Reader: A Brain-Healthy Lifestyle 2024-2025 PDF
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This reader on 'A Brain-Healthy Lifestyle' is for a psychology course, and covers topics such as social connection, brain aging, sleep, nutrition, and mindfulness. It provides a structured overview of relevant academic literature on these concepts.
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READER_ A Brain-Healthy Lifestyle 2024 - 2025 Academie Organisatie & Ontwikkeling Opleiding: Toegepaste Psychologie Onderwijseenheid: Basiskennis Psychologie A Brain-Health Lifestyle Leerjaar 2 Periode 1 1 INHOUDSOPGAVE (op volgorde van verschijnen in de re...
READER_ A Brain-Healthy Lifestyle 2024 - 2025 Academie Organisatie & Ontwikkeling Opleiding: Toegepaste Psychologie Onderwijseenheid: Basiskennis Psychologie A Brain-Health Lifestyle Leerjaar 2 Periode 1 1 INHOUDSOPGAVE (op volgorde van verschijnen in de reader) Week 1: Introductie BHL – Sociale Verbondenheid (pp. 3-18) Buettner, D., & Skemp, S. (2016). Blue Zones. American Journal of Lifestyle Medicine, 10(5), 318–321. Randolph, J. (2019). H6 Socializing and the brain. The brain health book: Using the power of neuroscience to improve your life. WW Norton & Company. Week 2: Brein, Gedrag en Veroudering (pp. 19-63) Phelps, E., Berkman, E., & Gazzaniga, M. (2022). Chapter 3: Biology and behavior. In Psychological Science (7de editie, pp. 67–115). New York: W.W. Norton & Co. Park, D.C., & Reuter-Lorenz, P. (2009). The Adaptive Brain: Aging and Neurocognitive Scaffolding. Annual Review of Psychology, 60(1), 173–196. Reuter-Lorenz, P. A., & Park, D. C. (2014). How does it STAC up? Revisiting the scaffolding theory of aging and cognition. Neuropsychology review, 24, 355-370. Week 3: Slaap (pp. 64-120) Coenen, A.M.L. (2016). Hoofdstuk 3 – Waarom slapen we eigenlijk? In Het slapende brein (pp. 51–64). Nieuwegein: Arko Sports Media BV. Coenen, A.M.L. (2016). Hoofdstuk 4 – De afwisseling van slapen en waken. In Het slapende brein (pp. 65– 86). Nieuwegein: Arko Sports Media BV. Caldwell, J.A., Caldwell, J.L., Thompson, L.A., & Lieberman, H. R. (2019). Fatigue and its management in the workplace. Neuroscience & Biobehavioral Reviews, 96, 272–289. Week 4: Voeding (pp. 121-175) Wenk, G. L. (2019). Chapter 2 - Neurobiology of Feeding: Hormones, Overeating and Aging. In Your brain on food: How chemicals control your thoughts and feelings (pp. 31 – 90). Oxford: University Press. Scholing, J., Remie, R., & Aarts, E. (2023). Voeding en de hersenen – tweerichtingsverkeer. Nederlands Tijdschrift voor Voeding & Diëtetiek. 78(2), 11-17. Agustí, A., García-Pardo, M.P., López-Almela, I., Campillo, I., Maes, M., Romaní-Pérez, M., & Sanz, Y. (2018). Interplay Between the Gut-Brain Axis, Obesity and Cognitive Function. Frontiers in Neuroscience, 12, 1–17. Week 5: Aandacht & Ontspanning (pp. 176-199) Tang, Y. Y., Hölzel, B. K., & Posner, M. I. (2015). The neuroscience of mindfulness meditation. Nature Reviews Neuroscience, 16(4), 213-225. Killingsworth, M.A., & Gilbert, D.T. (2010). A Wandering Mind Is an Unhappy Mind. Science, 330(6006), 932. Toussaint, L., Nguyen, Q. A., Roettger, C., Dixon, K., Offenbächer, M., Kohls, N., & Sirois, F. (2021). Effectiveness of progressive muscle relaxation, deep breathing, and guided imagery in promoting psychological and physiological states of relaxation. Evidence-Based Complementary and Alternative Medicine, 2021. Week 6: Beweging (pp. 200-229) Scherder, E. (2014). Hoofdstuk 8: Bewegen is niet alleen goed voor de conditie, maar ook voor de cognitie. In Laat je hersenen niet zitten (pp. 125–150). Amsterdam: Athenaeum – Polak & Van Gennep. Raichlen, D.A., & Alexander, G.E. (2017). Adaptive Capacity: An Evolutionary Neuroscience Model Linking Exercise, Cognition, and Brain Health. Trends in Neurosciences, 40(7), 408–421. 14 WEEK 1 Introductie a Brain-Healthy Lifestyle 3 637066 research-article2016 AJLXXX10.1177/1559827616637066American Journal of Lifestyle MedicineAmerican Journal of Lifestyle Medicine American Journal of Lifestyle Medicine Sep Oct 2016 Dan Buettner, BA, and Sam Skemp, BA Blue Zones: Lessons From the World’s Longest Lived Abstract: What began as a National lives is dictated by our genes, whereas might explain longevity. They found Geographic expedition, lead by Dan the other 80% is dictated by our that the lifestyles of all Blue Zones Buettner, to uncover the secrets of lifestyle. In 2004, Dan Buettner, residents shared 9 specific longevity, evolved into the discovery of CEO of Blue Zones LLC, was characteristics. These are called the the 5 places around the world where determined to uncover the specific Power 9. people consistently live over 100 years old, dubbed the Blue Zones. Dan and his team of demographers, scientist However, many individuals have and anthropologists were able to distill the evidence-based common the capacity to make it well into denominators of these Blue Zones into 9 commonalities that they call the the early 90s and largely without Power 9. They have since taken these principles into communities across chronic disease. the United States working with policy makers, local businesses, schools and individuals to shape the environments aspects of lifestyle and environment Power 9 of the Blue Zones Project Communities. that led to longevity. By teaming up What has been found is that putting with National Geographic and the To make it to age 100, it seems that a the responsibility of curating a healthy National Institute on Aging, Dan and person must have to win the genetic environment on an individual does his team, found the 5 demographically lottery. However, many individuals have not work, but through policy and confirmed, geographically defined the capacity to make it well into the environmental changes the Blue Zones areas with the highest percentage of early 90s and largely without chronic Project Communities have been able to centenarians (Loma Linda, CA, USA; disease. Blue Zones uncovered 9 increase life expectancy, reduce obesity Nicoya, Costa Rica; Sardinia, Italy; evidence-based common denominators and make the healthy choice the easy Ikaria, Greece; Okinawa, Japan; seen in among the world’s centenarians that are choice for millions of Americans. Figure 1). These 5 areas were located believed to slow this aging process. using epidemiological data, statistics, Keywords: Blue Zones; Power 9; Life birth certificates, and other research. 1. Move naturally. The world’s longest- Radius; Vitality Compass; Longevity; These areas were dubbed Blue Zones, lived people do not pump iron, run Health; Dan Buettner where people reach age 100 at 10 marathons, or join gyms. Instead, they times greater rates than in the United live in environments that constantly States. Once these areas were nudge them into moving without established, they sent in a team of thinking about it. They grow gardens T he Danish Twin Study1 anthropologists, demographers, and do not have mechanical established that only about 20% epidemiologists, and researchers to conveniences for house and yard of how long the average person identify the lifestyle characteristics that work. DOI: 10.1177/1559827616637066. From Blue Zones, LLC, Minneapolis, Minnesota. Address correspondence to: Dan Buettner, BA, Blue Zones, LLC, 80 South 8th Street, STE 1400, Minneapolis, MN 55402; e-mail:[email protected]. For reprints and permissions queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav. Copyright © 2016 The Author(s) These articles are based on The Annual Conference of the American College of Lifestyle Medicine (ACLM) held November 1-4, 2015, in Nashville, Tennessee—Lifestyle Medicine 2015: Integrating Evidence into Practice. 