5. y first encounter vast, developing market of baby
with the cheery, boomers fearful of losing their
bespectacled minds and memories to the
Japanese brain awful, incurable Alzheimer’s
expert Dr Ryuta disease.
Kawashima is not Kawashima’s Brain Training:
a happy one. I do all he politely How Old Is Your Brain? game has
asks, as quickly as I can, and already sold more than 5 million
after a few minutes his verdict copies worldwide since its
is delivered: I have a brain age launch last year, including more
of 70. than 35,000 in Australia since
Since I’m actually a few going on sale in June. With a
decades younger, this is not stylus to write on the computer’s
encouraging. But it’s hard to screen and voice-recognition
argue with Kawashima, since technology, the game claims
he’s just a disembodied head to determine your “brain age”
bouncing across the screen of and then provide exercises to
the Nintendo DS handheld lower that score. The optimum
computer games console. Later is 20, the age at which the brain
I share the news with the head is supposed to be sharpest. Do
of Alzheimer’s Australia, Glenn that, claims Kawashima, and it
Rees. “Well,” he says gloomily, will help ward off dementia.
“that was better than I did.” Kawashima is no invention of
All may not be lost. Just like the Pokemon crowd at Nintendo
a bulging belly can become a - he’s a Japanese neuroscientist
rippling six-pack and a wrinkled who has published studies on the
face can be Botoxed smooth benefits to Alzheimer’s patients
again, so new evidence suggests of brain exercises, as well as
the brain can also be buffed self-help books that have sold
and toned despite advancing millions. The game includes a
years. Nintendo’s computer variety of counting and memory
game is an early foray into a exercises: how many words from
Article Reprinted from: December 2-3 2006 / Thehe eekend Australian Magazine 3
Article Reprinted from: December 2-3 2006 / T WWeekend Australian Magazine
6. a list of 30 can you remember, how fast
can you count the syllables in a sentence,
how accurately and quickly can you do
100 simple sums? Nintendo sees the game
stimulating a new market; Kawashima
says it stimulates the prefrontal cortex - the
bit of the brain that gives us an upright
forehead, and which is linked to creativity,
self-control and communication.
For the brain age check, I have to call
out the colour of the words the computer
flashes up. This is known as a Stroop test,
and there’s a trick to it. The word may
say “blue” but be written in red. The
correct answer is red, but your natural
response is to read the word and say
“blue”. The computer measures not just
how many you miss, but how quickly
you do it. And, admittedly after a few Producing a bigger “brain reserve” can ward off dementia,
says neuroscience researcher Dr Michael Valenzuela.
problems recognising my voice, Dr K’s
program is telling me my brain is 70! That’s also the view of associate professor
Am I doomed already? Not at all, insists Michael Woodward, medical director of
the real Kawashima by email. “TRAIN aged care at the Heidelberg Repatriation
THE BRAIN!!” It’s increasingly the cry, Hospital in Melbourne and a national
as around the Western world Alzheimer’s expert on the disease: “I think anything
looms as one of the great unsolved medical that provides a mental stimulus to the
challenges for a population that is living brain can help form new connections
longer - and therefore is more susceptible between the brain cells - synapses - and
to degenerative brain disease. there’s increasing evidence that the more
First described by Dr Alois Alzheimer synapses we have, the more protection we
a century ago last month, there is have against Alzheimer’s.”
still no cure, although there are some There are plenty who hope to make
hopeful developments. Kawashima’s money from the idea. Nintendo also sells
own studies show big improvements in Big Brain Academy, Sony has developed
the communications and social skills of PQ: Practical Intelligence Quotient, and Posit
Japanese dementia patients whose brains Science in the United States has the Brain
were exercised by reading aloud or doing Fitness Program. There’s also a growing
simple arithmetic for 20 minutes a day. number of internet websites where, for
But does the “use it or lose it” strategy a fee, members can use computer-based
really work? “I think there’s cautious exercises claimed to supercharge their
optimism that they can make a difference,” brain cells. There’s Mybraintrainer.com,
says Rees of the games, adding that Nintendo Happy-Neuron.com and Brainbuilder.
