As a medical student at University I must have consumed the equivalent of a small lake of instant coffee.
Battling the demands of essays to be written and information to be memorised, I kept myself going with my trusty kettle and large jar of instant coffee.

By the time I graduated I was so sick of the stuff I couldn’t drink it any more and switched to tea.

It has only been in recent years that I have actually started to enjoy coffee again. But, I still can’t drink the instant sort. It has to be real coffee.

And I have to say; I look forward to my daily mid morning cup. I love the wonderful aroma and savour every last drop.

But does it do anything for our brain in terms of mental performance?

Caffeine has been described as the world’s most widely consumed psycho-stimulant.
How many of us start our day with that cup “just to get us going”?
Apparently 90% of Americans do.

Caffeine is a stimulant. In much the same way as amphetamines, cocaine and heroin are and no I am definitely not recommending those to start your day.
It works on our brain by speeding it up.
So yes, we are more alert when we consume caffeine.

The peak effect on our brain occurs 15 to 45 minutes after drinking the coffee and the total effect lasts around two hours.

How this works, is that in the brain we have receptors for a brain chemical called adenosine. Now, these receptors are unable to distinguish between adenosine and caffeine. So when we have that cup of coffee, the caffeine locks onto the adenosine receptors and blocks the adenosine from being able to exert it’s normal effect of slowing down brain cell activity. So, our brain cells speed up their rate of firing.

The trouble starts when the pituitary gland detects the increased rate of brain cell activity and presumes there is an emergency happening somewhere. This results in the flight or fight response being initiated, with the adrenal glands pumping out adrenaline to fire us up.

So yes we are alert and ready, but not necessarily in terms of improved mental performance.

Once the effect of the caffeine and the adrenaline has worn off we are likely to be feeling more tired and a bit flat.
Time for another cup of coffee to get us going again….. Leading to a vicious cycle being set up. We become addicted to that quick fix we appear to get from drinking coffee. Drinking a lot of coffee will actually make you feel more tired.
We need to remember too that caffeine is also found in tea and cocoa.

Can’t sleep at night? It could be the coffee.

Many people find that they can’t drink coffee late at night as it keeps them awake.
Caffeine has a half-life of 6 hours That cup of coffee you have mid afternoon will leave you still with around 50% of the caffeine in your system when you are going to bed that night. That in itself it not a huge problem. Many of us can get to sleep even with a significant amount of caffeine still in our system.
But remember that the caffeine blocks your adenosine receptors?
We need the adenosine to slow our brain cells down when we want to sleep. The caffeine interferes with your ability to have good quality sleep by reducing deep sleep, which we need for good brain function.

There is some good news about the caffeine though.
It increases our dopamine levels in our brain.
Dopamine is the neurotransmitter, which makes us feel good and happy.
So when I have my mid morning coffee, I am alert and happy too.

Does quitting coffee really give you a headache?

Want to quit or cut down your coffee consumption? That’s fine. Just be prepared for the withdrawals.
You may have heard of people telling you they get a caffeine withdrawal headache if they miss their coffee or try to cut down. That’s because the caffeine causes blood vessels to dilate. Remove the caffeine and the blood vessels constrict, which can cause a nasty headache.
That’s why people who suffer from vascular headaches (caused by blood vessel constriction) use caffeine tablets to take away the headache.
Plus you may suffer from aches and pains, extreme tiredness and depression during the period of withdrawal. But the worst is only for a couple of days.

Researchers at the University of Vermont and John Hopkins School of Medicine published a paper in 2009 demonstrating the physiological effect on our brain of quitting caffeine.
Caffeine withdrawal produced EEG changes, associated with the feeling of fatigue. Cerebral blood flow on ultrasound was also shown to increase. Subjectively those on the study reported feeling sluggish, tired and weary.

So yes it can take several days to get over the worst with reduced alertness and slower reaction times.
But by day 6 or 7 your body will have recovered, your blood pressure is like to be lower, you may have less anxiety, be sleeping better and be functioning mentally just as well as when you had been drinking coffee.

