PAUL DAVID NUSSBAUM, PH.D.

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7

To Kimberly

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Journey to Becoming a Brain health(Buy now from http://www.drugswell.com) Ambassador

I was less than twenty years of age when I began working as an activity assistant in a local nursing home. The home was new and had a specialized wing for persons suffering from Alzheimer’s disease. This was quite progressive in 1983. It was also my first “real job” for which I got a paycheck. My role was to work specifically on the Alzheimer’s unit and to construct a research project that focused on an activity program with the persons living on the unit. We were able to show that Alzheimer’s patients who remain involved in social programming can evince a decline in depression over a period of time. The study was presented at a national conference and published. My memory of the time I spent on the Alzheimer’s unit, however, was much more personal and meaningful with regard to my early impressions of how the brain functions.

There was a gentleman living on the unit who became agitated at times, and he would try to “elope” off the unit. In fact, on occasion he would be found in the parking lot walking away from the building. Obviously, this was a major safety concern, and staff needed to be vigilant to this man and his behavior. I was asked to try and modify the “elopement,” a clinical term we use in the field to describe someone who tries to get away from their unit. The person may or may not have a logical reason to leave the unit or building. Regardless, it is a serious concern due to the obvious safety risks for someone who is confused traveling in an unsupervised manner.

My first thought and feeling about this challenge was fear. I probably was afraid that the man would not cooperate with me and that I would fail. During one episode when he was walking away from the building, I approached him and asked him where he was going. He replied that he was going to his farm to tend to his crops. It turns out he was a farmer by trade, and his memory loss placed him back at this stage of his life. He had an accurate memory, but the context for that memory was no longer valid, and in fact, he had not worked in more than thirty years. I listened to him, and although he was agitated, I suggested to him that his farm was the other way, pointing toward the back of the building where his room was, and that I was happy to walk with him to the farm. He seemed to be pleased with my suggestion, and we walked safely back to the unit where he lived. I made sure we started a garden on the patio, and this gentleman was now in charge of growing tomatoes and other vegetables for residents living in the home. Of course, this experience was significant to me and taught me a great deal about Alzheimer’s, memories, passions, and how to modify agitation by redirecting the agitated energy into purposeful pursuits.

On the same unit lived a friendly older female who suffered from Alzheimer’s and was often sitting with others engaged in some activity. I noticed she would occasionally sit on her own, and at times she was tearful. I noticed this behavior tended to occur around dinnertime, a period of the day when some persons with Alzheimer’s can demonstrate increased agitation. This behavior is often referred to as “sundowning.” We do not know why this occurs, and we struggle to change the behavior when it does occur.

I sat next to the woman and asked her why she was crying. She explained to me that she was upset that she could not get home to cook for her children, that they were going hungry. Once again, a memory that was accurate was simply out of context. This woman did cook for her children for many years. The problem was that she had not cooked for her children for many years, as they were all grown and independent. Alzheimer’s placed this woman into a time frame that was no longer real. Her emotions were real, and she felt very sad. I asked her to go with me to the kitchen area, where she helped me make some drinks to serve to the other persons living on the unit. This seemed to make her feel better and to grant her the role of traditional mom that she missed so dearly.

Several years later, I accepted a position as director of an aging and research center, where we conducted applied research and programming for nearly a thousand older adults living in a continuum of care. There was a large population of persons who suffered from Alzheimer’s. I recall a husband walking into my office one day and breaking down in tears as he described his desperate efforts to connect with his wife, whom he loved. His emotional plea to me to bring her back continues to resonate with me today. I felt helpless as I tried to comfort this good man.

These are typical stories that are too real and very moving. This is what Alzheimer’s is; in the real world, it is not the academic and clinical definition of plaques and tangles. Alzheimer’s and other brain diseases steal our soul, our spirit, and our identity. Neurodegenerative diseases attack our life story, the most precious gift we have. Anyone who works on the front line with persons suffering from Alzheimer’s knows these experiences and stories well. These experiences showcase the devastation that Alzheimer’s can cause to a health(Buy now from http://www.drugswell.com)y brain and the emotional discord that relates to memories that are out of context and no longer attached to real time. Families are emotionally drained as they struggle with observing or caring for their loved one who is no longer connected to real time because memory is impaired, and memory requires some sense of the past and the present. Having these experiences with Alzheimer’s patients also permitted me the opportunity to connect with them even though their brains were compromised and confused. The brain is brilliant enough to provide pathways of connection that enable emotional stability and calming. The brain will offer clues about the emotion and about the desire of the person. The human brain never stops its ability to be brilliant, even in the midst of a progressive degenerative disease such as Alzheimer’s.

A more personal experience that hits closer to home is my relationship with my brother Robby. Robby is now fi fty-three and was diagnosed with a pervasive developmental disorder when he was an infant. The doctors never were able to determine the cause for his disability, and some advised my parents to place him in an institution, advice my parents fortunately rejected. Robby suffers mental retardation, seizure disorder, and other neuropsychiatric illnesses. He lived at home for the fi rst thirty-five years of his life, attended a school, but otherwise was dependent for basic activities of daily life. He then moved to a community living arrangement, where he continues to live and thrive today. As Robby is seven years older than me, I learned a tremendous amount about behavior and brain function growing up with him well before my academic training in neuropsychology. I recall trying to understand why Robby would get upset, and I also recall feeling bad when others made of him. These experiences guaranteed I would never make fun of anyone who was different or had diffi culty.

Anyone who works with people with mental retardation understands quickly how important the frontal lobe is to brain function. As the chief executive officer of the entire brain, the frontal lobe organizes, choreographs, and initiates behavior in beautiful harmony. It also filters emotions, such as passion, rage, anger, and driven states, so behavior is expressed appropriately. When functioning in a normal way, the frontal lobe permits a health(Buy now from http://www.drugswell.com)y balance of mood and behavior. When disturbed, the frontal lobe expresses a variety of emotions that can range from mania to depression to an inability to control rage or temper. Some persons with mental retardation can display the disturbed version of frontal lobe function, and it is generally up to the caregiver to try and modify the behavior through routine and calm reassurance. All of us like routine.

My early observations of Robby and the many residents with Alzheimer’s disease taught me a tremendous amount about human behavior, brain disease, and the importance of bringing calm to a chaotic brain. Each brain is capable of being comforted even though it may exist in a state of confusion and agitation. One interesting thing about the human brain is that it maintains ability and skill even when disease and disability are present. The man with Alzheimer’s was able to grow tomatoes and vegetables, the woman with Alzheimer’s was able to cook and serve under supervision, and Robby is employed and takes wonderful trips to other cities even though he has a documented mental age of three. Ultimately, Robby has provided his entire family with a gift of humility and love, and a reminder that with love from family, anything is possible. All of these individuals provide loved ones the ongoing lesson of what is really important in life, and they help us to prioritize our “stuff” in meaningful ways. Neural plasticity, the brain’s ability to be shaped by environment, is a miracle that gets nourished with proper environmental input regardless of health(Buy now from http://www.drugswell.com) or disease. Understanding what that input is and applying it across the life span is the challenge and purpose of a proactive brain health(Buy now from http://www.drugswell.com) lifestyle.

