Friday, April 15, 2011

Jogging the Memory of a Geezer

[**Warning**  This blog is another in my "Geezerhood" series.  Past entries have included "Embracing Your Inner Geezer," "How to Compress Your Morbidity," "The Power of Negative Thinking," and "So, What Do You Do All Day?".   Those readers who have decided they are immune from Geezerhood may find this material irrelevant and are urged to use discretion in reading further.]

As the saying goes, "Growing old isn't for whimps."  Besides the challenge of coping with physical changes, as discussed in my blog of  2/1/11, there is also the challenge of possibly losing your mind, or at least not being  able to remember where you put it.  Sad personal reminders of this are several academic colleagues of mine who are now in various stages of Alzheimer's, a disease made all the more tragic for these people because they were all bright, well-educated intellectuals with incisive minds. 

Alzheimer's is the most prevalent form of dementia, followed by dementia produced by strokes.  And it is indeed prevalent. According to the Alzheimer's Association, 5.4 million Americans have the disease.  At age 65 the estimated lifetime risk of developing Alzheimer's or some other form of dementia is 20% for women and 17% for men.  For those who make it to 85, the risk is much higher -- 43%.   And it is indeed deadly.  Alzheimer's is currently the 6th leading cause of death in this country, 5th for those over 65.  It is estimated that 61 percent of people with Alzheimer’s at age 70 will die before age 80 compared with 30 percent of people at age 70 without the disease.

An optimistic take on these grim statistics is that most geezers won't be stricken by Alzheimer's or other forms of dementia during their "golden years" -- if  20%  are afflicted, then the other 80% won't be, right?  While this optimism is justified in the strictest sense,  there is now a substantial body of scientific evidence that even "normal" geezers will experience some degree of cognitive decline due to changes in neurological processes and brain structure that are an inevitable result of aging.  These physical changes will likely be manifested in difficulties in learning, reasoning, decision making, cognitive task performance, and memory.   The evidence also shows, though, that there is a wide range among individuals in the type and degree of difficulties they experience, even among those with the same degree of  neurological degradation.  A more realistic approach then, is to ask "how much cognitive decline will I experience and is there anything I can do about it?"

The most recent research bearing on these questions has been nicely summarized and evaluated by Christopher Hertzog in a monograph published by the Association for Psychological Science (Hertzog et.al., 2008).  Hertzog's analysis of the available data suggests that there are a number of identifiable factors that influence a person's degree and rate of decline, and that there are certain interventions that can -- within limits -- alter an individual's position within the possible range of functioning.

It is important to note that the evidence for some of these "enrichment effects" is not very strong or is controversial, while for other factors the research seems much clearer and stronger.  For example, it is somewhat surprising that the common sense idea of staving off cognitive decline by leading an intellectually active lifestyle (the "use it or lose it" hypothesis) -- while it has received consistent empirical support -- must be tempered by the fact that the strength of the effect is not as strong as it is for other factors and may be open to alternative explanations  (Hertzog et. al., 2008).  Nonetheless, research over the last 10 years indicates that continued engagement in mentally stimulating activities (reading books, attending plays, playing chess, writing, playing a musical instrument, attending public lectures, taking courses, etc.) can reduce the debilitating effects of "normal" cognitive decline, and even lower the risk of dementia and Alzheimer's disease (Wilson et. al, 2007).

Another approach to cognitive enrichment is based on what might be called the "mental pushup" model., where older people are exposed to interventions that involve specific training in memory, reasoning, or problem solving.  For example,  in a study by Ball et al. (2002), 2500 participants over 65 went through training sessions in one of three cognitive domains:  memory, reasoning, or visual search.  The results showed marked gains for each training group that persisted over a 5-year follow up period.  As encouraging as these results seem, it was also found that the enhancement effects didn't transfer to performance-based measures of everyday problem solving or everyday speed of processing -- in other words, the benefits were restricted to the specific training domains and didn't generalize to other kinds of tasks.   A number of other studies have reached the same conclusion -- very little generalization of the cognitive gains achieved by training specific skills or processes (Hertzog et al., 2008).