has provided the association with a donation. com, among others. And real brain gyms
Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
7. with computers instead of exercise bikes - of the brain’s cognitive functions, such as
already dubbed “neurobics” - are starting memory, attention and problem-solving.
to appear in Australia. “And my own memory’s failing as well,”
It will be great news if it works, because Fairhall says. “I’ll decide to do something
dementia is a massive and growing and then forget what it was I’d decided to
problem, with Alzheimer’s the most do. It’s more minor things. I’ll plan to lock
common form. Fatal over about eight a window and when I get into the room,
years, it robs its victims of memory, reason I think, what am I here for?” But he did
and even their ability to eat for themselves. remember his wife had told him about the
Usually a disease of older age, dementia forum, and he’s hoping to learn something
strikes one in 15 Australians over 65 and useful. He does. Fairhall believed that
one in four over 85. As the average lifespan nothing could ward off dementia, but
rises, and more move into that older group, some scientists are convinced that quite a
the 210,000 who now have dementia is lot can be done to lower your risk.
expected to double by 2030. To begin, the crowd is introduced to
But old age alone isn’t the problem. some basics about the way their memory
Research also shows a surprisingly strong actually works. With three stages - encoding
link between aerobic fitness and a healthy information, storage and retrieval - trouble
heart and a healthy brain. The high-fat can arise if any stage fails. Then there is the
Western diet and sedentary lifestyle that short-term or working memory and, when
produces high cholesterol, high blood information is repeatedly used, the long-
pressure, coronary disease, obesity and term memory. They also get a crash course
Type 2 diabetes is also believed to be in the brain’s structure, with one area
contributing to more dementia. In health attracting special focus: the hippocampus,
terms, it’s the perfect storm. It means shaped like the tail of its Greek namesake,
Kawashima alone can’t solve the problem. the seahorse. This small, central part of
M
the brain is crucial to memory, transferring
EMORY IS VERY MUCH ON THE MINDS OF information from short-term to long-term
the 400 people who have jammed files. It’s like a sorting centre, moving
into the Eastern Suburbs Leagues things back and forth until they become a
Club in Sydney for a free forum memory.
headlined “Train the Brain”, organised “It’s the first to go with Alzheimer’s
by the University of NSW and Prince of disease,” says Dr Michael Valenzuela,
Wales Hospital. Another 200 have been a neuroscience researcher whose work
turned away, and the call goes up for those with University of NSW colleague
with seats to give them up to anyone over Professor Perminder Sachdev earned him
85. Not that the crowd is especially old, a prestigious Eureka Prize for medical
with many in their 50s. research this year. Valenzuela, born here to
Watching closely is 55-year-old Lloyd Chilean parents, trained as a psychologist
Fairhall, a keen-eyed man hoping to find specialising in older people before moving
an antidote to a dodgy memory. Several into medicine and then research.
members of his family have had dementia Now he tells the crowd that there’s
- the general term for the degeneration good news. Analysis of 22 earlier studies,
Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
8. THE BRAIN TRAINER QUIZ
1. If you turn your gloves inside-out and swap hands,
will the palms of the gloves be against your palms or
the back of your hands? covering 29,000 people, found that
2. Looking in the mirror, I notice that the clock on the boosting mental activity halved the
wall behind me appears to be saying five to two. What chance of developing dementia. And, he
time is it? adds, studies showed mice put into an
3. How many minutes before noon is it if one hour ago environment rich with puzzles, activities
it was twice as many past 10am? and other mice for socialising experienced
4. Two clocks are set at noon. However, one gains five a 50 per cent cut in the chemical signs
minutes every hour, while the other loses five minutes of dementia in their brains. The extra
every hour. How many hours will it take for the clocks stimulation produced more brain cells and
to read the same again?
pathways for information, and maybe also
5. If Jack is older than Kyle, and Kyle is younger than slowed the march of the disease itself.
Marie, but Marie is not as old as Scott, who is the
same age as Jack, who is the youngest? Later, over lunch, Valenzuela runs
through how he and colleagues produced
6. Which four-letter English word reads the same
backwards, forwards and upside-down? their stunning finding that the brain can be
trained to build defences against dementia,
7. There is a 10 per cent mortality rate with Major
Croak’s operations. If two soldiers are tracked at by producing a bigger “brain reserve”.
random from his ranks, what are the chances that The first step was to do a complex analysis
both will die in his service? of existing research to see if there was a
8. Which are the next three numbers in this sequence: common theme. They found that increased
100, 93, 86, 79, ... ? mental activity slashed risk by 46 per cent.
