One of the most fascinating articles I've read recently came from Jane Brody, to the NYTimes. It's the first popular article I've seen to point out that analyses of cognitively sharp elderly people actually show the same physical pathology of Alzheimers, yet they do not show any outward symptoms of dementia and manage to retain mental alertness.

An excerpt of the article follows below. You can find the full article on the NYTimes website; I believe they now offer free access.

I found this very interesting not only because we have elderly parents who are showing signs of dementia, but also because my DH suffered a haemorrhagic stroke at age 50. We actually did not realize the doctors did NOT expect him to recover fully (hurray for HMO care; nobody bothered to tell us how serious the stroke actually was!).

A part of his brain is actually dead - the one that regulates the unconscious nervous system. Yet within 2 months he was back at work, and with the help of regular acupressure treatments - believe me, the HMO wasn't much help at all outside of putting him on BP and heart medications - no one can tell that it ever happened.

HE can tell - there's some lingering numbness on his left side, and he has to concentrate more carefully on everyday things or his attention wanders. But otherwise he's fully recovered. When we switched doctors last year, the new doctor was truly surprised when he told her he walks two miles daily unaided. Her words were, "You don't use a cane?!?" Just from reading his medical records beforehand, she was expecting him to be partially disabled.

He is clearly using other parts of his brain to compensate for the stroke-damaged area. One factor we think may have helped his recovery is that we were heavily into martial arts for almost twenty years. There's a lot of meditation and esoteric aspects to the type of training we did. Maybe that mental discipline stuff helped - we'd like to think so, anyway!

Mental Reserves Keep Brains Agile
December 11, 2007 By JANE E. BRODY to the NYTimes

The brain, like every other part of the body, changes with age, and those changes can impede clear thinking and memory. Yet many older people seem to remain sharp as a tack well into their 80s and beyond. Although their pace may have slowed, they continue to work, travel, attend plays and concerts, play cards and board games, study foreign languages, design buildings, work with computers, write books, do puzzles, knit or perform other mentally challenging tasks that can befuddle people much younger.

But when these sharp old folks die, autopsy studies often reveal they have the same extensive brain abnormalities like those in patients with Alzheimers. Dr. Nikolaos Scarmeas and Yaakov Stern at Columbia University Medical Center recall that in 1988, a study of "cognitively normal elderly women" showed that they had "advanced Alzheimers disease pathology in their brains at death." Later studies indicated that up to two-thirds of people with autopsy findings of Alzheimers disease were cognitively intact when they died.

"Something must account for the disjunction between the degree of brain damage and its outcome," the Columbia scientists deduced. And that something, they and others suggest, is "cognitive reserve."

Cognitive reserve, in this theory, refers to the brains ability to develop and maintain extra neurons and connections between them via axons and dendrites. Later in life, these connections may help compensate for the rise in dementia-related brain pathology that accompanies normal aging.

Exercise: Mental ...

As Cathryn Jakobson Ramin relates in her new book, "Carved in Sand: When Attention Fails and Memory Fades in Midlife" (HarperCollins), the brains of animals exposed to greater physical and mental stimulation appear to have a greater number of healthy nerve cells and connections between them. Scientists theorize that this excess of working neurons and interconnections compensates for damaged ones to ward off dementia.

Observing this, Dr. Stern, a neuropsychologist, and others set out to determine how people can develop cognitive reserve. They have learned thus far that there is no "quick fix" for the aging brain, and little evidence that any one supplement or program or piece of equipment can protect or enhance brain function advertisements for products like ginkgo biloba to the contrary.

Nonetheless, well-designed studies suggest several ways to improve the brains viability. Though best to start early to build up cognitive reserve, there is evidence that this account can be replenished even late in life.

Cognitive reserve is greater in people who complete higher levels of education. The more intellectual challenges to the brain early in life, the more neurons and connections the brain is likely to develop and perhaps maintain into later years. Several studies of normal aging have found that higher levels of educational attainment were associated with slower cognitive and functional decline.

But brain stimulation does not have to stop with the diploma. Better-educated people may go on to choose more intellectually demanding occupations and pursue brain-stimulating hobbies, resulting in a form of lifelong learning. In researching her book, Ms. Ramin said she found that novelty was crucial to providing stimulation for the aging brain.

"If youre doing the same thing over and over again, without introducing new mental challenges, it wont be beneficial," she said in an interview. Thus, as with muscles, its "use it or lose it." The brain requires continued stresses to maintain or enhance its strength.

I tend to agree. The people that I have known that suffered from Alzheimers were those that had little or no interests outside of themselves. They hadn't done anything new in decades. Even those that worked had jobs that were the same thing, day in and day out.

It just stands to reason that when someone begins to slip, that the more active mind can understand and compensate in someway to counter the deficiency.

I can certainly relate, I always felt lucky having sharp grandparents as well -- they were both teachers who lectured long into life. Thats the key I think: challenge your brain. There was just an article about this very concept in Newsweek called "Jogging Your Memory." Scientists are finding that lost memory and cognitive ability can potentially be recovered by targeted brain exercises. One program discussed in the article, made by Posit Science, showed the ability in clinical trials to "turn back" the brains age by 10 years. Most of the program participants also reported positive benefits in their daily lives, too. .