318 4 vol. 10 no. 5 American Journal of Lifestyle Medicine Research from the Framingham Figure 1. Studies2 shows that smoking, obesity, Blue Zones (reprinted with permission from Dan Buettner). happiness, and even loneliness are contagious. So the social networks of long-lived people have favorably shaped their health behaviors. Blue Zones Sardinia Located off the coast of Italy, Sardinia is home to the world’s longest-lived men. This community of shepherds walk 5 mountainous miles a day or more. This natural movement provides all the positive cardiovascular benefits you might expect and also has a positive effect on muscle and bone metabolism without the point pounding of running marathons. The classic Sardinian diet is plant based, consisting of whole-grain 2. Purpose. The Okinawans call it Ikigai 6. Wine @ 5. People in all Blue Zones bread, beans, garden vegetables, and and the Nicoyans call it plan de vida; (except Adventists) drink alcohol fruits. Meat is largely reserved for for both, it translates to “why I wake moderately and regularly. Moderate Sundays and special occasions. up in the morning.” Knowing your drinkers outlive nondrinkers. The Sardinians drink wine moderately. sense of purpose is worth up to 7 trick is to drink 1 to 2 glasses per day Cannonau wine has 2 or 3 times the years of extra life expectancy. (preferably Sardinian Cannonau level of artery-scrubbing flavonoids as 3. Downshift. Even people in the Blue wine), with friends and/or with food. other wines. Moderate wine consumption Zones experience stress. Stress leads to And no, you cannot save up all week may help explain the lower levels of chronic inflammation, associated with and have 14 drinks on Saturday. stress among men. every major age-related disease. What 7. Belong. All but 5 of the 263 the world’s longest-lived people have centenarians interviewed belonged to Okinawa that others do not are routines to shed some faith-based community. Home to the world’s longest-lived that stress. Okinawans take a few Denomination does not seem to women, these South Pacific islands offer moments each day to remember their matter. Research shows that attending many secrets to longevity. The Okinawa ancestors; Adventists pray; Ikarians take faith-based services 4 times per tradition of forming a moai provides secure a nap; and Sardinians do happy hour. month will add 4 to 14 years of life social networks. These safety nets lend 4. 80% Rule. Hara hachi bu—the expectancy. financial and emotional support in times of Okinawan 2500-year old Confucian 8. Loved ones first. Successful need and give their members the stress- mantra said before meals reminds centenarians in the Blue Zones put shedding security of knowing there is them to stop eating when their their families first. This means keeping always someone there for them. In stomachs are 80% full. The 20% gap aging parents and grandparents Okinawa, at age 5, children are put into between not being hungry and nearby or in the home (it lowers these committed social networks. One feeling full could be the difference disease and mortality rates of children specific moai that Dan discovered had between losing weight or gaining it. in the home too.). They commit to a been together for 97 years; the average age People in the Blue Zones eat their life partner (which can add up to 3 of the group is 102. They meet every day to smallest meal in the late afternoon or years of life expectancy) and invest in drink sake and gossip. If one of them does early evening, and then, they do not their children with time and love. not show up, the other 4 put on their eat any more the rest of the day. (They’ll be more likely to care for kimonos to walk across the village to check 5. Plant slant. Beans, including fava, aging parents when the time comes.) on their friend. Okinawans also attribute black, soy, and lentils, are the 9. Right tribe. The world’s longest lived their longevity to the old Confucian mantra cornerstone of most centenarian diets. people chose—or were born said before meals Hara Hachi Bu, which Meat—mostly pork—is eaten on into—social circles that supported reminds them to stop eating when 80% full, average only 5 times per month. healthy behaviors, Okinawans created so they do not overeat. They also hold a Serving sizes are 3 to 4 oz, about the moais—groups of 5 friends that strong sense of purpose in their family. size of a deck of cards. committed to each other for life. One centenarian described the feeling of 319 5 American Journal of Lifestyle Medicine Sep Oct 2016 holding her great great great grandchild as “Jumping into heaven.” Figure 2. Loma Linda Life radius (reprinted with permission from Dan Buettner). This Adventist community in California outlives the average American by a decade. Taking their diet directly from the Bible they consume a vegan diet of leafy greens, nuts, and legumes. They recognize the Sabbath and downshift for 24 hours every week. Many of the Adventists are still very active into their late 90s; Dr Ellsworth Wareham, who is 95 years old, was told that a contractor wanted $6000 to build a privacy fence in his yard. Instead of paying the contractor he decided to do it himself. After 3 days of work he ended up in the hospital, but Ellsworth was not on the table, he was the surgeon performing the open-heart surgery, one of 20 surgeries performed that month. Similarly, Marge Jetton age 105 woke up People who nap regularly have up to have dropped by 70%. It is clear that every morning at 5:30 am read her Bible, 35% lower chances of dying from heart there is no quick fix, but there must be had a breakfast of slow cook oatmeal, disease. It may be because napping small changes to the environment to see nuts, and dates with soymilk and a prune lowers stress hormones or rests the heart. long-lasting health changes. juice shooter. She would then ride her One Ikarian in particular, Stamatis stationary bike for 30 minutes and get in Moraitis, moved to America when he was her Cadillac and drive to her volunteer Life Radius 22 years old to pursue the American jobs for 7 different organizations. dream. He was a painter, and Research shows that individuals spend immediately started having success, about 90% of their lives within 5 miles of Nicoya bought a house, married, and had 3 kids. their home, known as the Life Radius, Nicoyans spend just 15% of what At the age of 66 years, he developed seen here in Figure 2. To