It was like a scene reminiscent of a Dickensian novel.

Except Oliver Twist wasn’t asking for more. He was saying, “This doesn’t work!”

I had been given a heads up at the beginning of last week that a paper was about to be published on the effectiveness of brain training and that it was likely to engender significant media coverage.

They were not wrong. It certainly grabbed a lot of attention.

One friend came up to me and said “Jenny have you read the report that says brain training doesn’t work!”. “Yes” I said, “…….but have you read the feedback looking at the concerns about the methodology used and the generalisation of the conclusions reached?”
“Well, no I haven’t,” she said “But it was done using a very large number of people in the study and the researchers are from Cambridge, so it must be very valid.”

Another friend simply expressed her relief at the headline she had heard.
“Thank goodness” she said, “Now I don’t have to worry about which game or training program I need to look at, because now it’s been shown they don’t make a difference”.

Oh no!

Now, while I am delighted that the topic of brain training is out at the forefront of people’s minds and that it has engendered a good deal of healthy debate, I have been dismayed at how one sweeping statement can colour people’s overall acceptance of what is the “truth”.

My concern is that for the vast majority of people, the only message they have heard is “Brain Training doesn’t work” Period. Without any exploration of what this study did or did not really demonstrate.

My first friend concluded that because the study is published in a respectable journal, because it involved a large number of study subjects (the largest of it’s kind to date) and it’s authors are academics from a well respected academic institution, that the findings therefore must be correct and to be taken note of.
My question to her, which she dismissed, was despite all that, is it not still possible to have produced a flawed study with an incorrect or overgeneralised conclusion?

Lets look at what all the fuss has been about.

The study was conducted by Jessica Grahn and Adrian Owen and others from the Cognition and Brain Sciences Unit in Cambridge UK, in conjunction with the BBC’s “Bang Goes The Theory” TV program.

11,430 participants were involved in the 6 week online study.
All were healthy adults aged between 18 and 60 years of age.

They were divided into three groups.

The first group undertook basic reasoning, planning and problem solving activities.
The second group undertook more complex activities more similar to computer brain training programs for exercise on memory, attention, maths and visual-spatial learning. The third group were asked to use the Internet to research answers to trivia questions.

All the participants had base line cognitive testing done before and after the study, using tests that are commonly used in looking at brain function in older adults who have sustained a brain injury or dementia.

The study’s finding reported that all three groups showed the same amount of minimal improvement which the authors put down to “practice making perfect” and then went on to say that that therefore brain training (while helping you by practice to improve a certain mental skill) does not translate into in to better overall improved cognitive functioning in every day life.

Looking a little closer at this study, the participants spent a grand total of 24 training sessions of 10 minutes each over the six week period.
240 minutes is not very long to look at how effective a training program is. I very much doubt that if I spent 3 to 4 hours over six weeks learning Japanese, I would have not learnt more than a few rudimentary words or sentences. Learning a new skill or undertaking training takes a lot of time, consistency, practice and effort.
Is their program actually a good example of brain training?

Other neuroscientists who have their own cognitive training programs have stated that in their programs participants are required to be spending a minimum of 30 minutes per brain training session and for a minimum of 15 hours in total to see any cognitive benefit.

The paper was also criticised in having poor quality control as all the subjects merely logged on to the study training program from their own homes with no regulation about what else was going on around them during the time of their “training”.
The gold standard for all studies involves adequate control of all variables.

Plus the cognitive tests they used on their healthy subjects, are usually used on people over the age of 60 with significant cognitive impairment. Would one expect any significant improvement then in healthy individuals with such minimal training?

So what can we take from this paper ?

With the huge amount of money being spent in the development and sales of brain training programs: $265 in sales in one year expecting to increase exponentially, we do need better assessments of the different brain training programs out there. We need a better idea of how effective they are and whether the results marries up with the promise. Are you paying for effective cognitive training or for simply a bit of fun and entertainment.

The Cambridge study used their own brain training program, which had a number of limitations and was clearly shown to be ineffective. But that finding on it’s own does not necessarily mean all the other programs are ineffective as well.

It is misleading for the results to be extrapolated to say that because their program was ineffective therefore all brain training programs are ineffective. There is a vast array of published research in the literature that reveal some very effective positive results from certain training programs. What about all the existing training programs that are used to assist people who are recovering from stroke for example? Is there anyone who would dispute their value in assisting people in recovery from their brain injury?

Just because one brand of whitening toothpaste doesn’t do a very good job doesn’t mean that all the other brands of whitening toothpaste don’t work as well.

My own sceptical mind also wonders about having a TV program involved with this study. Is there perhaps a little vested interest in getting people interested in watching the TV show? A bit like the newspapers who know that bad news sells. Will having a controversial headline produce the same effect?