The study revealed that those people who drink coffee regularly have no mental benefit or advantage over those that don’t, despite those of us who like to think it helps give us the edge.

Oh well.

Maybe we should just enjoy coffee and its caffeine for what it is. A stimulant that will give us short term increased alertness and happiness.
We just need to make sure we don’t have so much that we impair our brain fitness and mental performance.

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Now I do enjoy a nice glass of red wine occasionally and there is a lot of noise in the media about red wine being good for us.

Why? Because red wine contains resveratrol, an antioxidant with supposedly lots of health benefits such as protecting us from cancer, cardiovascular disease and perhaps cognitive decline.

Look in the health food shops selling memory enhancing supplements and many include resveratrol. You can even buy resveratrol in capsule form.

So should be we be taking these supplements or drinking more red wine?

Let’s have a look at what some of the research is saying about all this.

First off, resveratrol is not only found in red wine. It’s also found in a number of other plants and foods such as blueberries, mulberries, peanuts even eucalypt, lily and spruce. But it is grapes, which have drawn the most attention.
The grape vines contain resveratrol in the roots, stalks, seeds and especially the skin of the grape.
I think I’ll stick to the grapes and the skin.
In the fermentation process to make red wine, the skins which contain a lot of resveratrol are included. This is what differentiates it from white wine fermentation where only the crushed berry juice is used, not the skins.
Not all red wines are equal either. The highest concentrations of resveratrol are found in the Labrusca, Muscadine and Vitus Vinifera varieties.
Dr Richard Hoffman and Mr Johansson at the University of Hertfordshire, UK have been looking at a number of different red wines to determine which have the highest concentration of resveratrol. So that one day we will be able to select which wine we wish to purchase, based on it’s resveratrol content.

So how does resveratrol exert it’s health benefits in the brain?

Let’s look at a study on ischaemic stroke published in April 2010. Researchers from John Hopkins used resveratrol in mice studies and found that the resveratrol works to increase a neuro-protective enzyme (called haem oxygenase) Mice given resveratrol as supplements who then suffered an induced ischemic stroke, sustained less brain damage than those mice who had not received the supplement, because the resveratrol boosted the haem oxygenase levels.

Moving on to look at Alzheimer’s disease where having higher blood markers of inflammation is known to be associated with a higher risk of developing the disease. In the Framingham Heart Study, 691 healthy seniors (aged 79 years and older) had their levels of cytokines (markers of inflammation) measured in blood tests. Over the next 7 years, 44 of the participants developed Alzheimer’s disease.
The results showed that those with the highest levels of cytokine in their blood had twice the risk of developing Alzheimer’s disease.

So what’s the link to resveratrol and inflammation?

Resveratrol has been shown in mice studies to protect them from acute inflammation. Researchers in the Medicine Faculty in Glasgow demonstrated that resveratrol supplements helped to prevent the body from producing substances called sphingosine kinase and phospholipase D, which are involved in triggering the inflammatory response.

So how does resveratrol help to protect us from Alzheimer’s disease?

In Alzheimer’s disease, the main brain changes are massive brain cell loss and the appearance of neurofibrillary tangles and plaques of beta amyloid.
Ongoing studies indicate that resveratrol promotes the clearance of beta amyloid that has formed, by inducing the body’s proteasomes. The proteasomes are the body’s waste disposal units for getting rid of unneeded cellular proteins that can then be recycled. The mechanism for how resveratrol does this, as yet remains unknown.
All that is known is that in those people with Alzheimer’s disease, the natural activity of proteasomes is reduced.

Thus much of the story remains untold. As yet we don’t know which are the best red wines to be consuming, or the quantity to produce the beneficial effects. It may be that resveratrol itself is the messenger, a stimulator of other protective enzyme systems, rather than the major player in the process.

What we do know now is that resveratrol

• Increases a neuro protective enzyme called haem oxygenase that will help protect us to some extent, in the event of a stroke.
• Dampens down inflammation (a marker for increased risk of Alzheimer’s disease) in the body by reducing the amount of inflammatory enzymes that form.
• Promotes the body’s natural protein waste disposers, the proteasomes, which help clear the brain of beta amyloid deposits.

