Archive for August, 2011

Sigmund Freud and Alzheimer’s Disease

August 31, 2011

No, the psychoanalyst Sigmund Freud did not have Alzheimer’s Disease. And, to the best of my knowledge, he knew of neither Alzheimer’s disease nor its founder, Alois Alzheimer. But according to at least one knowledgeable source1, Freud might have played an inadvertent role in Alzheimer’s being declared a disease. Alois Alzheimer was deeply conflicted about this issue. Clearly his patient was cognitively impaired. But was his patient suffering from a unique disease or was this just another manifestation of the many symptoms of dementia?

Alzheimer was offered a position in the laboratory of Emil Kraepelin. Emil Kraepelin was one of the most prominent psychiatrists of the era as was Sigmund Freud. However, the differed drastically in their approaches to psychiatry. Kraepelin was strongly of the opinion that psychiatry should be physically based just as the other medical specialties. However, at that time, Freud was all the rage with his psychological approach. Kraepelin wanted to move the emphasis in psychiatry back to a physical basis. Terming Alzheimer’s a disease, put it in the same category as tuberculosis and influenza. He was not claiming that mental diseases were necessarily infectious and transferable, but rather that they had a physical basis. As Alzheimer was an employee of Kraepelin, this might have played some role in it being declared a disease.

Some might wonder whether this is an important distinction. It is, as it affects the approaches taken. If it is a distinct disease, then it has a distinct diagnosis, and perhaps a distinct cure or treatment. If it is just another manifestation of dementia, then the question remains as to what is being treated. The best single predictor of whether a person will come down with Alzheimer’s is the person’s age. So Alzheimer’s is a product of aging, although it is not a necessary result of aging, as many age without suffering from the dementia known as Alzheimer’s. But the best predictor is not found in the genetics of an individual, although some people are more susceptible than others, but in age. Whether a person’s cognitive impairment can be diagnosed confidently must await an autopsy and the presence of amyloid plaque and neurofibrillary tangles. But autopsies have been performed on people who had amyloid plaque and neurofibrillary tangles, yet never showed any evidence of cognitive impairment while living. So what is Alzheimer’s? Fortunately we can take actions to reduce the risk of Alzheimer’s. Identifying these actions is one of the principal objectives of the Healthymemory Blog.

1Whitehouse, P.J., & George, D. (2008). The Myth of Alzheimer’s. New York: St. Martin’s Press.

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The Myth of Alzheimer’s

August 28, 2011

The Myth of Alzheimer’s by Peter J. Whitehouse, M.D., Ph.D. and Daniel George, M.Sc. is an important book. The myth is that Alzheimer’s is a single disease, and that a drug will be developed that serves as a silver bullet and eradicate Alzheimer’s. Whitehouse is no crackpot. He knows whereof he speaks. Note that he has a Ph.D and an M.D. Although he is now working as a clinician, he spent many years at the forefront of research on drugs to mitigate or eradicate Alzheimer’s disease (AD). He was a prominent researcher who was well funded and promoted by drug companies. When he became convinced that a cure for Alzheimer’s was not forthcoming, he turned his efforts to treatment.

Note that a definitive diagnosis of Alzheimer’s, even with today’s brain imaging technology cannot be made while the patient is living. It must await the autopsy of the individual. The presence of amyloid plaques and neurofibrillary tangles would confirm a diagnosis of Alzheimer’s. The problem is that autopsies of people who have shown no indications of cognitive impairments have also shown the presence of amyloid plaques and neurofibrillary tangles. Most drug treatments have been targeted to remove or mitigate these amyloid plaques or neurofibrillary tangles. Although some drug treatments have been able to slow the progression of Alzheimer’s in some people, these drugs typically have side effects and cannot prevent its progression. In some cases they just slow the occurrence of death, which prevents release from this degraded state. In an interesting history of the disease it becomes clear that its founder, Alois Alzheimer, had doubts that this was a distinct disease and that scientific competition forced Alzheimer’s employer to convince Alzheimer to call it a distinct disease.