engineer an America does on health care and are terminal lung cancer. Instead of dying in environment where longevity ensues, more than twice as likely than Americans America, he decided to move back to Blue Zones worked with researchers to to reach a healthy age of 90 years. Faith Ikaria and moved in with his parents. He create a blue print to optimize the Life and family play a strong role in Nicoyan started breathing the air, drinking the Radius. The team started by analyzing culture. So does plan de vida, or reason wine, and eating a Mediterranean diet. what individuals can do for themselves. to live, which helps Nicoyan elders After a few months, he planted a garden Individuals can engineer their kitchen, so maintain a positive outlook and active not planning on ever getting to harvest they eat about 100 fewer calories and lifestyle. Nicoyans eat little to no the vegetables; 37 years later he has a engineer their home, so they burn a processed foods but plenty of vineyard producing 200 L of wine a year. couple of hundred extra calories through antioxidant-rich tropical fruit. But they His secret he says? “I just forgot to die.” physical activity. This is done through also have 1 unique secret: calcium- and small changes such as putting a bowl of magnesium-rich water, which wards off fruit on the counter, serving food at the heart disease and promotes strong bones. Medical stove and not on the table, using hand Obesity and diabetes are running tools for yard work, and many more. In Ikaria rampant in the United States. Currently, every community, 80% of people want to People on this tiny Aegean island live 8 the culture is focused on adhering to change their health habits. By creating years longer than Americans do. They different diets and exercise programs. It social networks of these health conscious experience 20% less cancer, half the rate has been found that these are not people, it encourages healthy living and of heart disease, and almost no sustainable changes. Within the first 7 gives people a sense of purpose. dementia. Ikarians eat a variation of the months of a diet, more than 90% of Then, the researchers looked at places Mediterranean diet, with lots of fruits and individuals will have given up. There is a within the life radius. There are 115 vegetables, whole grains, beans, similar decline when it comes to evidence-based design tweaks and potatoes, and olive oil. Ikarians also adherence to gym memberships; after policies that can be put in place, so that downshift with a midafternoon break. just 2 years, the number of attendees will when people show up to school, work, 320 6 vol. 10 no. 5 American Journal of Lifestyle Medicine church, stores, and restaurants they are When a sandwich was ordered, the on the Power 9 teachings of Right mindlessly nudged to eat less and move customers automatically got fruit instead Outlook, Move Naturally, Eat Wisely, and more. These tweaks include things such of fries. By using different adjectives Belong; it then calculates their biological as standing desks at work, removal of rather than the “healthy choice,” age, overall life expectancy, healthy life vending machines in schools, no individuals were more likely to choose expectancy, and the years they are breadbaskets at restaurants, safe walking the best option. Grocery stores created gaining/losing because of their habits. It paths, and encouraging moais. healthy checkout isles, so that instead of then gives the users 12 customized According to the Centers for Disease candy bars and soda greeting people in recommendations to help them live Control and Prevention, the best the checkout, they saw fruit, water, and longer and better. This is a useful tool to investment on health is through policy. healthy snacks. take initially as a baseline test, then try By creating environments where fruits Schools signed Blue Zones pledges. out some of the specific lifestyle and vegetables are most accessible over They do not sell candy for fundraisers, recommendations, and 3 to 6 months fast food, a dramatic decrease in obesity and there was no candy for good grades. later, take the quiz again. is seen. If there are 6 or more fast food Based on a University of Minnesota study Recommendations include reducing salt restaurants within half a mile of an calculation that prohibiting eating in intake, joining a faith-based community, individual’s home, they are 40% more hallways and classrooms would occasion quitting smoking, improving attitude, and likely to be obese than if there are less a 11% per year drop in student body many more. than 3. By putting policies in place to mass index (BMI), the project convinced limit the number of fast food restaurants schools to adopt the policy. Then, 25% of Summary and putting regulations on smoking, the community signed a personal pledge policy makers can see a drastic increase that they would take steps toward a Blue Zones started as a way of in health. If streets are walkable and healthy lifestyle. discovering the healthiest lifestyles that bikeable, parks are cleaned up, and the After about a year and a half, there was lead to vitality and longevity. Now, 12 active option is the easy option, physical a 3.2-year bump in life expectancy; the years after the start of this massive activity of the entire population can rise community lost a combined weight of project, Blue Zones is a way to design by 30%. 7280 pounds; and health care costs the healthiest lifestyles possible for dropped by 40%. individuals and for entire communities. The goal for Blue Zones is to not only Albert Lea make the healthy choice the easy choice, Blue Zones Expansion In 2008, Dan and the Blue Zones team but also the unavoidable choice. finalized the blue print for Life Radius. After seeing the results in Albert Lea, They had to make sure that it could be Blue Zones began interviewing larger Authors’ Note applied to an American city. Buettner cities to take on. The beach cities of Los and his team interviewed 5 cities to be Angeles were chosen.3 Blue Zones To join the Blue Zones mission, contact [email protected]. More information about the project can be obtained at https:// the pilot project, and they picked Albert worked with city planners to make the communities.bluezonesproject.com/. The authors disclose the Lea, MN, a town of 9000 people. The streets built for humans instead of cars. following conflicts of interest: Dan Buettner is the CEO of Blue team first went in and listened to the The rate of smoking went down by 30%; Zones and Sam Skemp works at Blue Zones as Program organizations to find what they needed. BMI went down by 14%; and people Manager. AJLM They brought in Dan Burden who works reported healthy behaviors. with communities across the country to From there, Blue Zones moved into References create more walkable environments. Iowa with the same strategy; 10 cities Albert Lea wanted to widen Main Street were chosen.4 Smoking went down by 1. Herskind AM, McGue M, Holm NV, and up the speed limit. Blue Zones 8.8%, and healthy eating went up by Sorensen TIA, Harvlad B, Vaupel JW. The heritability of human longevity: a convinced them to build a walking path 10.5%. Then, Blue Zones started working population-based study of 2,872 Danish around their lake instead. The path is in Fort Worth, TX, and Kauai, HI, and are twin pairs born 1870-1900. Hum Genet. now packed 11 months out of the year now in 27 cities across the United States. 