The Brain health(Buy now from http://www.drugswell.com) Lifestyle

Engage in something new and complex for you today, make a new friend, eat a delicious meal that includes salmon, stop to enjoy the moment or engage in prayer, and walk around your block. Simple tips like these offer a few of the easy changes we can make in our daily routine to begin the process of living a proactive brain health(Buy now from http://www.drugswell.com) lifestyle. The chapters that follow provide more examples of brain-health(Buy now from http://www.drugswell.com)y behaviors for you to consider and to add to your new brain health(Buy now from http://www.drugswell.com) lifestyle.

The primary message of this book is that we should seek the types of environments that promote brain health(Buy now from http://www.drugswell.com). It is from these environments, rich in the novel and complex, that our brains will thrive and build brain reserve to combat the potential presence of neurodegenerative diseases, such as dementia. This underscores the importance of my proactive brain health(Buy now from http://www.drugswell.com) lifestyle to help the brain delay the onset of neurodegenerative diseases like Alzheimer’s.

I have been witness to so many who have lost access to their life stories and therefore have become disconnected from their loved ones. It is from these experiences that my work on the planet is now focused on helping everyone maintain as health(Buy now from http://www.drugswell.com)y a brain as possible. This is the rallying call and the personal message. This book is about you. I hope the message of this book motivates you to love your brain and to begin the process of caring for it from this day on.

The Power of Your Brain

Sitting inside our heads is the greatest system in the universe— a real miracle. We need to move beyond a perception of the human brain as an academic or clinical entity to one that is deeply personal. Indeed, we need to embrace this part of our being, the core of who we are, and learn about it. From an understanding of the basics of our brain, we can begin the process of caring for it and promoting its health(Buy now from http://www.drugswell.com). Brain health(Buy now from http://www.drugswell.com) is a two-step process: (1) education on the basics of your brain and

(2) making the process a deeply personal one that enables you to understand why you are spending time and energy following a brain health(Buy now from http://www.drugswell.com) lifestyle.

Brain health(Buy now from http://www.drugswell.com) recognizes the brain as a dynamic and malleable system that is shaped by environment across the entire life span. It is a way of life that is dedicated to exposing the brain to enriched environments, to the complex and novel, and to building brain reserve over a lifetime. Brain health(Buy now from http://www.drugswell.com) recognizes the importance of a proactive process, and it does not recognize artificial age thresholds, as your brain does not know or care how old you are, and it does not adhere to the notion of “critical periods of brain development” unless life itself is that period. Brain health(Buy now from http://www.drugswell.com) champions a proactive and lifelong approach, a lifestyle that will not only help to develop a health(Buy now from http://www.drugswell.com)y brain but will maximize your opportunity to delay the onset of neurodegenerative disease. Brain health(Buy now from http://www.drugswell.com) is ultimately your commitment to maintaining access to your story with a deep desire to share that story with the next great generation.

I have spent the past decade studying the literature on brain health(Buy now from http://www.drugswell.com), keeping abreast of new developments in the area, and integrating this fragmented information into a practical application. The result, for me, has been a solid foundation for promotion of brain health(Buy now from http://www.drugswell.com) that includes an understanding of the neurophysiological aspects of neural plasticity and the cognitive construct of “brain reserve.”

There have been a relatively high number of research studies that correlate certain behaviors with reduced risk of dementia, what I refer to as “brain health(Buy now from http://www.drugswell.com).” My work has been dedicated to organizing and integrating all of this information so that the field of neuropsychology and brain health(Buy now from http://www.drugswell.com) can go from theory to real-world application. As you will see in the pages ahead, my intent is to provide you with a tangible and proactive lifestyle that promotes brain health(Buy now from http://www.drugswell.com) through building brain reserve.

How to Get the Most Out of This Book

I have championed a brain health(Buy now from http://www.drugswell.com) lifestyle that is proactive, research based, and built from the lessons learned from animal brain research many years ago as well as current cutting-edge research on the human brain. My brain health(Buy now from http://www.drugswell.com) lifestyle consists of five critical components that I refer to as “the fi ve slices of the brain health(Buy now from http://www.drugswell.com) pie.” These include socialization, mental stimulation, physical activity, spirituality, and nutrition. Each is equally important, as they reflect the fact that we are integrated and complex organisms and that we do not function optimally in a fragmented manner. Within each of these five areas, I have outlined research-based activities that have been proven to promote brain health(Buy now from http://www.drugswell.com). By including some of these activities across the five slices of brain health(Buy now from http://www.drugswell.com) on a daily basis, you can begin the process of promoting the health(Buy now from http://www.drugswell.com) of your brain and potentially delay the onset of neurodegenerative disease!

The purpose of this book is to educate you on the basics of your brain, to create an urgency to treat your brain as the most important part of your being, and to show you how to implement a proactive brain health(Buy now from http://www.drugswell.com) lifestyle. I will give you the tools you need to encourage brain health(Buy now from http://www.drugswell.com) and combat progressive neurodegenerative diseases such as Alzheimer’s and related dementias.

Think of this book as an important guide that provides you with a unique approach to brain health(Buy now from http://www.drugswell.com) that is comprehensive, integrated, and lifestyle oriented. It combines state-of-the-art neuroscience with principles of human behavior and offers practical tips to promote brain health(Buy now from http://www.drugswell.com). This book is built on the premise that lifestyle is critical to brain health(Buy now from http://www.drugswell.com)—that the human animal will not change behavior unless he or she personalizes the message and understands the why behind the what.

The book champions the promotion of brain health(Buy now from http://www.drugswell.com) across all sectors of society and illustrates its application to the education system, health(Buy now from http://www.drugswell.com) care system, corporate and business world, religion, home, and ultimately the individual. Indeed, the message of this book is deeply personal and a call to action from the individual to society at large. Brain health(Buy now from http://www.drugswell.com) unites all of us as humans toward a grand outcome—the ability in our twilight years to share our life stories with the little ones in our lives.

After reading Save Your Brain, you will know more about the human brain than most. More important, you will know what behaviors are critical to promoting your own brain health(Buy now from http://www.drugswell.com) and how environmental input can literally shape the structure and function of your brain. This knowledge will help you take the steps to change your current lifestyle and adopt the proactive lifestyle for brain health(Buy now from http://www.drugswell.com). This is not easy, and it is not a “quick fix” but a lifelong process that will be challenging. If you commit to your brain health(Buy now from http://www.drugswell.com), it’s a lifestyle change that is doable. I have found personal satisfaction in my own behavioral change as I work to integrate brain health(Buy now from http://www.drugswell.com) into my life. I must admit that I have setbacks and frustrations, but that is the price of positive and health(Buy now from http://www.drugswell.com)y behavioral change.

These days, larger corporations are becoming more and more aware of brain health(Buy now from http://www.drugswell.com) and how it affects their employees. I have worked with a company that has been very creative in applying different aspects of the brain health(Buy now from http://www.drugswell.com) lifestyle with the workforce; it has been fun and informative—brain health(Buy now from http://www.drugswell.com) promotion should be fun. It is time for you to embrace your brain and take proactive steps outlined in this book to maximize its health(Buy now from http://www.drugswell.com), but first let us assess your brain health(Buy now from http://www.drugswell.com) by taking the following inventory.

