MINDALERT

GOOD NEWS ABOUT THE AGING BRAIN!SPECIAL LECTURE BY MARIAN DIAMOND

AND ARNOLD SCHEIBEL

A JOINT PROGRAM OF

THE AMERICAN SOCIETY ON AGING

AND THE METLIFE FOUNDATION

T he American Society on Aging is delighted to be able to partner with theMetLife Foundation and the Archstone Foundation to develop theMindAlert program, which seeks to translate new research on our body’s

ability to keep our mind alert in later life into practical tools for elders andaging-services providers. In this booklet you will find the following:

• A monograph from the MetLife Foundation MindAlert Lecture Series, whichwas established to disseminate the latest research information on maintain-ing and enhancing cognitive function in late life. The first MindAlert lecturewas presented at the First Joint Conference of ASA and the National Councilon the Aging, held in New Orleans in March 2001. Drs. Marian Diamond andArnold Scheibel, two internationally reknowned researchers, were the invitedspeakers. This monograph represents an edited transcript of their talk—and istruly good news about the aging brain.

• Brief descriptions of the 2001 winners of the MetLife Foundation MindAlertAwards. This awards program was set up to identify and recognize innovativecommunity-based programs that translate research related to enhancing cog-nitive function in later life into practical mental/cognitive health promotionactivities. This booklet presents the key elements from each of the 2001 win-ning programs. Contact information for the winning programs is also providedfor those interested in learning more.

If you would like to learn more about the MindAlert program, including its Web-based clearinghouse of resources on mental fitness, please visitwww.asaging.org/mindalert or contact Therese McNamee, manager of education,training and special projects at theresem@asaging.org.

GOOD NEWS ABOUT THE AGING BRAIN

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Can I touch your cerebral synapses thismorning? We’ll see.

I would like to begin with a general in-troduction before presenting the specificbrain research from my laboratory at UCBerkeley that holds the promise of what Icall “successful aging.”

In our democratic free society, the hu-man brain has the privilege and capacity todetermine its own destiny. But no one saidit was easy. It has been said that aging is notfor sissies, but in fact, life is not for sissies. Ifrequently use the title “An OptimisticView of Aging” when I present my re-search.Who wants to listen to a talk called“A Pessimistic View of Aging”? Yet recentlyI was asked to speak at a retirement confer-ence. I thought to myself, the concept of“retirement” is contrary to my desires andvalues in life. Should I really accept thischallenge? And the answer was “Yes.”

Have you ever looked up the word retire-ment in the dictionary? Retire definitely hasa negative connotation. It means to with-draw, resign, regress, recede, abdicate,depart,and on and on.There is no synonym indi-cating anything upbeat or forward-thinkingor optimistic.We know Robert Browning’sfamous stanzas “Grow old along with me /The best is yet to be / The last of life forwhich the first was made . . . ”What an ex-hilarating perspective! His words certainlydo not suggest the necessity to resign, re-treat, regress, recede or withdraw from life.

In light of the profound social changesand medical advances that have taken placein American society, why has it taken solong to challenge the very meaning of theword retire? Can’t we find a new word toinspire us to move forward into a periodthat amounts to almost one-fourth of ourpotential lifetime? I asked people all overthe country to help us find a substitute forretire: a single, acceptable, positive word forthis segment of our lives. I finally found onethat I think currently fills the need: redirect.In fact, the moment I heard the word I wasexcited.Think about it—isn’t redirectionwhat we wish to do when we want to

change our style of living after following aspecific pattern for so many years? I’m toldthat aarp wishes to drop the R from itsname, the American Association of RetiredPeople.Why not keep the R and change itto “Redirected”?

Redirect suggests moving in a differentdirection but continuing to surround our-selves with stimuli to fulfill the remainingone-fourth of our one hundred years.

My scientific research for the past manyyears has focused on the effects of the envi-ronment on the brain—the external envi-ronment out here and the internal environ-ment inside each one of us. Our laboratoryexperiments have focused on identifyingfactors that influence the well-being of thebrain, because the brain has the capacity toredirect its own desires.What other cells cando that? That three-pound mass, which Ican hold in one hand, has the capacity toconceive of a universe one billion or morelight-years across. Just think what those cellscan do.The brain is truly a phenomenalstructure, and keeping it healthy for our en-tire existence on earth is a goal we can andshould aspire to. I am going to touch uponfive basic factors for maintaining brainhealth.You’re going to say there’s nothingnew about them,but I’m going to be givingsome scientific evidence of their benefit.

Number one, and in my mind the mostimportant, is diet.What we feed this brainsignificantly affects its well-being.Two, wemust exercise the body and brain. Exercis-ing not only the brain but the total body isnecessary to maintain a healthy brain.Three, we must challenge the brain. It getsbored; we know that well. So we neednewness, new things in our life. Andfifth—last but definitely not least—wemust share basic human love.

When studying the brain it is essential tokeep in mind that development and agingare a continuum.Your brain doesn’t just de-velop in the first part of life and age in thelast part.While your brain was forming inthe embryo, it was developing nerve cells atthe rate of about , per second.Think

Marian Diamond

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of that explosive development—, persecond. But before you were born you hadalready lost percent of those cells. Every-body worries about losing cells at the otherend of the life cycle when in reality you lostmore nerve cells before you were born.

A Look at the Brain

Let’s start with a look at the human brain,a phenomenal mass that weighs about threepounds—roughly percent of our totalbody weight—yet gets a fourth of the car-diac output. Have you ever watched your

heart on an echocardiogram? I saw minethe other day. I could see the valves open-ing and closing.What a thrill to know ex-actly how it works. With every beat itpumps a fourth of that cardiac output tothis precious brain.

Equally wondrous is that no two humanbrains are alike. No two of you will be lis-tening to this lecture in the same way. Notwo of you will walk away with exactlythe same ideas and information. I hopeyou will learn the message that I am try-ing to present about the dynamics of thisbrain and about keeping the brain dy-namic for a lifetime.

How does your brain feel about studyingitself? The brain itself has no feeling:Youcan cut it and it does not feel the injury.Sensory receptors in other tissues initiatethe impulses that bring the pain sensationsto the brain for analysis. Let us look at thisdiagram of the brain (see Figure a and b).For me to be talking to you now, one partof my brain is firing: Broca’s area, whichdeals with motor speech. Some people acti-vate motor speech in a broader area, some alittle further toward the front. But it is gen-erally in the inferior frontal area.

