, but when it happens while I’m trying to have a good time, it really pisses me off!

There was concern back in the day about possible long-term cognitive effects of regular marijuana use, but the research hadn’t been done yet. Fifty years later, there is still a dearth of information, but a few studies stand out.

Long-term chronic use is associated with reduced prefrontal brain volume. Heavy use has also been found to lower cognitive performance among teenagers several weeks after their last high. However, it appears that the effects of marijuana use among older Americans have been largely ignored. A 2019 review of the literature summarized the thin evidence this way:

“Marijuana (with chemical compounds THC and CBD) causes impairment in short-term memory; increases heart and respiratory rates, elevates blood pressure; and contributes a fourfold increased risk for heart attack after the first hour of smoking marijuana. These effects may be pronounced in older Americans with compromised cognitive or cardiovascular systems.”

These effects, though, are experienced while you are stoned. There is next to nothing to be found about long-term effects on the brain. Interestingly—and counter-intuitively—there was one study I came across suggesting that marijuana use might be helpful in recovering from brain injury, as it appears to have neuro-protective qualities!

Other articles mentioned the problem of driving under the influence because reaction times are impaired which leads to more accidents, as well as the respiratory problems associated with smoking pot which, while not as damaging as cigarette smoke, are still rough on your lungs.

So what’s a Baby Boomer to do? 

First, edibles appear to be easier on your body than smoking weed, but it will take a lot longer to get high, so be careful about dosing. 

Second, don’t drive or operate heavy machinery while stoned! 

(Learn more about these 2 points here: https://www.nytimes.com/2022/04/12/well/live/driving-while-high-marijuana.html )

Third,  although ‘chronic’ usage (apparently more than 16 times per month) has been shown to be harmful, there are no reported studies about occasional use. That doesn’t mean that it’s not bad for you, it just means that it hasn’t been studied. But if you have to choose between alcohol (which is a known neurotoxin) and marijuana (which isn’t), well, that appears to be a no-brainer. 

Of course, you always have the option of abstaining from mood-altering chemicals altogether, which is probably the safest position you can take when it comes to maintaining brain health.

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S2E36. Dodging Dementia Bullets

Dementia risk-management was not something that was on my mind when I was 20. Or when I was 30, 40, 50 or even 60, for that matter. Had it been, I would have been shit out of luck because the research had not been done yet and so there were no guidelines to work with.

Looking back at my life, though, it appears that I did a pretty good job of dodging high-risk dementia-related behaviors. Of course, I could not have done it intentionally because I didn’t know what those behaviors were, so basically, I lucked out. But as Pippin’s father Charlemagne told him: ‘It’s smarter to be lucky than it’s lucky to be smart!’

Here’s a partial summary of my smart luck. I’ve highlighted risk factors for dementia in bold.

Let me start with something that’s not a behavior at all: my genetic makeup. First and foremost, I was born a male. For reasons that are still not yet fully understood, women are at higher risk for developing dementia.

Secondly, it appears that I did not inherit the dreaded APOE4 gene which is linked to early onset Alzheimer’s. My mother demented at around the age of 83, but her sister was cognitively spry when she died at 94. Nobody on my father’s side lived long enough to find out if there was any dementia lurking there.

Like most boys growing up in the 50s and 60s, I played tackle football with pads after school every day in the fall. I was pretty small for my age, earning the nickname ‘shrimpotz’ in 4th grade, and I was still only 130 pounds when I got to my sophomore year of high school, so I figured playing football was hopeless and switched to running. The lucky thing here is that I was never knocked unconscious or had a concussion. Another risk factor averted. 

Not only did I dodge that bullet, but running became a lifelong habit. I was in the first cohort of joggers to take to the streets, back when it was considered cool for cars and trucks to try to run you off the road. Unknowingly, I had adopted one of the 5 core behaviors for reducing dementia risk…and I did it at a very early age.

I also lucked out when it came to education. I started school in Newark, NJ, where the quality of the education offered had already begun its decline from the system that produced Philip Roth in the 1940s to the one that failed and was taken over by the State of New Jersey in the 1990s. When I was about to enter 4th grade, my parents were able to move us to a town with some of the best schools in the state. I flourished there and wound up getting into Brown University.

All of that was fortuitous because, as it turns out, attending a high quality elementary school and going to college are both protective factors. Again, lucky me!

But it didn’t stop there. When I was 44, I decided to become a psychologist and so I spent the next 6 years in graduate school, first at Marywood University in Scranton, PA, and then at the University of Connecticut. Once again, I didn’t do it to promote my long-term brain health, but we now know that that kind of intense cognitive challenge involving learning new skills and information is also one of the pillars of dementia risk-reduction.

Along those lines, I suppose it also helped that I changed careers every 10 years and that all of those careers were people-oriented.