9. I married my boyfriend, we had such fun; our But that very general finding gave no
happiness grew when we had a son. If our son’s father clue as to what was going on in the minds
is Roy’s first boy, what relation am I, then, to Roy? of people who appeared to be benefiting.
10. If it takes six elves one hour to fill four sleighs with So the researchers took a group of older
toys, how long will it take one elf to fill one sleigh? healthy people and gave half of them
Which is the odd one out in each of the following? five weeks of memory exercises. Using a
brain-scanning technique called magnetic
resonance spectroscopy, they checked
1]
whether the exercises produced significant
A B C D E
changes to the brain’s chemistry.
Mostly they did not. But in the
hippocampus something was going
2]
on, with increased levels of a chemical
called phosphocreatine. This was doubly
A B C D E
interesting. “First, memory problems begin
in the hippocampus,” says Valenzuela. “So
3] it makes sense that practising a memory
A B C D E
exercise will stimulate some kind of change
in the memory area. Phosphocreatine was
interesting because in animal studies, it
was protective of neurons; it protected
4]
them from dying off under stress.”
COMPILED BY THERESE MOODIE-BLOOM
A B C D E
2 LINES; C IS 2 ARCS 1 LINE)
THE RIGHT OF THE BLACK TRIANGLE ON THE OTHERS) 4.C. (OTHERS ARE 1 ARC,
2.D. (BOOMERANG IS BLACK ON THE LHS IN THE OTHERS) 3.D. (BLACK DOT IS TO
Reprint from Dec 2-3 ‘06 The Weekend Australian Magazine
SAME TRIANGLE IS ROTATED IN THE OTHERS, BUT B HAS BEEN FLIPPED OVER)
8. 72, 65, 58 9. DAUGHTER-IN-LAW 10. 90 MINUTES. SHAPE ANSWERS 1.B. (THE
ANSWERS 1. PALMS 2. 5 PAST 10 3. 20 4. 72 HOURS 5. KYLE 6. NOON 7. 1 IN 100
9. S
O EXERCISING THE BRAIN SEEMED TO TRIGGER year study of stroke victims led by Brodaty
increased production of a protective and Sachdev, reinforced that idea. That
chemical - but did it make new brain showed that the memory centre - the
cells, or new connections? With 100 hippocampus - shrank at just half the
billion neurons, the number of connections rate in older, mentally active people as
in a human brain runs to about 100 trillion those who weren’t mentally stimulated. So
- which according to experts provides the Kawashima’s game ought to help?
brain with more pathways than there are Maybe not. Valenzuela fears games aren’t
atoms in the universe. the solution because they’re too narrow
Alzheimer’s clear-fells in this neural and likely to be short-term. He stresses
forest, producing deadly deposits known as the key is to have fun and do something
“plaques” from a protein called amyloid. that involves long-term social, physical
Creating more connections might give and mental activities. Learn to sail, he
the brain more options in the event of advises, take up Tai-chi, tango dancing
Alzheimer’s. It wasn’t possible technically or learn a new language. “If you want to
to see if the exercises made this happen get a benefit, you’re really going to have to
in people, although it had with mice. sustain it for the rest of your life,” he says.
“Greater mental activity, social activity
and physical activity means your chances of
reducing risk are better.” DR MICHAEL VALENZUELA
I
But Valenzuela thinks these new cells T’S A DREADFUL THING TO SEE DEMENTIA AT
and pathways are being produced. And work. This is not a disease that strikes
the evidence that this could help ward off quickly, like flicking a switch. Instead,
dementia comes from studies showing that the light dims gradually over time
not everyone whose brain is attacked by before flickering and fluttering, offering
Alzheimer’s loses their mind or memory. fewer and briefer glimpses of a mind
In fact, autopsies have shown that up covered by deepening shadow. For those
to 30 per cent of people whose brain of us forced to watch, the overwhelming
contained significant cell damage typical feeling is of powerlessness. I recall one
of Alzheimer’s showed no obvious sign particularly awful moment in my own
of dementia in life. How is this possible? father’s gradual submission to dementia:
Valenzuela thinks it’s evidence that some there he was, banging on the other side
people have a “brain reserve” that allows of the door, pleading with me to come
them to compensate for the damage. Some back. And there was I, sneaking out after
people have more natural brain reserve - an hour spent walking and talking, at the
but anyone, at any age, ought to be able hostel that had become a prison to prevent
to build it up with enough stimulating him wandering off. “Roy, Roy, come back,”
exercises, he thinks. he called desperately through the door.