What the paper maybe does highlight, is that there are no short cuts to maintaining your brain or trying to improve one’s mental cognition. And yes, I would certainly agree with that.
I also think we need to incorporate an array of initiatives to maintain or attempt to improve mental fitness. Brain training programs are only one facet.

There is plenty of evidence supporting the notion that managing other lifestyle factors including physical exercise, eating well, managing stress and getting enough sleep, will all help in our quest to stay mentally fit and optimise our brain health.

What I suggest now is for you to grab a cup of coffee and settle down for a bit of a read for yourself.
Here is the article from Nature magazine. Let me know what you think.
I do enjoy a bit of a debate.

Owen, A. M. et al. Nature advance online publication doi:10.1038/nature09042 (20 April 2010).

Laughing is good for your brain.

As Woody Allen said,

“I am grateful for laughter except when the milk comes out of my nose.”

When did you last have a good laugh? You know one of those really good deep belly laughs where you temporarily become engulfed in an uncontrollable fit of the giggles.
The one where your body is shaking helplessly in uncontrollable spasm, with tears pouring down your face. Where you become helpless to think, move or do anything until the moment is gone and our outpouring of guffaws, snorts or hoots has passed.

And how did you feel afterwards? Relaxed? Exhausted? You are likely to be feeling happy and to have a more positive outlook on life.
Laughing allows our problems and worries to not seem so big or scary anymore. Our resilience to life’s challenges improves.

And that’s why laughter is so good for our brain. We think better, have increased memory capacity, improved focus and attentiveness and are more positive when we include laughter in our lives.

When we laugh, a variety of different areas in our brain light up in activity. In less than half a second our logical left brain analyses the words or situation we are exposed to. Our frontal lobes then look to organise and plan and deal with our emotional response. Then our “big picture” right hemisphere “gets it” and finally our sensory and motor areas become involved, processing the visual cues and providing the outward physical response.

Do you remember or have you noticed, in school, it is those teachers who are able to engage their students with fun and excitement in their lessons, that the whole learning experience becomes so much more memorable?

If we are studying or working really hard, taking even a short break or time out with friends, to share a laugh or a joke will help us make a huge difference to our learning ability. We can focus and concentrate better, both essential prerequisites for memory.

Children laugh so much more than we do as adults. Kids laugh up to 300 times a day. Adults are lucky if we manage 17 laughs a day.
Where did all that fun go?

What is one of the first social cues we look for in our newborn babies?
That’s right, their first smile. That first toothless grin is such a magic moment, bonding infant with parent.
When we hear babies and children laughing, we are more likely to laugh too.

If you are feeling down or in need of cheering up, have you ever decided to find a comedy show on the TV or gone to watch a funny film? Why do we choose to do this?
Because we know from experience that if we do, it provides us with a temporary escape from all the other stuff in our lives that may be overwhelming us, making us sad, depressed or anxious and makes us feel better overall.

Remember laughter is infectious. Catch one person laughing and the mood in the whole room will lift and others will join is as well. It bonds people sharing the experience and improves the group’s ability to communicate better with each other afterwards.
Even if we don’t share the same language, a shared laugh crosses all barriers.

How can you bring more joy and laughter into your own life?

First up, choose to do so.
Look for opportunities to “lighten up”, maybe not take yourself so seriously and let go.
Relax!

Practise smiling.
Make a conscious effort to smile and acknowledge people (even if and especially if you are not feeling like it)
Smile at the checkout chick in the supermarket ( And they are sometimes in serious need of a smile)
Smile at random strangers. So what if they think you are nuts?
They may just think you are a happy person and they may even smile back. And every smile you receive back will lift your mood.

Next time you are up early (tomorrow right!) maybe taking the dog for a walk, or going to the gym or a run, practise smiling at people you pass. By the time you get to work and have already exchanged smiles with half a dozen or more people, you are likely to be in a much better frame of mind to start your day.
Smiles defuse tension and anxiety.
They provide support and show someone you care.

It takes more muscles to smile, so give your face a work out and smile and laugh often!

Spend time with others who make you laugh and who enjoy humour in their own lives. Sharing a joke with friends builds connections and allows us to express our true feelings more.

There are even laughter classes now. The medical and social benefits of laughter have been recognised as being so beneficial that trained laughologists (no really!) run classes with the purpose of reducing stress, raising energy levels, making you more positive in outlook and strengthening your immune system. Laughter triggers the brain to release endorphins, the feel good chemicals that help us to achieve a sense of well-being. Our levels of dopamine and serotonin increase and our levels of cortisol decrease.
The study of laughter is gelatology (sounds to me like ice cream) I’d like two scoops of that please with an extra squirt of dopamine.