With its heavy doses of sugar, refined flour, saturated fats, beef and fried foods, the American diet is a notorious contributor to dementia risk. For a long time, I ate with abandon in service to my taste buds, ignoring calories, cholesterol and fat content. Can you say “large pizza with extra cheese, sausage and pepperoni?” 

Fortunately, I did not have a sweet tooth and my metabolism did not lend itself to excessive weight gain. Thus I dodged two more dementia bullets in spite of myself: diabetes and obesity.

My worst period in terms of unhealthy eating was when we were running our B&B. I was the cook, serving up eggs, bacon and breakfast pastries every day. And every day I ate what I was cooking. By the end of that run, though, I realized that I needed to make some changes. There was a history of heart disease on my father’s side (it killed both him and his father when they were around 60), so I figured I better start eating a heart-smart diet. The research for that was plentiful, so I gave up red meat, began using low-fat products, and ate more vegetables, fish and pasta. As fate would have it, all those changes were helpful in maintaining brain health (and constitute another pillar of a brain-healthy lifestyle). I was in my 40s at the time.

I was never a big drinker. In fact, I was a cheap drunk, getting tipsy on just 2 beers. In college, I tried to become a ‘better’ drinker (you can imagine the peer pressure) and even managed to down a 6-pack of Schlitz one night before passing out. But excessive drinking was not in the cards for me. That doesn’t mean that I never got drunk because I did when the occasion merited it. But I never really liked the taste, whether it was beer, wine or hard liquor. Even now, it’s hard for me to drink a few ounces of red wine with dinner, but I do it for the purported brain-health benefits.

On the other hand, I never had any desire or interest in smoking. I hated it ever since I was in grade school and my parents used to light up at the dinner table at the end of the meal. I became an anti-smoking advocate at an early age, so much so, that people were astonished to learn that I had smoked pot! Oh, I suppose I took in my fair share of second-hand smoke (my first wife of 36 years was a smoker), but I think its safe to put this in the ‘dodged a bullet’ column, too.

There are a few other risk factors I haven’t covered here. You can see them all at this link to see how lucky you’ve been:

https://www.nhs.uk/conditions/dementia/dementia-prevention/

Finally, there is one risk factor I haven’t yet dodged, and it’s the biggest one: age. The older you are, the greater your chances of dementing. But dodging that bullet is a good thing, isn’t it?  🙂

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S2E35. The Fog Of Memory

It was the spring of 1986. I had quit my job in Newark, NJ, and we had moved out to Tyler Hill, PA, where we were renovating an 1847 farmhouse with plans to open a B&B by the 4th of July weekend.

I was in one of the bedrooms on the 2nd floor where I was removing more than a century’s worth of floral print wallpapers. The work was slow and painstaking, first soaking small sections in a solution of vinegar and water and then scraping it carefully so as not to gouge the plaster beneath it.

It was also pretty mindless. After a while, I started to replay memories. I was 35 at the time, so my just-ended career in Newark, high school and college years, and growing up were not all that long ago.

I seemed to be watching the movie of my life playing in reverse. The farther back I went, the faster the reel seemed to spin, until I saw my baby pictures in my mind’s eye and the movie ended.

I felt inexplicably exhausted, so I lay down on the floor and closed my eyes…and a feeling of relief swept over me. Suddenly, I felt unburdened by my past and all the emotional baggage that came with it.

I soon realized that all those memories were no longer as close and vibrant as they had been just a few moments before. It was as if I had packed them all into boxes and moved them up to the attic. 

Whatever happened that day was not intentional on my part, but it seems to have repeated itself every 10 years when I switch careers. It’s as if I hold on to a ton of potentially relevant information in case I need it, but then put it into long-term storage as soon as I don’t.

It happened again last year when I ended my 10-year career volunteering for the Democratic Party. No sooner had I quit as chair of the local organization than my memories of a decade’s worth of campaigning became remote. They had joined the previous sixty years worth of boxes in the attic of my mind, in a place that I refer to as ‘ago’ to differentiate it from the here and now. 

I envy people who say they remember events as if they were yesterday. I have no such ability. When I rummage around in one of those boxes, my recollections appear as photographs, not movies. And they are definitely not high-def! Many have shifted perspective, so I have a bird’s eye view instead of my actual eye-witness perspective. 

Many memories have been replaced by memories of the photographs of those events which I’ve viewed over the years. It’s a poor substitute, but it’s all I’ve got at this point.

Although I can’t conjure up strong visual images, I have detailed memories of the stories I’ve told about those long-ago events. My semantic memory (i.e., the facts surrounding events) is much stronger than my visual recollections. Auditory memory is pretty much non-existent.

Occasionally, strong emotional memories will surface. A feeling—sometimes triggered by a smell—will overwhelm me. I can’t always place it, but it’s familiar…and usually warm and pleasant.

