The Aging Brain:
Strategies for Staying
Mentally Fit
Rita Balice-Gordon, Ph.D.
Professor of Neuroscience
University of Pennsylvania School of
Medicine
Today’s talk
• Brain structure and function
• Normal aging vs. diseases of aging
• What we can do about it
Brain vital statistics
• Adult weight: ~ 3 pounds
• Adult size: ~ a medium
cauliflower
Different brain parts have different
functions
• Divided into right
and left halves
• Left half controls
movement on
body’s right side
• Language area is
mainly on left
Brain components: Neurons, Glia,
Synapses
• The brain has billions of
neurons, each with an axon
and many dendrites.
• Number of neurons:
100,000,000,000 (100 billion)
• Neurons communicate via synapses
• Number of synapses:
100,000,000,000,000 (100 trillion)
• To stay healthy, neurons and glia
must communicate with each other,
carry out metabolism, and repair
themselves.
Today’s talk
• Brain structure and function
• Normal aging vs. diseases of aging
• What we can do about it
Normal brain aging
• ~10% neuron loss by age 90
• No large-scale addition of new neurons in the
mature human brain
– Some addition of new neurons in some brain regions
(hippocampus, olfactory, etc.)
– Function unknown
• New synapses are formed throughout life and
you can modify your brain’s capacity to do this
What’s the difference between
normal brain aging and
dementia / Alzheimer’s disease?
• Normal age-related memory problems
– Forgetting where you put your car keys,
glasses, etc.
– Not remembering names of people you
haven’t seen for several years
– Forgetting an item or two on a memorized
shopping list
– Forgetting why you went into a room
Changes in cognition with normal
aging
• Intellectual abilities
– improve until late 30s or early 40s
– are stable until mid-50s or early 60s
– change begins to occur in late 60s
– noticeable effects beyond the mid 70s
What’s the difference between
normal brain aging and
dementia / Alzheimer’s disease?
• Memory changes which may be abnormal
– Forgetting relationships of close family
members (e.g., grandchildren)
– Putting things in odd places
– Forgetting an upcoming appointment, special
event, etc. – and still not remembering it after
it is pointed out to you
– Getting lost in a familiar place while driving
What’s the difference between
dementia and Alzheimer’s disease?
• Dementia: the general term used to describe loss of
previous memory or thinking function
– “de”: loss of
– “mentia”: thinking power
• Alzheimer’s disease: a specific type of dementia
• $100 billion annually in health care and societal costs
• A new analysis suggests that about 3.4 million Americans
age 71 and older - one in seven people in that age group have dementia, and 2.4 million of them have Alzheimer’s
disease (AD).
Alzheimer’s disease
• Impaired memory (especially for recent events)
• At least one of the following:
– Difficulty with speech (aphasia)
– Difficulty with recognition (agnosia)
– Difficulty with fine motor skills (apraxia)
– Difficulty with judgment, insight, planning
ahead, organizing (executive dysfunction)
Memory problems in Alzheimer’s
disease
• Short-term memory
– affected first
– leads to difficulty recalling events from hours
to several weeks
• Long-term memory
– usually preserved early in the course of AD
– very good recall of events from years ago
Progression of AD
• Starts very gradually, and inconsistently
• Gradually progresses over months to years
• In addition to memory difficulties, may see
– Apathy
– Other changes in personality
– Hallucinations (false perceptions)
– Delusions (false beliefs)
– Poor judgment
Progression of AD: Changes in
brain vital statistics
• AD spreads
through the
brain.
• The cerebral
cortex begins to
shrink as more
and more
neurons stop
working and die.
Brain of healthy
individual, age 60
Brain of individual
with advanced
Alzheimer’s disease
Hippocampus 
learning
and memory
Progression of AD: Changes in
brain components
• The brains of people
with AD have:
– an abundance of betaamyloid plaques,
which are dense
deposits of protein and
cellular material that
accumulate outside
and around nerve cells
– an abundance of
“neurofibrillary
tangles,” which are
twisted fibers that build
up inside the nerve
cells
Today’s talk
• Brain structure and function
• Normal aging vs. diseases of aging
• What we can do about it
Use it or lose it
Four strategies to stay mentally fit
1. Maintain your general health.
2. Exercise your body.
3. Exercise your mind.
4. Stay socially active and connected.
1. Maintain your general health
• Regular check-ups
• Follow physician’s instructions to manage diabetes,
cardiovascular health, etc.