1996;96:319-323. with individuals walking. The sidewalks 2. Christakis NA, Fowler JH. The spread of throughout the community were obesity in a large social network over 32 Vitality Compass years. N Engl J Med. 2007;357:370-379. connected, so people could walk from their homes to downtown without In association with the University of 3. Buettner D. The Blue Zones: 9 Lessons for having to walk through fields or busy Minnesota Public Health Department, Living Longer From the People Who’ve Lived the Longest. Washington, DC: National intersections. Dan and his team created the Vitality Geographic Society; 2008. Grocery store and restaurant pledges Compass, named the Best Online Tool 4. Buettner D. The Blue Zones Solution: were created to help individuals change for Retirement and Longevity by the Wall Eating and Living Like the World’s the way they eat. Restaurants were Street Journal. This tool has users answer Healthiest People. Washington, DC: required to offer 3 plant-based entrées. lifestyle and background questions based National Geographic Society; 2015. 321 7 8 6 Socializing and the Brain: Stay Connected to Improve Your Neural Connections WHILE NOT A SOCIAL BUTTERFLY BY ANY MEANS, Gene was the type of person who tried to push himself to stay engaged with others. Twice a week, he would meet with a handful of friends for “coffee club” at a local café. Conversations were good (often better than the coffee), and he found it was a stimulating way to start the day. I saw Gene periodically over a few years, and despite having some mild cognitive problems in our initial evaluation, he didn’t show increased memory difficulties over time. Multiple factors come into play when we understand why people do or do not show cognitive changes, but in Gene’s case, I had a hunch that prioritizing social activity with friends was helping his brain stay healthy. Anecdotally, I’ve seen the same pattern play out in many socially engaged individuals, and the science seems to reinforce what my colleagues and I have observed. Let’s look at some of the details. THE BACKGROUND SCIENCE This chapter focuses on the relatively new area of inquiry examining the relationship between social activity and brain and cognitive functioning. Recall that social activity is another part of the “A” (activity engagement) referenced by the C.A.P.E. model. But what do we mean by social activity? We are fundamentally wired to seek out social interaction, and most of us socialize with others on a regular basis in many different ways. Social encounters include impromptu conversations at the grocery store with a neighbor or friend, brief chats with coworkers between meetings, or catching up with a loved one at the end of the day. Perhaps a family dinner at home or on the town, doing volunteer work, being involved in a community group such as a book or garden club, or attending meetings with colleagues are more common in your life. There are more ways than ever to socialize: face-to-face interaction, making a phone call, video conferencing with a family member or friend, sending an e-mail, writing a text message, or posting on one of the ever-growing forms of social media. In studies that assess social engagement, the way interactions are quantified for research purposes varies but often involves asking people how often they interact with someone for more than 10 minutes at a time. So, a quick interaction with a store clerk wouldn’t count, but coffee with a friend or a slightly extended phone call would. We know that socializing with people we care about or find interesting is emotionally rewarding... and the reverse is emotionally taxing. In addition, scientists have learned fairly recently that positive social interactions are really good for the brain. The frequency of our social activity, the size of our social network, and our sense of social support all impact cognitive skills and brain health. Conversely, social isolation and negative social interactions can be detrimental to the brain. In this chapter, we’ll look at what the research says in these areas and how the science can guide our decisions about our social lives. How Does Being Social Keep Us Healthy? We can all probably relate to the idea that being connected to and supported by others feels good. Maybe it’s our relationship with a partner or spouse, a long-standing connection with an old friend or group of friends, positive family ties, or camaraderie with coworkers. When we have these positive interactions, it does something for us in the moment from an emotional standpoint. It also improves our overall health and affects our basic physiology across the life span. We’ve known for many years that social support helps us manage stress and improves our cardiovascular health. Indeed, people who feel more supported have lower blood pressure, better endocrine function, and stronger immune systems. Our social network size is closely related to social support, and refers to how many people we have meaningful relationships with and see on a fairly regular basis. The size of our social network is also linked to health, and people with more friends and acquaintances tend to be healthier, live longer, and fight disease better. More generally, when we have enriching connections with others, we experience less stress, manage the stress we encounter better, and soak in positive emotion easier. This, in turn, helps the body operate at higher levels. Conversely, feeling less connected can lead us to make proverbial mountains out of molehills. And having fewer social ties sets up an increased risk of various physical problems like obesity and heart disease. We’re also learning more about the relationship between social connections and the brain. For example, when we have positive interactions with other people, the pleasure centers of the brain light up like a Christmas tree (a familiar metaphor in the neuroimaging community). In contrast, negative encounters tend to stir up brain regions that are active when we experience physical pain. This suggests that social tension and physical discomfort are closely related, particularly in terms of how the brain processes these types of experiences. 