I remember myself through a fog. I can still make out the shapes of my past, but they’re distant. I know that all of these things are part of me, but I just can’t see them all that well, even though I can describe them in great detail.

I have no idea whether this is normal or not. I don’t think it’s gotten worse with age. I think I’ve always been like this…but I’m not sure because I don’t think I thought about it when I was younger.

Which makes me wonder where it goes from here. 

I’ve been watching a series of lectures on the ‘Joy of Mathematics’ from TheGreatCourses.com. I remember loving math classes in high school and being good at it. I remember the joy of solving equations. I graduated from Brown just 2 courses short of meeting the requirements for a degree in math.

Yet watching these lectures has shown me that the lion’s share of all that learning and studying is completely gone from my memory. I know: use it or lose it. But it still seems a shame. And it raises the specter of vast stores of memories falling into a black hole from which there is no recall.

That possibility makes even foggy memories look really good by comparison!

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S2E34. Uh-oh: Memory Failure!

(Theodore Ribot, in The Diseases of Memory published in 1881, pointed out that the first characteristic of amnesia in patients with dementia is the loss of memory for recently experienced events with relative preservation of remote events.)

I opened an email from Greg, a classmate at Brown some 50 years ago, that include a link to a recent article in The Guardian titled “Stop drinking, keep reading, look after your hearing: a neurologist’s tips for fighting memory loss and Alzheimer’s.”

I appreciated his thoughtfulness in sending it to me as I am always on the lookout for articles that might generate the inspiration for a blog episode. This article was an interview with Dr. Richard Restak and the occasion was the release of his new book The Complete Guide to Memory: The Science of Strengthening Your Mind.

I googled the book before I even finished reading the article, then downloaded the electronic version so I could scan its contents. A lot of the usual material was covered and I was struck by the fact that here was yet another neurologist covering a lot of the same material that is standard for this type of tome. It didn’t look like there was much that I hadn’t covered in prior posts.

 As I was moving it to the trash, though, I noticed that I had previously downloaded this very book!

Strange, I thought, that I hadn’t recognized the cover art. The name ‘Restak’ seemed familiar, but I couldn’t place it. Thinking logically, I realized that I must have read the book and, therefore, I must have blogged about it. So I scanned the titles of all my posts looking for one in which I might have written a review of the book. Since nothing jumped out at me, I began opening posts with potentially related titles and soon found it. It was S2E28: Working Memory Workout? published on July 15th.

That was only a month ago…and my memory of reading that book had all but evaporated!

What a kick in the pants! Here I was doing daily workouts to improve brain performance and I just had a major fail of episodic memory, the kind of memory malfunction that Ribot described back in 1881.

Episodic memory is our memory of what happens to us: what we do and what we experience. How could I not remember reading this book just a few weeks ago when I had obviously spent a lot of time reading it, thinking about it, and finally writing about it?

Forming an episodic memory has three stages. First you have to pay attention to the event. Basically, if it didn’t make much of an impression when you first experienced it, it’s unlikely that you will recall it later on. 

Second, you need to encode it into memory. You do this by thinking about it, processing it, replaying it, and linking it to other experiences so it fits into a framework for remembering. 

Finally, you need to be able to retrieve it. Recall memory is when you can retrieve it from your memory banks without any assistance. Recognition memory is when you need cues or hints in order to find it. Unsurprisingly, recognition is easier than recall. In either case, though, the memory must have been encoded for you to unearth it later on, with or without a little help from your friends.

So what had happened to cause my memory failure? I clearly had paid attention to the book and processed it more than enough to guarantee encoding. It would be easy to conclude that this was therefore a retrieval error…but maybe not. Why did it not come rushing back to me after seeing multiple cues, including the cover and table of contents? Alternatively, the breakdown could have been caused by a failure in any one or in any combination of the three functions.

I did a quick web search of articles about episodic memory and came across one that suggested you could improve it by watching a movie and then listing as many of the scenes as you could remember. It seemed to me that this could also serve as a reasonable test of your ability to recall episodic memories, so I tried it with a movie I had just watched the night before: ‘Hud’ starring Paul Newman.

I waited 5 days to give my brain a chance to consolidate the memory and, perhaps, even time enough to forget a little about it before attempting the task. 

Now, obviously, I don’t know how many scenes there were nor how many scenes a brain-healthy 71-year old would remember, but I came up with 43.

I’ve got to believe that that’s pretty good. I’m pretty sure I didn’t miss much, so I’m going to put off worrying about any possible episodic memory failures for the time being.

But it is a little scary to see how it might sneak up on you.

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S2E33. How To Keep Your Brain Young

I stumbled across a book referenced in an article I was reading and was intrigued by the description of the author: “Professor Kerryn Phelps AM, Australia’s most trusted GP.”