For you to be looking at this diagramyour visual cortex, in the back of the brain,is firing.You see stars when you get hit onthe back of the head because your visualcortex has been jarred.For you to be listen-ing to me, a little area in your superior tem-poral lobe is being activated.The area of thecerebral cortex responsible for hearing isvery small in comparison with the amountof cortex devoted to seeing. For me to bemoving my pointer, the motor cortex isfiring.The highest cognitive processing isgoing on in the prefrontal cortex, just be-hind your forehead.The prefrontal cortex isresponsible for such functions as initiative,judgment, working memory, planningahead, sequencing events, and so forth.Eachpart of the cerebral cortex has a generalfunction, but it obviously has its veryspecific functions as well.

Diet and Brain Growth

Let us now return to the five basic factorsresponsible for keeping our brains healthy

VISUALCORTEX

AUDITORYCORTEX

RETICULARCORE

BROCA'SAREA

DORSOLATERALPREFRONTAL

CORTEX

MOTORCORTEX

HIPPOCAMPUS

Figure 1a

Figure 1b

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and active during our lives.The first is diet.Yes,diet is vital to the brain just as it is to ourbody as a whole. For the brain to growhealthily from infancy, it certainly needsprotein to maintain and develop its nervecells and their branches. Here is a nerve cell(Figure ). In the outer layers of your brainyou have several hundred billion nerve cells.The processes developing from the cellbody are called dendrites. Dendrites receiveinput from other nerve cells. Integration ofthe input takes place in the cell body, result-ing in an electrical impulse that continuesdown the axon, a fiber from the cell bodyleading to the target tissue.The tips of theaxon are not continuous with the receptivedendrites on the next nerve cell adjacent toit—there is a gap between them.An electri-cal impulse travels down the axon to thetips, and then a chemical is liberated to crossthe gap and stimulate the adjacent den-drites.This chemical is called a neurotrans-mitter.The neurotransmitter is liberated,crosses the gap, and then the electrical im-pulse continues through the new dendrites.

When we first started working in the fieldthere were perhaps five neurotransmittersknown.The other day I called Floyd Bloom,the former editor of Science magazine, whois one of the major researchers in the field. Iasked him,“How many neurotransmittersare known today?” He said at least a hun-dred.So you get a glimpse of the magnitudeof chemical reactions in our brains. It’s awonder that any two people ever think alikeand understand each other with such a dy-namic nervous system that must keep allthese transmitters in proper balance.

I am spending time on dendrites andaxons because, whenever we talk about thegrowth of the brain during development,we are primarily considering the growth ofdendrites and axons and the connectionsthey are making with other cells and targettissues.One nerve cell can get input from asmany as , other nerve cells in onepart of the brain. But most cells don’t havethat much input. Each cell can do a trem-endous amount of computation, and wehave more than a hundred billion cells.

Now let’s take a minute to talk about howdendrites develop. In the frontal lobe of anewborn human’s cerebral cortex, just be-

hind the forehead, we can see very fewbranches on the nerve cells as they begin todevelop. By the age of two an enormousamount of branching is going on.However,not all those dendrites have made appropri-ate connections yet,which is why two-year-olds are sometimes difficult to deal with.

When my husband and I were teachingin Africa in , we found that in Nairobi,Kenya, women would noteat protein while theywere pregnant becausethey learned that they de-livered babies that weretoo large. By reducingtheir protein intake whilepregnant they deliveredsmaller babies. My imme-diate question was “Whateffect does this reducedprotein intake have on theinfant brain? “ When wecame back to Berkeley,westarted an experiment in-volving pregnant rats.Wefed half the pregnant rats anormal, high-protein dietand gave the other half alow-protein diet. Thebody weight of babies whose mothers werefed the reduced-protein diet was percentless than that of babies whose mothers hada normal protein diet.And the brains?

Dendrites in those baby rats whose moth-ers had reduced protein just did not developfully.When we put those babies in enrichedenvironments with lots of objects to ex-plore, their dendrites did not increasesignificantly, as they did in babies whosemothers had a normal diet and enriched liv-ing conditions.We learned that it is impor-tant to have a protein-rich diet to growhealthy nerve cells that can respond posi-tively to enriched living conditions.

In a follow-up experiment, we gave thelow-protein-diet mothers high-proteindiets after delivery and gave their babieshigh-protein diets after they wereweaned—and then we got those dendritesto grow.Furthermore,when we put the ba-bies in enriched environments, their brainsbenefited from the stimulation.These expe-riences and my ongoing studies give me

CELL BODY

DENDRITES

AXON(WITH BRANCHES)

Figure 2

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•cause to worry about well-intentioned pro-grams that focus on children ages threethrough five. I believe that considerablemoney should be directed toward goodprenatal care.You can be certain that well-developed embryonic and fetal brains arefar more able to benefit later from HeadStart and other enrichment programs.

Returning to the dietary componentsthat are key to developing and maintaining ahealthy brain, it has been validated thatcholine is extremely important in the diet.Choline is necessary to form an importantneurotransmitters, acetylcholine, as well asenzymes that help acetylcholine functionappropriately. We have learned fromRichardWurtman at the Massachusetts In-stitute ofTechnology that if you don’t haveenough choline in the diet, the cell canni-balizes its own membrane to make acetyl-choline. So it’s extremely important to havecholine in the diet.

What are dietary sources of choline?() Soybeans and soy products. These days

you will find an increasing number of soy-based products on the shelves.We tofu advo-cates have it with marmalade for breakfast.

() Egg yolks.You say you are not going toeat egg yolks because of their cholesterol,but if you have low cholesterol levels, youcan have egg yolks.

() Peanuts. These are somewhat high infat and sodium, but use them moderatelyalong with other source foods. My fatheralways had a big bowl of peanuts for uswhen we came home from school.

() Liver. There are those who do enjoyliver! I do.

I mentioned only one neurotransmitter,acetylcholine, but remember, you haveabout different neurotransmitters serv-ing your body’s chemical needs. Other im-portant ones are dopamine, serotonin, andglutamate.You can look up the dietarysources for these neurotransmitters in yourspare time.

We have known for some time that vita-min B is essential for the well-being of thenervous system. Let’s just take one B vita-min, vitamin B. B is important in the me-tabolism of amino acids, which are relatedto the structure of protein.Vitamin B isvital to the creation of neurotransmitters.

What happens if we have a vitamin B defi-ciency? Our memory is impaired, causingtrouble with our ability to register, retainand retrieve memory.A shortage of B alsocan lead to nerve damage in the hands andfeet.A few vitamin B sources: potatoes, ba-nanas, chicken breast, beef top round,turkey white meat, rice bran, carrot juice,rainbow trout. Just a selection taken fromthe literature to show you that there aremany sources for B.

Antioxidants are other important sub-stances for the care and feeding of thebrain. Most everybody knows the majorantioxidants, vitamin C and vitamin E, andtheir food sources.The American ChemicalSociety website lists rich sources of antioxi-dants—including blueberries and strawber-ries. How many of us are aware that theseare rich sources in antioxidants?