The thesis of the book is best captured from the following excerpt from page 220, …”It is unlikely that there will ever be a panacea for brain aging and baby boomers should not rely on extraordinary advancements being made in their lifetimes besides the promises of the AD empire that make their way into our headlines. Our attention must begin shifting from mythical cure to hard-earned prevention, from expecting a symptomatic treatment for AD to choosing behaviors that may delay the effects “of cognitve decline over the course of our lives.” Many, if not most, of the behaviors he discusses have been mentioned and advocated in the Healthymemory Blog.

The book provides a superb tutorial on the history of AD from its unassuming beginnings to the development of an AD Empire. It reviews the science underlying AD and the role of genetics in AD. It discusses past and present treatments for AD. It explains how to identify someone who might need a prescription for memory loss, and how to prepare for a doctor’s visit. It presents a new model for living with brain aging as well as a prescription for successful aging across the life span. An epilogue is titled “Thinking Like a Mountain: The Future of Aging.”

This is an important and interesting book for everyone, but especially for us Baby Boomers.

Healthy Memory: Physical versus Cognitive Activity

August 25, 2011

Many articles on maintaining brain health and cognitive competence advocate the benefits of physical activity. This point is indisputable. Physical activity is good for the brain. However, cognitive activity is mentioned only rarely in this context, even though there is ample evidence that cognitive activity benefits both brain health and cognitive competence.

A study1 compared the benefits of mental and physical activity in older women over a period of six months. Two hundred and fifty-nine women aged 70 to 93 years were randomly assigned to one of three groups: a computer course, an exercise course, or a control group (for comparison purposes). Both the computer group and the exercise group showed improved delay story recall compared to the control group. They maintained performance in delayed word recall and working memory as opposed to the control group, which showed a decline over the 6 month period.

The authors concluded the following: “ In healthy older women, participation in new stimulating activities contributes to cognitive fitness and might delay cognitive decline. Exercise and computer classes seem to generate equivalent beneficial effects.”

An obvious question here is whether physical activities combined with cognitive activities would produce additive effects. I know of no study that has assessed the effects of both activities together. If anyone does know of such a study, please leave a comment. Nevertheless, a good argument could be made for engaging in both activities. Physical activities can maintain and build the body, and mental activities can maintain and expand the mind.

1Klusman, V., Evers, A., Schwarzer, R., Reishies, F., M., Heuser, I., &Dimeo, F.C. (2010). Complex mental and physical activity in older women and cognitive performance: a 6-month randomized and controlled trial.

© Douglas Griffith and healthymemory.wordpress.com, 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Positive Psychology

August 21, 2011

Positive Psychology is a movement that was started by the psychologist Martin E.P. Seligman. In a way, this is a bit ironic as he gained earlier recognition in psychology for his research on learned helplessness. In this research he showed that if animals were exposed to an environment of random shocks from which there was no escape, these animals were unable to learn in another setting that they could avoid these shocks. These findings were extrapolated to a human setting in which there are few positive rewards and few opportunities in which people simply give up and stop trying.

Seligman was disturbed by the emphasis placed in clinical and counseling psychology on malfunctioning individuals. He was not arguing that these populations did not deserve attention, but, rather, that attention should also be given to positive behaviors and thought that lead to happiness. The website for Positive Psychology can be found at http://www.ppc.sas.upenn.edu/index.html.

There was a session at the annual meeting of the American Psychological Association (APA) on Positive Psychology. On the whole, I am impressed with this movement. In other words, I am positive about Positive Psychology. My position should no be surprising given some previous Healthymemory Blog posts (“Continuing to Be Positive After Thanksgiving, “The Second Half of Life,” and “Change Your Brain By Transforming Your Mind.”). Buddhism encourages a positive attitude both to others and yourself. Positive thinking leads to happiness. It can also encourage perseverance and lead to success.

But there are parts of Positive Psychology that give me some concern. Emphasis is placed on finding and developing personal strengths. Although this is certainly good advice, I think it would be a mistake to focus on and develop personal strengths exclusively. If there are certain skills that are important to achieving your goals, but which are skills at which you do not excel, I think it would be a grave mistake to ignore them. For example, it certain mathematical skills would be helpful to achieving your interests, it would be good to focus on them and develop certain proficiencies. Once you have worked at something long enough you can become good enough where you actually enjoy the skill as it becomes a strength. Similarly, if giving presentation or public speaking is important to your pursuits, but you, like many, are fearful of speaking in public, consider addressing that fear. There are programs to help you overcome this fear and speak in public effectively and persuasively. Successful athletes do not usually work on what they are good at, but what they don’t do well, so they become more skilled at their sport. Deliberate practice is the term describing practice that focuses on correcting weaknesses or shortcomings.