9 How Does Social Activity Help the Brain? There is growing evidence that the more socially active you are, the healthier your brain will be. Increased social activity is associated with better executive functioning, quicker thinking speed, and improvements in some types of memory. These findings are seen across the life span, although the majority of published research has been conducted with older adults. The brain particularly benefits when we engage in multiple social activities rather than just one; a weekly coffee with a friend is good, but adding in time with a hiking club or a community group is better. So how much socializing is necessary for the brain to get a boost? As we’ll see, you don’t have to become a gregarious social butterfly to reap the brain-based rewards of socializing. Multiple studies over the past 15 or so years have shown that being socially active translates into improved health and a better-looking and better-working brain. There is also evidence that being socially active reduces the risk of developing dementia. The most powerful studies follow people over the course of time to see whether staying socially engaged helps the brain. Social engagement is usually determined based on the amount of time people spend with friends, family members, or coworkers. The bottom line is that the more we interact with others, the more likely our brain and cognitive skills will be in good shape. It remains unclear why social activity is so beneficial for the brain, although when you think about the details of a social interaction, the brain clearly gets a solid workout. You need to listen well and comprehend what the other person is saying, read body language (facial expressions, gestures) to interpret the context and emotion of the message, remember how this conversation might be related to distant or recent experiences, think about a response (or decide between multiple responses), and then respond, all in a very short period of time. We can also think of the emotional benefits of positive interactions: we feel more connected, less stressed-out, and have a better sense of control over our environment. As we’ll discuss in Chapter 10, reducing stress in various forms can really help the brain. Getting a mood boost with social activity might be one of the main reasons why the brain benefits when we get together with others. We have less of the potentially noxious hormone cortisol circulating in our bodies when our mood is brighter, and socializing on a regular basis keeps our immune system firing on all cylinders. In addition, emotional support from others quiets the parts of the brain that light up when we feel threatened and ramps up brain regions that respond when we feel safe. Being more socially active also seems to help our cognitive skills even when we aren’t able to do other brain-boosting activities such as exercise, reading, or crossword puzzles. Studies often look at multiple types of activities and account for (or “control for”) one activity while analyzing another. In fact, we see that being social is positive for the brain above and beyond other activities such as exercise. A large study a few years ago found that after considering effects of physical and mental activity, people who were most socially active showed the least amount of memory, spatial skill, and processing speed decline over a 5-year period. Even a small uptick in socializing was found to reduce cognitive decline by almost 50%. This study was also interesting because personality type was accounted for; even people who were more introverted tended to benefit from being more social. Other research has found that social activity can enhance our executive function skills—including working memory and mental flexibility—even if we’ve already experienced cognitive decline. Notably, there’s also evidence that being more social makes us feel like our memory is better, even independent of performance on cognitive tests. How about the social nature of our job? Some people have jobs where they need to be social throughout the day; others may be staring into a computer monitor most of the time. While the latter is not necessarily problematic (though periodically standing up, walking around, and socializing is generally a good idea), people who have more socially active jobs are less likely to develop cognitive problems such as dementia later in life. And when we have more socially contained or isolated jobs, there’s evidence that we can make up for being less social at work by being more social outside of work. This brings up another issue: Does it matter if our social activity is at work, at home, in the community, or something other than face-to-face? We seem to know much more about the brain-related effects of how much we socialize (and as we’ll talk about soon, the size of our social network) than about how and where we interact with others. In-person social contact is probably better for the brain than e- mail or texting; phone calls and video conferencing may be helpful for brain health (and for promoting positive emotions) but may not be quite as good as being physically present with a loved one. Some recent research related to prevention of depression has some relevance here. In one large study with more than 10,000 participants, scientists gauged how often people were in touch with friends or family members face-to-face, by phone, or in writing (which included e-mail). Those who were most socially active, which was quantified as three or more social contacts per week, were the least likely to become depressed. While in-person contact was by far the best way to go (particularly with friends), more frequent e-mail contact with others was better than less contact. Frequency of telephone contact didn’t seem to matter as much for one’s mood as in-person interactions. Perhaps a lesson we can learn from this study is that when we can interact with others in person— particularly people we like—we should try to prioritize this over a phone call or e-mail, when possible, for the sake of our mood. We can also bridge this idea to brain health. Considering that there are important links between cognitive and emotional function (and dysfunction, particularly depression), we can probably conclude that the more face-to-face interactions we have, the healthier our brain will be. Social Networks and the Brain What about the overall size of our social network? Does that confer additional brain-related benefits? Research has a lot to say about this aspect of socializing too. And the bottom line here is that the more people we have in our broader social clan, the better our brain tends to function. Some of the early knowledge in this area came from the so-called Nun Study, where hundreds of nuns were studied over many years (during life, and after death) to help understand why and how some people age better than 10 others. As we touched on earlier, one of the most remarkable findings from this study related to the appearance of the nuns’ brains on autopsy. While some of their brains looked very similar to those with full-blown dementia, during life, many of these nuns were functioning well day to day. In other words, there was something they were doing to reduce the impact of dementia-related brain changes on their daily cognitive skills. One likely possibility is that the breadth of their social networks (in addition to engagement in mental and physical activities) was preventing them from descending into dementia. As we’ll see, more recent research findings point in this very direction. When