Interesting! A book about brain health by a general practitioner and not a neurologist or neuropsychologist? A consumer of research instead of a creator of research? And from Australia? Because of these anomalies, I wondered if her perspective would differ from everything else I’ve been reading written by Americans with more traditional backgrounds…so I read her book, How To Keep Your Brain Young which was published last September.

Some differences were immediately apparent, such as the spelling of words like ‘foetus’ and ‘coeliac disease.’ When citing research studies, she tends to reference where the work was done instead of the authors’ names, so you come across things like, ‘in a study done at the University of Sydney…’ She seemed to prefer citing work done in Australia, and that was layered on top of references to Australian epidemiological studies and policies of Australian public health agencies. All in all, it was refreshing to see the view from down under.

The most striking thing about this book, though, is the range of topics covered. Although any book about brain health will necessarily cover dementia-related topics, Professor Phelps goes above and beyond in cataloguing the wide variety of things that can affect one’s brain health over one’s lifetime. You might expect a cradle-to-grave approach, but she goes beyond that, not just to pre-natal concerns, but all the way to pre-conception factors that might affect the brain-in-waiting!

Her thoroughness is carried throughout the book with an attention to detail that could only be rooted in the curiosity of someone who found every fact about the brain to be enormously fascinating. She begins with a description of the various brain structures, their functions and the neurotransmitters that drive the system. I have to admit that if I was not already well-versed in those topics, I would have found it very difficult to follow. It’s not that she uses a lot of technical jargon, but that she presents the information in a rapid, unadorned format. ‘Just the facts, ma’am,’ as Sergeant Joe Friday used to say. Her writing is unembellished. There are few anecdotes and personal reflections. There is no poetry in her prose. She writes like a GP speaks: ‘Here’s what the tests show and here’s what you can do about it. I’ve written you a prescription.’

Nonetheless, it’s riveting and breathtaking in its scope. There are short chapters about virtually all the things that can affect your brain in a lifetime, including alcohol, medications, chemotherapy, smoking, anesthesia, gluten, glucose, blood pressure, street drugs, menopause, stress, depression, your gut biome, stroke, brain injury and brain cancer. Factors that don’t merit their own chapters are covered in the chapter on dementia. Oddly, though, she doesn’t address air pollution, toxic chemicals or pesticides.

I thought the best line of the book came in her summary of the effect of using methamphetamines. After detailing all the different ways it kills neurons and affects brain function, she dryly remarks that ‘it really doesn’t have a lot going for it.’

After detailing what proper brain function looks like and inventorying all the things that can go wrong, she settles into a discussion of the things you can do to protect your most valuable organ throughout your lifespan, or as she puts it, ‘how to keep your brain young.’ There are chapters dedicated to cognitive challenge, exercise, diet, supplements, social connectedness, relationships, sleep and mind-body therapies. She also includes a chapter on the brain-enhancing properties of pets, which is something I hadn’t come across anywhere else.

Professor Phelps closes the book with a lifetime prescription for protecting your brain and preserving its performance. It comes down to avoiding brain injury, exercising, optimizing your diet, controlling your blood sugar, managing cholesterol, improving your gut health, controlling your blood pressure, building and maintaining social networks, sleeping soundly, stimulating your mind, taking care of your emotions, being cautious with prescribed medications, avoiding illicit drug use, not overusing alcohol, never smoking, and considering using supplements and herbs.

It seems like a lot until you realize that you’ve got a whole lifetime to figure it out. Obviously, the earlier you start, the better off you’ll be. Nonetheless, the research says that benefits will accrue no matter when you engage.

So, to answer my initial question, the view from down under is pretty much the same as it is from here in West Chester, PA!

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S2E32. Still Making Mistakes

I’m doing all the right things. I’m eating right, exercising, staying mentally active, getting good sleep, and hanging with friends whenever possible…and I’m still making lots of mistakes. What’s up with that?

Well…actually…nothing. It’s perfectly normal. The brain research doesn’t promise that you’ll stop making errors. It doesn’t even say you will have significant improvements in your memory, language skills, motor or executive functions. All it says is that your decline will be slower than it would have been had you not done all the right things. 

It’s akin to trying to protect a sand castle you built on the beach. You can pile wet sand around it to keep out the incoming tide, and that will work for a little while. Your castle might last a little longer than the one 3 umbrellas over, but at some point, it will be lost. The idea, though, is to enjoy it as long as possible. And that’s about all we can ask and hope for.

Unfortunately, we only get to live life once, so we’ll never get to compare the two trajectories for ourselves. We just have to take it on faith that living a brain-healthy lifestyle gives us our best shot at preserving our mental faculties for as long as possible.

So what kind of screw-ups have I committed recently? Here are three that stand out:

1. We made an overnight visit to Virginia to help my niece Kay celebrate her 70th birthday. On the return trip, we detoured to Harper’s Ferry for some sightseeing, arriving home around 6pm. 