A second result, stemming from a five- I wanted to shout the same thing to the
Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
10. SO HOW DID YOU SCORE?
Brain Training. A noisy characters - it’s more
TV interfered with the learning and honing your
results. “I ended up with a skills. I normally play
brain age in the 80s. So I games with first-person
switched the TV off and did shooters and RPGs (rocket
it several more times and propelled grenades) and
got my brain age down to stuff. So it’s nothing like
the 60s, 50s and the 40s. it - you’re doing maths
It’s a great idea - it’s a real questions and reading
DEANE HUTTON (65) hook that gets people in, GAVIN STEWARD (19) aloud and stuff like that.
PRESENTER if they think they have a TAFE STUDENT I did the 20 calculations
chance to improve on their in 19 seconds. No, I don’t
Hutton fronted the Curiosity score. It is training part of “When I started I got have any problems with my
Show for 18 years and your brain ... but there’s 24 - and I did it again memory. I’d like to think
now appears on The New so much more in brain today and I got 24 again. my brain’s in good shape.
Inventors. “I found it so training such as making So that’s all right. The But it did say to me,
addictive that I flattened comparisons, judgment, game’s different to what ‘You’re under 20 so take
the battery,” he says being curious, asking you expect in a normal the results with a grain
of playing Nintendo’s questions.” game. It’s not, like, with of salt.’”
man whose name I share. having forgotten the purpose of that switch
The disease was taking him rapidly away. on the wall. And a CD player I bought him
It had stolen his independence and was to play some relaxing music proved useless
now eating away at his memory, although when he couldn’t remember how to turn it
he still knew me back then. Just by being on.
there, I had taken away some of his fear. One weekend I took him to the beach.
And now I had to leave. I could do nothing, On the drive there, I was disconcerted
knowing his condition was irreversible. to hear him say how he’d recently been
The best I could hope for at that time talking with one of his sisters in his house,
was for a speedy progression past that even though he’d not seen any of his
stage of fear and anxiety, a time when he family since leaving England in 1965. And
seemed to know something was wrong but then, tired by the effort of keeping him
probably no longer remembered what it comfortable, I agreed to his suggestion he’d
was. I comforted myself with the thought like a walk along the beach. Like an idiot, I
he’d forget his distress, and forget I’d been blithely watched him head along the sand
there. But I’m not sure it works that way. from the balcony of the apartment, and
I’d sensed something was wrong when his suddenly realised what I’d done: he’d never
landlord called me about late payments of remember where he’d come from. So I ran
rent. He’d simply forgotten to make them. after him, and eventually found him by a
Problems handling money are often the nearby road.
first signs of dementia. We moved him into That was about eight years ago. He’s
new accommodation where he didn’t have long forgotten my name, or how to speak.
to worry about money, but that proved These days he spends much of his time
hopeless too. sleeping. He can no longer eat by himself,
He’d unscrew the light to turn it off, so on one recent visit I fed him instead of
Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
11. the nurse. He hadn’t lost his appetite, at
least. But inside his head, the brain had
been shrinking, the neurons dying, and the
pathways clogged.
