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save your brain 5 things you must do to keep your mind young and sharp paul david nussbaum ph.d new york chicago san francisco lisbon london madrid mexico city milan new delhi san juan seoul singapore sydney toronto[close]
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copyright © 2010 by paul david nussbaum all rights reserved except as permitted under the united states copyright act of 1976 no part of this publication may be reproduced or distributed in any form or by any means or stored in a database or retrieval system without the prior written permission of the publisher isbn 978-0-07-171785-4 mhid 0-07-171785-4 the material in this ebook also appears in the print version of this title isbn 978-0-07-171376-4 mhid 0-07-171376-x all trademarks are trademarks of their respective owners rather than put a trademark symbol after every occurrence of a trademarked name we use names in an editorial fashion only and to the benefit of the trademark owner with no intention of infringement of the trademark where such designations appear in this book they have been printed with initial caps mcgraw-hill ebooks are available at special quantity discounts to use as premiums and sales promotions or for use in corporate training programs to contact a representative please e-mail us at bulksales@mcgraw-hill.com terms of use this is a copyrighted work and the mcgraw-hill companies inc mcgrawhill and its licensors reserve all rights in and to the work use of this work is subject to these terms except as permitted under the copyright act of 1976 and the right to store and retrieve one copy of the work you may not decompile disassemble reverse engineer reproduce modify create derivative works based upon transmit distribute disseminate sell publish or sublicense the work or any part of it without mcgraw-hill s prior consent you may use the work for your own noncommercial and personal use any other use of the work is strictly prohibited your right to use the work may be terminated if you fail to comply with these terms the work is provided as is mcgraw-hill and its licensors make no guarantees or warranties as to the accuracy adequacy or completeness of or results to be obtained from using the work including any information that can be accessed through the work via hyperlink or otherwise and expressly disclaim any warranty express or implied including but not limited to implied warranties of merchantability or fitness for a particular purpose mcgraw-hill and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free neither mcgraw-hill nor its licensors shall be liable to you or anyone else for any inaccuracy error or omission regardless of cause in the work or for any damages resulting therefrom mcgraw-hill has no responsibility for the content of any information accessed through the work under no circumstances shall mcgraw-hill and/or its licensors be liable for any indirect incidental special punitive consequential or similar damages that result from the use of or inability to use the work even if any of them has been advised of the possibility of such damages this limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract tort or otherwise.[close]
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contents 7 preface vii introduction 1 1 2 3 4 5 6 7 8 9 10 the importance of brain health 17 how your brain works 31 adopting a healthy brain lifestyle 51 the five critical areas of brain health 61 critical area 1 socialization 77 critical area 2 physical activity 91 critical area 3 mental stimulation 105 critical area 4 spirituality 125 critical area 5 nutrition 141 pioneering a bold future for brain health 187 resources 197 index 205 v[close]
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preface 7 e very author can only hope that the content of his or her work will generate enough interest to connect with people i have been fortunate enough to work directly with the public for more than a decade and witness the deep personal connection that brain health can make my work across the united states has taught me several lessons including the need to make sure my message is personal and is felt on a personal level by the audience second people are genuinely interested in learning about their brains and for most our interaction is an introduction into the miracle of their brain third people are willing to change behavior to promote their health but that change does not occur unless informed by the why and the how behind the change fourth millions of baby boomers are now caregivers for parents who have dementia and these caregivers do not want to suffer the same misfortune they want to preserve access to their life stories finally due to current public interest in health and health care there is recognition that a proactive lifestyle toward health is important particularly for the brain together these lessons have motivated me to write this book to connect more with people about the most personal of all stories their brain health and the brain health of their loved ones vii[close]