At our apartment building we need to put the garbage outside our doors between 6-8pm for pick-up later that evening, so I was glad we got home early enough for me to get it out on time.

It’s usually picked up by 9pm, but when I went to bring the receptacle back in at 9:15, it still hadn’t been picked up. And not at 10pm, either. I checked once more at 10:30 and it still hadn’t been picked up.

I wondered what was wrong, as this had never happened before. If there was going to be a disruption in trash collection services, we always got an email notice from management, but that hadn’t happened.

So I looked up and down the hall to see if our neighbors’ trash had been removed and immediately noticed that no one else had put their container out.

DOH!

I knew full well that garbage is picked up 5 nights each week, Sunday through Thursday…and it was SATURDAY!

2. I was making a grilled cheese sandwich for Sally and had just placed it into the frying pan to brown when she asked me to help her with a problem she was having ordering concert tickets online.

I walked over to her chair, picked up her computer, and quickly found the problem. I clicked my way through the various menus and got to the point where she could finalize payment…when I smelled something burning.

OMG!

I had completely forgotten about the grilled cheese sandwich! Fortunately, the living room where Sally was sitting and the kitchen bookend a single open area and so I was able to see, hear, and smell what was on the stove from where I was standing. I sprinted the length of the apartment in record time and was able to get the pan off the burner before the sandwich was completely ruined.

That might have been my worst mistake to date. It had the potential to be disastrous. And it’s the kind of thing we, unfortunately, hear about all too often. It frequently signals the beginning of the descent into a world where there is reason to question our ability to live independently. 

3. “What we’ve got here is failure to communicate.”

Remember that line from “Cool Hand Luke?” That scene had to do with Paul Newman’s resisting the authority of the prison boss…which has nothing at all to do with the misunderstanding that Sally and I had last week. I just love that line, which is why I quoted it. 😀

Our ‘failure to communicate’ was not at all passive aggressive on my part. Sally asked me if I would do something for her while she was visiting a friend in New Hampshire and I said that I would. The problem, though, is that what I thought she wanted me to do and what she actually wanted me to do bore no resemblance to each other!

So when the time came, I remembered full-well that I had an assignment, taking several actions to make certain that I could fulfill my responsibility. I was ready. The problem was that I was faithfully attempting to fulfill the wrong task.

Upon her return home the next night, Sally was not at all pleased to learn that I hadn’t done what she asked. We tried to recall the conversation where things went awry and both of us had solid recollections supporting our respective positions. 

There’s no doubt in my mind that Sally did, indeed, say what she intended to say and that I latched on to an errant phrase and ran with it in a different direction, leading to the snafu. Regrettably, other people were involved.

We all know that you can’t remember something if you don’t first pay attention to it, so I guess I need to work on my listening skills, as well.

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S2E31. Sweet Dreams Are Made Of This

When I was growing up, my mother valued her children’s sleep above all other bodily functions. When I was 12, I used that to my advantage when I wanted to play hooky from Hebrew school by staying up late the night before and then pretending not to wake up the next morning when she called me.

In college, a had a fierce bout of depression and found myself sleeping 12-16 hours every day. My therapist told me it was a defense mechanism whereby I tried to escape from reality. It sounded plausible at the time.

I used to wake up most nights at 3am. My best guess was that it was a little bit of residual trauma from when I was 6 or 7 and I was startled awake by the phone ringing. It was the hospital calling to tell us that my grandmother had died. My mother jumped out of her bed, wailing and crying hysterically. I glanced at the clock in my room and saw that it was 3am. Just recently, I learned that about 35% of us habitually wake up at 3am…and a related trauma is not a prerequisite at all.

In my early 30s, when I was the executive director of a performing arts center, I used to doze off in my office every afternoon. I fought it for a long time in the belief that I shouldn’t  be sleeping on the job, but then I decided, screw it! As soon as I’d start to get drowsy, I would buzz my secretary and ask her to hold my calls, lean back in my chair and nod off.

My afternoon napping habit never left me. When my first wife and I ran a B&B in northeastern Pennsylvania, I would retreat to the rope hammock hung between a pair of birch trees or lie down on the porch swing on most days in the late spring, summer and early fall. Those were the best naps of my life!

Fifteen years later, as the staff psychologist on an inpatient behavioral health unit, I took my nap a little earlier to coincide with my lunch break. Without my asking, our director sent out a notice that staff should not disturb Dr. Braffman during lunch unless there was an emergency and a patient was in crisis. Now that’s how you value nap time!

In graduate school, I learned about the 4 phases of sleep. Later studies revealed that you cycle through these phases 4-6 times every night, and that you can dream at any time, not just during REM sleep. 

New research published last month reported that there is a noradrenaline cycle that wakes you up as many as 100 times during the night. The awakenings are measured in milliseconds, so you are unaware of the vast majority of them.

