August 2, 2012
Washington Jewish Week
William Treger

You’ve heard of aerobics, but what about “neurobics?”

For an aerobic workout, you might go for a brisk walk, play tennis, or go to the gym for some cardio, activating your mind and body at once.

But where might you go to isolate and activate the mind, and neurobically “work out” your brain?

If you are not into crossword puzzles, Suduko, or trying to learn a new language, you might one day venture out to a local “brain gym,” now surfacing in urban centers across the country. One nearby brain gym is the Walter Reed Army Medical Center’s Brain Fitness Center, designed to help war veterans and service members heal from service. Though not set up for civilians, the goal for all brain gyms is to strengthen minds and build up and restore cognitive skills.

At the brain gym, seniors can “work out” with new computer games designed to stretch the mind’s reasoning, memory, language, quantitative, visual, and spatial skills. One may work out with brain-bending “mental fitness software,” to exercise cognitive skills and improve memory and concentration.

To reinforce gym lessons, one may also buy brain workout applications for personal computing systems including laptops, tablets, and iPhones.

Happy Neuron, Inc., Cognifit Ltd., Posit Science, and Lumos Labs, Inc. are catchy names – all companies that create software for the brain fitness sector.

To critics, going to the brain gym may seem like going to a computer lab at a local library or school; the work stations set you before a computer terminal and leave some feeling sedentary.

Today, in the health education community, it’s widely known that exercise is a critical component for maintaining seniors’ physical and mental health, yet the Centers for Disease Control estimates that only 14 percent of adults ages 65 to 74 and 4 percent of adults over 75 exercise regularly.

If brain gyms seem sedentary, then you might try “exergaming,” a new fitness trend combining exercise with high tech gaming. (Think Wii Fitness, very popular in senior centers for a snapshot of exergaming).

Exergaming is designed for both seniors and youth, including youth with developmental disabilities.

Marc Sickel of Rockville’s Fitness for Health, a center specializing in exergaming, draws seniors to his workout space for both group and individual sessions.

Sickel works with seniors in 50-minute sessions, he says, “to find, process, and execute on information across the midline.”

“The big thing with seniors is to get them moving and thinking. We also incorporate math. We give them a [physical] task and incorporate a cognitive component – get them active and get them to think,” Sickel says.

“I might ask you questions while you’re hitting a set of lights. With elderly people we want to work on strength and flexibility. The idea of mind-body-soul – that’s what we’re dealing with, all together.”

Sickel’s goal is to make exercise combined with cognitive activity “stimulating and fun,” so it does not feel like work. “We need to work with seniors in their world. They might have other therapies. If they have a lot going on, [coming here] might become a stressor. I don’t want it to be a stressor,” he says.

Proponents of brain gyms and exergames say they have the promise for maintaining, if not improving, cognitive health.

While learning new physical and cognitive skills is essential for working to maintain cognitive health, critics in the medical community are wary of programs offering seniors restored cognitive health. The hard data and evidence for their programmatic value is not in, they say, and like many programs offered to seniors, they need to be carefully evaluated.

According to Dr. David Loreck, a geriatric psychiatrist who works with the Maryland Alzheimer’s Association, “The best advice to seniors is to stay as active as possible including social, exercise, and mental activity. Anything you can do to control causes of vascular disease is good medical common sense. Make sure you and your doctor are monitoring for high blood pressure, high cholesterol/lipids, diabetes, as well as maintaining a healthy body weight with a heart healthy diet including limiting salt to national guidelines.

“Staying mentally active, socially active, and getting as much exercise as possible is also good health common sense, although any new exercise program should be reviewed with your doctor.

“No one program is the program. Seniors are besieged with lots of schemes and need to be very cautious of any plan that promises too much. Currently, no intervention has been shown to clearly prevent Alzheimer’s disease or slow the underlying disease progression. The existing FDA-approved medications may have a mild benefit for some of the symptoms of Alzheimer’s Disease such as performance on memory testing or may delay nursing home placement.

“We’re probably still in the infancy of brain science in trying to understand normal aging and the brain, particularly the boundaries of where normal aging ends and much more aggressive degeneration of diseases such as Alzheimer’s Disease begins.”

Dr. Nicholas Schor, a geriatric psychiatrist based in Olney, says, “Seniors need to maintain a healthy lifestyle and have a broad range of social interactions, have friends, close contacts and a well-rounded life.” Schor visits senior citizen homes and conducts comprehensive evaluations and mental illness visits with patients with depression and dementia.

“With the Internet,” Schor says “a great number of patients [are using] it for socialization – Facebook and email. Seniors utilize the Internet to learn new things, through videos and chat groups – seniors never really stop learning.”