- The Washington Times - Tuesday, March 4, 2003

Elderly residents in the Powhatan Nursing Home in Falls Church gather into groups to solve crossword puzzles projected onto a screen in their recreation area. It's part of the facility's regular activity program, which also includes Scrabble and other games involving concentration.
The activities "stimulate memory and thought processes," says Phyllis Crampton, director of the home.
The effort is a deliberate plan to draw on residents' various talents and abilities. The result is a sense of emotional satisfaction and accomplishment, which, in turn, can stimulate further interest in flexing mental muscles.
TV game shows such as "Wheel of Fortune" also "are a very big deal" at Powhatan, Ms. Crampton reports.
The home's approach is fully in line with research that says challenging the mind on a regular basis can improve the mental faculties in which memory plays a transcendent part.
Though often regarded as an abstract concept, memory the mental capacity to retain and recall facts, events and impressions is grounded in the physical makeup of the brain.
There are three types of memory long-term, short-term and procedural with different parts of the brain involved, Dr. Majid Fotuhi explains in his recently published book, "The Memory Cure: How to Protect Your Brain Against Memory Loss and Alzheimer's."
The hippocampus, for example, is essential for making new memories. The cortex that surrounds all the brain structures, including the hippocampus, stores old memories, among its other duties. All parts of the brain are interconnected and operate through the subtle interchange of minuscule electrical and chemical interactions.
"Memory is an integral part of all your daily activities," Dr. Fotuhi writes. "Everything you do requires either a memory of something you learned before or learning something new."
Citing documentation from the latest studies in the field of aging, the book is a message of hope and reassurance for laymen, especially aging members of the baby-boom generation alarmed by all the attention being paid to Alzheimer's and imagining worst-case scenarios for themselves.
Twenty years ago, Dr. Fotuhi notes in an interview, even doctors regarded memory loss as normal for people older than 65. It was assumed that senility was inevitable because of a loss of memory cells in the brain.
Medical science since has shown that the brain may shrink slightly with each decade, but the number of brain cells does not decline significantly. Synapses that connect the brain cells may occur less frequently and slow a person's ability to process information, but mental stimulation forms new synapses.
Dr. Fotuhi, 40, a neurology consultant at the Alzheimer's Disease Research Center at Johns Hopkins Hospital, says the best method for a person to increase the number of synapses in his or her brain is through mental and physical stimulation as early as possible in life.
His experience with patients in their 60s and 90s has taught him that people attentive to and involved in the world around them are less likely to develop memory loss or show symptoms of Alzheimer's disease.

Instead of being a sign of senility, memory loss can be a symptom of a psychiatric problem.
"A lot of people who have memory problems have depression," Dr. Fotuhi says.
"It doesn't make sense for people in midlife to worry about something in their 80s that may happen, especially when there are things they can do," says Dr. Fotuhi, who will speak on the subject Saturday at 4 p.m. at the Barnes & Noble store at 12th and E streets NW.
He doesn't deny that mild forgetfulness is a normal experience in aging, but he believes that with enough conscious effort, a person can forfend the worse effects. That attitude is shared by Dr. Gary Small, 50, director of the UCLA Center on Aging and author of another self-help book, "The Memory Bible: An Innovative Strategy for Keeping Your Brain Young."


Both men believe it is possible to reduce the risk of becoming an Alzheimer's victim just as it is possible to reduce the risk of a heart attack. In some cases, the regimen is the same: frequent exercise and a common-sense diet that controls hypertension and cholesterol.
"Several long-term studies have shown that what relates to the heart also affects the brain," says Dr. Fotuhi, who also is on the staff at Harvard Medical School.
Dr. Fotuhi's next book may be about what he calls the brain reserve: "The brain has the capacity to become more complex and sophisticated regardless of age," he says. "People once thought that learning and expanding the brain would happen only when you are a child. It seems now that middle age is a good time for the brain to develop. Biological evidence shows that this is possible."
People tend to think that if their memory is failing, their whole brain is weakening, he observes. "That is not the case. The brain has many functions, only one of which is memory."
Dr. Small underscores the mental benefits of physical and emotional well-being and includes practical techniques "mental aerobics," he calls them that he says will improve memory skills.
He is particularly concerned about the harm to the body from stress and its effect on brain and cognitive processes, and he cites a study showing how prolonged exposure to stress hormones adversely affects the hippocampus memory center in laboratory animals.
"How our emotions motivate us to act has a significant impact on keeping our brains young," he writes.
His advice to people for reducing stress is a familiar one: meditation, yoga or physical exercise. Exercise stimulates endorphins, the body's natural anti-depressant hormones.
Dr. Small scoffs at "photographic memory." He believes people claiming to have such an asset simply have what he says are better "coding" techniques. The memory's filing and storage systems work best when there is meaning attached to the information, he says.
His method of improving one's skills relies on the process of "active observation," summarized in three code words: "Look, Snap, Connect."
Dr. Fotuhi prescribes what he calls a "10-Step Memory Protection Plan," weighted heavily on the side of improving one's physical health.
He is very strict about his diet and makes a habit each day of eating fresh fruit for breakfast and lunch and then a piece before dinner "just for the fun of it" and because "it keeps you from overeating."
"You cannot overdo this," he says. "I can't imagine anyone getting sick or coming to the hospital after having too much fruit, although ideally one should eat different kinds."
In a study with young and middle-aged rats, he says, when the middle-aged rats got blueberries, "they acted more like young rats. It was surprising that it made such a difference."
The same rules apply to his advice about exercise.
"Just 30 minutes a day, two or three times a week, the more the better. As long as you do something, make it a priority. It adds up. There are no miracles, but I am convinced these things make a big difference over the decades."
He feels equally strong about telling people to "find games that stimulate the brain."
Engage in pastimes that employ thinking, such as chess or poker or learning a new language, he recommends. Do something fun such as crossword puzzles or a dance class that requires you to remember movements.
His favorite activity of this kind is playing chess with someone "a little above my level."
Speaking from his UCLA office, Dr. Small is somewhat more relaxed about his own health-maintenance plan. It includes vitamin supplements and a casual walking routine. "I like to eat fish and avocados, but I don't always have time," he says. "I try to get on a treadmill, but ordinarily only take stairs. There is only so much you can do."

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