How to beat brain drain

There's something ridiculous, even disturbing, about the human brain. Its pitiful vulnerability, unsheathed from the skull; its alter-ego as the horribly pulsating epicentre of some malevolent sci-fi ogre.

Yet, this unloved organ is the seat of everything we know, feel, and think. And neurologists are only beginning to grasp the immense resourcefulness of the shifting architecture of the brain.

Research by neuroscientists, including the University of Auckland's Professor Richard Faull, has revealed the brain to be highly plastic: it can create new neurons and modify existing networks in response to changing circumstances.

Thinking, feeling and acting actually change the brain' structure and organisation from top to bottom. I think, therefore my brain reconfigures.

Researchers are now working to harness the brain's ability to make new cells for the treatment of degenerative brain diseases such as Alzheimer's Disease, and to aid recovery from stroke and head trauma.

What we do to our brains now could affect how well they keep working as we age.

University of Auckland neuroscientist Dr Cathy Stinear says we must shake the old fatalism about our brains.

"There's a multitude of factors affecting brain health; only some of them are under your control," says Stinear. "But the ones that are can make a difference."

Childhood: plastic fantastic

The brain is at its most brilliantly plastic in our earliest years.

Stinear: "Kids can pick up a language much quicker than we can. We've all been passed by a 3-year-old screaming down the slopes on skis."

By encouraging the love of learning and curiosity, parents can equip their children with the learning habits that will protect their mental agility later in life.

"Early experiences lay the framework of your brain for the rest of your life."

Brains need enough stimulation to develop properly. Studies in the 1990s of Romanian orphans aged 23 to 50 months found their social and cognitive development was severely delayed, due, it was thought, to their deprived conditions.

Researchers in the long-term Dunedin Study have shown the harmful physical and psychological effects persist long after the childhood maltreatment ends. That induces stress, which raises the likelihood that the child will grow up into an adult who suffers mental problems.

Just as important as stimulation is sleep. A recent finding from that same study suggests lack of sleep in childhood could lead to adult obesity, which is a risk factor for steeper cognitive decline with age and for dementia.

Play nicely
Staying at school could make your mind more resilient. Low education is a known risk factor for dementia.

A 2007 study suggested every extra year of formal education delayed advanced memory decline by about two-and-a-half months.

The theory is that education helps us create "cognitive reserve": a wider variety and complexity of neural connections, so that if disease or natural cell loss with age knocks out one section of a pathway we have alternatives to fall back on.

A little stress is good for learning; too much for too long can damage mental and physical health (and your romantic chances).

Simply going out with friends can offer powerful stress relief. Research into baboons has underlined the importance of connectedness. Old age strips male baboons of status, causing great stress to most, but a few seemed relatively unbothered by harassment from the younger, aggressive males. They spent their middle age befriending the females, and that friendship seemed to buffer them.

So by all means party, say the neuroscientists, but don't overdo it. Stinear: "You can't just trash your brain in adolescence and your 20s with poor diet, alcohol and drugs and think if you just walk 30 minutes a day when you hit 40 you'll be alright."

Charge and recharge
Travelling, starting a career or a family often means burning the candle at both ends. But sleeping keeps us sharp, and inadequate sleep can raise the risk of stroke and depression.

"A lot of us can relate to that feeling of being hopelessly jet-lagged, you just can't take anything in," says Stinear.

The neurologists' plea to sports players and daredevils is protect your head. There's increasing evidence that even apparently mild concussion can make the brain less adaptable to stress and ageing, and that repeated concussions can cause serious long-term brain damage.

Analysis of dead
American athletes' brains has revealed extensive brain damage that resembles the effects of Alzheimer's Disease. One researcher called the brain damage in an 18-year-old multi-sport athlete who had suffered multiple concussions "shocking".

Former All Black Josh Kronfeld is not surprised by the research. He wore headgear on the field following a neck injury.

Even so, he was knocked out once and suffered "quite a few" knocks to the head that momentarily blacked out his vision or caused a gong-like ringing sound, something that happens every couple of games at professional level, he estimates.