Dr Patch Adams in the US is well known for his use of humour and laughter as a way of helping people heal when they have been sick.
Humour has been to shorten to reduce the amount of pain experienced by patients when recovering.
Which would you rather have? A couple of painkillers or a shot of humour?

Studies have shown that watching a comedy program rather than a drama, allows our blood vessel walls to relax, increasing blood flow and oxygen flow to our brain and reducing blood pressure.

And don’t forget, we tend to be more attracted to people we perceive as having a good sense of humour.
So, what’s a simple way to be perceived as an attractive person, that others would want to be with?

You got it.
Let go, and have a good laugh.

In my last blog post I talked about the effect that smoking in general has on our memories.

Now it’s time to move on to the impact that passive smoking has on our brains, and those of our children.
And to look at the effect smoking has on those young adolescents and adults who actually take up smoking themselves.

Passive Smoking, Diabetes and Dementia risk

Passive smoking is associated with an increased risk for developing impaired glucose intolerance, a precursor for diabetes, which is itself, a risk factor for dementia.

A US study on 4500 subjects over a 15 year period, gave the following results in percentages those who developed impaired glucose tolerance.

22% of the smokers
17% of the passive smokers (ie living with a smoker)
14% of ex smokers
12% of non-smokers

In other words, the passive smoking group had a higher risk of developing impaired glucose tolerance even compared to the ex smokers.

And smokers themselves had almost twice the risk of non-smokers.

Another valid reason to give up the smokes.

We are witnessing an explosion in the number of people with obesity and diabetes, both major risk factors for impaired cognitive performance and dementia.

Why add to that risk by continuing to smoke?

Passive smoking, dementia and reduced academic performance.

Passive smoking;

• can lead to cancer in non-smokers.
• can lead to the development of heart disease in non-smokers.
• can lead to an increased risk of impaired glucose metabolism, a precursor for diabetes in non-smokers.

Heart disease and diabetes are associated with increased risk of dementia.

In the BMJ (British Medical Journal) of February 2009 it was stated that “second hand smoke (ie passive smoking) increases a person’s risk of dementia and other forms of cognitive impairment and also is associated with poorer cognitive performance in children and adolescents”

Good grief. If ever there was an incentive to give up smoking for the sake of your kids, surely this has to a big one!

The message is stark.

Passive smoking is linked to increasing your risk of dementia.

It also reduces academic performance in younger children and adolescents.

Dr. Mark Eisner for the University of California agreed in his statement that the evidence is emerging: parental smoking may impair a child’s cognitive development.

Prolonged exposure to passive smoking can lead to cardiovascular disease, increased risk of stroke and cognitive decline.

If I am repeating the message, it is because I think it is crucial to understand this.

Still in the US, a study by Leslie Jacobsen at Yale showed that adolescents who smoke showed inaccuracies and impairments of their working memory.

It was even suggested that teenagers who smoke are perhaps going to need additional educational support because of this.

Plus, it was the boys (who tend to start smoking earlier than girls) who were found to be most impaired in tests of selective and divided attention.

This was highlighted further by a study just published, by Prof Weiser of the Tel Aviv University Dept of Psychiatry and Sheba Medical Centre at Tel Hashomer Hospital.

The study looked at 20,000 young men enlisted in the Israeli army who were all healthy young adults aged between 18 and 21 years.

Around 28% smoked one or more cigarettes a day, 3% were ex smokers and 68% non-smokers.

They found that the average IQ for the non-smokers was 101
The average for the smoking group was 94
For those who smoked a packet or more a day they scored even lower at 90.

In an average population of healthy young men an IQ score would be expected to be between 84 and 116.

In his group socio-economic background was not a factor. These were all healthy young adults from a variety of backgrounds.

Plus, they were able to show that in twin brothers where one was a smoker and the other was not, the non-smoking twin on average registered a higher IQ

If we don’t want our kids to be dumbed down, then we seriously need to encourage them not to take up smoking in the first place as well as seeking to minimise any potential exposure to passive smoking.

As parents we all want the best for our kids and to see them grow and succeed in life.
Why would we knowingly diminish their ability to do well academically by either smoking ourselves or allowing them to smoke as teenagers?

If you are an adult who smokes, giving up will not only benefit your health, it will also benefit the health of your family in terms of protecting their brain.

Remember passive smoking is as deadly as smoking itself.

Yet another valid reason to give up the smokes.

Yul Brynner the actor, left us a number of years ago in 1985.
He died from lung cancer.

His message was clear and still as relevant as ever.

“Just don’t smoke.”

What action are you going to take to protect yourself and your family?