Although we appear quiescent while we sleep, there’s actually a lot of important business going on under the hood. It’s the time when we consolidate memories and new learning and replenish our available stores of vital neurotransmitters. If you don’t sleep well or long enough, you’re going to have cognitive problems the next day, e.g., brain fog and you’ll be prone to making a lot of mistakes.

Another critical function of sleep is to clean up the chemical detritus left over from your brain’s daily activities. There is a whole separate network in your head that performs this task, running in parallel with the neural networks with which we are all so familiar. It’s called the brain’s glymphatic system.

It’s hypothesized that your brain’s ability to clean up the daily messes that it makes plays a critical role in preventing dementia. One way this might work would be by removing beta amyloid that is created as part of an immune response like a fever. 

What I haven’t been able to find anywhere in the literature, though, is a description of the magnitude of this cleaning power. Can your brain completely clean house every day? Is there enough residual power to clean up festering messes that overwhelmed the system on earlier occasions? In other words, is it destiny that our brains eventually be overrun with chemical garbage? Or can we chip away at accumulations of waste products until all our neural pathways are functioning again? Or is breaking even on a daily basis the most we can hope for?

We don’t know the answer to those questions yet, but we do know that somewhere between 7-9 hours of restful sleep on a regular basis helps tremendously. And naps are good for you, too (thank you, lord!), so long as you don’t overdo it to the point where they start to affect your nighttime slumber.

The impact of consistently high-quality sleep on your brain’s health can not be overstated. If you aren’t sleeping well (i.e., less than 6 hours each night), you might want to consider implementing some behavioral changes now that will reduce your risk of dementia by 30-50% later on.

To sleep better, lay off the alcohol in the evening and no more caffeine after 12 noon. Set a fixed schedule for going to bed and waking up. Stow your electronic devices about an hour before bedtime. Make a list of all the things you want to do the next day so you don’t lie awake thinking about them. You might want to do a meditation/relaxation/deep breathing exercise just before bedtime. Make sure your bedroom is dark and the temperature is somewhere in the 60s.

If you do all of these things and still have trouble sleeping, it will be well worth your while to get evaluated. There are a range of products out there—both natural and pharmaceutical—that can offer you support, if you need it.

Pleasant dreams!

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S2E30. Can Vaccinations Prevent Dementia?

An interesting study published last month reported a 40% reduction in the risk of getting Alzheimer’s dementia for people 65 and over who regularly receive flu shots. What’s more, the earlier you start getting your annual shot (i.e., before the age of 60), the greater the protective benefit.

That’s a fascinating and wonderful finding, but it begs the question: why? Why would getting a vaccine that trains your immune system to fight off the flu virus protect you from developing dementia? Especially when the dementing process has probably been active in your brain for a number of years?

Immunology is a field of science that is way out of my comfort zone, but I read some journal articles anyway to see if I could make any sense of it. So please take what I say with a few grains of salt, as I may be wildly misinterpreting the data.

It seems that flu vaccine isn’t the only vaccine that is protective against dementia. Tuberculosis, tetanus, pneumonia, and herpes vaccines are also beneficial…but direct links between the viruses involved and dementia have not been found.

Perhaps, I theorized, the vaccines prevent you from getting the targeted illnesses which, in turn, means that you have fewer incidents of extreme immune-response inflammation which, in turn, minimize your brain’s production of beta amyloid and tau proteins. Sounds reasonable, right? But this study controlled for the number of times people actually got the flu and there was no correlation.

I thought, maybe, that people who get their annual flu shots are, in general, more health conscious and engage in other lifestyle habits that are protective (e.g., diet and exercise). But that didn’t turn out to be a factor, either.

The study’s authors suggested a couple of possible explanations, all of which require a significant amount of further research before any causal conclusions can be drawn. And—to be honest—in some instances, I had trouble understanding what they were proposing. The one hypothesis that made the most sense to me posited that vaccinations for specific viruses also have a general effect on one’s immune system, modifying it in a way that enhances its ability to deal with the chemical compounds that really are at the root of dementia, whether they be beta amyloid and tau or some other as yet unidentified compounds.

If this turns out to be the case, then it’s possible that the COVID pandemic has a silver lining for all of us who faithfully received our two shots and follow-up boosters. We should know in about 5-10 years.

Given these findings, it’s not surprising that there are trials currently underway to test vaccines specifically designed to train your immune system to recognize and attack beta amyloid plaques. As I’m not a big fan of that theory, I have my doubts that it will actually work as intended, but it might be beneficial because of the general effect that vaccines have on the immune system. I wonder: How will the researches tell the difference if, indeed, a significant effect is found?