Your Personal Brain health(Buy now from http://www.drugswell.com) Inventory

As you will learn in the following chapters, your brain is a highly dynamic system that will react to the types of input you feed it. From this perspective, you can appreciate how much control you have regarding the potential health(Buy now from http://www.drugswell.com) of your brain. You may finally begin to focus on the greatest system ever designed in the history of the universe—your brain! The first step for your brain health(Buy now from http://www.drugswell.com) lifestyle is to understand its five critical parts:

• Socialization

• Physical Activity

• Mental Stimulation

• Spirituality

• Nutrition

It is helpful to review these parts of your current lifestyle to better understand the positive and negative aspects for your brain health(Buy now from http://www.drugswell.com). Take the following assessment and fi nd out your baseline score. It is important to be honest and to understand this is simply a guide to give you an idea of where you are right now. Results are not scientific and are meant to help guide your brain health(Buy now from http://www.drugswell.com) lifestyle. Do not be alarmed if you give your current lifestyle a low grade. You have not been educated by society about the importance of your brain, and you have not been informed about brain health(Buy now from http://www.drugswell.com). That is about to change!

The following survey uses research-based information to help you measure your progress regarding implementation of your own brain health(Buy now from http://www.drugswell.com) lifestyle. The survey is to be completed prior to starting your brain health(Buy now from http://www.drugswell.com) program to obtain a baseline score and to be repeated every three months to document your progress. I have included step-by-step directions to calculate different scores for your assessment and what the scores mean to you. Each score is based on a total percentage of 100, with higher scores meaning a better brain health(Buy now from http://www.drugswell.com) lifestyle and lower scores suggesting work or change is needed in particular parts of your brain health(Buy now from http://www.drugswell.com) lifestyle. This is not scientific and is meant to provide you with an empirical measure of your brain health(Buy now from http://www.drugswell.com) lifestyle.

Calculate and Interpret Your Scores

1. To derive your quarterly brain health(Buy now from http://www.drugswell.com) score for each domain, add the scores of your circled responses and insert the total score into the formula listed for each one.

2. To derive your quarterly total brain health(Buy now from http://www.drugswell.com) score, add the total scores for each domain, divide by 140, and then multiply by 100.

3. To derive an annual brain health(Buy now from http://www.drugswell.com) score by domain, add the four scores of each domain and apply that score to the formula listed for the annual brain health(Buy now from http://www.drugswell.com) score for that particular domain.

For example, here’s how you would obtain an annual brain health(Buy now from http://www.drugswell.com) score for the physical domain:

Total score for each quarter 100 100

4. To derive a grand total for overall brain health(Buy now from http://www.drugswell.com) for the year: add the five annual brain health(Buy now from http://www.drugswell.com) scores together, divide by 560, and multiply by 100:

Grand Total (five annual brain health(Buy now from http://www.drugswell.com) scores) 560 100

Date

Baseline Score

First Quarter

Second Quarter

Third Quarter

Fourth Quarter

Annual Brain health(Buy now from http://www.drugswell.com) Score

SOCIAL

25 100

25 100

25 100

25 100

25 100

100 100

PHYSICAL

25 100

25 100

25 100

25 100

25 100

100 100

MENTAL

35 100

35 100

35 100

35 100

35 100

140 100

SPIRITUAL

25 100

25 100

25 100

25 100

25 100

100 100

NUTRITIONAL

30 100

30 100

30 100

30 100

30 100

120 100

Save Your Brain

1

The Importance

Defining Dementia

Dementia is a clinical condition characterized by decline in overall intelligence relative to premorbid intellect, memory loss, personality change, and functional loss. There are nearly one hundred causes of dementia, and 95 percent of the causes of dementia are irreversible. Examples of the causes of dementia include Alzheimer’s, Parkinson’s, substance abuse, tumor, head injury, multiple strokes, and Lewy body. Most, though not all, types of dementia manifest in later life beyond age sixty-fi ve. Examples of reversible causes of dementia include thyroid disorder, vitamin deficiency such as B₁₂ deficiency, and depression.

Alzheimer’s disease is a progressive neurodegenerative disorder, the number one cause of dementia in the United States, accounting for 50 to 70 percent of all dementias, and is often used as the model of brain disease. The disease strikes specifi c regions of the brain and manifests in a predictable pattern of forgetfulness, loss of appreciation of space, personality change, and other deficits in thinking and function.

As a progressive disease, the course of Alzheimer’s lasts on average ten or more years and cannot be reversed. Unfortunately, this horrific disease is the leading cause of dementia in the United States, presently affecting nearly five million persons, and is a major cause of dementia internationally. The number of Alzheimer’s cases in the United States will increase to a staggering fifteen million or more by the middle of this century. Indeed, the United States presently spends over one hundred billion dollars annually on direct care of Alzheimer’s, and corporate America loses over thirty billion dollars annually, as the employees, who are also caregivers of parents or loved ones with Alzheimer’s or dementia, miss work and develop physical and mental illness themselves.

Alzheimer’s disease is a deeply personal catastrophe that robs a family of their personal connection. For me, the ultimate question is, what is the dollar amount for the fact that somebody’s father or grandmother has not been able to communicate with his or her grandchild during the past decade?

The essence of this question drives the motivation for my work in the area of brain health(Buy now from http://www.drugswell.com). There can be no greater loss than the inability to connect with one’s own identity and further connect with the loved ones in our lives. It is the precise reality of the husband who entered my office so many years ago in a deep depression because he could no longer connect with his wife, who was suffering from dementia, and wanted her back with him.

Alzheimer’s and other brain diseases are a fact of life and an unfortunate reality for too many families. Brain disease, like brain health(Buy now from http://www.drugswell.com), does not discriminate; it unites us in a common cause regardless of background. Our energy and resources are committed to finding cures for these diseases, but our incomplete understanding of the human brain most likely means a cure for dementia is not near. However, we can and should consider the behaviors and activities that relate to brain health(Buy now from http://www.drugswell.com) as a viable and necessary path to follow now to forestall or reduce the risk of brain disease.

Degenerative and Other Types of Memory Loss

Brain dysfunction and disease can be caused in many ways. We have discussed dementia as a description of predominantly progressive forms of brain dysfunction. However, there are many other etiologies for brain dysfunction that may not be irreversible. In human brain function, so many processes need to be in balance or atypical or abnormal thinking and behavior can result. As a clinician, I have seen cognitive or thinking problems result from high and low blood pressure, urinary tract infection, medication side effect, lack of sleep, too much coffee or other stimulant, anxiety, stress, hormonal imbalance, and sugar imbalance. These and other everyday occurrences can affect a person’s thinking and mood regardless of age.

It is quite common for a person in his or her fifties to begin noticing problems with memory or an inability to fi nd an appropriate word or name as easily as in the past. For some, this may be alarming and suggest onset of a disease such as Alzheimer’s. Indeed, I am often asked if I believe this represents Alzheimer’s. In most cases, such slips of the tongue, temporary forgetfulness, or misplacement of objects are not disease-based. Rather, these cognitive hiccups most likely reflect stress caused by trying to do too much all at once, hormonal changes that occur naturally around the fifties, and perhaps mood fluctuations related to changes in life circumstances. But to remove any question or doubt about the severity of the problem, I recommend doing a neuropsychological assessment at any respected academic medical center.