What decision are you going to take right now and commit to, in order to protect your brain health and that of your children in relation to smoking and passive smoking?

How can you keep your kids safe and discourage them from taking up smoking?

Just don’t smoke and keep your brain and your kids brains protected from passive smoking.

OK, hands up!
Which one of you didn’t know that smoking is bad for your health and is associated with an increased risk of heart disease, stroke and cancer?

Apart from the remote tribes people such as those living in the Envira region of the Brazilian/Peruvian rainforest, most people are aware of the negative effects cigarettes have on your health.

But did you know about the damaging effect smoking actually has on your brain?
And did you know about the damaging effect of smoking on your kids’ brains that are subjected to second hand smoke?

Do I have your attention?

Let’s start with the evidence available which tells us that

• smokers have poorer memories
• reduced problem solving skills
• and an increased risk of dementia.

In the 10 seconds it takes for the nicotine and other chemicals to reach your brain after the first drag on the cigarette, changes occur in your brain affecting your mood, your well-being and memory.
The effects of that cigarette will last for about 20 to 40 minutes in your body.

Thought that smoking makes you more alert?
Think again. A US study by the University of Michigan has shown that smokers have a slower and less accurate thinking ability.

Long term smoking damages your memory, your ability to problem solve and reduces your IQ.

Ouch!

Why is it so hard to quit smoking?

In the brain, we have a neurotransmitter called acetylcholine that is associated with a number of the body’s functions including learning and memory. It also facilitates other neurotransmitters that are associated with mood, memory and appetite. The nicotine attaches to the acetylcholine receptors in the brain mimicking its actions and promotes dopamine levels. Dopamine is associated with pleasurable feelings.
Ever wondered why some people say they enjoy smoking? Could be the raised dopamine levels talking.
Plus the elevated dopamine is the partial answer to why it is so hard to stop smoking, as the nicotine addiction wants you to keep those nice dopamine levels up.

If you smoke, you will score lower on memory tests. Period.

Smoking more than a packet a day will lead to increased difficulty remembering names and faces.

And remembering names is one of the most commonly voiced concerns about memory loss.

Smoking more than a packet a day provides you with a regular cocktail of toxins including toluene (also found in paint thinners and solvents and we know what that does for your brain), which can cause confusion and memory loss.

Ladies.
Those of you who smoke into middle age and menopause need to be aware that nicotine will lower your blood oestrogen levels and may inhibit the effect oestrogen has on your brain, exacerbating any brain cell effects of the fluctuating oestrogen levels.

Women who smoke will score 20% lower in tests of executive thinking ie reasoning, planning and organising.

So what is the evidence supporting smoking affects memory?

Dr Marcus Richards at University College London did a study on 5362 people born in 1946 and divided them into groups as either smokers, non-smokers and ex smokers.

They were given a list of 15 words for 2 seconds each and were then asked to write sown as many as they could remember,
In the second part of the test they were shown a page of letters and they were given one minute to find and remove all of the “P’s” and “W’s”

The results showed the smokers had the lowest scores for memory.

Those who had given up smoking, had a lower level of decline than those who had continued to smoke. So if you do smoke you will still be doing your brain a huge favour by stopping.

The relationship between memory and smoking was most marked in those who smoked 20 a day plus. In other words, the more you smoke the worse the effect on your memory.

Smoking can therefore be seen as accelerating age related memory problems.

Is this surprising?
Well, impaired memory is not uncommon in smoking related illnesses including cancer, heart disease, stroke, bronchitis, emphysema and asthma.

Why smoking has this effect remains unclear but it is thought that it could be because smoking increases a person’s risk of developing high blood pressure (itself a risk factor for dementia). it has also been found that tobacco contains a substance called NNK which can cause neuroinflammation. It is this inflammation that may lead to neurodegenerative disorders.

Or it may be that smoking has an effect on the supply of oxygen on the brain.

Or it could be a direct toxic effect of the multitude of other toxins found in cigarette smoke.

Whatever the underlying reason, it is clear that smoking affects memory and is an increased risk for dementia.

Hint, this is a really good reason to give up the smokes.
It would be a really good idea to stop now.

The benefit of stopping is that there is less memory deficit the earlier you quit.

And it’s never too late to stop.

I look forward to hearing your comments. But no excuses about how hard it is to give up smoking. I’ve heard them all.

If you smoke you have an addiction (as well as a shrinking brain) so it takes a decision, commitment and perseverance to quit.

You can do it.

In Part Two of this blog on smoking Jenny will be covering the worrying evidence of the effects of passive smoking on our kids and the effects on kids brains if they themselves smoke.

Stay tuned.

Ref: American Academy of Neurology (2007, September 6). Smokers Are More Likely To Develop Dementia.