researchers determine the size of someone’s social network, they often ask how many times one has seen a friend or relative over the past month. So, in a way, the bar is set fairly low for the amount of people one interacts with. Many of us see friends or family members on a daily basis. Hopefully you’re in this category, but if you’re not, there are reasons to connect with new coworkers or people in the community, or to reinvigorate a relationship with an old friend. Some of the more compelling studies have found that the more people you connect with on a regular or semi-regular basis, the less likely you’ll show cognitive decline, and the longer you’ll live. A study from the Rush Alzheimer’s Disease Center sought to understand whether a larger social network was linked to fewer cognitive problems in people whom they studied for about 5 years. The scientists found that people with many social connections were almost 40% less likely to experience cognitive decline than someone with one primary social tie. This finding, and a related result regarding frequency of social activity, was unchanged after accounting for other things that can affect social connectedness, like marital status, educational level, annual income, and physical and mental activity. Other work has shown that the risk of dementia is quite high in those with few or no consistent social contacts, and that each additional person added to your social network—as long as these relationships are satisfying and supportive—further decreases the risk of cognitive impairment as you age. Following up on our Nun Study discussion, some of the science has more directly linked social network size to the impact of brain changes on our cognitive skills. A fascinating study tried to determine whether social networks could buffer the effects of pathological changes to the brain. They studied older adults who were healthy at the beginning of the study, and determined the social network sizes of these adults via interviews. They also assessed cognitive skills such as working memory and episodic memory using neuropsychological tests. The study participants were tracked cognitively until they passed away. Then the researchers examined the participants’ brains, which they had previously agreed to donate to the study. A noble contribution to say the least. The key result from the study was groundbreaking: the larger the participants’ social networks were during life, the less that brain disease affected their cognitive abilities. In other words, even if the autopsied brains appeared to be from individuals who had Alzheimer’s disease, the same people didn’t show the cognitive impairment usually found in Alzheimer’s while they were alive. Further, this pattern played out across multiple types of memory as well as overall cognitive ability. Research like this has poignantly clarified the importance of our social choices on how the brain works, even in the face of neurodegenerative disease. It is also important to note that social network size isn’t everything; the quality of our social interactions is probably just as meaningful. Some research has found that the more satisfied we are with others in our social networks, the less likely we are to develop dementia. As we’ll discuss later, frequent interactions that are negative or even toxic can have significant consequences for brain health. Social Support and the Brain Diane saw me for a baseline neuropsychological evaluation after being diagnosed with multiple sclerosis (MS). Her physical and cognitive MS symptoms were relatively mild, and she was able to stay fairly active most days. One of the things she really prioritized was seeing friends and family as often as she could. She had quite the social schedule, sometimes visiting or being visited by two or three different people each day. She laughed and told me, “My social life is great, but it’s almost exhausting! Seriously, though, I feel fortunate to have a good group of people who seem to like being with me and who I know I can count on if things go south.” In the clinic, I observed that her performance on cognitive testing was stable over the course of 4 years. She showed some mild difficulties with cognitive processing speed— common in MS—but minimal worsening over time. The science indicates that people like Diane tend to have more robust brain skills over the years, at least in part because they feel connected to and supported by others. Beyond the amount of time we spend socializing, or the size of our network, the sense of support we feel from people we interact with is important too. When we’re supported by others, we take solace in knowing there’s someone we can count on. More generally, we feel less alone in the universe. So, there are clear emotional benefits to having a social safety net. That said, what does social support do for our brains? Is there something about support from others that impacts our cognitive skills and brain health? Fortunately, and as I saw with Diane, the science clearly indicates that the more supported we feel, the better our brains seem to function. An early study in this area looked at the effects of social support on cognitive aging in a large sample of older adults. At the beginning of the study, the researchers asked the participants about their social lives, including the level of support they felt from others in their social circle. They also assessed multiple thinking skills, which were considered in a global cognitive performance score. Then, 7 years later, the researchers reexamined the participants’ cognition. The most critical factor in determining whether people showed better brain skills since their earlier testing: social support. People who felt more supported by others performed better on multiple cognitive tests; those feeling like they were largely on their own showed evidence of poorer brain health. Importantly, these findings remained meaningful above and beyond other factors including physical activity, physical health, psychological status, and annual income. In other words, feeling that others care 11 for us may be more important for brain health than many other life-impacting issues. Some of the details from earlier research have recently been fleshed out a bit, particularly regarding which cognitive skills benefit from more social support. While some work has found that more social support is related to better overall cognitive functioning, there are also specific benefits for executive functioning (including working memory and task shifting), processing speed, and spatial skills. Some research has found that our sense of being supported well by others is linked to how effectively we can pay attention, and that feeling less supported can negatively affect our verbal memory over time. And there’s evidence that feeling the scales of social reciprocity tipping in our favor—a sense that we’re receiving more social support than we’re giving to others—is tied to a 50% reduced risk of dementia. One specific aspect of social support that’s been looked at is