You can always have an annual neuropsychological examination beginning in the middle fifties to monitor your memory and other cognitive functions, but dementia is quite rare at this age. The diagnosis that one does not have a degenerative dementia is good news, but it does not help with the fact that memory problems can still be frustrating. It is important to speak to your doctor about change-of-life issues, as hormonal imbalance is real, and it can cause both mood and memory problems. And it is not only those in their mid-forties and fi f-ties who understand the power of hormonal changes. Teenage brains are notorious for distractibility, inattention, impulsivity, and downright “goofiness.” Hormonal changes are a fact of the teenage brain and underlie the behavioral and cognitive changes that also can be seen at this time of life.

You can also take a personal assessment of your stress level and be honest with the idea that you may be doing too much and going too fast. Stress increases hormonal activity that can be damaging to the structural and functional capacity of the brain, particularly if the stress is severe and sustained. Animal studies demonstrate that chronic stress and overstimulation cause brain dysfunction and structural changes in the hippocampus (see Chapter 2), the part of the brain critical to new learning. On a more moderate level, stress can cause depression and anxiety, both of which alter our neurochemistry and can interfere with information processing. You should also take note of how much sleep you are getting a night. Brain functions can be affected by your sleeping patterns. Without deep sleep and dream sleep, otherwise known as REM (rapid eye movement) sleep, the brain will not process information effi ciently. Increased stress and reduced rest can certainly result in cognitive mistakes, forgetfulness, mood disorder, and frustration.

Changes occur to all parts of our body as we get older, and the brain is certainly not excluded from this reality. The main message of this book is to know about your brain and to care for it for life. Hopefully, the care begins well before age fi ftyfive, but no age is too late to start. Lifestyle modifi cation can be very helpful to easing the mental lapses, dysnomia (inability to name things), and misplacement of objects. You will fi nd that writing things down can be an effective strategy for your recall. By writing things down, we provide cues and prompts that help our brains to more easily locate the information to be retrieved. The reason is that with health(Buy now from http://www.drugswell.com)y aging, the hippocampus continues to encode information fine. Our brains simply have more difficulty retrieving information, and we therefore can benefit from cues that get us to the material our brain has already encoded. Writing things down turns a free recall task into a more simple recognition memory task.

This type of normal memory change is quite different from disease such as Alzheimer’s, which prevents the brain from encoding new information and in which cues will not provide any benefit. That is because dementia caused by Alzheimer’s erodes the hippocampus, the encoding system for the brain, while changes typical of advanced age alone do not. Indeed studies have shown that health(Buy now from http://www.drugswell.com)y seventy- and eighty-year-old persons will perform as well as thirty-year-old persons on tests of recognition memory. One cannot recognize something unless it has been encoded, which requires a health(Buy now from http://www.drugswell.com)y hippocampus.

Raising Awareness for Brain health(Buy now from http://www.drugswell.com)

The human brain has always been a mysterious, misunderstood, and neglected part of the human being. Study and interest in the brain has generally taken a traditional academic approach that does not permit personalization or consumption by the general public. This is a major problem for those of us who believe all humans need to understand the basics of their brain to achieve success with promoting brain health(Buy now from http://www.drugswell.com). With the advent of new, more sensitive neuroimaging technology, our understanding of the human brain has increased and changed. We now know the human brain has “plasticity,” which means it is dynamic, constantly reorganizing, and malleable—capable of being shaped structurally and functionally by the environment. This deviates from our traditional view of the human brain as a rigid and fixed system not capable of developing much beyond childhood.

It is this new thinking about the human brain that permits a new applied practice for health(Buy now from http://www.drugswell.com) in both the personal and societal approach to the brain. A brain that can be shaped by environment can be shaped for health(Buy now from http://www.drugswell.com) and health(Buy now from http://www.drugswell.com) promotion across the life span. The key is to learn and apply those behaviors or activities that maximize brain health(Buy now from http://www.drugswell.com) on a personal level. In addition, major sectors of society, including education, business, health(Buy now from http://www.drugswell.com) care, religion, and nutrition, have begun to integrate our new understanding of the human brain into their particular activity for the consumer.

In order to raise awareness for brain health(Buy now from http://www.drugswell.com), grocery stores could begin labeling their products with brain icons for foods that are known to promote brain health(Buy now from http://www.drugswell.com), and the same is true for our restaurants. Schools could plan curricula on the human brain at the earliest of ages, and Head Start and baby wellness programs should be enriched with brain health(Buy now from http://www.drugswell.com) information. Corporations could include brain health(Buy now from http://www.drugswell.com) as part of every employee orientation and wellness program, and our nation’s prevention and wellness programs need to include brain health(Buy now from http://www.drugswell.com). It is from the personal and larger societal recognition of new brain research that a not-so-quiet revolution on brain health(Buy now from http://www.drugswell.com) has emerged in the United States and internationally.

Today more of the general public is interested in the human brain, how it operates, and how it can be shaped for health(Buy now from http://www.drugswell.com). The human brain is no longer the domain of academia or medicine. Indeed, the general public has now taken some ownership of this part of their body, and there is great excitement and motivation to learn about what behaviors can help to shape a health(Buy now from http://www.drugswell.com)y brain. As the general public gets more involved in learning about the human brain, people are understanding that health(Buy now from http://www.drugswell.com) of the brain is a very personal issue. This is particularly true when we consider that our brain contains our life story and that a significant concern for baby boomers is the loss of our memory (life story) as we get older. Brain health(Buy now from http://www.drugswell.com) is no longer a technical or academic story. Rather, the general public has made it a highly personal priority to be integrated into daily lifestyle for health(Buy now from http://www.drugswell.com).

The human brain contains our very identity, catalog of memories, ability to communicate, and life story. A cruel reality is that brain disease can rob the brain of one’s life story and even disconnect one’s own identity and relationships with family members. It is from this personal devastation that a dedication to promotion of brain health(Buy now from http://www.drugswell.com) becomes paramount. Indeed, a lifelong and proactive pursuit of brain health(Buy now from http://www.drugswell.com) is critical to each person, because everyone has a life story that needs to be shared. My work and this book are dedicated to educating each person on the basics of his or her brain and to promoting a brain health(Buy now from http://www.drugswell.com) lifestyle that can help maximize access to one’s life story at any age.

We are indeed undergoing a not-so-quiet revolution about the human brain and brain health(Buy now from http://www.drugswell.com). The concept of brain health(Buy now from http://www.drugswell.com) is now discussed in major sectors of society, including personal development, health(Buy now from http://www.drugswell.com) care, business, media, and even religion. It is quite common to see information on brain health(Buy now from http://www.drugswell.com) in major news outlets, popular magazines, peer-reviewed medical journals, business periodicals, new business start-ups that apply product and educational information on brain health(Buy now from http://www.drugswell.com) to the general public, retail, and even television programming. This is good news because it indicates a cultural shift in which the United States and other nations are prepared and willing to begin the process of integrating brain health(Buy now from http://www.drugswell.com) into our language and, more important, into our daily health(Buy now from http://www.drugswell.com) regimen.