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viii preface as a clinical neuropsychologist i have cared for hundreds and probably thousands of patients who suffer from diseases and conditions of the brain ranging from depression mania schizophrenia and substance abuse to dementia associated with alzheimer s disease stroke parkinson s disease tumors epilepsy and head injury these and other afflictions of the brain provide a real picture of the significant loss that can occur when the brain is damaged there is a realization that the brilliance of the brain is at the same time fragile it is from the loss of brain capability that a deeper appreciation of the brilliance and gift that is the brain emerges it can also be the motivation to learn more about your brain and to begin the lifelong work toward brain health i have had the wonderful opportunity to speak to thousands of people from diverse sectors of society all across the united states and beyond about the human brain my work and my message is to provide information on the basics of the human brain how the brain operates and can be shaped by environment and how my brain health lifestyle can be a guide to follow to promote brain health as you read along you will find that this book is written in a personal informative and fun manner so that everyone can benefit by learning more about their brain health from feedback i have received on presentations delivered to small groups in basements of buildings and audiences of more than five thousand people i have learned that the public is very interested and enthusiastic about brain health the message has found its way to the united nations the national press club major media outlets newspapers and magazines the internet,[close]
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preface ix and new business start-ups and into the hallways of education health care corporate america libraries health insurance and retail i ve spent many hours speaking to reporters and audiences about the miracle of the human brain and i ve written several books on the topic a lot of what drives this mission is my firm belief that it is critical to take what we learn in the lab and from research and communicate it and apply it to the general public which is why i approach brain health from the perspective of lifestyle as the brain is the center of our identity it is easy to understand why people are so interested most people enjoy learning about themselves and will work to improve their health if they are told how this book is a major step toward taking my message of brain health to a larger audience and instilling in them the idea that there is a miracle sitting within our heads that enables our every thought emotion and behavior we know more now about the human brain than at any other time in our history we will continue to learn and we certainly have much to learn however it is now abundantly clear that many stimuli in our everyday environment can shape both the structure and function of our brain we now believe the human brain is directly affected by the types of environments we are exposed to on a daily basis for some individuals an enriched environment can literally promote the health of the brain while others may cope with more traumatic stimuli such as war regardless it is critical that we all understand that our brains will be shaped by the type of environmental input or stimuli that we encounter on a daily basis.[close]
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x preface journey to becoming a brain health ambassador i was less than twenty years of age when i began working as an activity assistant in a local nursing home the home was new and had a specialized wing for persons suffering from alzheimer s disease this was quite progressive in 1983 it was also my first real job for which i got a paycheck my role was to work specifically on the alzheimer s unit and to construct a research project that focused on an activity program with the persons living on the unit we were able to show that alzheimer s patients who remain involved in social programming can evince a decline in depression over a period of time the study was presented at a national conference and published my memory of the time i spent on the alzheimer s unit however was much more personal and meaningful with regard to my early impressions of how the brain functions there was a gentleman living on the unit who became agitated at times and he would try to elope off the unit in fact on occasion he would be found in the parking lot walking away from the building obviously this was a major safety concern and staff needed to be vigilant to this man and his behavior i was asked to try and modify the elopement a clinical term we use in the field to describe someone who tries to get away from their unit the person may or may not have a logical reason to leave the unit or building regardless it is a serious concern due to the obvious safety risks for someone who is confused traveling in an unsupervised manner.[close]
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preface xi my first thought and feeling about this challenge was fear i probably was afraid that the man would not cooperate with me and that i would fail during one episode when he was walking away from the building i approached him and asked him where he was going he replied that he was going to his farm to tend to his crops it turns out he was a farmer by trade and his memory loss placed him back at this stage of his life he had an accurate memory but the context for that memory was no longer valid and in fact he had not worked in more than thirty years i listened to him and although he was agitated i suggested to him that his farm was the other way pointing toward the back of the building where his room was and that i was happy to walk with him to the farm he seemed to be pleased with my suggestion and we walked safely back to the unit where he lived i made sure we started a garden on the patio and this gentleman was now in charge of growing tomatoes and other vegetables for residents living in the home of course this experience was significant to me and taught me a great deal about alzheimer s memories passions and how to modify agitation by redirecting the agitated energy into purposeful pursuits on the same unit lived a friendly older female who suffered from alzheimer s and was often sitting with others engaged in some activity i noticed she would occasionally sit on her own and at times she was tearful i noticed this behavior tended to occur around dinnertime a period of the day when some persons with alzheimer s can demonstrate increased agitation this behavior is often referred to as sundowning we do not[close]