We continue on just a little more on tothe interaction of calcium and your para-thyroid gland. Most people are familiarwith the thyroid gland in the neck, but didyou know the parathyroids are right theretoo? Usually four of them.They regulatethe amount of calcium in your blood. Ifyou have low blood calcium, hormonesfrom your parathyroid glands act on cells inyour bones to extract calcium from thebone in order to raise your blood calcium.Everybody knows that calcium is importantfor bone structure, but did you know that itis also important for nerve impulse conduc-tion? It is important for muscle contraction.

Exercise

Now let us turn to our second key factorin maintaining a healthy brain: exercise.Arecent article I read mentioned that lack ofexercise was responsible for increased inci-dence in sugar diabetes, cardiovascularproblems, obesity and depression.We knowthat exercise improves skeletal muscle toneand function and that it helps our venousreturn in our legs, indicating the impor-tance of keeping our legs active. Exercise isessential to bring oxygen to all parts of thebody—especially the brain.What area ofthe brain has been shown to be subject towhat we call anoxia, or a reduced amountof oxygen? The hippocampus (see Figure

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b).The hippocampus deals with the pro-cessing of recent memory and visual spatialprocessing.As we age and our blood vesselsbecome less efficient, it is very important toexercise to get the oxygen through the vas-cular system up to the hippocampus, as wellas to the rest of the brain and body.

I like to always emphasize swimming asa good form of exercise. When we getolder, we may walk a good deal using ourlower extremities, but do we use our upperextremities? Swimming exercises the entirebody including both upper and lower ex-tremities. How many of you feel depressedafter you have sat indoors for severalhours? I know I certainly do. Exercise hasbeen shown to benefit the balance of yourneurotransmitters.

I also learned the other day that exercisehas been shown to benefit children with hy-peractivity problems.Are our children get-ting enough exercise sitting in front of theircomputers and video games all day long?Everyone should have planned exercise forpossibly one hour each day—just as youbrush your teeth and eat your breakfast daily.

Challenging the Brain

I have come to challenge, a third vitalcomponent of brain health. What I amabout to say has been validated by my yearsof laboratory research. In terms of successfulaging, it is not enough to continue activitiesin the same groove, year after year, with thesame expenditure of mental and physicalenergy. Remember Alice in Wonderland,who discovered that on the other side ofthe looking glass a person had to move veryfast to stay in the same place? The underly-ing laws of physics Lewis Carroll was play-ing have their correlate in neurophysiology:the brain needs new challenges if it is to re-main a healthy, functioning organ.Trans-lated, if you like to do crossword puzzlesand you’ve been doing the same kind ofcrossword puzzles year after year, try morecomplicated puzzles next time or introducea new game that will challenge differentskills that are lying dormant.

In order to get ideas about human brainfunction we look at rat brains, which havemany of the same basic patterns of brain

structures as humans, only rat brains are thesize of pecans whereas our brains are thesize of cantaloupes. I offer the results of oneof our rat experiments dealing with “en-riched” and “impoverished” environments.In the enriched environment, rats live ina large cage and have objects to play with. Itis very important to have something chal-lenging in the cage with these rats. In con-trast, the impoverished environment housesa rat who lives all by itself with no objectsto challenge it.These two experimentalconditions were compared with a controlgroup of rats living three to a cage in asmall cage, which is the standard laboratoryway of housing rats.

Examining and comparing brain tissuefrom each of the three groups yields awealth of information.The outer layers, justlike those in our brains, are called the cere-bral cortex. Cortex means “bark.”The cor-tex is a dynamic structure—parts of thehuman cortex have sent humans to themoon.The thickness of the cortex is one ofthe first measurements we make because itis simple and lets us know if changes are oc-curring in the constituents of the cortex,namely, neuron number and size, dendriticgrowth, synaptic growth. In our little ratswe can measure what happens to the cor-tex when we put the animals in differentenvironments. First, we measured the diff-erence in cortical thickness between pairs of enriched and nonenriched malerats.We found that the rats living in en-riched environments demonstrated somechanges (increased thickness) in the frontalarea, no changes in the general sensory areaand dramatic changes— percent—in thevisual cortex.

As in most of the work now done withlaboratory animals, we wanted to deter-mine whether female rats would respond inthe same way.When we measured the diff-erence in cortical depth between pairs ofenriched and impoverished nonpregnantfemale rats, we saw some changes in thefrontal area, some changes in the generalsensory cortex, and percent change in thevisual cortex, not quite as much as in themales. My students suggested that we chal-lenge the enriched females to see if wecould bring that visual cortex up to the

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•level of the males. Sure enough, we did.How? We put obstacles in front of theirfood cups. Every time they wanted to eatthey to climb over all those obstacles. Now,did we try to bring the male general sen-sory cortex up to that of the female? No,that’s an experiment we saved for futurestudents to complete.

Why is thicker better? Psychologists havetested the rats living in enriched or impov-erished conditions and found the enrichedrats ran maze tests faster than did the im-poverished. Evidently more dendrites—thicker cortices—indicate a greater abilityto solve problems.With humans, we pur-posely have to work harder as we age to setup challenges for us. It’s easy to take thesimple route. It’s hard to add additionalchallenges.

There are obviously different kinds ofchallenges. Here’s another experiment weconducted on rats.We put a rat in one cor-ner of a maze and food in the opposite cor-ner.The rat ran right to food.The next daywe put one barrier in the box.The rat hadto run around the barrier to find his food.The next day another barrier and so forth.Pretty soon we had barriers, so he reallyhad to learn to get through barriers to findfood. Simple task. How much of the brainchanges when we challenge it with a sim-ple task? We found percent changes, butonly in his visual cortex.That’s a statisticallysignificant difference, but only in one areabecause the rat is only dealing with onekind of challenge. In multisensory enrichedenvironments we change most of the cere-bral cortex, not just a single area.

A single-input challenge changes just asingle area of the brain. So children (oradults) sitting in front of computers all daylong are being fed a specific input. Multi-sensory enriched environments involve var-ied toys, sociability and changing stimuli.Now, you may ask, what is most importantin the enriched environment? Sociability—having all the rats living together—or justbeing surrounded by challenging objects?Other investigators conducted experimentsin which rats were put in an enrichmentcage with no toys.An increase in the cere-bral cortex occurred but it was not as muchas when rats were in a cage with toys.

Then one rat was placed in the enrichmentcage by itself with the toys. Its cortexchanged much less than that of rats wholived with toys and other rats. So both so-ciability and challenge are important. I cantell you how researchers got the rat livingalone with the toys to experience greaterchanges:They gave it methamphetamine,and it ran around and interacted with thetoys.We certainly do not recommend thisapproach! Thus, we’ve been able to showthat these experimental conditions, thestimulus objects plus the friends, were bothnecessary to create the most significantchanges to the brain.

