Monday, July 20, 2015

MINDFULNESS, WORD GAMES AND DEMENTIA

I turned 60 in March. In some ways I can’t believe I've made it to 60. Until I gave up drinking some 15 years ago I drank enough alcohol for 3 or 4 lifetimes. And I smoked a hell of a lot too until I gave up smoking some years ago. And I suffered from clinical depression for many years as well. I could go on. My major concern now is warding off dementia. (By the way, dementia is not a specific disease. It's an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80 per cent of cases.)

Now, I haven’t been diagnosed with dementia but in recent times I have observed in myself some cognitive changes that are consistent with mild cognitive impairment (MCI), in particular, some loss of ability to remember recent events. I know one thing, I am definitely not as mentally 'sharp' as I was 20 years ago, or even 5 years ago.

Source: Physiopedia. Carers guide to dementia.

MCI is a slight but noticeable and measurable decline in cognitive abilities, including memory and thinking skills. It can affect up to 20 per cent of the population at any one time—and half of them will progress to full-on dementia. In other words, a person with MCI is at an increased risk of developing dementia. Of course, years of drinking didn’t help there, but there are certain risk factors not in my favour such as past heavy drinking and smoking, hypertension and elevated cholesterol (albeit both well-controlled these days), and depression (well in the past now, but who knows).

A year or so ago my neurologist gave me a simple dementia test (a cognitive test). I passed the test but I had a little bit of trouble with one or two tasks, the main one being this --- I was asked to name, in 60 seconds, as many words as I could beginning with the letter, say, ‘T’. I started out well --- ‘task’, ‘test’, ‘train’, ‘transport’, ‘truck’, and so on, and so on, but after calling out about a dozen words beginning with the letter ‘T’ there was a long silence on my part. That’s right. I  just couldn’t think of any more words beginning with the letter ‘T’. Well, I did pass the test overall but I scored not at all well on the task just described. Hmm.

So, I am into so-called ‘brain games’ in the form of various word games and puzzles (my favourite one is that old chestnut Jotto, a logic-oriented game), IQ test problems, brisk walking, and various other activities including, of course, mindfulness. 

I’m good on numerical ability (despite hating math at school), classification and general mental ability, and very good on visuo-spatial ability but, despite being a very good wordsmith, it comes as quite as a shock to learn that I’m not good at all when it comes to questions, games and puzzles that test verbal ability (eg ‘Find the odd one out: LEEGA / WARPSOR / RALK / LAHEW … Answer: WHALE [All the others are birds: eagle, sparrow and lark]). Hence, Jotto. (My favourite actress, Lucille Ball, excelled in Jotto and other word games such as Scrabble, so I've read. She would even play Jotto while at the wheel of her car, being able to retain in her head a whole series of 'jots', a jot being a certain number of letters that were in both the guessed word and the ‘secret word’.)


Now, as to the importance of engaging in active leisure activities to help ward off dementia, there are studies suggesting that those who have no leisure activities, or who have very little diversity in leisure activities, or who engage only in passive leisure activities (principally watching TV) are more likely to develop dementia (see, eg, Friedland R P et al, Proc Nat Acad Sci USA, 10.1073/pnas. 061002998). Additionally, it seems that leisure activities may reduce the risk of incident dementia, possibly by providing a reserve that delays the onset of clinical manifestations of the disease (see, eg, Scarmeas N et al, Neurology 2001;57(12):2236-42). 

And diet? Well, dietary patterns have long been associated with decreasing cognitive decline and reducing one’s risk of dementia. In that regard, those who follow the MIND diet (high on natural plant-based foods and low on animal and high saturated fat foods) can lower their dementia risk by as much as 50 per cent. So, like many others, I've made some changes to my diet.


As an aside, there are a couple of prescription medications I take that can cause memory loss. The drugs in question are a statin (a cholesterol-lowering drug) and an anticonvulsant (to treat nerve pain associated with my trigeminal neuralgia).

As respects statins, a study published in the journal Pharmacotherapy in 2009 found that three out of four people using statins experienced adverse cognitive effects ‘probably or definitely related to’ the drug. The researchers also found that 90 per cent of the patients who stopped statin therapy reported improvements in cognition, sometimes within days. In February 2012 the US Food and Drug Administration ordered drug companies to add a new warning label about possible memory problems to the prescribing information for statins.

Then, there is the anticonvulsant drug that I take. Anticonvulsants, that depress signalling in the central nervous system, can cause memory loss.

Now, here’s something close to my heart and the subject-matter of my blog. A 2013 study published in Neuroscience Letters found as little as 15 minutes of daily meditation can significantly slow that progression. Researchers had a group of adults with MCI, all between the ages of 55 and 90, do a guided meditation for 15 to 30 minutes a day for eight weeks, as well attend weekly mindfulness check-ins. Eight weeks later, MRIs showed improved functional connectivity in the default mode network (that is, the part of your brain that never shuts down activity), and slowed shrinkage of the hippocampus, the main part of the brain responsible for memory that usually shrinks with dementia. Participants also showed an overall improvement in cognition and well-being.

Studies also show that brain-training games help to sharpen the mind and potentially prevent cognitive diseases like Alzheimer’s disease. As for speaking more than one language, it would appear that being bilingual helps delay the onset of several forms of dementia. Previous studies of people with Alzheimer’s in Canada showed that those who are fluent in two languages begin to exhibit symptoms four to five years later than people who are monolingual. 

A leading theory as to why bilingualism can affect dementia suggests the key may be the constant suppression of one language, and switching between the two. If switching languages is the reason, it could also explain why the researchers saw no additional benefits of speaking more than two languages. So, I’m trying to re-learn French, a subject in which I excelled at high school (7th in the State [New South Wales, Australia] in the HSC in 1972), but now a language I’ve virtually forgotten in the ensuing 43 years. And I'm finding it damn hard! Whereas 40 years ago I could learn, say, a dozen new French words each evening, and remember them all a week later (and longer), it's not so today. I've forgotten most of the words by next morning. It's all very depressing, especially in light of something I've read, namely, that picking up a new language's vocabulary is supposedly much easier for adults than learning the rules that govern its grammar or syntax. (As for the latter, egad!) Additionally, it is said that older learners of another language are less likely to have good pronunciation or accent.

Well, there we have it. Am I worried that I may get dementia? Yes and no. Yes, for obvious reasons. No, because I live my life one day at a time, never thinking the worst nor fearing it. I'm ready for whatever life dishes out.





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