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xii preface know why this occurs and we struggle to change the behavior when it does occur i sat next to the woman and asked her why she was crying she explained to me that she was upset that she could not get home to cook for her children that they were going hungry once again a memory that was accurate was simply out of context this woman did cook for her children for many years the problem was that she had not cooked for her children for many years as they were all grown and independent alzheimer s placed this woman into a time frame that was no longer real her emotions were real and she felt very sad i asked her to go with me to the kitchen area where she helped me make some drinks to serve to the other persons living on the unit this seemed to make her feel better and to grant her the role of traditional mom that she missed so dearly several years later i accepted a position as director of an aging and research center where we conducted applied research and programming for nearly a thousand older adults living in a continuum of care there was a large population of persons who suffered from alzheimer s i recall a husband walking into my office one day and breaking down in tears as he described his desperate efforts to connect with his wife whom he loved his emotional plea to me to bring her back continues to resonate with me today i felt helpless as i tried to comfort this good man these are typical stories that are too real and very moving this is what alzheimer s is in the real world it is not the academic and clinical definition of plaques and tangles alzheimer s and other brain diseases steal our soul our spirit and our iden-[close]
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preface xiii tity neurodegenerative diseases attack our life story the most precious gift we have anyone who works on the front line with persons suffering from alzheimer s knows these experiences and stories well these experiences showcase the devastation that alzheimer s can cause to a healthy brain and the emotional discord that relates to memories that are out of context and no longer attached to real time families are emotionally drained as they struggle with observing or caring for their loved one who is no longer connected to real time because memory is impaired and memory requires some sense of the past and the present having these experiences with alzheimer s patients also permitted me the opportunity to connect with them even though their brains were compromised and confused the brain is brilliant enough to provide pathways of connection that enable emotional stability and calming the brain will offer clues about the emotion and about the desire of the person the human brain never stops its ability to be brilliant even in the midst of a progressive degenerative disease such as alzheimer s a more personal experience that hits closer to home is my relationship with my brother robby robby is now fifty-three and was diagnosed with a pervasive developmental disorder when he was an infant the doctors never were able to determine the cause for his disability and some advised my parents to place him in an institution advice my parents fortunately rejected robby suffers mental retardation seizure disorder and other neuropsychiatric illnesses he lived at home for the first thirty-five years of his life attended a school but otherwise was dependent for basic activities of daily life he then moved to a community living arrangement where he continues to live and[close]
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xiv preface thrive today as robby is seven years older than me i learned a tremendous amount about behavior and brain function growing up with him well before my academic training in neuropsychology i recall trying to understand why robby would get upset and i also recall feeling bad when others made of him these experiences guaranteed i would never make fun of anyone who was different or had difficulty anyone who works with people with mental retardation understands quickly how important the frontal lobe is to brain function as the chief executive officer of the entire brain the frontal lobe organizes choreographs and initiates behavior in beautiful harmony it also filters emotions such as passion rage anger and driven states so behavior is expressed appropriately when functioning in a normal way the frontal lobe permits a healthy balance of mood and behavior when disturbed the frontal lobe expresses a variety of emotions that can range from mania to depression to an inability to control rage or temper some persons with mental retardation can display the disturbed version of frontal lobe function and it is generally up to the caregiver to try and modify the behavior through routine and calm reassurance all of us like routine my early observations of robby and the many residents with alzheimer s disease taught me a tremendous amount about human behavior brain disease and the importance of bringing calm to a chaotic brain each brain is capable of being comforted even though it may exist in a state of confusion and agitation one interesting thing about the human brain is that it maintains ability and skill even when disease and disabil-[close]
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