Another condition we wanted to investi-gate besides the thickness of cortical tissuein these experimental groups was the im-pact of enriched and impoverished envi-ronments on a substance called lipofuscin.Lipofuscin is an “aging pigment” that accu-mulates in your brain as you age. It isthought to interfere with the normal func-tioning in nerve cells.You do not wantnerve cell bodies filled with an aging pig-ment because they normally are busy pro-ducing proteins to supply their many func-tions.We found that rats put in enrichedenvironments produced less of this agingpigment in their brains. Just another plusfor having challenge and activity in thebrain throughout one’s lifetime.

Brain Challenges and the Immune System

Our most recent research has focused onhuman beings.A secret passion of mine wasto find a relationship between the cerebralcortex and the immune system.The im-mune system is, of course, extremely im-portant to our health at all ages, and cer-tainly it is critical to successful aging.Theresults of our research, which are just beingpublished now, made it into the pressaround the world.We learned a great dealabout people who challenged their cerebralcortex to affect their immune systems, eventhough they didn’t know that’s what theywere doing.

From our animal studies we’ve learnedthat the dorsolateral frontal cortex was re-lated to the functioning of the immune sys-

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tem:The dorsolateral frontal cortex wasdeficient in immune-deficient animals.How did we learn that? In , the Frenchstripped off most of the cerebral cortex intheir mice and they found that this processaffected the number of circulating T cells inthe blood.We had to find out which part ofthe large cortex specifically affected the im-mune system.

Eventually we found an area on both theright and left cortices that was thinner inimmune-deficient female mice. (These im-mune-deficiency studies were all done withfemale mice because the French startedwith females.) The immune-deficient micehad no thymus gland, which is responsiblefor producing T cells.The thinner corticalarea is called the dorsal lateral frontal cor-tex.The rest of the cortex was fine as far aswe could measure.When the thymus wastransplanted back into the immune-defi-cient animal, the deficiency in the corticalarea was reversed. So we know we have anarea of the cerebral cortex related to theimmune system.

It was my dream to find this area of thecerebral cortex, because it is under volun-tary control. I say I want to pick up thispointer, I do it.That’s voluntary control.Can we voluntarily, then, stimulate thisarea? We learned that experimenters hadgiven schizophrenic patients what is calleda Wisconsin Card-Sorting Test, which isgood for clinically testing psychologicalfactors.While the patients were undergoingthe card-sorting test, they had a pet scan,which showed that the test activated thedorsolateral frontal cortex.

Most people haven’t heard of the Wis-consin Card-SortingTest because it’s prima-rily used clinically.We wanted a card gamethat everybody has heard of—say, bridge.The game of bridge uses working memory.It uses planning ahead. It uses sequencingand initiative and judgment.All of these arefunctions of this part of the cortex.

We had women come to the lab toplay bridge with one another.We tookblood from them before they started play-ing to measure the initial level of their Tcells.Then we took blood from them afterplaying bridge for an hour and a half, andfound that they had significantly increased a

specific type of T cell.The before-and-afterdata were exciting to us because we found asignificant increase in their cd-positive Tlymphocytes.We did not find such a T cellincrease in the blood samples of the controlwomen who did not play bridge, but sat lis-tening to quiet music during the time theothers were playing bridge.

We were terribly thrilled with these newresults. Clearly, the cerebral cortex plays arole in controlling the immune system.Now we have to learn to “educate” thatdorsolateral cortex and help keep our im-mune system healthy.This is just a prelimi-nary study. It has to be replicated and fol-lowed through. But to me it was a veryexciting moment.

Now, what happens if the brain is dam-aged? Our students conducted another se-ries of experiments in the late s to findout.We found that if you lesion the leftmotor cortex in a young, sexually maturerat, it will lose the function of its rightforepaw.They did this to a number of rats,and then they put half in nonenriched(control) environments and half in enrichedenvironments.When they looked at thebrains of rats placed in nonenriched condi-tions, they found that dendrites did notgrow very much around the lesion, on theopposite side or back in the sensory area ofthe cortex. But in the enriched environ-ment those dendrites grew significantly.The dendrites grew around the lesion.They grew in the opposite side and theyeven grew back in the somato-sensory cor-tex. From these findings we can only con-clude that, even when brain damage is pres-ent, animals living in a stimulatingenvironment are able to compensate for thedamage. Look at the promise that holds forour species who receive some degree ofbrain injury.

Newness Versus Overstimulation

What happens if you overstimulate oroverenrich the brain? My conversationwith a pediatrician concerned that childrenare being constantly bombarded with newexperiences inspired the following experi-ments. In our previous experiments withrats we just changed the toys in the cage

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•two or three times a week.“Newness” is animportant part of challenge, so we had tochange the toys. Otherwise, the brain atfirst increases and then decreases withboredom. It needs stimulus to keep thosedendrites extended. In our new experi-ment, instead of changing toys two or threetimes a week, we changed the toys at seveno’clock at night, eight o’clock at night,nine o’clock at night, four nights a weekfor four weeks.

We bombarded those little rats with stim-ulation.We didn’t know if we were going tosee huge brains,or not—that’s the fun of re-search. It seems that the significantly differ-ent results we had recorded between the en-riched and nonenriched rats in our originalexperiments did not continue to increasewhen we stepped up the frequency ofchanging the toys for the enriched group.

So, with too much coming in we did notincrease the enrichment effect; it was less.Stress reduces the cortex at the same timethat enrichment tries to increase it.Whatstress factor is involved? Corticosteroidscoming from the adrenals. Corticosteroidsreduce the cortical thickening.We take outthe adrenals and the cortex grows signifi-cantly.It shows how much the cortex is nor-mally being held back by corticosteroids.

The lesson for humans? Too much stressdecreases the dimensions of the cortex andis detrimental to our well-being at any age.So when we teach for the schools we men-tion that children must learn in environ-ments with more enrichment than stress.Too much stress decreases the dimensionsof the cortex.

Love and Nurturing

Our last subject, oddly enough, is love.Alittle background:We had started our ex-periments using young rats,which are read-ily available and easy to work with.Wefound they were growing dendrites withenrichment.We then decided to raise ourrats to see if we could change the brain inmiddle-aged rats. So we raised rats up to days of age, equivalent to -year-oldhumans.We put half in enriched conditionsand half in nonenriched conditions, and wecould still find increases in the cerebral cor-

tex with enrichment to the brain. But wewere beginning to lose the animals at days, so we could not come up with con-clusive results on middle-aged rats.