Later, while studying physiotherapy, he had his inner-ear balance and co-ordination tested in a class demonstration, and failed the test.

Workaholics take heed
Long hours can dull your mind and increase depression. A new study of 2214 middle-aged British civil servants found those working more than 55 hours a week had poorer mental skills than those working standard hours.

Future research will investigate if these effects are lasting and predict dementia.

People who were clinically obese, had high blood pressure or high cholesterol at 40 doubled their chances of developing dementia by the age of 60. Having all three risk factors made dementia six times more likely.

Strokes, which affect 8000 New Zealanders a year, have the same underlying cause as heart disease. Exercise for your the sake of your brain as well as your heart, say neurologists.

There's also evidence that cultivating a positive frame of mind now may extend your life. The landmark "Nun Study", led by American neurology professor David Snowdon, has tracked 678 nuns since 1968 with the aim of demystifying brain disease.

One finding is that personality traits such as optimism, adaptability and a willingness to try new things help us age well. Nuns whose autobiographies revealed a positive attitude at the time they took their vows were 2.5 times more likely to live longer than those with a more negative attitude.

Call in the reserves
By the 50s, the slight neuron shrinkage that began in your 20s picks up pace, giving rise to noticeable changes in memory and other mental faculties.

It takes longer to recall names and words. Learning takes longer, but the information generally still sticks. Attention to detail wanes, multitasking becomes more tricky, and placing an event in time and place becomes more difficult.

But you can offset these changes by stocking up your cognitive reserve through staying engaged and connected.

Take a course or a lover.

If you're overweight and under-exercised, it's not too late to stem the damage. Recent research shows moderate daily exercise in middle age can help to delay, reduce or even reverse the normal cognitive slowing that comes with age. This applies for older ages, too. One study showed people who walked about 2km every day performed significantly better on cognitive tests than those who exercised less.

Early-onset Alzheimer's is rare but devastating. According to Alzheimers New Zealand, there are about 2200 people under 65 with dementia in this country. One in 100 people have dementia in their 60s. The impact is wide-ranging. For every person with the disease, seven others are involved in their care.

Mix it upBrain structures critical to memory may have shrunk by as much as 25 per cent from their size in early adulthood. As natural brain shrinkage continues, it's even more important to bolster plasticity by keeping actively engaged in life. Use it or lose it, say the neurologists.

You don't have to start a degree: simple changes such as taking a new route to a friend's place keeps your brain lithe.

And don't worry if crosswords aren't your bag. A 2008 American study of middle-aged and older people found using the internet stimulates the brain centres that control complex reasoning and decision-making.

There's no need to pay for expensive "brain gym" sessions, either: many activities that engage you and that you enjoy have as many brain benefits.

The prevalence of diseases such as Alzheimer's and Parkinson's increases through these years.

Dr Phil Wood, a North Shore hospital geriatrician, runs a memory clinic that offers diagnostic and treatment advice for such neuro-cognitive disorders. There is a shortage of such clinics in smaller centres, he says.

Research by him and others is focussed on delaying the onset, or slowing the progress of brain disease. Various drugs are being trialled that show early signs of easing the symptoms of Alzheimer's.

Keep brushing
Your best bet is to stay interested, involved and stimulated mentally, socially and physically.

One in four people aged 85 and older have dementia. Here and abroad, there is concern that we are not doing enough to prepare for the baby boomer surge in dementia heading our way. Last year, there were an estimated 41,000 people with dementia in New Zealand. At current rates, that number could rise to 75,000 in 17 years, and 147,000 in 2050.

But Wood is upbeat. Because most European countries are 20 years ahead of us in terms of their ageing population, we can learn from their experience, he says. And while there is a trend for specialists to go abroad, attracted by better pay, many return. They bring back with them rich experience and contacts.

There are hopeful developments in other areas. Stinear was part of a team that invented a mechanical device that primes the brains of stroke victims to learn, greatly aiding their recovery. But rather than waiting until the damage shows, Stinear wants lifelong brain care to become as second nature as dental care. "You don't decide to start brushing your teeth when they start getting really sore or falling out."