However, there have some very recent attempts to develop training strategies involving more complex mechanisms that do show generalization.  One example is training in quickly switching between different tasks or between different sets of cues relevant to the same task,  both of which are abilities involving cognitive control that usually decline significantly with age.  In a study by Karbach & Kray (2009)  this type of intervention not only significantly improved older adults' task-switching performance,  but also produced generalized improvements in verbal and spatial memory, and reasoning skills.

Another promising new approach is "metacognition"  training.  "The essential feature of metacognitive interventions is to train individuals to assess processing demands of task contexts and to select, implement, and evaluate strategies during performance" (Hertzog et al., 2008, p. 20).  For example, one metacognitive approach trains people on using mnemonic memory techniques coupled with self-testing to determine when material has been learned well enough to permit later retrieval (Dunlosky et al., 2007).  Research indicates that the generality of this technique enables older people to apply it to everyday situations outside the experimental context.

As promising as some of these training strategies are, there is one type of intervention that recent research shows is hands down the most effective in lessening cognitive decline associated with aging:  physical activity.  It even seems to "compress cognitive morbidity" so that the period of diminished mental capacity is shorter, even among those with Alzheimer's and other forms of dementia (I discussed compression of morbidity regarding physical aspects of aging in an earlier blog).

The fitness fanatics out there no doubt are vigorously nodding their heads in agreement as they read this before their spinning class or after their 15-mile run.  But the real news in this research is that (a) the level of physical activity required to achieve significant benefits is really quite modest, and (b) beneficial effects can be achieved even when the physical activities are initiated later in life. This is particularly encouraging for those geezers who have physical limitations or injuries that prevent them from engaging in high impact aerobics, or for those who weren't physically active in their younger years.

For example, in a study by Kramer et al. (1999) older adults who were in good health but sedentary were randomly assigned to either a training condition in which they walked briskly for 1 hour per day 3 days a week for 6 months, or a condition in which they performed stretching and toning exercises for the same amount of time.  Those in the walking condition but not the stretching and toning condition showed generalized improvement in various aspects of cognitive functioning, including the ability to selectively process task-relevant information while ignoring irrelevant information, the ability to override inappropriate responses, and the ability to switch rapidly between multiple tasks.

In another example, the activity levels of 6,000 women aged 65 and older were assessed (e.g, blocks walked per week, flights of stairs climbed per day, frequency and duration of  various exercise and sports activities) and then levels of cognitive functioning were measured 6-8 years later (Yaffe et al., 2001).  Those who were more active were 30% less likely to show cognitive decline, even after adjusting for education level, health status, and other rival explanations.  Interestingly, walking distance was related to cognitive functioning whereas walking speed was not, suggesting that even moderate levels of activity have a beneficial effect.

Finally, a number of studies have found that modest physical activity and exercise can reduce the probability of severe cognitive problems in later life.  Rovio (2005), for instance, found that physical activity in middle age consisting of as little as 20-30 minutes twice per week of exercise vigorous enough to produce breathlessness and sweating reduced the risk of dementia 20 years later by 52%. 

After evaluating all of the available research regarding cognitive functioning in older adults, including the studies focusing on physical activity, Hertzog et al. (2008) offers this optimistic conclusion:
"What is most impressive to us is the evidence demonstrating benefits of aerobic physical exercise on cognitive functioning in older adults. Such a conclusion would have been controversial in the not-too-distant-past, but the evidence that has accumulated since 2000 from both human and animal studies argues overwhelmingly that aerobic exercise enhances cognitive function in older adults.  The hypothesis of exercise-induced cognitive-enrichment effects is supported by longitudinal studies of predictors of cognitive decline and incidence of dementia, but also by short-term intervention studies in human and animal populations.  The exercise-intervention work suggests relatively general cognitive benefits of aerobic exercise but indicates that cognitive tasks that require executive functioning, working memory, and attentional control are most likely to benefit."  (p.41)

Geezerhood is tough.  But thanks to increases in our scientific understanding of aging, we are seeing some real advances in practical ways to come to terms with it.  Cognitive decline may be inevitable, and for some us it will be devastatingly severe.  But thankfully there are ways we can lessen the degree to which the quality of our lives are impacted by the relentless march of time.