Following the publication of our find-ings, I was invited to the German Academyof Sciences to report on my work.While Iwas there, I was struck when a scientistthere who said that the German rats livedto be days. I came back to Berkeleywondering how were we going to get ourrats to live longer?

We tried to figure out what was missingin the design of our experiment.When Iwould talk with groups of older folksaround the country, I felt that many ofthem just weren’t getting enough attention,enough tlc, enough daily kindness. Sure,they had their televisions, they had goodfood, but where was the love? We didn’t seeit. So we decided to give our rats love.

Instead of just putting them in little cageswhen the rat cages were being cleaned, weheld the rats against our lab coats and wepetted them.We got those rats up to days, put half of them in enriched environ-ments and half in nonenriched environ-ments, and at days—equivalent to -year-old people—we were still findingthicker cortical tissue among those ratsmaintained in enriched conditions. Num-ber one, we got them to live longer. Num-ber two, we got those brains to change.How can we not conclude that stimulatingthe brain works its magic right up until theend, and may even prolong life? Why doyou think Arne and I haven’t retired?

We used to believe as scientists that theloss of dendrites was an inevitable correlateof the aging process. It was simply our fate.Yes, it takes concerted attention to stave offthe “inevitabilities” we have accepted for solong, but is the price really that high? Is ittoo much work to follow a healthy diet,enjoy plenty of exercise, seek out new chal-lenges and get lots of love? My own life andwork have been enriched immeasurably bytwo statements I absorbed many years ago.How fortunate that my English family creststates,“Love conquers all.” My Swiss grand-mother added,“In spite of all difficulties,upward and onward.”

A good combination.

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It’s a pleasure to have the opportunity tofollow Marian’s wide-ranging presentationof some of the things that we feel are quiteimportant.Today, I will talk briefly about afew more things. First, we’ll start with thebad stuff: How does the brain age in aworst-case scenario? We don’t, for a mo-ment, believe that any of us will follow thatroute but we want to take some meas-ures—measures that rise, in part, directlyout of Marian’s work.

Next, I’ll talk about how the humanbrain responds to an enriched input.

Marian has shown you the basic researchin rats that led us to look at the importanceof brain enrichment. I can show you mate-rial from human brain tissue that supportsand perhaps expands on these findings.

Marian mentioned to you several factsthat came out in research, for instance, thefact that enrichment is enrichment onlywhen there’s effort involved.You knowwhat they say, no gain without strain.Wewant to show you why it seems to be thatthe strain has to be there in order for en-richment to be effective.

Aging-Related Changes to the Human Brain

Let me start with the sexiest picture I have:the human brain (Figure a).I show it to younot just for its essential beauty but also be-cause it makes an example.This is what anormal, intact adult human brain shouldlook like. It is pink because it is a highly vas-cularized structure.As you know, the sur-faces are deeply creased.We call the little hillsgyri and we call the little valleys sulci.

Human cortices are built this way as op-posed to the very smooth cortices on thelittle animals that Marian has worked with.This kind of gyration (meaning the brainhas a geological landscape) increases thesurface area of the brain, where all thethinking occurs, without massively increas-ing its bulk.

In this second brain (Figure b), you seethat the gyri are narrower and the sulci

much deeper. Look how deep the great lat-eral fissure is.

This is quite typical of the brains of oldpeople who have undergone brain atrophy.Now, some degree of atrophic change oc-curs in the majority of people.We still arenot sure what allows some of us to escape a

certain amount of atrophy almost com-pletely. Some of us undergo small amountsof atrophy that apparently don’t affect ourcognitive function.And then, of course, afraction of us will experience some kind ofsenile dementia.Alzheimer’s is perhaps thebest known dementia, although by nomeans the only one.

Arnold Scheibel

Figure 3b: The brain of a patient with senile dementia ofAlzheimer’s. Note the enlarged spaces (sulci) between each

fold (gyrus) of brain tissue due to progressive atrophy.

Figure 3a: The normal human brain.

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•Data from recent studies are highly sug-

gestive that although the severe forms of se-nile dementias are, to some extent, geneti-cally predetermined, our future does notnecessarily lie in our genes.And what wedo with our brain tissue may have a greatdeal to do with the way we spend the latterparts of our lives. It’s an interesting con-cept—we must take our living brains intoour own hands, so to speak.

Here’s a picture of a typical cortical cell(Figure ).We call it a pyramidal cell be-cause its cell body is pyramidal in shape,rich with dendritic branches. Notice theprogressive loss of dendrites.

In a sense the dendrite is the visible coinof the realm.The richer your dendritic ex-tensions, the richer your dendritic plexi.Cells of people with dementia actuallyshrivel into themselves.The synaptic con-nections that depend upon the extent ofthe dendrites are progressively lost as thedendrites disappear.As that happens yourlevels of cognitive function also diminish.It’s like spending a good deal of your yearsnow with a wonderful computer with ahundred gigabytes.All of sudden you comein one morning and the poor little thinghas only fifty kilobytes of function.

This is why Marian and I have been moreand more sensitized to the need to keep thedendritic system alive and growing.

We would like to make it possible forpeople, exclusive of those who are unluckyenough to follow an Alzheimer-type pat-tern, to avoid the shriveling entirely andkeep the cells richly branched and pyra-mid-shaped.

One other thing appears in photographsof brain tissue in far-advanced cases ofAlzheimer’s disease. Masses of dense fiberschoke the nerve cells to death.We call thesemasses neurofibrillary tangle material.These great masses here are masses of anunusual protein we call amyloid.

Many of you have probably heard ofamyloid.We know now that one of thehallmarks of abnormal, toxic aging is theprogressive laying down of amyloid masses.Not only do they destroy the connectionsaround them, they appear to be directlytoxic to nerve cells.We want to get amyloidout of the way.

The Good News

Here’s the good stuff. How do dendritesgrow? They grow by adding branches, andbranches off those branches.

This process appears to be active allthrough life if we give brain cells the properkind of stimulation,or“enrichment.” I wantto share with you a couple of straightfor-ward experiments done with human brains.

Now, for ethical reasons and for the kindof things we all empathize with we do notwant to do experiments on individuals.However, very often individuals will theirbrains to science.And this is very important.It’s one thing to look at the brain of someonewho is deceased. It’s another thing to haveenough information about that individual toknow how he or she lived his or her life.What were the high points?What were thenegative,the degrading components?

When we put this background informa-tion together with study of the deceasedperson’s brain we can learn a great deal. Forexample, we stain the nerve cells, and this isperfectly easy to do, to get a picture of theperson’s typical apical (upper) dendrites andbasilar (lower) dendrites.

