Tuesday, November 16, 2010

Brain Plasticity in Older Adults: You Can Teach Old Dogs New Tricks

Our brains can continue to grow at any age. One of the startling revelations of the 21st century is the improvement in our knowledge of nerve cell development among older adults. Known as neurogenesis or brain plasticity, this new knowledge is showing us that the brain has the ability to CHANGE throughout life by forming new connections between brain cells, and to alter function. For a long time, it was assumed that as we become older, the connections in the brain became fixed, and then it was just a matter of time that we started “losing” brain cells. However this assumption is being aggressively challenged by recent studies showing that the brain never stops changing.

This evidence comes from a number of different observations. In a study of London taxi drivers who are learning some 25,000 streets, researchers found that compared with bus drivers (who had a fixed route), taxi drivers’ brains changed, with more brain cells growing in one part of their brain that is related to knowledge of maps. This study shows that the brain is an active neurological mechanism and not just a warehouse for cells. The brain is more than a reserve gas tank, switching from tank A to tank B, but has ‘plasticity’, a flexibility that can change the capacity and function of specific areas.

Plasticity can also be observed in the brains of people who speak more than one language. It appears that learning a second language is possible through functional changes in the brain: the left back part of the brain is larger in bilingual speakers than in the brains of those who just speak one language. Differences also occur in musicians’ brains compared to those of non-musicians. Brain volume was highest in professional musicians, intermediate in amateur musicians, and lowest in non-musicians in several brain areas. Finally, extensive learning of abstract information can also trigger some changes in the brain. By looking at the brains of German medical students three months before their medical exam and right after the exam, then comparing them to brains of students who were not studying for exam, students’ brains showed changes in regions known to be involved in memory retrieval and learning.

This growing evidence is popularizing the idea that the adult brain is more malleable than assumed and that it can regenerate throughout life. Decreased mental capacity is something that occurs through physical and functional changes in the brain. It can be avoided and even reversed through a variety of environmental enrichment activities, including physical and mental training exercises. The secret is to challenge the brain, to do novel and stimulating tasks that do not rely on established ways of doing things.

A number of new computer programs can help accomplish this. San Diego County is lucky to have a community college system for older adults that offer these programs for free. Working with Pat Mosteller, SDSU gerontology program is looking at how effective these programs are among older adults of different ethnic backgrounds. Other novel things you can do independently—start writing with your opposite hand, learn an exotic language, listen to bird songs and figure out what birds they are, learn to play an instrument, or learn mathematics.

Hopefully we will be able to show that we can teach old adults new tricks after all.

Mario Garrett PhD is a professor of gerontology at San Diego State University. He can be reached at mariusgarrett@yahoo.com © Mario Garrett 2010

Aging in Place: How to Continue Living at Home

The quest for independence is a constant motivator in life. From the time we learn to walk, to driving our first car, to buying our first home, we strive to become and remain independent—a characteristic that does not change with age. According to research by the American Association of Retired Persons (AARP), 9 out of every 10 older adults want to stay in their own homes as they age. However, “aging in place” is often made more difficult because of health care needs. Despite a need for day-to-day assistance, however, most (82 percent) would prefer to stay in their homes. Only a few express a preference for moving to a facility where care is provided (9 percent) or for moving to a relative’s home (4 percent). A recent survey MetLife Mature Marketing Institute showed that 91 percent of pre-retirees, age 50 to 65, responded that they want to live in their own homes in retirement. Of that group, 49 percent want to stay in their current homes.

This unplanned phenomenon, of individuals aging in place, is having a radical effect on the composition of some neighborhoods, especially in San Diego County. A recent study undertaken at SDSU by Maurizio Antoninetti, looking at Naturally Occurring Retirement Communities (NORCs)--which is a clustering of households with aging residents--shows that although we have a number of communities that are rapidly aging, only a few of these NORCs have any supportive services that will enable aging in place.

Living in a house which is not designed for frail older persons is the primary cause of falls among older adults. Falls are the leading cause of injury-related visits to the emergency room in the U.S. and the primary cause of accidental deaths (75 percent) in older people over 65. Each year, more than 12,000 older adults in San Diego County arrive at the hospital after a fall. You are more likely to fall if you take four or more medications, have foot problems, get dizzy, have problems seeing, or have trouble walking and getting around.

Despite this statistic, living by one’s own rules is a key reason for staying in one’s own home, with 42 percent of seniors choosing it as one of their top three considerations. But how realistic is this? A recent survey by The SCAN Foundation in California reported that “. . . should they need long-term care, many working Californians are only a month away from economic crisis.” While most pre-retirees expect they will be able to live independently during retirement; relatively few (14 percent) expect they will need day-to-day assistance. Although the idea of getting older is on the minds of most, adult children are more likely to think their parents will become dependent and need their help then their aging parents themselves.

Aging in place is possible only with planning, and even with the best laid plans, older adults need to entertain the idea that aging in place is but another life stage and that we still need to discuss all the options for all eventualities. Discuss with your loved ones how you would like to live if you become dependent. Who has access to your money, your personal items? Who should be in charge of your hygiene? Talk with alternatives for end-of-life, explain what you want. These are tough issues to bring up. Growing old is not for sissies.

Mario Garrett PhD is a professor of gerontology at San Diego State University. He can be reached at mariusgarrett@yahoo.com © Mario Garrett 2010