ON THE BRINK
•
Might he have been helped by using
his brain more, a new hobby, even by Even if your brain can bench-press a Mack
arithmetic and reading aloud? For my truck and arm-wrestle a supercomputer,
father, it’s too late to know, but for others it can’t stop Alzheimer’s disease progressing if it
some doctors believe there is hope. starts. The only real protection is to halt the spread
Neuropsychologist Nicola Gates of dying brain cells- and a group of Melbourne
is one of them. An absence of long- scientists think they may have found a way.
term trials proving that brain training “If you’re a mouse [with Alzheimer’s-type
can ward off dementia hasn’t stopped dementia], we can basically make you normal now,”
her opening a brain gym in Sydney’s says Professor Ashley Bush. For humans it’s more
uncertain. But within a few months Bush and the
Mosman. HeadStrong Cognitive Fitness
team from the Mental Health Research Institute of
is bankrolled by investors who see a strong Victoria should have a pretty good idea if they’ve
market in Sydney’s well-heeled but ageing hit on one of the great medical breakthroughs.
suburbs, and fronted by Gates who brings
Melbourne firm Prana Biotechnology, with Bush
the professional experience and academic as chief scientific adviser, is set to trial a new
training. In her late 30s, Gates has been drug called PBT2 in people in the early stages
working with brain injury victims for the of Alzheimer’s disease in Europe after seeing
past 13 years, citing that as proof the brain sensational results in mice genetically engineered
can rebuild. to be comparable to a human with Alzheimer’s.
The first clients begin their mental “It was breathtaking,” says Bush. “The mice get
exercises this month. Gates insists her returned to absolutely normal behaviour within
computer-based exercises are grounded days, so it really looks like a detoxification. Getting
in scientific research and backed by New them to recover ... was not really contemplated as
being possible.”
York specialist Dr Elkhonon Goldberg, a
pioneer of brain gyms. “You go in and The mouse studies showed PBT2 can block
complete tasks that target brain function and even reverse the disease, “but even more
importantly it can dramatically improve the memory
such as processing speed, verbal fluency, and cognitive function of the mice.”
and new learning capacity,” she says.
Gates says until recently doctors Bush’s theory on the cause of Alzheimer’s has
been 16 years in the making but is not shared by
believed the brain could not regenerate, most international experts. He and other Australian
and that advancing years meant inevitable scientists working on the project argue it’s the
deterioration. “Now you can increase result of a failure of a protein called amyloid to
your functioning rather than accept that properly manage key metals zinc and copper in
with age you’re going to be slower, more the brain.
forgetful,” she says.
“In fact, there’s a lot to be said for older
brains that has been missed in our general
celebration of youth.” All that accumulated
knowledge means older people can
Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
12. solve problems at a deeper level, and that is the same sort of high-fat
while being less impulsive and menu that has produced a surge of
better focused. She acknowledges obesity and Type 2 diabetes.
Valenzuela’s point that mental So significant are the risks
exercise is not enough, and says her from high blood pressure and
clients will also be asked about diet cardiovascular disease that
and exercise, and may be directed Professor Ralph Martins, director
to a dietician or local fitness gym. of the Centre of Excellence for
But how can she be sure it will keep Alzheimer’s Disease Research and
dementia at bay? “That’s what the Care in Western Australia, believes
research consistently indicates,” she physical exercise may be more
insists. “The question is not whether beneficial than mental gymnastics.
to do it; the question is how often One theory, since the brain is a
to do it, and how much benefit.” voracious consumer of oxygen in the
blood, is that better blood flow just
makes for healthier brain cells. But
Martins says it is more complicated.
He is now studying four groups of
people - those who increase physical
exercise, those who increase mental
exercise, those who do both, and
those who do neither - to see which
is most effective.
Some studies have shown aerobic
fitness reduces the amount of
shrinkage in the brain in old age.
“There’s a lot to be said for older brains,” And Martins says there’s evidence
says Nicola Gates.
that increased physical activity
Even if that is right, a sharp brain also boosts the production of high-
doesn’t look like being enough. In density lipoprotein - HDL - which
the past few years, poor physical mops up cholesterol from the blood.
health and diet have come to be seen New evidence from his laboratory
as direct contributors to memory suggests HDL may also lower the
trouble. There are no magic foods, level of the main killer of brain cells
although some experts recommend in Alzheimer’s, the amyloid protein.
small amounts of alcohol - one to But how much exercise, and which
three drinks a day, especially red type, remains uncertain. Martins
wine - fish, Vitamins E and C, recommends walking 4-5km about
folic acid, and anti-oxidants. More five times a week.
important is what you shouldn’t eat,
10 Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine
13. C
LEARLY, IT’S AN IMPRECISE increase activity in a wide area of
business. And maybe, as the brain, that probably increases
argued by US neuroscientist synapses, and increased numbers
Timothy A. Salthouse of the of synapses probably protect you
University of Virginia, it’s more an against the amyloid and other
“optimistic hope” than hard science. causes of Alzheimer’s.”