The simplest way to measure our results isto have a group of concentric circles in theeyepiece of the microscope we use to studybrain cells.We center the cell body in themiddle and then count the number of den-drites that cross each circle. Let’s say theinner circle has three or four crossings.Aswe go out to the third, fourth or fifth circleswe get , crossings.As we go out fartherthe crossings obviously become fewer.Thenwe graph the number of crossings againstthe number of circles, and connect the lines.

What we get is a graphic pattern.And es-sentially, the area under that graph directlyrepresents the amount of dendritic tissuethat this cell has generated. If the graph ishigher or if it comes out at a leisurelyangle,we can be sure that the cell had moredendritic tissue that is distributed in aricher way.

This is a very simple way to do somerough quantitative measurements on den-dritic richness or poorness.

In one study, we used this process to lookat the brains of a group of or people

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about whom we had data as to how theyspent their lives.

For example, one person was a clerk-re-ceptionist, apparently a very fine typist.An-other individual was a major-appliance re-pairman.A third fellow was a tailor, a fourthan office-work typist, a fifth a mechanic.

What did we want to do with the brains?Marian indicated to you that specific partsof the cerebral cortex serve specific func-tions and specific parts of the body. Know-ing this, we sampled a part of the brain thatwe knew took care of hand and finger mo-tions and contrasted that with an adjacentpart of the brain that took care of sensoryinputs from the surface of the chest.We canimmediately infer there should be an enor-mous functional difference. I don’t sense myenvirons by rubbing my chest against thewall. I sense it by touching the wall, right?So the hand-finger part of the cortex gath-ers very powerful, subtle input,and the chestpart of the cortex gathers gross, uneducatedinput. If more input—enriched input—makes dendrites grow, we should be able tosee in the hand-finger area a much richerdendrite pattern than in the chest area.

We found consistently dramatic differ-ences—for all but three of the individuals.

Do you know what we found with thefellows that fooled us? We found that twoof them were left-handers, so they were notusing the right hand as the leading hand.There was very little difference betweenleft-handed function and chest function.The third individual turned out to be asalesman. He was a right-hander but welearned from his wife that he was veryclumsy; he never could use his hands effec-tively.The dendritic pattern told the story.

Here’s another, similar experiment.Asyou all know, most of us are “left languagedominant.” The left hemisphere of ourbrain takes care of all the computationalwork in language.The right hemisphere,also very important, is not interested in se-mantics and syntax and computation. It’s in-terested in the flow, the sound of speech,what we call the melody and the prosody.Without my right hemisphere I wouldspeak in a rhythmless monotone,and you allwould leave the room as soon as you could.

There’s a tremendous difference in what

these cortical systems do.We inferred—andthis was a dangerous inference—that thedendritic tissue on the left-language-domi-nant side should be much more complexthan over on the same area of the rightside because we feel that cognition mustbe more subtle than emotion. It’s a danger-ous presumption: Sometimes it’s true andsometimes it’s not.We sampled cells from

the area that computes language outputand other cells from the area just behind it,which enervates the muscles of thetongue, larynx and pharynx to carry outthe commands.

Everything worked out as we expectedwith the left language area far surpassing allothers, including the right language area,except in one person.

We were disturbed to find that in hisright language area the dendritic systemswere more complex. It turned out that thisindividual was a lifelong lefty. He was oneof the relatively small number of peoplewho are right language dominant, and itshowed very clearly.We learned, then, thatform follows function.The more you use asystem the more your dendritic tissuegrows in that system. It’s a valuable lessonto remember.

One last bit of data: In another study thatI did with my graduate student, Bob Ja-cobs, we looked at the brains of people.We

Figure 4: Contrast between a normal cortical pyramidal cell in thehuman cerebral cortex (A) and a similar cell, showing advanced

degenerative changes in senile dementia (B).

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•always work without knowing the charac-teristics so the knowledge doesn’t modifyour judgment when we’re counting den-drites.We found that the group could bebroken into three groups on the basis of thedata. One group had a certain amount ofdendritic tissue, the second had more, andthe third group had even more.We couldn’tfigure out what caused these differencesuntil we examined the data we had on theindividuals’ lives. You know what wefound? The first group only had an ele-mentary school education. The secondgroup had gone through high school andperhaps a year of college.The group withthe highest number of dendrites had com-pleted college and graduate school. It wasan eye-opener.

What I’m reporting to you is a correla-tion between the amount of dendritic tis-sue and the amount of education.The re-sults say nothing about cause or causality.You might argue, well look, the poor folkswho had less dendritic tissue couldn’t makeit out of elementary school.That’s perfectlypossible. However, on the basis of what weknow from the animal work of Marian andothers, it does look as though challenge,constant input and new information wereat stake here.The third group could un-doubtedly live richer, more fulfilling livesbecause of a higher education level.

Now, I want to finish up with the third,last component of our discussion.What arethe possible mechanisms that are basic tothe processes that Marian has told youabout, that we’ve hinted at here?

Inside the brainstem is an area that wehaven’t mentioned before.It’s a very old areaknown as the reticular core of the brain-stem. Sensory input—it doesn’t matterwhether it’s touch, vision, audition, any ofthese—comes in through the brainstemthrough the thalamus,where it has a numberof connections.Then it goes through thiscurious little half-moon structure, which isactually a filter system, up to the cortex.From the cortex, in this case the direct sen-sory cortex,the input is disseminated to var-ious parts of the cerebral hemispheres.

On its way into the cortex the sensoryinput adds information to the reticular for-mation or reticular core.The reticular core

is like the telephone operator in a littleNew England town about years ago.Everything came through her switchboard.Right? She rerouted all the calls and gradu-ally became familiar with everybody’s busi-ness.That’s what the reticular core does. It iscontinuously listening to everybody’s busi-ness. Now, unlike the New England tele-phone operator who remembered all theawful secrets of the town forever, the retic-ular core has a very short, fickle memory. Itis interested only in what is new, different,exciting and unexpected.That which is dulland repetitive it just forgets and ignores. Itsown activity goes down steeply unlesswhat’s coming in is exciting and new.

That’s important to us because the role ofthe reticular core is to project to all parts ofthe cortex,not just to a single part.The coreactually determines the levels of activity allthroughout the cortex, including the levelsof genomic activity, activity that producesthe protein that may produce dendrites. So,when Marian was stressing to you the im-portance of the fact that sensory input befresh and engaging and new and different, itwas because this input is necessary for thereticular core to get involved and help usactually grow new dendritic tissue.

