04/15/2011© Center for Healthy Aging 1 Enhancing Cognitive Fitness and Quality of Life in Older...

04/15/2011 © Center for Healthy Agingwww.centerforhealthyaging.com

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Enhancing Cognitive Fitness and Quality of Life in Older

Adults: Evidence and Trends

Paula E. Hartman-Stein, Ph.D.2011 OAGE ConferenceAdvocacy for Change:

Empowering Older Adults and Their FamiliesColumbus, Ohio


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Objectives1. 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.

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)


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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)


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Foundations of cognitive fitnessMovement: 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.)


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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)


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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)


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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)


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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?


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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


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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)


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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.)


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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)


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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.)


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Wellness Programs in the community

• Quilting and digital photography(Lodi-Smith & Park)

• Oral Life Review (Meuser)


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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.


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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


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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


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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.)


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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.


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Supporting cognition and well-being 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.)


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National trends in community-based cognitive

pursuitsCreativity and the arts:“The Dancing Heart”: Vital Elders Moving in Community, Minneapolis, Minn. (Genne)

Drama & Acting – Performance (Noice & Noice)


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National trends: Cultural Pursuits

Art, Museums and Culture: Hearthstone initiatives around the world.(Caulfield, S.)


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National trends: Cultural Pursuits

The Songwriting works model: enhancing cognitive fitness through collaborative musical composition and performance.(Friedman, J-K)


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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.)


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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


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Resources

• Brain Fitness Blog www.sharpbrains.com• Kirtan Kriya meditation:

www.alzheimersprevention.org

04/15/2011© Center for Healthy Aging 1 Enhancing Cognitive Fitness and Quality of Life in Older...

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