• Treat depression
• Identify sources of stress and take action to reduce
them: chill-lax
• Follow good nutritional guidelines
• Limit alcohol, recreational drug use, smoking
• SLEEP – is critical for memory formation (and general
health)
2. Exercise your body
• Aerobic exercise
– 20 minutes or longer
– at 60% of maximum heart rate or higher – WITH YOUR PHYSICIAN’S
APPROVAL
– 3-4 times per week
• What is aerobic exercise?
– Emphasizes cardio / respiratory system
– Longer duration exercise, involving large muscle groups in repetitive
actions
– Important to include warm up and cool down periods
– Stretching is important to avoid muscle and joint injury
– Jogging, rowing, cycling, swimming, walking
• Aerobic exercise is not:
– Fishing, golfing, strolling, grocery shopping, gardening, doubles tennis!
http://hpp.beckman.uiuc.edu/news/WallStJNov162006.pdf
How to Keep Your Aging Brain Fit: Aerobics
Forget Crossword Puzzles -- Study Says 3 Hours of Exercise a Week
Can Bolster Memory, Intellect
By SHARON BEGLEY
November 16, 2006; Page D1
The key to keeping intellectually sharp as we age may not be
mental gymnastics, as commonly recommended, but real
gymnastics.
According to a new study, the brain's long, slow decline may
not be inevitable. For the first time, scientists have found
something that not only halts the brain shrinkage that starts in a
person's 40s, especially in regions responsible for memory and
higher cognition, but actually reverses it: aerobic exercise. As
little as three hours a week of brisk walking -- no Stairmaster
required -- apparently increases blood flow to the brain and
triggers biochemical changes that increase production of new
brain neurons.
As brains age, normal wear and tear starting in middle age
causes them to process information more slowly, which means
it takes longer to make judgments and grasp complex
information. Older brains also take longer to switch from one
task to another and are less adept at "multitasking" (such as
driving while simultaneously tuning the radio and checking the
tailgater)...
3. Exercise your mind
• Degree of education is the strongest buffer and one of the best
predictors of later memory impairment.
• Not related to IQ: education sets a pattern of reading, chess,
crossword puzzles, etc. that become lifelong exercises.
• Mentally stimulating activity protects the brain in ways that are poorly
understood.
• Develop strategies to address your particular behavioral concerns:
–
–
–
–
Make notes and lists
Use humorous visual images
Rehearse names, facts ahead of time
Do one thing at a time
• Brain calisthenics
Brain calisthenics
Instructions: Say the color the word is
printed in, not the word itself. Try to say
all 10 without a mistake in 15 seconds.
Blue Yellow Red Green Red
Green Blue Red Yellow Green
Brain calisthenics
Instructions: memorize these 20 words by
studying them for 3 minutes. Then write
down as many as you can remember in 1
minute.
Circle
Bread
Dog
Sister
Coat
Pilot
Rope
Office
Map
Thunder
Tubing
Pottery
Shape
Edge
Section
Apple
Mind
Head
Kite
Brand
Circle
Bread
Dog
Sister
Coat
Pilot
Rope
Office
Map
Thunder
Tubing
Pottery
Shape
Edge
Section
Apple
Mind
Head
Kite
Brand
Brain calisthenics
• Try Sudoko and other strategic games that
require planning, strategy
• Develop new and challenging ways of doing
household tasks
– Brush your teeth with your non-dominant hand
• Try things outside your comfort zone
– If you’re a math whiz, try painting; if you’re an avid
reader, try math games
4. Stay socially active and connected
• Solitary activities to increase brain fitness are
great, but group activities are even better:
–
–
–
–
–
Book club
Music groups, choir
Dinner groups
Play cards in a group (great for multi-tasking)
Play chess and other games that require strategic
thinking
– Play sports on a team, league
– Travel
– Lectures / courses
Four strategies to stay mentally fit
1. Maintain your general health.
2. Exercise your body.
3. Exercise your mind.
4. Stay socially active and connected.
Perspective
• Fears of memory problems in later life, although they are
real, can become exaggerated.
• One can manage memory issues that arise as a result of
normal aging by following 4 strategies and some
memory tricks (make lists, do one thing at a time, etc.)
• In spite of age-related changes in some cognitive
functions, the vast majority of older adults retain more
than enough reserve capacity for a meaningful,
satisfying life of independence.
What should I do if I suspect that I
have memory problems?
• Talk to your familiy members, friends
• Talk to your personal physician
• Blood tests, CT scan or MRI scan
• Consult local Alzheimer’s Association
A few useful resources
•
•
•
•
•
•
•
www.alz.org
www.nia.nih.gov
www.aarp.org
www.fi.edu/brain/index.com
www.time.com/time/covers/20060116/puzzles
www.braingle.com (and many others)
www.mybraintrainer.com (just for fun, free “test”
– don’t sign up for for-fee service!)