Remember the half-moon-shaped filterthat I told you about? This filter is actually aseries of little gates, or gatelets, that controlaccess to the cortex.The prefrontal cortex(the area responsible for the highest levels ofcognitive function) has a direct level ofcontrol over these gatelets. Since you—thehighest level of you—are really a prefrontalcortex, you can learn to control thesegatelets.That’s how biofeedback works.That’s how autohypnosis works.That’s whythe yogi can lie on a bed of nails and notonly not feel the pain but not even getscratched or begin to bleed.With practice,you can gain control over what comes intoyour brain, by the use of this prefrontal cor-tex working on this system. So this givesyou, at least potentially, another measure ofcontrol over your brain and yourself.

Finally, the exciting data that Marian haspresented shows that if we stimulate thisprefrontal cortex through something chal-lenging like playing bridge, we can actuallymake positive changes in our immune sys-

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tems. In the case that she studied she wasable to show these changes in a certainform of lymphocyte, the cd cell.

Where do these changes occur? Well, thesources for immune system activity inadults are usually in the spleen and in theshafts of the long bones.The prefrontal cor-tex also turns out to be the only corticalarea that projects directly to our hypothala-mus and pituitary.And the hypothalamus in

turn, this great visceral center, is in chargeof the immune system working in thespleen and long bones.You see, you can ac-tually plot out schematically the routes bywhich these wonderful effects of enrich-ment occur. For me the most excitingthing is that it gives us a significant degreeof control over ourselves and our future.And I think this is our major challenge aswe age.

Marian Diamond, PhD, is professorof human neuroanatomy and totalbody anatomy in the Department ofIntegrative Biology at the Universityof California, Berkeley.

Arnold Scheibel, MD, is a professorin the Department of Neurobiology atthe University of California, LosAngeles, Medical Center.

THE LECTURERS

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T he ASA–MetLife Foundation MindAlertAwards were established in to recognize

innovations in mental fitness programming forolder adults.The awards recognize programs,products or tools that promote cognitive fitness inlater life. Programs are judged for their innova-tion, their basis in research, demonstration of theireffectiveness, their potential for replicability, andthe extent to which they are accessible to diversepopulations of elders.The following are descrip-tions of the award winners.

The Adult Activities CenterAdult Day Services of Orange CountyCosta Mesa, CA

One of the MindAlert Awards rec-ognized the achievements of the Adult Ac-tivities Center at Adult Day Services of Or-ange County in Costa Mesa, Calif.TheAdult Activities Center, directed by Cor-dula Dick-Muehlke, offers a continuum ofservices to address the unique needs of peo-ple in the early stages of Alzheimer’s diseaseand their caregivers.

While advances in the diagnosis andtreatment of Alzheimer’s have led to earlieridentification of individuals with dementia,California’s system of care remains focusedon serving those with moderate-to-severeimpairment.The Adult Activities Centeroffers a comprehensive set of services forpeople in the early stages of the disease.

The New Connections Club is a dayprogram that incorporates research-basedinterventions such as memory retraining,exercise and reminiscence therapy to en-hance cognitive, physical and emotionalfunctioning.The Activities Club is an out-ings-based day program for those who arerelatively independent but can no longerbenefit from cognitive interventions.“Memory Boosters” is the title of a -week set of memory retraining classesoffered at the center and in the community.“You’re Not Alone” is a -week set of par-allel support groups for early-stage individ-

uals and their caregivers.And “Living WithAlzheimer’s Disease,” a three-week psy-choeducational series, is offered for care-givers.

Each component of the services offeredat the Adult Activities Center is designed inlight of studies demonstrating the effective-ness of particular approaches with early-stage individuals and with their caregivers.By drawing on existing research, the AdultActivities Center differs from the handfulof other early-stage programs, which arerecreationally focused and take the typical“whatever works” approach to dementiacare.Although it is commonly believed thateven early-stage individuals cannot benefitfrom memory retraining,Adult ActivitiesCenter participants have, for example,shown significant improvements in theirability to identify famous faces and placesfollowing weeks of practice.

A survey of caregivers whose loved oneshave participated in the Adult ActivitiesCenter for a minimum of months re-vealed a variety of benefits. Of the re-spondents, the majority reported that theirloved ones were happier (%), less de-pressed (%), more interested in life (%),and less anxious (%) as a result of partici-pation. Benefits experienced by caregiversincluded having more time for personal ac-tivities (%), feeling less stressed (%) andmore relaxed (%), gaining a better under-standing of dementia (%), being less iso-lated (%) and finding it easier to continueworking (%).

Mind Your Mind: Workshops for Mental FitnessPresented Around the United States

A second MindAlert Award was given toMind Your Mind, a systematic, well-rounded mental activity program that pro-motes mental fitness in older adults. Beat-rice Seagull, professor emeritus at RutgersUniversity, New Jersey, has presented MindYour Mind workshops to nearly , par-

2001 MINDALERT AWARDS

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ticipants since . Mind Your Mind is aneducational workshop activities programthat systematically promotes mental fitnessin older adults. It is designed specifically forgroups in senior centers and adult commu-nity facilities; participants range in age from to -plus.

Based upon the idea that continued in-tellectual stimulation is a tremendousbenefit to successful aging, the programempowers its participants by strengtheningtheir minds and by enhancing their feelingsof control over their lives. Emphasis is onthe potential for self-improvement. Olderadults consistently express their fears aboutdeclining memory and decreasing mentalabilities. By directing attention to the con-cept of mental fitness, participants are en-couraged to work on keeping the mind inpeak shape. In a classroom setting, theworkshop activities provide a structure forthem to reflect upon their cognitive capaci-ties, practice their thinking skills and in-crease their self-confidence.

The MindYour Mind program is a com-plete “mind workout,” similar to a physicalworkout, with exercises designed to stimu-late multiple parts of the brain.The theoret-ical framework is based on distinct cognitiveskills—memory, flexible thinking, percep-tion, using language, reasoning—which areclearly defined and described.The activitiesfor each skill provide practice in that area.Included are warm-ups; mind benders; rid-dles; verbal and perceptual tasks; and exer-cises to promote memory and retrieval,flexible thinking, spatial relationships andproblem solving.The activities range fromeasy to more complex.Some of the tasks aregenerational, connected to knowledge ac-quired during a lifetime of experiences.

The program combines practice inthinking skills with concise factual infor-mation about the aging process.A series of“mini-talks” on directed topics are given atintervals during the course to provide thefactual material.These topics include “TheAging Mind: Normal Changes,” “TheBrain and Blood,”“The Neuronal Net-work and Neurotransmitters,”“The Evolv-ing Brain,”“You and Alzheimer’s Disease,”and “Enhancing Brain Function—WhatYou Can Do.”

Strategies for improving mental fitness ineveryday situations complement the exer-cises and factual material.The strategiesrefer to common experiences of olderadults, offering simple problem-solving so-lutions as well as opportunities for groupdiscussion and interaction.