References:

Ball, K., Berch, D.B., Helmer, K.F., Jobe, J.B., Leveck, M.D., Marsiske, M. (2002.  Effects of cognitive training interventions with older adults:  A randomized controlled trial.  Journal of the American Medical Association, 288, 2271-2281.

Dunlosky, J., Cavallini, E.,  Roth, H.,  McGuire, C.L., Vecchi, T., & Hertzog, C. (2007).  Do self-monitoring interventions improve older adults' learning?  Journal of Gerontology: Psychological Sciences, 62B (special issue I), 70-76.

Hertzog, C., Kramer, A.F., Wilson, R.S.,  & Lindenberger, U. (2008).  Enrichment effects on adult cognitive development:  Can the functional capacity of older adults be preserved and enhanced?  Psychological Science in the Public Interest, (9).

Karbach, Julia, & Kray, Jutta (2009). How useful is executive control training? Age differences in near and far transfer of task-switching training.  Developmental Science,  978-990.

Kramer, A.F.,  Hahn, S., Cohen, N.J., Banich, M.T., McAuley, E., Harrison, C.R., et al. (1999).  Aging, fitness and neurocognitive function.  Nature, 400, 418-419.

Rovio, S., Kareholt, I., Kelkala, E.I., et al. (2005).  Leisure time physical activity at midlife and the risk of dementia and Alzheimer's disease.  Lancet Neurology, 4, 705-711.

Yaffe, K., Barnes, D., Nevitt, M., Lui, L.Y., & Covinsky, K. (2001).  A prospective study of physical activity and cognitive decline in elderly women.  Archives of Internal Medicine., 161, 1703-1708.


Wilson, R.S., Scherr, P.A., Schneider, J.A., Li, Y., & Bennett, D.A. (2007).  The relation of cognitive activity to risk of developing Alzheimer's disease.  Neurology, 69, 1911-1920.

Friday, April 1, 2011

It's a Guy Thing

My sister recently forwarded me a story that has been circulating on the internet for quite some time, though I have never seen it before.   I'll quote it below, then make some comments about whether it is true or not.  Right now, though, you should know that I was gasping for breath from laughing when I read it.  In short, you have been forewarned that this is my kind of humor (see What, Me Worry? for an analysis of what makes me laugh):

Pocket Tazer Stun Gun, a great gift for the wife. A guy who purchased his lovely wife a pocket Tazer for their anniversary submitted this:
Last weekend I saw something at Larry's Pistol & Pawn Shop that sparked my interest. The occasion was our 15th anniversary and I was looking for a little something extra for my wife Julie. What I came across was a 100,000-volt, pocket/purse-sized Tazer.

The effects of the Tazer were supposed to be short lived, with no long term adverse affect on your assailant, allowing her adequate time to retreat to safety...??

WAY TOO COOL! Long story short, I bought the device and brought it home... I loaded two AAA batteries in the darn thing and pushed the button. Nothing! I was disappointed. I learned, however, that if I pushed the button and pressed it against a metal surface at the same time, I'd get the blue arc of electricity darting back and forth between the prongs.

AWESOME!!! Unfortunately, I have yet to explain to Julie what that burn spot is on the face of her microwave.

Okay, so I was home alone with this new toy, thinking to myself that it couldn't be all that bad with only two AAA batteries, right?

There I sat in my recliner, my cat Gracie looking on intently (trusting little soul) while I was reading the directions and thinking that I really needed to try this thing out on a flesh & blood moving target.

I must admit I thought about zapping Gracie (for a fraction of a second) and then thought better of it. She is such a sweet cat. But, if I was going to give this thing to my wife to protect herself against a mugger, I did want some assurance that it would work as advertised.

Am I wrong?

So, there I sat in a pair of shorts and a tank top with my reading glasses perched delicately on the bridge of my nose, directions in one hand, and Tazer in another.
 The directions said that:
a one-second burst would shock and disorient your assailant;
a two-second burst was supposed to cause muscle spasms and a major loss of bodily control; and
a three-second burst would purportedly make your assailant flop on the ground like a fish out of water.