Another thing about this recent study that caught my attention was the finding that it reduced the risk of developing Alzheimer’s by 40%. Other studies have shown that exercise reduces your risk by 30-45%. Adherence to the Mediterranean Diet has been shown to reduce one’s risk by somewhere between 30-72%. And don’t forget the benefits of regular cognitive challenge, good sleep hygiene and social engagement. Yet most experts say that you can reduce your risk of dementia by only 40-50% by implementing all of these strategies. How can that be? Why isn’t the protection rate up around 75% or more if you implement all of the strategies the research has identified?

There are some studies that tried to simultaneously measure the impact of two or more of these factors and they show the effects to be independent of each other…yet the total effect doesn’t seem to increase as you add more levels of protection. That seems odd to me.

Is it possible that each factor impacts the same unknown dynamic that causes dementia but by different means? Or are there a variety of different etiologies for the cluster of symptoms we have defined as ‘dementia’ and each of these factors are protective against some but not all of them? Do some strategies go after the root cause while others build resilience to compensate for damage that occurs elsewhere?

It’s mind boggling (no pun intended).

I just hope my brain is still in good enough shape to appreciate it when the research finally reveals the answers. In the meantime, I’ll faithfully show up for every vaccination that Medicare and my insurance cover!

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S2E29. Brain Training Is Hard Work!

As I mentioned at the end of the last episode, my disappointment with my short-term memory led me to subscribe to ‘BrainHQ,’ a computerized cognitive training program. This past week was my first week using it and…man o’ man!!!…it’s hard work!

Before I continue, let me reassure you that I am not shilling for BrainHQ. I chose it from the myriad of online cognitive training offerings because it is being used in a range of research programs and has some published studies to support it. Having said that, the data is mixed and the jury is still out as to whether or not this particular program (or any purported brain-enhancing program) generates any meaningful improvement in one’s life.

But—just as I decided that in regards to diet that if I’m going to put something in my mouth, then it might as well provide something that supports brain health—I came to the same conclusion about computer games. Instead of wasting an inordinate amount of time playing a mindless but addictive game like ‘Bubble Shooter,’ I might as well get some benefit out of that same block of time by playing games that just might provide some health benefit. 

To see if it was really worth doing, though, I spent time this week looking at some of the recently published research about the effects of cognitive training programs. One study that caught my eye was a meta-analysis (i.e., a study that analyzes the data from many studies all at once) of changes in brain connectivity attributable to cognitive training. 

You might recall from S2E23: Repaving Your Cognitive Infrastructure that our brains develop neural circuits that connect distant areas that are used simultaneously to complete tasks. As we age and our abilities start to decay, we recruit more areas to help perform the same functions. This is made possible by brain plasticity and is at the heart of cognitive resilience as a protective factor against dementia.

The meta-analysis I read combined data from a number of fMRI studies and revealed that computerized cognitive training changed these pathways and linkages. There were increases in activity in some areas and decreases in others. The overall pattern was to move in the direction of restoring the circuitry that existed before age-related attrition began. In effect, it (roughly) restored your brain to the way it was two years earlier. That’s pretty impressive, no?  

If I’m understanding it correctly, when your frontal lobes begin to atrophy, your brain recruits neurons from other more posterior regions to pick up the slack. But cognitive training strengthens your frontal lobes so they no longer need to use the support they had previously requisitioned. Thus the frontal areas showed more activation and the more posterior areas showed less. Fascinating!

So I jumped into my training with the fervor of a new convert and immediately set a goal of ‘working out’ for an hour every day. This, apparently, was considered a very aggressive plan of action as BrainHQ recommended 20 minutes/day at least 3 times a week as a good place to start.

The program allows you to target a variety of brain functions (e.g., attention, speed, memory) and so I went after memory instead of following the suggested general approach which covers all the bases. Was I in for a surprise!

It was really hard. The tasks included both audio and visual versions of the ‘N-Back’ card task that I described in last week’s episode (S2E28), as well as an audio version of the card game ‘Concentration.’ 

The program is designed to push you to a challenging level without frustrating you to the extent that you quit. So the exercises start off easy, progress until you fail, and then drop back to easier versions. The sweet spot is when you maintain an 80% correct response rate.

I struggled with the frustration, though. On the N-Back card task, I mustered up all the attention and focus I could to visualize the briefly-shown cards in an order that would help me identify the correct one when the time came….but I didn’t get very far.  😦

All of my best efforts not withstanding, my visualizations of the cards would disappear shortly after a few new cards were turned over. It was as if an evil magician was doing a disappearing act inside my head. Poof! Now you see it…now you don’t!

I beat up on myself because I knew that my performance represented a decline from my peak abilities. Yes, I know that this is true for all of us if we are fortunate enough to get to this age, but having it slap me in the face like that was a little hard to take.