Optimism is generally a good disposition, but it can be overdone (See the Healthymemory Blog Post “Can Optimism Be Bad?”). So be positive, but not too positive. Be optimistic, but not too optimistic.

© Douglas Griffith and healthymemory.wordpress.com, 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Thought Suppression

August 17, 2011

The title of Daniel Wegner‘s Invited Address for receiving the 2011 Distinguished Scientific Contribution Award at the APA meeting was “Setting Free the Bears: Escape from Thought Suppression.” The title of the address comes from a challenge by the novelist Dostoevsky to try not to think of three bears. This is very difficult to do except for a very short period of time. Although this is a challenging mind game, it relates to the more serious psychological problem of trying not to think unwanted thoughts. Wegner’s Ironic Process Theory provides an explanation of why this is so difficult to do. According to Ironic Process Theory there are two opposing mechanisms at work. The first process unconsciously and automatically monitors for occurrences of the unwanted thought. The second is the conscious operating process. When there is an increase in the cognitive load with which your mind is dealing, your unconscious monitoring process supplants your conscious operating process and the unwanted thought becomes conscious.

Most regard the Ironic Process Theory as providing a good theoretical explanation of the phenemonon. But the obvious question is, what can be done about it. Wegner presented a detailed and thorough discussion of possible remedies for thought suppression. But the remedy that he personally found most effective, and the one that I think is most effective, I shall call meditative breathing. This involves trying to focus on one’s breathing to the exclusion of all extraneous, intruding thoughts. Doing this for five to ten minutes can be effective although proficient meditators can do this for many hours.

The general benefits of this type of meditation go far beyond thought suppression. More information can be found in the following Healthymemory Blog Posts: “The Relaxation Response,” “Does Meditation Promote a Healthy Memory?” “Continuing to Be Positive After Thanksgiving,” and “Costly Gadgets or Software Not Required for a Healthy Memory.”

© Douglas Griffith and healthymemory.wordpress.com, 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Conscious Thought

August 14, 2011

The topic of consciousness has been addressed in a number of Healthymemory Blog Posts (“Change Your Brain by Transforming Your Mind,” “We Are the Law: Free Will, The Human Mind, and the Limits of Determinism,” “Consciousness and the Grandmother Cell,” “Fluid Intelligence and Working Memory,” “What is Incubation,” “How Do We See,” “Brain, Mind, and Body,” “What is Consciousness,”, and “Attention”) because it is an important topic. For most lay people, consciousness is psychology. It is how we deal with the world on a daily, and nightly, basis. It is a tad ironic, that for many academic psychologists consciousness is an epiphenomenon that we view in our minds, and that most, if not all, behavior and thought occur below the level of consciousness. So consciousness is viewed by some as a movie we see in our head as we proceed through our life. The believe it has no real function.

Consequently, it was refreshing to hear the presentation by Ray F. Baumeister at this year’s annual meeting of the American Psychological Association (APA) titled the “What, Why, and How of Consciousness.”1 Most theories that contend that consciousness is epiphenomenal focus on input and or output processes. Baumgartner does not address these theories as for him the role of consciousness is central to what occurs between input and output processes. He argues that conscious thought is for internal processing that facilitates downstream interaction with the social and cultural environment. Consciousness enables the construction of meaningful, sequential thought. These constructions are found in sentences and narratives, logical reasoning, quantification, causal understanding, and narratives. In short, it accounts for intellectual and social life. It is used for the simulation of events.

It is estimated that people focus an average of 30% to 40% of their thoughts on concerns that are unrelated to their present behavior. Some people’s minds wander from the here and now more than 90% of the time. Even when tied to present behavior, conscious thoughts are often used for to recall similar behaviors from the past, anticipating the consequences of present behaviors, or considering alternative courses of action.

Baumeister contends that thought sequences resemble film clips that the brain makes for itself, allowing different parts of the brain and mind to share information. The production of conscious thought is linked to the production of speech, because the human mind evolved to facilitate social communication and information sharing. This led to culture and the adaptive success of humankind as the social species.