Until the remaining pieces of jigsaw are found to explain all of how resveratrol works, it would appear that continuing to enjoy a small amount of red wine is unlikely to be detrimental to our brain health and might even be doing us some good.

Over the centuries, meditation has been used to reduce stress, improve focus, attention and memory.

A few years ago when going through a period in my life that was proving to be somewhat stressful, I enrolled in a six-week meditation course.
And I have to say it was hugely beneficial.
Having to mentally and physically stop for that one brief hour each week, was very calming and it did help me cope.
I can’t say it was easy either. Being a person always on the go, never allowing myself the luxury to step back and stop the endless mind-chatter was quite a challenge and it took a while to get the hang of it.
But then I would start to look forward to that time, and little by little I did learn how to focus on the breath, to be more “present” and just take in the sounds around me with out allowing my thoughts to rudely intrude and distract.
I could actually just acknowledge them and let them float off somewhere else.

Whilst there of a lot of awareness of the beneficial physiological changes associated with meditation for some time, it has only been over the last few years that scientific studies have been able to show more of what is going on in the brain when we meditate and the promise that further research may have, for future brain health benefits.

The brain itself actually undergoes physical change in response to meditation.
A study by Sara Lazar, research scientist from the Massachusetts Hospital Boston showed that regular meditation causes thickening of the cerebral cortex in those areas of the brain associated with decision-making, attention and memory.

The question arising from her study is: Would regular meditation slow the natural thinning of the cortex that occurs with age?

The cortex is associated with higher brain function. So, can meditation be shown to increase attention span, sharpen focus and improve memory?

The proponents of meditation say it can:

In 2007 a study by Amishi Jha and Michael Baine at Penn’s Stress Management Program at the University of Pennsylvania looked at how meditation affected the three separate components of paying attention ie:

• The ability to prioritise and manage tasks and goals.
• The ability to voluntarily focus on specific information.
• The ability to stay alert to the environment

They had two groups. The first group was new to meditation and undertook an 8 week course, which included 30 minutes daily meditation.
The second group was experienced in meditation and went on a full time one-month retreat.
Both groups underwent computer-based tests on response speeds and accuracy and both groups showed improved performance in attention and ability to focus. The experienced group did better overall but the new group demonstrated significant improvements over just a course of weeks.

The implications here suggested it would be worthwhile teaching employees to meditate, because even 30 minutes a day produced improved attention and focus.

Attention is the key to learning. So it would appear that meditation allows you to improve your attention and hence learning capacity.

The Deutsche Bank, Google and Hughes Aircraft now offer meditation classes for their workers because of the perceived benefits to their employees
with:

• Increased productivity
• Reduced stress related illness
• Reduced absenteeism
• Reduced number of errors or mistakes
• Improved recall and memory due to having a relaxed and clear mind.

Mental activity in meditation is wakeful and relaxed. Professor Jim Lagopoulos from Sydney University used EEG testing to look at the difference in the brain when mentally active, resting, asleep or meditating as the brain has some form of electrical activity in all of these.

What he found was that those engaged in non-reactive meditation produced more marked changes in electrical brain wave activity associated with wakeful relaxed attention, compared to those who were just resting without any specific mental technique.

What about meditation as a tool to prevent memory loss?

The results of a small pilot study into use of meditation to prevent memory loss was published in March 2010 by Dr Dharma Singh Khalsa and Andrew Newberg Associate Professor of Radiology Pennsylvania University School of Medicine

They had 15 subjects age 52 to 77 years. with known memory problems.
They undertook 8 weeks of Kirtan Kriya mediation for 12 minutes a day.

All the subjects underwent cognitive testing and brain imaging at the beginning and end of the 8-week period.

The meditation used was very simple.
The subjects had to repeat four sounds SA, TA, NA, MA while touching their thumb to index, middle, ring and little finger.

They had to perform this out loud for 2 minutes,
At a whisper for 2 minutes
In silence for 4 minutes
Then a whisper for 2 minutes
And finally out loud again for 2 minutes

They were all given a meditation CD to play at home.

