Enhancing Cognitive Fitness and
Quality of Life in Older Adults:
Evidence and Trends
Paula E. Hartman-Stein, Ph.D.
2011 OAGE Conference
Advocacy for Change:
Empowering Older Adults and Their Families
Columbus, Ohio
04/15/2011
© Center for Healthy Aging
www.centerforhealthyaging.com
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Objectives
1. Explain the research foundation behind
cognitive enhancement programs.
2. Describe the evidence that exercise,
meditation, and expressive writing enhance
cognition and mood.
3. Highlight innovative community-based
programs for improving cognitive fitness and
quality of life of older adults.
04/15/2011
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www.centerforhealthyaging.com
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Enhancing Cognitive Fitness in Adults: A
guide for the use and development of
community-based programs. (In press,
Eds. Hartman-Stein, P.E. & La Rue, A.,
New York: Springer Science + Business
Media)
04/15/2011
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www.centerforhealthyaging.com
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Foundations of overall cognitive
fitness
Behavioral strategies:
Evidence for aerobic exercise (Boot &
Blakely)
Evidence for meditation (Khalsa &
Newberg; Kaszniak)
Consumer-based fitness programs:
“jury is out.” (Zelinski, Dalton & Smith)
04/15/2011
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Foundations of cognitive fitness
Movement: 3 hours
a week of brisk
walking may halt or
reverse brain
atrophy. Exercise
increases the brain’s
volume of gray and
white matter
(connections
between neurons.)
04/15/2011
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Foundations of cognitive fitness
Exercise: Close to “behavioral magic”:
aerobic exercise has been linked to better
cognitive flexibility, long term memory,
improvement of mood and reduction of
anxiety.
(Boot & Blakely)
04/15/2011
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Foundations of cognitive fitness
In preliminary studies, older adults with
memory problems are improving their
cognitive functioning after an 8 week long
program of meditation. Promising results for
reduction of caregiver stress. (Khalsa &
Newberg; Kaszniak)
04/15/2011
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Foundations of memory fitness
“Efforts must focus on building a larger
repertoire of strategies and skills that can
enhance memory and on training that will
help an individual decide what strategy
will help him/her in a specific situation.”
(Dunlosky, Bailey & Hertzog)
04/15/2011
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Approaches to memory fitness
• Diagnosing the problem: What are you
trying to remember?
• In what contexts do you need to learn
the info?
• Time frame to learn it?
04/15/2011
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Strategies for memory efficiency
• External reminder systems: From
written lists and date planners to
electronic calendars and reminders on
cell phones and I-pads.
• Explicit noticing and rehearsing
• Elaboration, imagery, associations
• Self-testing
• Spacing practice
04/15/2011
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Community-based programs to sustain
healthy cognition and well-being
• HABIT at the Mayo clinic (Healthy
Action to benefit independence and
thinking): note-taking, physical and
relaxation exercises, and emotional
support.
• Take Charge pilot program in
Wisconsin, 8 sessions, 16 weeks; (La
Rue)
04/15/2011
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Community-based programs to sustain
healthy cognition and well-being
• Peer led training programs (Ercoli, Cernin,
& Small)
• Senior guest programs at universities;
Discussion groups in college classes
(Cichy & Smith)
• Osher Life-Long Learning Institutes
(Alexander et al.)
04/15/2011
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National trends in cognitive fitness for
older adults
Intellectual Competitions: Odyssey
of the Mind; adult spelling
contests, e.g. AARP National
Spelling Bee.
(Stine-Morrow & Parisi;
Hartman-Stein & De Forest)
04/15/2011
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Wellness programs in the community
• Need for choice, e.g.—Keys to a Sharp
Mind, model program at a retirement
facility (Biermann & Hartman-Stein)
• Behavioral support to increase
adherence to the exercise protocol.
(Potkanowicz)
• Nutrition to promote brain health (Desai,
et al.)
04/15/2011
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Wellness Programs in the community
• Quilting and digital photography
(Lodi-Smith & Park)
• Oral Life Review (Meuser)
04/15/2011
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Community-based programs to sustain
healthy cognition and well-being
• Creative writing programs
– Evidence of positive impact on working
memory in young adults
– Thoughts about ongoing stressful events
are irrelevant demands that interfere with
working memory capacity and expressive
writing reduces their draw on working
memory.
04/15/2011
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Creative writing benefits
• Qualitative research study of older
adults showed improvements:
– Coping with conflicts
– Increasing decision-making skills
– Aid to memory
– Problem solving
– Contemplating life’s meaning/new level of
consciousness or spirituality
04/15/2011
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Personal expressive writing: Effect on
health and well-being
•
•
•
•
•
•
Lowered frequency of physician visits
Improved immune functioning
Decreased blood pressure
Reduced pain severity
Improved depressed mood
Reduced anger
04/15/2011
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Creative/expressive writing in groups
• Guided autobiography
• Understanding mind-body
connections
• Spiritual autobiography
• Connecting with nature for health
• Caregiving: Increasing
compassion
(Hartman-Stein, P.)
04/15/2011
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Supporting cognition and well-being
in MCI
• Focus on behavior and life style
changes over pills
• No one can be sure how lifestyle
changes affect MCI.
• Positive well-grounded activities help
avoid excessive disability.
04/15/2011
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Supporting cognition and wellbeing in MCI
• Early memory loss clubs (Fritsch et al.)
• Montessori-based methods for engaging
persons living with dementia (Camp,
Zeisel & Antenucci.)
• Brain brightening: Neurotherapy
approaches (Thomas, L.T.)
04/15/2011
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National trends in community-based
cognitive pursuits
Creativity and the arts:
“The Dancing Heart”: Vital Elders Moving in
Community, Minneapolis, Minn. (Genne)
Drama & Acting – Performance
(Noice & Noice)
04/15/2011
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National trends: Cultural Pursuits
Art, Museums and
Culture: Hearthstone
initiatives around the
world.(Caulfield, S.)
04/15/2011
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National trends: Cultural Pursuits
The Songwriting works model: enhancing
cognitive fitness through collaborative
musical composition and performance.
(Friedman, J-K)
04/15/2011
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Community programs with a positive
societal impact
Voluntarism: Gaining cognition and well being
through giving back
– Experience Corps through Johns Hopkins
Medical School (Rebok, et al.)
– The Intergenerational School in Cleveland
(George, D.)
04/15/2011
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Brain Activities Websites
• Brain games available on the web
without charge
www.fitbrains.com/games
• www.gamesforthebrain.com
• www.freerice.com/index.php
04/15/2011
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Resources
• Brain Fitness Blog
www.sharpbrains.com
• Kirtan Kriya meditation:
www.alzheimersprevention.org
04/15/2011
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