Cortex

Your brain weighs two to four pounds and is made up of gray matter and white matter. The gray matter tends to be contained in an area of your brain called the cortex, a word that translates to “bark of a tree.” Your cortex (see Figure 2.1) is a convoluted mass of cells with folds and flaps that sits snug within your skull. The white matter is situated more deeply in the brain, beneath the cortex, and helps to bridge or connect different regions of the brain. White matter helps to propel information and to insulate cells and nerve tracts.

It developed from the back to the front, meaning the front part of your cortex is the most recent member or region of your brain to develop, evolutionally speaking. The cortex is primarily responsible for your most complex thinking abilities, including memory, language, planning, concept formation, problem solving, spatial representation, auditory and visual processing, mood, and personality. Processing in the cortex tends to be conscious and intentional. For example, the cortex is responsible for your reading this book at this very moment—your intent to educate yourself about brain health(Buy now from http://www.drugswell.com) is driven by your cortex.

The cortex is generally organized by four primary regions, or lobes: the frontal, temporal, parietal, and occipital (see Figure 2.2). Each of these four lobes has specific behaviors and functions primary to its region. For example, the frontal lobes are also known as the executive system since they help execute behavior, organize behavior, plan, conceptualize, maintain cognitive flexibility, and stabilize mood. Your personality is thought to reside in the frontal region of your brain. Your temporal lobes are the site of your auditory brain, memory and new learning, language, and perhaps religiosity. Your parietal lobes help you with orientation to space, memory, reading and writing, mathematics, and appreciation of left versus right. Finally, your occipital lobes help you to see, discriminate what you see, and perceive.

Subcortex

Sitting just under the cortex and on top of the ascending brain stem are a number of smaller and generally more primitive structures (relative to the cortex) known as the subcortex. Your subcortex primarily processes rote skills and procedures. Some, if not most, of the processing conducted in the subcortex is subconscious. Activities such as driving, dressing, typing, and most other routine tasks involve multiple rote procedures that are conducted at a subconscious level. Your subcortex and cortex are distinct regions of the brain, but they do not sit in isolation of one another. In fact, there are numerous connections between these two important brain regions. The brain operates as a symphony, with numerous and distinct regions harmonizing perfectly as one unit.

Left and Right Hemispheres

The second learning technique divides the brain “left to right,” appreciating that the brain is comprised of two distinct yet integrated hemispheres we call the dominant and non- dominant sides of the brain. We refer to these sides as hemispheres, and you have a left hemisphere and a right hemisphere (see Figure 2.3). Each hemisphere is connected by a bridge known as the corpus callosum. As you will learn in this section, each hemisphere has some distinct, yet not necessarily mutually exclusive, responsibilities.

Interestingly, your behaviors and functions are related primarily to one of these two hemispheres. For example, most of us—and nearly all right-handers—have language distributed primarily in the left hemisphere. We refer to the hemisphere in which language is based as the dominant hemisphere as a sign of our respect for the importance of language. Left-handers with a parent who is left-handed, a relatively rare phenomenon, have a higher probability than right-handers of having language functioning distributed primarily in the right hemisphere. They would be right-hemisphere dominant.

Your dominant hemisphere—left for most of us—also processes details, is task-oriented, logical, analytical, and sequences information. Most of Western civilization is built around the left hemisphere, as our classrooms are set up in rows and columns of chairs, and our cities tend to have tall buildings in rows and columns. We tend to focus more on the detail and less on the gestalt. Your non-dominant hemisphere helps you process non-language information, such as size, shapes, sounds, and space. Your ability to navigate in space, locate your car in a parking garage, or get home from a walk is an example of non-dominant function. Likewise, your ability to appreciate distinct sounds, such as a baby’s cry or a fire alarm, tends to be a process of the non-dominant hemisphere.

Your two hemispheres are connected by a bridge of cells referred to as the corpus callosum. Information crosses from one side of your brain to the other over the corpus callosum, and this is a critical part of your brain’s ability to remain so functional despite its many complex operations on a daily basis. Interestingly, the female brain is thought to have a larger corpus callosum, which underscores the notion that female brains process information differently from male brains. Females tend to utilize both sides of their brains more to process than men, who tend to rely primarily on one side, the dominant hemisphere. It is probably not coincidental that audiences across the nation always respond with the same answer to my question, “In what area of a common behavior do men and women struggle with each other on a daily basis?” The answer is communication, which you’ll learn more about in the chapters ahead.

Neurons

The operation and function of your brain is ultimately conducted by the millions of brain cells we refer to as neurons. A neuron (see Figure 2.4) contains a cell body sometimes referred to as a soma, a long arm extending out from the cell body referred to as an axon, and branchlike fi gures called dendrites that extend out into the brain environment seeking new information to relay back to the cell body.

Indeed, information from the cell body travels down the axon into the surrounding brain, while information from the environment is gathered by the dendrites and brought back to the cell body. This ongoing exchange of information by the brain is why we refer to it as the central information processing system.

We are taught that our brains contain millions of brain cells and that each neuron can communicate with another ten thousand neurons. Interestingly, one neuron never touches another neuron, but two cells may communicate via chemicals, and this chemical marriage is called a synapse. The more synaptic connections you develop over your life span, the health(Buy now from http://www.drugswell.com)ier your brain may be, because it is building up brain reserve. Brain reserve, as you will learn, may have the ability to delay the onset of neurodegenerative diseases such as Alzheimer’s.

The miracle is that your brain is dynamic and continues to be shaped and to develop. It has plasticity. As such, there is no finite capacity or limitation. In this way, your brain is very distinct and actually much superior to the fanciest of all computers because computers will always have built-in limitations and finite capacity. Your dynamic brain is shaped by environmental input across your life span, beginning in the womb. There really is no critical period of brain development, unless one considers life itself to be the measure. As you will learn in the next section, the type of environmental input your brain receives can make a difference regarding the health(Buy now from http://www.drugswell.com) of your brain. You do have some control, and this is great news!

Hippocampus

When I give lectures to the public, I always want my audience to personalize the message. This story is, after all, about you and your brain. It really does not get any more personal. Learning about oneself can be fun and challenging. There is one part of your brain that I emphasize because this structure, the hippocampus, is so critical to you and your life story. A hippocampus (see Figure 2.5) sits in the middle of each of your temporal lobes, which lie under your temples on each side of your head.

Your hippocampus, or hippocampi, for plural, as you have one in each hemisphere, takes new information in and maintains the information in a type of working buffer. If you believe the information is important and you need to store the information for an extended period of time, your hippocampus will transition the information to a specific area of your cortex. This process is not random, but rather very sophisticated, as the process of storage seems to be stimulus-based. That is, if you are learning information that is visual, your hippocampus will help store that information permanently in the visual cortex of the brain. The same process is thought to occur for the other four types of sensory input: sound, touch, taste, and smell.