About three days into my training, I recalled something I learned in graduate school. Your brain has a ready supply of neurotransmitters on call to maintain a high level of focused attention for about 45 minutes. After that, you can still focus, but your efficiency drops off. I used this fact when I was taking hours long exams by stopping every half hour and doing deep-breathing exercise for 3 minutes to restore my neurotransmitter reserve before returning to the test. It seemed to work then, so I applied the principle again now: I divided my hour of daily exercise into two 30-minute sessions several hours apart. I could feel the difference and see the improvement in my performance during the second half of the workout. 

(Come to think of it…45 minutes is about how long I can practice the recorder or read a book without losing focus. Interesting!)

The good news here is that, after a week of training, I can see that I’ve made progress on all of the tasks. Not a lot, but progress, nonetheless. Enough progress to keep me from quitting. But, damn…this is hard work!

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S2E28. Working Memory Workout?

A majority of the mistakes and cognitive errors that I have documented in this blog involve failures of working memory. Working memory is where we hold information online while we manipulate it and/or consider what to do with it. It’s where we hear our internal voice. It’s the central cog in our executive functioning network.

Consequently, it’s not pretty when you start to experience declines in your working memory abilities which, as it so happens, are usually the first to go as we get older.

So I was intrigued by an article in The New York Times last week that reviewed a new book (The Complete Guide to Memory: The Science of Strengthening Your Mind) by neuroscientist Dr. Richard Restak in which he asserts that exercising your working memory can forestall its decline and possibly even restore prior losses. The article covers his 7 key recommendations and you can read it here.

Regular readers of this blog know me well enough to figure out that I downloaded the book and read it this week. It reviews all the usual types of memory and he adds a few new ones of his own construction. He pays more attention to brain structures than most books of this type, but he keeps his narrative breezy and conversational, including examples ‘ripped from the headlines,’ as they say.

He recounts the usual litany of techniques you can use to better remember lists, but I was most intrigued by his lengthy discussion of working memory and exercises you can do to actually strengthen it.

One such exercise was to name all of the United States presidents in chronological order, beginning with FDR. Then do it in reverse order. Then do it alphabetically. Then do it in reverse alphabetical order. If you want to try this, I’ll give you a hint: there are 15 of them.

It took me a little while one sleepless night to master this task. As I did so, I felt like I could actually see the places where my working memory let me down and where answers were swimming nearby but just out of awareness.

He recommended making other lists that you can manipulate in similar ways, and to practice organizing them in your mind every day. 

He also recommended daily practice with what is known as the ‘N-back task.’ The easy-to-do-at-home version of this only requires a deck of playing cards. First, you select two cards that will be your ‘trigger’ cards, say a ten and a three. Then you turn over the cards one by one, look at them, and place them face down in a pile. When one of your trigger cards appears, you have to name the card that preceded it. This is the ‘1-back’ version of the task. After you’ve mastered it, you can make it more difficult by trying to name the card that was two cards before the current card, or ‘2-back.’ 

I immediately pulled out a deck of cards and tried it…and failed miserably at the 2-back version. I did alright with the 1-back version, actually having the most difficulty remembering which were my 2 trigger cards!

This piqued my interest in working memory tasks and so I googled it. I discovered quite a number of sites offering (for a subscription fee) computerized versions of a wide variety of working memory tasks. 

I tried a number of them and quickly discovered how limited my working memory is. I was especially bad at tasks that required me to remember visual images. In fact, I noticed that I retained virtually no memory of the images and had to resort to semantic memory to complete the task, i.e., naming the images that had flashed on the screen and remembering the names, not the pictures.

Neuropsychological tests are very good at isolating and identifying your weaknesses, and these were no exception.

Dr. Restak talked about my condition in his book. It’s called ‘hypophantasia’ which is the inability to retain fleeting visual images in your mind’s eye. Conversely, people who are exceptionally adept at doing this have ‘hyperphantasia.’ My first wife was such a person. She could walk through someone’s house once and later draw a diagram of all the rooms on every floor…to scale! Most of us have abilities that fall somewhere along this spectrum from hyper- to hypophantasia.

This experience alarmed me enough to want to initiate a structured workout routine to try to improve (or at least slow the deterioration) of my working memory. My recollection, though, was that—Dr. Restak’s exhortations notwithstanding—the research is mixed about whether computer games and tasks can actually improve your cognitive abilities. In most cases, it appears that you can get better at the computerized task, but that it doesn’t generalize to improve your ability to perform other tasks of daily living. What was I to do?

Right on cue, I received an email from one of my college roommates, Tom, with an article from The Boston Globe about several large-scale, age-related cognitive studies that are being launched in New England. Among the variables being tested are brain training techniques. The program offered by a company called BrainHQ will be used in these studies.

Well, if it’s good enough for the researchers, then it’s good enough for me! So I went to www.BrainHQ.com and subscribed for a year for $96.00. My intention is to do a 1-hour workout each day…if the frustration from getting too many wrong answers doesn’t overwhelm me.  

Wish me luck!

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