1Although it might be difficult obtaining this address, much of its content and the citations found in this blog post can be found in “Conscious Thought Is For Faciliting Social and ‘Cultural Interactions: How Mental Simulations Serve the Animal-Cultural Interface” by Roy F. Baumeister and E.J. Masicampo in the Psychological Review, (2010), 117. 945-971.

© Douglas Griffith and healthymemory.wordpress.com, 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Reducing the Risk of Alzheimer’s Disease: Knowns and Unknowns

August 10, 2011

This title was the title of an invited address at the 2011 Meeting of the American Psychological Association (APA). The address was delivered by Dr Margaret Katz who is a professor of psychology, gerontology, and preventive medicine at the University of Southern California, where she directs the education core of the USC Alzheimer Disease Research Center. She is also the foreign adjunct professor in the Department of Medical Epidemiology and Biostatistics at the Karolinska Institute in Stockholm, Sweden.

The projections are that, unless there is signficant progress in prevention by 2040, there will be about twelve million people in the United States suffering from Alzheimer’s. Alzheimer’s accounts for about two-thirds of the cases of dementia. There is a genetic component contributing to the risk of getting Alzheimer’s, but the degree of that risk is still under research. In any case, the genetic risk factor is not something that any individual can control, so the remainder of this post will be focused on activities that reduce the risk of Alzheimer’s.

Diabetes and obesity are risk factors that increase the probability for Alzheimer’s. Depression, stress, neuroticism, and tooth loss also increase the probability of Alzheimer’s. However, there are many activities that can reduce the probability of Alzheimer’s

The higher the level of education, the lower the risk of Alzheimer’s. So returning to school and increasing one’s level of education might be an option to consider. It can also lead to a job with more occupational complexity (see below).

Cognitive engagement, that is engaging in activities that require the use of the mind. The Healthymemory Blog is devoted to increasing cognitive engagement. Mnemonic techniques are activities that engage one’s creativity, recoding abilities, imaging abilities, and also involves both hemispheres of the brain.

Occupational complexity refers to the cognitive and social demands of a job. To the extent that your occupation is complex, your risk factor is reduced.

Diet is important. The diet that is good for your heart is also good for reducing the risk of Alzheimer’s.

Light or regular physical exercise reduces risk.

Social engagement also reduces the risk for Alzheimer’s. Transactive memory involves other human beings and can lead to greater social engagement and the lowering of the risk for Alzheimer’s.
These activities also tend to lead to an increase in cognitive reserve. This refers to a reserve that retards the onset of Alzheimer’s. However, once Alzheimer’s sets in, the rate of decline is much faster. Although this might seem like bad feature, it can be interpreted that should you get Alzheimer’s and have this cognitive reserve, the amount of time suffering from the disease should be less.

The conclusion of Dr . Gatz’s presentation was that there should be a lifetime commitment to brain health. The Healthymemory Blog strongly concurs.

© Douglas Griffith and healthymemory.wordpress.com, 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Gone to the Annual Meeting of the APA

August 3, 2011

APA stands for the American Psychological Association. I’ll be meeting friends and colleagues and attending presentations and symposia. I hope to bring back some interesting content for the Healthymemory Blog. There will be a brief hiatus in blog postings while I attend the meeting, assimilate the material, and decompress. Then, too, I need to produce the posts.

In my absence I would remind you that there is plenty of material already on the Healthymemory Blog for your perusal. There are more than 200 posts that provide information on human memory, mnemonic techniques, and transactive memory, which includes the memories of fellow humans and the wealth of information available via technology.

The objective of this blog is to promote brain and memory health, and to maintain and grow effective cognitive functioning. The primary audience for this blog are the baby boomers. I am at the leading edge of the baby boomers, so I have a great deal of personal interest in this topic. I hope, however, that the Healthymemory Blog has general interest. I find these topics fascinating and want to share them with others of all ages. Besides, we all need to be concerned about effective memories throughout our lives, not just when we are studying in school, or later in life when we are concerned about warding off dementia. Our memories define who we are, and they are key to both a successful and a fulfilling and enjoyable life.

© Douglas Griffith and healthymemory.wordpress.com, 2011. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.