Your hippocampi represent your vital learning and encoding structures, thereby helping you to build your life story and maintain your personal memories. Alzheimer’s disease, as mentioned in the previous chapter, is a leading cause of dementia, and the disease destroys very early the hippocampi of the brain. As a result, those afflicted with this terrible brain disease cannot learn new information, and they typically will repeat statements. As you will learn in the next section, your hippocampi are critical structures to brain health(Buy now from http://www.drugswell.com). Recent research suggests your hippocampi have tremendous ability, including new brain cell development referred to as neurogenesis.

Environmental Effects on Brain Plasticity and Reserve

We now believe that the human brain is shaped by our environment. This means that our brain will respond to everything that we do and all that is going on around us. Something as simple as a television show or a hug, or as complicated as screaming at someone or experiencing loss and grief affects the structure and function of our brain. This wonderfully intricate marriage between environment and brain function defines neural plasticity and enables us to consider what environmental input might be best to promote our own brain health(Buy now from http://www.drugswell.com). Your understanding of this simple fact and the power of neural plasticity permits you to engage in a proactive effort to shape your own brain across your life span.

Every day we have experiences that can teach us about the function of our brain and how environment and our brain have an important and ongoing relationship. I often say that the chemistry of our brains is altered all the time, but not with pills, syringes, or liquids. Instead, words may be the single greatest neurochemical activator, and messages provided to us by our parents have a particularly long-term effect. Other environmental stimuli, such as temperature, touch from another, pain, imagery on television or the movies, emotional events, news, victory and defeat, loss, and many others affect our mood and disposition, a result of neurochemical change. Such change then typically leads to behavioral change, and this is how we lead our lives. In short, environment shapes our neurophysiology and behavior every day.

It is important you learn about the power of your brain and how it can be shaped and nurtured over the course of your life. We refer to the dynamic, constantly reorganizing, and malleable nature of your brain as brain plasticity. Understand that your brain is not a rigid or static system with a limited capacity or finite critical period for development. The power of brain plasticity permits you to implement a lifelong and proactive program to grow and promote your own brain health(Buy now from http://www.drugswell.com).

Animal Brain Research: How the Environment Affects the Brain

To better understand why brain plasticity is important to you, we can look to some basic findings of animal brain research. In the 1950s, research was conducted to investigate whether environment had any effect on the structure and function of the animal brain. Researchers designed a study with rodents raised in two distinct environments: an “enriched” environment versus an “unenriched” environment. Rodents were raised in one of these two environments, and then their brains were analyzed and compared at autopsy. Results yielded signifi cant differences in the brains of these rodents. Specifically, rodents raised in an enriched environment had a larger cortex, more cellular connections, called synapses, that lead to brain reserve, and developed new brain cells, called neurogenesis, in the hippocampus, the structure critical to new learning and memory.

I became interested in this work, and I wanted to know how researchers defined an enriched environment. My review of this work suggests three factors were critical to the enriched environment: socialization (animals had to have other animals of their own kind in the environment); physical activity (animals had a running wheel to exercise on); and mental stimulation (there were toys in the environment animals could play and interact with). Animals raised in unenriched environments were raised in isolation, had no running wheel, and had no toys to play with. While this research offered highly signifi cant and important findings regarding the effects of the environment on brain structure in the animal, the critical issue of whether the same findings could be established for humans remained unknown.

When thinking about a proactive brain health(Buy now from http://www.drugswell.com) lifestyle, I believe the three critical factors of the enriched environment found in the animal studies are equally important to humans. Plenty of research supports the role of socialization, physical activity, and mental stimulation in reducing the risk of dementia in humans. However, the human organism is more complex than rodents and is stimulated by environmental input that is also more complex in nature. As you will learn in later chapters, my brain health(Buy now from http://www.drugswell.com) lifestyle recognizes the complexity of the human brain by including two new factors, nutrition and spirituality, in addition to the three factors established from the animal literature.

How Environment Affects the Human Brain

It was not until the late nineties that a landmark study discovered that the human brain has the ability to generate new brain cells. This study was a threshold moment for our species, as it confronted traditional thought that the human brain was a rigid system with no ability to regenerate. We had always believed the brain was born with all of its brain cells, that the human brain lost brain cells on a daily basis, and that our brains did not replace the lost cells with new ones. The study also indicated that the new brain cells were generated in the human hippocampus, analogous in animals to an area neurogenesis was found in the animal brain. Today, research is ongoing to determine if neurogenesis occurs in other regions of the human brain or if it is specific to the hippocampus.

New brain cell development is one outcome of a brain with plasticity. Remember, plasticity refers to a brain that is dynamic, constantly reorganizing, and malleable. The human brain, therefore, is now thought to possess the same type of neural plasticity as the rodent brain. Interestingly, the animal studies were conducted on rodents across their life span with an equivalent human age of seventy or eighty. A human brain that generates new brain cells mandates a curiosity of how this wonderful adaptive ability occurs. We can return to the animal studies to derive some answers to this question. The enriched environment led to new brain cell development in the hippocampus of the animal. The three critical factors important to the enriched environment in this study included socialization, physical activity, and mental stimulation. Therefore, it makes sense to ask if the human brain is similarly affected by environment and if the enriched environment promotes positive brain changes in the human.

As you will read in the next chapter, there is good reason to believe that the human brain benefits from a novel and complex environment. Similar to the enriched environment discussed in the animal research above, novelty and complexity infers stimulation that demands more of the human cerebral cortex and increases the potential for development of brain reserve. Stimuli that are novel and complex require the cortex to be engaged, as the brain has either not been exposed to the information before or it has not mastered the information. In contrast, passive, rote talents or overlearned information rely more on the subcortex and are not thought to be as brain health(Buy now from http://www.drugswell.com) promoting. It is also important to know that the first potential enriched environment is the womb and that the type of environment you expose your brain to will have consequences your entire life. The miracle of brain plasticity does not end at a particular age. Indeed, the human brain probably does not know its chronological age and will demand and benefit from enriched environments at every age. The major point of this section is that you are strongly encouraged and empowered to expose your brain to the novel and complex every day regardless of your age!

Enhancing Brain Reserve

Brain reserve is a well-known concept that refers to a buildup of brain cell connections that serves to assist the brain in the battle against neurodegenerative diseases. To better understand brain reserve, consider the following simple analogy that I use in my lectures on the human brain. Imagine flying in an airplane nearly a thousand feet above the ground. As you peer out your window down at the ground, you will see two very distinct scenes. The first scene is a jungle where there are so many trees you cannot see the ground. The second scene is an island with one palm tree blowing slowly in the wind. You want your brain to be like the jungle, the lush foliage symbolizing a tremendous number of synaptic connections. This is referred to as synaptic density and is a direct measure of brain reserve. You do not want your brain to look like the island with one palm tree. The reason is also simple. Think of Alzheimer’s or other types of dementia or brain disease as a weed-whacker: the disease will invade the brain and begin to cut down the neurons and synaptic connections. This occurs just like a weed-whacker cutting through the weeds around your house. If your brain looks like a jungle, filled with synaptic connections, it will take Alzheimer’s or another brain disease a long time to show its ugly clinical face. However, if your brain looks like the island with one palm tree, the clinical signs of Alzheimer’s will manifest quickly because there is no reserve to fight it off.