Mind Your Mind approaches the conceptof mental fitness as an ongoing undertakingrather than as a statistically measurable char-acteristic.The message of the program isthat just like physical fitness, mental fitnesscan be constantly improved. Scientific re-search regarding the continuing capacity ofthe brain to grow in later life, such as thatconducted by Professors Diamond andScheibel, provides the primary motivationof the program:“Use it or lose it.”

Elder RehabDepartment of Speech and Hearing Sciences, University of ArizonaTucson, AZ

The Elder Rehab program, the thirdwinner of the MindAlert Awards, is acognitive, language, physical-fitness and“partnered volunteering” program for peo-ple with mild to moderate Alzheimer’s dis-ease.The purpose of the program, which isdirected by Sharon M.Arkin, is to improvethe quality of life of people with dementiaand their caregivers and to slow the rate ofcognitive decline.

Twice-weekly interventions are providedby undergraduate “rehab partners.”Thesestudents provide a weekly session of physi-cal fitness training during which they ad-minister between and different mem-ory and language stimulation activities.Participants’ responses to the various activi-ties are recorded so that the program can bemonitored. The program includes fourcomponents:

Memory Training. Memory training usesresearch-based methods to help dementiasufferers retain still-remembered personallysignificant facts about their lives and relearnthose that they may have forgotten.

Language Activities. These activities buildon preserved abilities—social graces and

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•pragmatic communication skills such asturn-taking; the ability to respond to cue-ing and external stimuli; songsheets for“oldtime favorites”; word games andquizzes; verbal fluency exercises; and theability to discuss topics that don’t dependon personal or historical facts, but draw onaccumulated life experiences and personalvalues.

Exercise.To experience the benefits of ex-ercise on health, psychology and mood,Elder Rehab student partners serve as mo-tivators, drivers, personal trainers and con-versation partners to make what could bean onerous chore a stimulating, ego-build-ing and fun experience.

Volunteer Work. Participants in the pro-gram are encouraged to step out of the roleof care recipient and provide meaningfulservices to others.This social involvementand the positive feelings received from con-tributing to the welfare of others has beendemonstrated to have physiological andpsychological benefits.

More than people have participated inthe program to date. Standardized measure-ments of participants showed that theseindividuals maintained their level of lan-guage and cognitive function over a two-semester period while showing significantgains in the recall of autobiographical factsand improvement in their mood and overallquality of life.

HONORABLEMENTIONSMy Turn ProgramKingsborough Community College, City University of New YorkBrooklyn, NY

Rivier Institute for Senior Education (RISE)Rivier CollegeNashua, NH

AWARDS REVIEWCOMMITTEE

ASA expresses its gratitude to the reviewcommittee for their work in reviewingaward submissions: Carol Cober, aarp-Health and Wellness Unit,Washington,DC;Sandra Cusack, Gerontology ResearchCentre, Simon Fraser University,Vancouver,BC; Marian Diamond, Integrative BiologyDepartment, University of California,Berkeley;Nancy Emerson Lombardo,Cen-ter for Research on Women,Wellesley Col-lege,Wellesley, MA; Marge Engelman, Uni-versity of Wisconsin, Madison; BarbaraGinsberg,My Turn Program,KingsboroughCommunity College, Brooklyn, NY; JudyGoggin, Elderhostel, Boston, MA; PaulNussbaum, Neurobehavioral Services,Aging Research and Education Center,Mars, PA; and Arnold Scheibel, Neurobiol-ogy Department,ucla Medical Center, LosAngeles, CA.

ABOUT THE MINDALERT AWARDS

New research is showing that cognitive decline is not an inevitable part of the aging process.The brain isable to grow new nerve extensions at any age, and emerging evidence suggests that brain cells are capa-

ble of regeneration in the hippocampus—an area of the brain vitally important to the laying down of newmemories and information.

New knowledge about the brain means that mental stimulation should be maintained throughout life.These findings offer a striking new model of aging that suggests that elders have the opportunity to leadqualitatively better lives filled with more knowledge and wisdom—and an increased capacity to contributeto society.

To promote the translation of this new research on cognitive fitness into practice, the MetLife Foundationhas joined with the American Society on Aging (ASA) to create the MetLife Foundation-ASA MindAlertAwards.This awards program identifies and recognizes programs that provide valuable information and ac-tivities supporting enhanced cognitive function in later life.The award not only rewards successful and inno-vative programs, it provides a wealth of ideas and guidance for organizations seeking to create or improvetheir own programs.

American Society on Aging

With , members, the American Society on Aging (ASA) is the United States’ largest association ofprofessionals in the field of aging. Founded in , ASA’s mission is to promote the well-being of agingpeople and their families by enhancing the abilities and commitment of those who work with them.To thatend, ASA offers a wide variety of conferences and networking opportunities and Web-based training everyyear.The society also publishes a bimonthly newspaper, a quarterly journal and nine quarterly newslettersfor its members.To obtain more information on ASA and to join, visit www.asaging.org.

MetLife Foundation

MetLife Foundation (formally known as the Metropolitan Life Foundation), established in by theMetropolitan Life Insurance Company, has been involved in a variety of initiatives related to the issue ofaging. Since , the foundation has supported research on Alzheimer’s disease through the MetLife Foun-dation Awards for Medical Research program and has contributed over $ million to efforts to find a cure.In addition, the foundation has provided support for a new traveling exhibit on memory, an Alzheimer’s As-sociation public-education video for use by caregivers and families of persons with Alzheimer’s disease andthe distribution of the association’s quarterly newsletter. MetLife Foundation has contributed more than$ million to support health, education, civic and cultural programs throughout the United States. Formore information about the foundation, please visit its website at www.metlife.org.

Further Information About Brain Research

Accessible information about research on successful aging and the healthy brain can be found in thebooks Aerobics of the Mind by Marge Engleman and Keep Your Brain Alive by Lawrence Katz, as well as in thearticle “New Brain Research Suggests Link Between Wellness and Lifelong Learning” by Judy Goggin,published in the Older LEARNer (the newsletter of ASA’s Lifetime Education and Renewal Network) andposted online at www.asaging.org/networks/learn/ol-.html.

The MindAlert Program, sponsored by the American Societyon Aging, the MetLife Foundation and the Archstone Foun-

dation, is dedicated to sharing the findings of new researchshowing that cognitive decline is not an inevitable part of theaging process.

This book contains the transcript of a series of exciting lec-tures given by noted researchers Marian Diamond and ArnoldScheibel. The speakers discuss their research on factors thatinfluence the well-being of the brain and offer readers con-crete suggestions for keeping their brains healthy and activeas they age.

Also profiled inside are the winners of the 2001 MindAlertAwards, which recognize programs that support enhanced cog-nitive function in later life.