In March, Salthouse published a long That’s gratifying, since Kawashima
review of the scientific papers on has been working me hard,
the subject in the journal Perspectives counting how many syllables I read
on Psychological Science. He found no each second, testing my memory
convincing evidence that mentally of lists of words and numbers,
stimulating activities prevented the and demanding I draw pictures
brain’s decline in older age. That of koalas and kangaroos on the
was his professional opinion, he screen. “What wonderful results!”
wrote, but “my personal view is that his bouncing head tells me after a
people should behave as if it were particularly speedy bout of simple
true”. Mental exercise did no harm, maths calculations. “I may start to
was fun, and “if you can still do it, cry here!” He tells me my brain age
then you know you have not yet has come steadily down, after that
lost it”. rocky start, to below 40. Good, but
Michael Woodward of the nowhere near the optimal 20.
Heidelberg Repatriation Hospital And in any case, does my better
agrees there’s no absolute proof memory for lists and quicker
you can delay Alzheimer’s. “All that maths add up to anything other
you’re hearing about prevention than exactly that? From his office
- this mental and physical activity at Tohoku University, Kawashima
- at this stage has not been tested,” is supremely confident that all this
he says. “It’s all just associations, so work is warding off Alzheimer’s
you can’t be sure it’s preventive. It’s “100 per cent!” the 46-year-old tells
a chicken-and-egg phenomenon: me in an email. The evidence, he
is it because people who are prone insists, is concrete.
to Alzheimer’s are less likely to be Still, Kawashima’s own approach
physically or mentally active, or is it to life seems to back the idea that the
because people who are physically best strategy for a well-buffed brain
or mentally active are preventing is a broad range of activities, rather
Alzheimer’s? We don’t know the than hunching over a computer
answer.” screen. Does he play Brain Training?
Still, he says playing more “No,” he says bluntly. “I am too
mentally stimulating games makes busy to play games.”
sense. “Games like the Nintendo do
This article was written by The Weekend Australian’s staff writer Roy Eccleston.
Article Reprinted from: December 2-3 2006 / The Weekend Australian Magazine 11
14. Mind your Mind®
Alzheimer’s Australia’s dementia risk reduction program
In 2005, a panel of eminent geriatricians The Mind your Mind® program includes:
and psychogeriatricians led by Associate
Mind your Brain
Professor Michael Woodward examined
When the mind is active, the brain
the national and international scientific
is protected.
literature to identify dementia risk
reduction strategies. Mind your Body
Exercise regularly – your brain will love it.
Studies of large groups of people showed
that those who adopted ‘brain-healthy’ Mind your Diet
lifestyles at mid-life may have a reduced A balanced diet promotes brain health.
risk of developing dementia.
Mind your Social Life
Mind your Mind® aims to encourage An active social life is good for the brain.
people to adopt healthy lifestyle habits
that may protect against decline in Mind your Health Checks
thinking and memory abilities as they age. Regular health checks are important for
brain health.
The simple brain-healthy habits in the
program can improve your health and Mind your Habits
lower your risk of heart disease, stroke, Stop smoking and don’t abuse alcohol.
diabetes – and dementia. Mind your Head
Wear a helmet when appropriate.
What is dementia?
Dementia is a general term to describe Alzheimer’s Australia gratefully
problems with progressive changes in acknowledges the support of
memory and thinking. Alzheimer’s disease The Australian News Ltd.
is the most common type of dementia.
Dementia can happen to anybody, but it
For more information:
becomes more common over the age of
www.alzheimers.org.au
65, and especially over the age of 75.
National Dementia Helpline 1800 100 500
Early signs may not be obvious – only a
doctor or specialist can properly
diagnose dementia.
15.
16. National Dementia Helpline
1800 100 500
www.alzheimers.org.au
Mind your Mind® is generously supported with funding from