Indeed, some research has shown that even though brains are diagnosed with Alzheimer’s at autopsy due to the presence of neuropathological markers such as tangles and plaques, a significant number of these persons never demonstrated the clinical aspects of the disease in life. This is explained one way using the brain reserve concept. Perhaps people who never manifested Alzheimer’s in life, even though they had the neuropathologic characteristics in their brain at autopsy, had built up brain reserve to fight off or delay the onset of the disease.

The power of brain reserve to stave off the effects of Alzheimer’s is further supported by findings that relate higher education and occupational levels to lower risk of Alzheimer’s. For those with high education or occupation levels who do manifest Alzheimer’s, their disease begins to emerge later on than for those without this kind of background, and once the disease manifests, they die soon after. The theoretical reason for this is that when the disease presents clinically, it is already advanced into the final stage because the person’s brain reserve had been fighting it off.

Educational settings and workplace settings are good examples of environments that can be enriched. You expose your brain to these environments frequently across over the course of your life. Each of these two environments provides the opportunity for you to engage in a novel and complex setting that promotes the development of brain reserve. To the extent that these environments or other settings become rote and passive, brain reserve will not be as developed, and the overall health(Buy now from http://www.drugswell.com) benefit for your brain is not enhanced.

It is your personal challenge to expose your brain to novel and complex experiences and enriched environments on a daily basis. Studies suggest the earlier in life you begin to expose yourself to enriched environments, the greater the health(Buy now from http://www.drugswell.com) benefit to your brain—even well into your late life. This fi nding is supported by research that demonstrates that having a higher IQ in childhood and young adulthood reveals a reduced risk of Alzheimer’s and other brain health(Buy now from http://www.drugswell.com) issues later in life. Language development in young adulthood also reveals a reduced risk of neuropathologic changes in the brain, while those who have passive lifestyles in their forties show an increased risk of Alzheimer’s and other brain disorders later on in life.

Passive lifestyle is defined by a list of activities that do not require much in the way of cortical activation. One example on the list was television viewing, a behavior that tends to be rather mundane and nonengaging in most cases. Passivity can be thought of as using the subcortex primarily when we are engaged in routines, rote processes, and even subconscious behaviors. Active behaviors are more brain health(Buy now from http://www.drugswell.com) promoting because we are stimulating our cortex with conscious and complex thinking that helps to build brain reserve. Brain health(Buy now from http://www.drugswell.com) promotion is about the activation of the cortex through completion of tasks that are “complex and novel.”

These findings on humans support the idea that diseases of the brain that manifest late in life may actually begin early in life. Further, these findings suggest we can become involved very early in life with a proactive lifestyle that promotes brain health(Buy now from http://www.drugswell.com) and that helps to reduce the risk of Alzheimer’s and related dementias later in life. It is important to prioritize a proactive lifestyle for brain health(Buy now from http://www.drugswell.com) regardless of your age, to embrace the power of brain plasticity and development of brain reserve, and to have fun in the process of caring for your brain!

Reviewing the Brain Basics

You have now accomplished something you may not have thought possible: you have learned the basics of your brain. In

fact, you now know more about the human brain and yourself than the vast majority of other people. This new knowledge enables you to really appreciate the importance of a proactive brain health(Buy now from http://www.drugswell.com) lifestyle because you now can understand how what you do quite literally impacts the very structures and functions of your brain. Behavioral change is most likely to occur if one personalizes the message and is told why something will help him or her. You have personalized the message, and your new knowledge of brain basics enables you to move forward fully prepared for not only understanding the brain health(Buy now from http://www.drugswell.com) lifestyle but being able to apply it with great understanding.

Now that you have basic knowledge of how the brain works, you probably feel empowered and excited to learn more!

3

Adopting a

health(Buy now from http://www.drugswell.com)y Brain

Seeking Experiences That Are Novel and Complex

I am often asked if particular behaviors are good or health(Buy now from http://www.drugswell.com)y for the brain. As an example, people will ask me if the New York Times crossword puzzle is good for the brain. This is a good question because it tells me the person is thinking about his or her lifestyle and its potential impact on the brain. You most likely will have noted that I use the terms “novel” and “complex” to help you understand what types of behaviors or activities promote brain health(Buy now from http://www.drugswell.com). Your brain wants to be stimulated at every age, and we have already learned that the conscious behaviors that are processed by the cortex lead to a greater development of brain reserve, that which really represents brain health(Buy now from http://www.drugswell.com).

Novel means new and complex means hard. Ask yourself if a given behavior is complex and novel for you. If the answer is yes, then the behavior is most likely one that will be processed by the cortex and thus will help to develop brain reserve, promoting brain health(Buy now from http://www.drugswell.com). If the answer is no, the behavior is most likely rote or passive, processed by the subcortex, and therefore most likely not brain health(Buy now from http://www.drugswell.com) promoting.

The reason a novel and complex behavior or activity promotes brain health(Buy now from http://www.drugswell.com) is that the brain has not experienced the particular behavior. If a behavior or activity is actually new to the brain, there are very few neural circuits to facilitate the behavior. It is as if the region of the brain necessary to conduct the behavior is dormant and needs to be activated. An activity that is novel and complex is most likely one that is diffi cult for you, one that you do not want to do—at least at fi rst—and one that will make you feel inferior initially. However, as the brain practices that which is considered novel and complex, it continues to develop brain cells (building of brain reserve) necessary to produce the given behavior, and over time, a talent emerges. A person will describe this transition as “I am more comfortable with this,” or “I am getting the hang of this,” to really describe what is happening in the brain at the cellular level. The reason the person is feeling more comfortable is that the brain is developing more neurons to facilitate his or her ability to produce the behavior. Practicing novel and complex activity results in a neurophysiological process that not only permits a smooth execution of the particular behavior (now a talent) but also leads to building brain reserve!

On the opposite end of the spectrum, we can also choose activities that are rote and passive. Indeed, much of our time is spent on activities that are rote and passive. It is human nature to do that which we are good at and comfortable with, likely in part because the rote and passive is also easier for our brains, but unfortunately these activities do not use the cortex and do not result in development of brain reserve.

Adoption and implementation of a brain health(Buy now from http://www.drugswell.com) lifestyle requires you to make a conscious decision to welcome more activities that are novel and complex, to resist the passive and rote, and to realize that this will be hard and that failure will be a health(Buy now from http://www.drugswell.com)y reality. From failure will come success, and this can only occur with development of brain reserve. You’ve probably heard the phrase “No pain, no gain,” and the same is true for engaging in novel and complex activities to promote brain health(Buy now from http://www.drugswell.com).

Overcome the Automatic Resistance to Change Your Lifestyle

Your understanding of how and why the novel and complex leads to brain health(Buy now from http://www.drugswell.com) is a critical first step to adopting a brain health(Buy now from http://www.drugswell.com) lifestyle. However, once you understand the mechanics of how brain reserve occurs through stimulation of the cortex, it is also necessary to introspect and review your current lifestyle.

It is normal for all of us to engage in a daily routine that is highly procedural, predictable, and without much that is new. It bears repeating that when we engage in such a daily routine, we are relying heavily on brain structures and functions that do not facilitate development of brain reserve. Because our daily routines are so entrenched, we are not even conscious of them for the most part; we simply act. Our ability to make our behaviors conscious and to actually try and change our daily routines is a practical but difficult means to activate our cortex and to begin the process of building brain reserve. The first step is to become conscious of what we do every day.