In the control group with memory loss, they were asked listen to two Mozart violin concertos for 12 mins a day.

Of the 15 in the meditation group;
7 had mild age associated memory impairment
5 had mild cognitive impairment
3 had moderate impairment with Alzheimer’s disease.

Of the 5 in the control group;
2 had mild cognitive impairment
3 had age related memory impairment.

The results found that those in the meditating group showed increased blood flow to frontal and parietal lobes (areas associated with memory retrieval) on scanning. In cognitive testing they all had improved performance in general memory and attention.

Those who had listened to music, showed some increased blood flow in different areas of brain but of less significance and they showed no improvement in cognition.

The suggestion from the study is that meditation may be useful in those with mild memory impairment to slow down or inhibit progression of memory loss by “strengthening” the brain.

Whilst interesting, it has to be noted that this was an extremely small study, but certainly warranting further investigation with larger studies to see if this finding can be replicated.

Other researchers have also looked at the question of whether meditation can assist focus and thereby allow better memory

Dr Gary W Small, Director of Memory and Ageing Research Centre, University of California has found that exposing older people to technology such as the internet changed their brain activity in just one week. He found that the older subjects showed an increase in frontal lobe activity in their brains and where short term memory and decision-making is important.

Meditation appears to be a useful tool not only for the workplace but also to perhaps assist us to maintain our cognition, as we get older.
It may not be too long before meditation is offered more widely as a strategy to keep us brain fit.

“White Noise” It is the Living End.

Working from home has many varied blessings. One of which is the peace and quiet, allowing thoughts to flow……..

Except when renovations are underway.

For the last few weeks, my mind has been subjected to the additional external stimuli of loud banging, power-saws, the radio playing at full blast and some fruity conversational interactions between the tradies, starting around 6.45 am each morning.

Is this distracting? Yes.
Has it impacted my ability to concentrate and focus on the task at hand? Just somewhat.

Noise is a form of stress and as we know stress is bad news for our thinking and our brain.

If we hear a sudden loud or unexpected noise such as a car back-firing or a police siren, we may respond with a startle reflex. Our body and mind is quickly alerted to the possibility of danger and the need to get out of the way. This is the classic flight or fight response.

The noise itself apart from making us jump, does us no harm.

But, what about chronic low level noise?

It is actually low-level ambient noise which does us the most harm in terms of affecting our ability to think clearly and retain information.

It’s the “white noise” as they say in the song, the noise from living in congested cities with road traffic noise. The sound of sirens, school play grounds and living under the flight path of aeroplanes.

And although we think we get used to it and take little notice, unfortunately
the effect on our brain continues and it does not habituate.

This leads the body to experience ongoing stress and induces cortisol release. Ongoing cortisol secretion impacts our brain by killing off brain cells (never a good thing) and reduces our brain cells ability to form new connections with each other. In particular, it impairs the prefrontal cortex, the area of the brain used for executive decisions, planning and organisation and is thought to reduce dopamine levels to that area as well. Dopamine is a neurotransmitter important for regulating the transmission of information from other parts of the brain to the prefrontal cortex.

The National Institute for Occupational Health and Safety in the United States has reported that ambient noise affects people’s health generally by increasing stress levels.

Again in the States, the American Census rated noise a higher problem than crime, litter, traffic or inefficient government.

In the workplace, low-level noise from working in open plan offices has been shown to lead to higher levels of stress and lower task motivation.

In one study, forty experienced female clerical officers (average age 37 years) were assigned to either a quiet office or one with low intensity noise. Those working in the noisier areas, experienced high levels of stress hormone (measured in urinary epinephrine levels), made 40% fewer attempts to solve a unsolvable puzzle and made only half as many ergonomic adjustments to their work stations. In other words their brains were stressed, so they were less willing or able to participate as well in work tasks, as those working in the quieter work areas.

And it’s not just adults in the workplace who may be disadvantaged from trying to work in noisy environments.