church attendance. A large study that followed over 3,000 Mexican Americans over about 7 years found that those who attended church services at least once a month showed significantly better cognitive functioning than less frequent churchgoers. Factors such as gender, age, and specific religious affiliation did not significantly alter the findings. Similar findings have been observed in African American and Caucasian adults too. Faith comes in many forms, and regardless of denomination, the social cohesion felt in faith communities appears to have many brain-related benefits. Some people like volunteering in the community—a noble type of social support that usually pays dividends for all involved. Perhaps it’s working a few hours a week at a local food bank or homeless shelter; maybe restocking books at a town library is more your style. Beyond the feel-good nature of volunteering for the volunteer—not to mention the benefits for individuals being served and the community at large—volunteering has a nice side benefit that few know about. Simply put, volunteering helps the brain work better, even in people with cognitive problems. Taking social research out of the laboratory and into the real world can be particularly powerful. A great example of this strategy was a study that examined whether participating in a volunteer program for elementary school children (“Experience Corps”) would affect volunteers’ own cognitive functioning. The volunteers helped with reading skills, library tasks, and classroom activities across the academic year for 15 hours per week. At the end of the school year, compared to those in a control group who did not volunteer, the people in the study showed much better memory and executive functioning (such as organizational skills and flexible thinking). The researchers also found that people with cognitive problems at the beginning of the study showed significant cognitive improvement. It seems intuitive that serving as a volunteer in an elementary or other school would tax and ultimately grow important skills like organization and mental flexibility; this study has the evidence to prove it. In similar research looking at brain-related changes (using structural and functional neuroimaging), volunteers in the Experience Corps program showed more activity in some frontal lobe areas and greater overall brain volume as a function of their work. Further, the longer they volunteered, the more their brains changed for the better. The findings were particularly notable for volunteers with the highest risk of cognitive problems. The take-home message from these fascinating studies is that engaging in volunteer activity in the community not only helps those receiving the support; the ones providing the service appear to experience healthier brains too. Troubling Social Experiences and the Brain We all have challenging interactions from time to time, some more than others. Hopefully the good or neutral interactions outweigh the bad. It’s important to consider these separately, because even if we have enriching experiences with some folks, our negative social encounters can essentially erase the cognitive and health-related benefits of positive ones. Two general types of social challenges are especially problematic: social conflict and social isolation. Experiencing strain or conflict with others is an inevitable part of life. Conflict can be a one-time event, such as a negative interaction with a snarky coffee shop employee, or something more chronic, such as marital tension or a challenging relationship with a boss or coworker. Conflicted and positive interactions can certainly occur on a regular basis with the same person. For example, a good lunchtime conversation with a friend can sour when the topic of paying the bill comes up. It perhaps goes without saying that strain with someone we’re close to also hits us harder than a negative interaction with someone we don’t know as well. On average, and unfortunately, negative interactions tend to be more powerful and stick with us longer than positive ones. It’s much easier to ruminate about an encounter that was troubling than one that lifted our spirits. What does this have to do with the brain? Well, we know that individuals who consistently have negative interactions are less able to regulate cortisol, a hormone that is linked to stress and illness. Cortisol can also damage the brain, especially when it circulates for extended periods of time (we’ll talk more about this in Chapter 10). In a related vein, some research has found that social conflict doesn’t just have implications for stress levels; social challenges negatively affect how the brain works. One study followed middle-aged people over a 10-year period. The researchers found that individuals reporting the most negative relationships showed faster decline in executive functioning (in particular, problem solving and verbal fluency) than people with more positive connections. In other words, “accelerated aging” occurred in those with the worst relationships, particularly regarding some executive skills. Curiously, memory wasn’t really affected by negative social interactions, suggesting that conflict preferentially degrades only some cognitive abilities. Another problematic aspect of our social life is when we experience isolation. Being isolated from others can sometimes be hard to avoid—for example, while traveling for work, during illness, or while raising children—but being chronically isolated nevertheless has broad health consequences. For example, research finds negative effects of social isolation on the immune system and blood pressure throughout life. Believe it or not, the health-oriented effects of isolation are not unlike those related to obesity or smoking, including problems with chronic disease, diabetes, and high cholesterol. Even more alarming: older adults who are socially isolated are significantly more likely to die prematurely than 12 those who are more socially connected. Feeling lonely can also do a number on brain health. Over the course of a decade, people who report loneliness have been found to show more rapid cognitive decline than others, even after considering other social and health factors. In fact, cognitive skills in lonely people have been found to decline 20% faster than in those who don’t report feeling lonely. While depression and loneliness can certainly occur together, loneliness itself affects brain health above and beyond our mood state. In a related vein, those with a limited social network show a significantly increased risk of developing cognitive impairment or full-blown dementia, with one study showing that particularly socially isolated individuals are at a 60% higher risk of cognitive changes. These findings serve as a cautionary tale, reminding us not only of the importance of being socially connected, but also of the perils of reducing our social ties. Knowledge is power, and I hope that our discussion here has clarified the implications of both positive and negative interactions as they