Any burst longer than three seconds would be wasting the batteries.

All the while I'm looking at this little device measuring about 5" long, less than 3/4 inch in circumference (loaded with two itsy, bitsy AAA batteries); pretty cute really, and thinking to myself, 'no possible way!'

What happened next is almost beyond description, but I'll do my best.

I'm sitting there alone, Gracie looking on with her head cocked to one side so as to say, 'Don't do it stupid,' reasoning that a one second burst from such a tiny lil ole thing couldn't hurt all that bad.. I decided to give myself a one second burst just for heck of it.

I touched the prongs to my naked thigh, pushed the button, and...

HOLY MOTHER OF GOD. WEAPONS OF MASS DESTRUCTION. WHAT THE... !!!

I'm pretty sure Hulk Hogan ran in through the side door, picked me up in the recliner, then body slammed us both on the carpet, over and over and over again. I vaguely recall waking up on my side in the fetal position, with tears in my eyes, body soaking wet, both nipples on fire, testicles nowhere to be found, with my left arm tucked under my body in the oddest position, and tingling in my legs! The cat was making meowing sounds I had never heard before, clinging to a picture frame hanging above the fireplace, obviously in an attempt to avoid getting slammed by my body flopping all over the living room.

Note:
If you ever feel compelled to 'mug' yourself with a Tazer,
one note of caution:

There is NO such thing as a one second burst when you zap yourself! You will not let go of that thing until it is dislodged from your hand by a violent thrashing about on the floor!
A three second burst would be considered conservative!



  • My bent reading glasses were on the mantel of the fireplace.


  • My triceps, right thigh and both nipples were still twitching.


  • My face felt like it had been shot up with Novocain, and my bottom lip weighed 88 lbs.


  • I had no control over the drooling.


  • Apparently I had crapped in my shorts, but was too numb to know for sure, and my sense of smell was gone.


  • I saw a faint smoke cloud above my head, which I believe came from my hair.



  • I'm still looking for my testicles and I'm offering a significant reward for their safe return!

    PS: My wife can't stop laughing about my experience, loved the gift and now regularly threatens me with it!
     
    If you think education is difficult, try being stupid!!!!

    This story has been circulating since 2004, and although it has never been determined for sure that it is just a wildly funny made-up tale, there are strong hints that it is just that.  Most telling is that the story has changed over the years by being updated and expanded -- for example, in the original story it was Jessie Ventura who was the pro-wrester instead of Hulk Hogan.  You can compare the version above with the original available on  Snopes.com, my favorite site for researching stuff like this.  Despite the strong possibility it didn't really happen, it is still very funny indeed.  Oh, and a little quick Googling reveals that such devices do, in fact exist.  For example,  at BestStunGun.Com you can buy one for about $70 that is the size of a pen, generates 800,000 volts, and requires just two small 3-volt CR2 batteries.

    Incidents that really have happened and which showcase human (usually male) stupidity are collected and presented at another of my favorite sites, The Darwin Awards.  The Darwin Awards "...salute the improvement of the human genome by honoring those who accidentally remove themselves from it..."   Here's just one example, called Dying to Go:

    Dying To Go
    2009 Darwin Award Nominee
    Confirmed True by Darwin



    (12 April 2008, Florida) Traffic was moving slowly on southbound I-95. Shawn M. had recently left a Pompano Beach bar, and now he was stuck in traffic. As the saying goes, you don't buy beer--you just rent it, and Shawn couldn't wait another moment to relieve himself. "I need to take a leak," he told his friends. Traffic was deadlocked, so the waterlogged man climbed out, put his hand on the divider, and jumped over the low concrete wall... only to fall 65 feet to his death. "He probably thought there was a road, but there wasn't," said a Fort Lauderdale police spokesman. The car was idling on an overpass above the railroad lines.

    His mother shared her thoughts. "Shawn didn't do a whole lot for a living. He got along on his charm, just like his father."

    Though his death was tragic, Shawn's downfall proves the old adage: Look before you leak!
    Definitely more of my kind of humor.