An Austrian study demonstrated how low level noise induced a stress level response (with raised heart rates and blood pressure) in children and could lead to an impaired ability to learn.

They looked at 115 kids in Grade 4. Half lived in quiet areas (sound level equivalent to 50 decibels,) Half lived in noisier areas.

The study showed that children subjected to chronic noise stress were more likely to demonstrate “learned helplessness”, a condition linked to poverty and some forms of depression. They simply don’t bother to make the effort or try.
Girls seem particularly at risk.

So, maybe we need to be aware of the ambient noise that surrounds us and our families on a day-to-day basis. Especially now that we understand that it is potentially causing us to think more poorly.

Are there any ways you can implement changes either in your own work place or at home, to help minimise the effect of ambient low level noise and assist our brain function?

I’d love to hear whether your work place has already implemented changes to enable staff and workers to work more easily in a quiet environment.

And remember we are talking about low-grade ambient noise, not jack hammers and rock concerts which can cause actual hearing loss.

“White noise, White noise,

All that I’m hearing from you…..”

Mention Alzheimer’s’ Disease and most people will think of an older person with dementia.
But not everyone with dementia is over the age of 65.

There are a number of people diagnosed around the world every year with what is known as early onset Alzheimer’s disease. The majority of these people are in their mid forties and fifties.
In what many would consider their prime of life.
They account for 5-10% of all people diagnosed with Alzheimer’s disease.

But what if you were in your early thirties?

Could you possibly contemplate what it would be like to be told at the age of 31 or 32 that you had Alzheimer’s disease?

A couple of days ago I watched a short TV segment which told the story of two young women both in their early thirties who have early onset Alzheimer’s disease.
It was confronting viewing.

One young woman was diagnosed just after finding out she was pregnant with her first child. Now a young mother, she is incapable of caring for her new baby and has to be supervised 24/7. Her daughter will never know the once vibrant, energetic woman who is her mother. The young woman’s eyes have that vacant look, she has difficulty speaking, and her prognosis is bleak. Her husband appears to be coping (at least in front of the television cameras) but is clearly grieving. Her own mother, devastated by her daughter’s rapid deterioration, helps where she can, caring for her daughter and granddaughter.

The other young woman is scared, very scared. Not only for herself, as she witnessed her own mother die from the disease when she was in her thirties, but for her own daughters. She has three girls aged 15 months, 8 years and 9 years. Because this particular form of Alzheimer’s is autosomal dominant, her daughters have each got a 50% chance of inheriting the same condition.

These two women have a very rare form of Alzheimer’s disease triggered by a defective gene called presenilin 1. This is one of three genes that are linked to early onset familial Alzheimer’s disease. Presenilin 1 is the most common of the three.

This is different from the APOE gene that can increase your risk of developing Alzheimer’s disease in general. Having APOE does not guarantee that you will definitely develop Alzheimer’s. Though not having it doesn’t guarantee that you won’t either.

But the genetic link with Presenilin 1, Presenilin 2 and APP is far stronger and hence the risk of familial transmission is far greater. A prenatal test for early onset Alzheimer’s disease due to Presenilin 1 is apparently available.
Genetic counselling would be very important to have, before undergoing this test.

Professor Ralph Martins based in Perth, West Australia is one of the world’s top leaders in Alzheimer’s’ disease research. He has dedicated his life to this research and has spent 26 years in this field. He is currently involved in an international study, which is looking at sufferers of early onset Alzheimer’s disease such as the two young women on the TV program. Because this group experiences a much more aggressive form of the disease which progresses much faster, they may hold the key to assist researchers find out more about how and why the disease develops. Professor Martins hope is that by identifying markers, a simple blood test will be able to devised, which will allow people to know whether they have Alzheimer’s disease long before any symptoms develop.

If picked up early, then there will be greater chance for interventional treatments to be more effective in limiting the devastating effect of the disease. Perhaps one day it will also be possible to to prevent the progression of the disease.

The link for the TV segment is below.
Please watch it.

http://au.tv.yahoo.com/sunday-night/features/article/-/article/7147834/alzheimers-research/