Think about your daily routine—it will help you identify how much rote and passive behavior you have in your life. For example, most of us probably get out of bed, make some coffee or tea, get cleaned and dressed for the day, travel to work, and engage in the daily tasks of our occupation. Most of these behaviors are done at the subconscious level because they are so habitual. To change this routine, you fi rst must know what your routine is. You can then attempt to make some small changes, thereby creating a new set of behaviors during your day that will activate your cortex and promote development of brain reserve.

You might be surprised by what you discover, but remember, most humans are highly routinized animals by nature. The transition from the rote and passive to the novel and complex requires you to ask for each behavior, is this novel and complex for me?

Ask yourself the following questions: Can I sit at a different seat at my dinner table for the next seven days consecutively? Can I sleep on a different side of the bed for the next seven days consecutively? Can I survive moving the trash can in the kitchen? These questions are meant to have some fun, but they also raise the important point that change of routine is perhaps one of the most difficult challenges humans incur. If we cannot sleep on a different side of the bed, how are we going to be able to adopt a new diet or begin an exercise routine? These are a few simple questions that I pose to my audiences across the country to help them realize how hard behavioral change actually is. It may be the most difficult thing for us humans to accomplish, particularly if the change needs to be sustained over time. My contention is that behavioral change can occur, but we first need to personalize the message of change, and we need to know why we are changing a particular behavior.

You eventually want to fill your day with as many novel and complex activities as you can, though a good place to begin is to include one a day and build from there. This is the fundamental and personal process of building a brain health(Buy now from http://www.drugswell.com) lifestyle. The goal is to build brain reserve across your life span because this process is health(Buy now from http://www.drugswell.com) promoting.

Humans resist the transition from rote and passive to the novel and complex because it is hard. It places them in an uncomfortable situation, it is unpredictable, and it does not nurture the ego as failure occurs. The good news is that persistence can result in the novel and complex becoming rote, the uncomfortable becoming comfortable, the unpredictable becoming predictable, and even the development of the ego. It’s a great feeling to know that you have worked hard to master a particular activity that was difficult for you in the past. Remember, the lifelong process for brain health(Buy now from http://www.drugswell.com) is to continue exposing your brain to the novel and complex.

The fact that humans resist change is directly related to an increase in obesity, diabetes, and hypertension and is indirectly related to conditions such as stroke and dementia. It is well documented that lifestyle is perhaps the single greatest factor that we can control to improve not only our health(Buy now from http://www.drugswell.com) but our longevity. It is lifestyle and not any health(Buy now from http://www.drugswell.com) care system that contributes to health(Buy now from http://www.drugswell.com) versus disease and longevity versus premature death. We can cut premature death in half if we exercise, eat health(Buy now from http://www.drugswell.com)ier, and do not smoke. How can something sound so simple and yet be so hard to achieve? The answer is that humans do not like to change. It is difficult for us to change our eating habits, to engage in a consistent exercise routine, to slow down and reduce our stress, to create time for more socialization, and to engage in the novel and complex. Yet these are the fi ve domains of the brain health(Buy now from http://www.drugswell.com) lifestyle (nutrition, socialization, physical activity, mental stimulation, spirituality) that need attention and change in order to increase your chance of maintaining access to your life story!

Commit to a health(Buy now from http://www.drugswell.com)y Brain Lifestyle

An unfortunate reality is that unhealth(Buy now from http://www.drugswell.com)y lifestyles lead to diseases like obesity, diabetes, and brain-related health(Buy now from http://www.drugswell.com) problems, all of which increase the risk of stroke, dementia, and Alzheimer’s as well. The good news is that these conditions can be managed and even prevented by a health(Buy now from http://www.drugswell.com)y lifestyle. Lifestyle begins with an attitude that declares, “I am committed to a life of health(Buy now from http://www.drugswell.com)y choices.” You can become a champion of a proactive brain health(Buy now from http://www.drugswell.com) lifestyle and actually serve as a role model to others, particularly your children and grandchildren.

We already know about several basic preventative measures to take every day for brain health(Buy now from http://www.drugswell.com), like wearing a helmet when riding a bike, wearing a seatbelt when in the car, and being cautious with activities that have the potential to cause head injuries. But, in addition to these safety tips, research shows that brain health(Buy now from http://www.drugswell.com) is promoted by a lifestyle that includes stress reduction, consumption of antioxidants and omega-3 fatty acids, physical exercise, socialization, and exposure to enriched environments with the novel and complex. A conscious choice to review your current lifestyle and begin implementing change within each of these five domains to the brain health(Buy now from http://www.drugswell.com) lifestyle is critical. Additionally, lifestyle is proactive, energized, and lifelong. A lifestyle that promotes health(Buy now from http://www.drugswell.com) will be effective at any age, but the earlier you get started, the better the outcome. Your goal should be to make the brain health(Buy now from http://www.drugswell.com) lifestyle a routine in your life.

Adoption of a brain-health(Buy now from http://www.drugswell.com)y lifestyle can occur on an individual basis and on a more macro or societal basis. The individual basis is probably most important and most effi cient, as you have direct control over the change. However, every nation should consider prioritizing brain health(Buy now from http://www.drugswell.com) and implement policies that reinforce this priority. Now let’s take a closer look at the five critical areas for brain health(Buy now from http://www.drugswell.com) and what you can do to keep your brain young, fit, and sharp!

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The Five Critical

Areas of

Research-Based Approach: Identifying the Five Critical Areas

My health(Buy now from http://www.drugswell.com)y brain program is research-based, easily understood, and practical, as anyone can consider making changes to incorporate these activities into their own daily life. The other positive aspect of my lifestyle is that anyone can assess each of the five different lifestyle domains and understand which is a strength and which is a weakness, thereby providing a guide as to where the biggest change in behavior may need to occur. My program rests on the cognitive construct of brain reserve and the belief that neural plasticity affords the brain a wonderful opportunity to achieve health(Buy now from http://www.drugswell.com).

While my brain health(Buy now from http://www.drugswell.com) lifestyle is developed from a sound understanding of brain and behavior, cognitive science, and clinical research, I realize that a practical way to apply the lifestyle is in many ways most critical—you’ll find all of the practical strategies to implement this lifestyle in the chapters ahead.

The brain health(Buy now from http://www.drugswell.com) program that I offer you is unique in that it is lifestyle-based, comprehensive, and integrates many different research findings into one practical approach that is easy to adopt. My brain health(Buy now from http://www.drugswell.com) lifestyle was applied recently as part of a small pilot investigation with health(Buy now from http://www.drugswell.com)y independent older adults. This work was done together with Emeritus Assisted Living ( www.Emeritus.com) at a campus in the Boston region. I believe we were the first to launch a prospective lifestyle study on brain health(Buy now from http://www.drugswell.com) (Dr. Nussbaum’s Brain health(Buy now from http://www.drugswell.com) Lifestyle) and the first to propose a lifestyle that was comprehensive (including all of the five critical areas of brain health(Buy now from http://www.drugswell.com) and not just one).