relate to brain health. THE BOTTOM LINE The importance of social interaction and the brain comes down to these key points: Frequent social activity (including with friends, family members, or coworkers) is good for emotional and cognitive health. Social interactions that last at least 10 minutes have more powerful brain effects than shorter encounters; more social “doses” of this duration are better for the brain. Having a relatively large network of social connections is enriching for the brain and reduces the risk of developing dementia. If you don’t interact with many people at work, make sure you have plenty of social time at home and with friends. Feeling a sense of support from others in your life has important emotional and brain-related benefits. If you have physical limitations and can’t exercise very much, consistent social activity may make up for less time exercising, particularly in terms of brain health. Being socially isolated and lonely is toxic to overall health and, specifically, brain health. When possible, avoid people who tend to put you in a negative emotional or psychological space. Beyond the benefits to those being served, volunteering in the community is associated with brain- related benefits for the volunteer, including better executive functioning and memory, as well as more brain volume. THE BRASS TACKS: PERSONAL STRATEGIC PLANNING TO INCREASE SOCIAL ACTIVITY Number of people I can rely on and talk with about challenging issues (consider both family members and friends): These people include: Types of socializing I engage in: Where I like to be social: Factors that get in the way of me socializing more: Top two things that interfere with me being more social: 1. 13 2. Strategies that I can use to overcome social barrier #1: Strategies that I can use to overcome social barrier #2: Small steps I can take to socialize (even a little bit more) this week: Small steps I can take to socialize (even a little bit more) this month: Social goals I have for myself over the next 3 months: Social goals I have for myself over the next 6 months: Things I’ve learned from this chapter that could help me become more socially active: How being more socially active is consistent with my current values: 14 exercise improves prefrontal cortex but not hippocampal function in healthy adults, Journal of the International Neuropsychological Society, 21, 791–801. 100 A reasonable answer comes from a study that reviewed about 100 clinical trials: See J. Gomes- Osman et al. (2018), Exercise for cognitive brain health in aging: A systematic review for an evaluation of dose, Neurology: Clinical Practice, 8(3), 1–9. 101 people tend to process information more efficiently and be less error-prone after a period of HIIT: See C.R.R. Alves et al. (2014), Influence of acute high-intensity aerobic interval exercise bout on selective attention and short-term memory tasks, Perceptual and Motor Skills, 118(1), 63–72; see also S.-C. Kao et al. (2017), Comparison of the acute effects of high-intensity interval training and continuous aerobic walking on inhibitory control, Psychophysiology, 54, 1335–1345. 101 HIIT may also boost executive functioning skills for a longer period than moderate exercise: See H. Tsukamoto et al. (2016), Greater impact of acute high-intensity interval exercise on post-exercise executive function compared to moderate-intensity continuous exercise, Physiology & Behavior, 155, 224–230; see also J. Hwang et al. (2016), Acute high-intensity exercise-induced cognitive enhancement and brain-derived neurotrophic factor in young, healthy adults, Neuroscience Letters, 630, 247–253. 101 HIIT has also been found to enhance physical fitness: See K. Weston et al. (2014), High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: A systematic review and meta-analysis, British Journal of Sports Medicine, 48, 1227–1234. 101 We know that beginning to exercise at any point in life: See Q. Tian et al. (2014), Physical activity predicts microstructural integrity in memory-related networks in very old adults, Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 69(10), 1284–1290; see also S.J. Colcombe et al. (2006), Aerobic exercise training increases brain volume in aging humans, Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 61(11), 1166–1170. 102 Multiple studies have shown that the more fit we are in midlife: See J. Kulmala et al. (2014), Association between mid- to late life physical fitness and dementia: Evidence from the CAIDE study, Journal of Internal Medicine, 276, 296–307; see also S. Rovio et al. (2005), Leisure-time physical activity at midlife and the risk of dementia and Alzheimer’s disease, Lancet Neurology, 4, 705–711; N.L. Spartano et al. (2016), Midlife exercise blood pressure, heart rate, and fitness related to brain volume 2 decades later, Neurology, 86, 1–7. 102 any level of physical activity is associated with a lower risk of cognitive impairment: See F. Sofi et al. (2011), Physical activity and risk of cognitive decline: A meta-analysis of prospective studies, Journal of Internal Medicine, 269, 107–117. 102 Even in the near term, stronger cardiovascular fitness in middle age is associated with more brain volume: See N. Zhu et al. (2015), Cardiorespiratory fitness and brain volume and white matter integrity, Neurology, 84, 1–7. 102 One of the longest studies examining exercise and the brain: See H. Horder et al. (2018), Midlife cardiovascular fitness and dementia, Neurology, 90(15), e1298–e1305, doi:10.1212/WNL.0000000000005290. 103 recent research followed a group of over 3,000 children and adolescents: See S. Rovio et al. (2017), Cardiovascular risk factors from childhood and midlife cognitive performance: The Young Finns Study, Journal of the American College of Cardiology, 69, 2279–2289. 103 The executive functions of the brain... also really respond to exercise: See E. Cox et al. (2016), Relationship between physical activity and cognitive function in apparently healthy young to middle- aged adults: A systematic review, Journal of Science and Medicine in Sport, 19, 616–628. 103 this biological profile of sorts is also associated with reduced executive functioning: See S. Kaur et al. (2016), Serum brain-derived neurotrophic factor mediates the relationship between abdominal adiposity and executive function in middle age, Journal of the International Neuropsychological Society, 22, 1–8. 104 People who maintain a consistent exercise habit are often internally motivated to do so, but also tend to have a friend who is pretty active: See E. Burton et al. (2018), Effectiveness of peers in delivering programs or motivating older people to increase their participation in physical activity: Systematic review and meta-analysis, Journal of Sports Sciences, 36(6), 666–678; see also I. Janssen et al. (2014), Correlates of 15-year maintenance of physical activity in middle-aged women, International Journal of Behavioral Medicine, 21, 511–518. 104 what you look at while exercising really seems to matter: See M. Rogerson et al. (2016), Influences of green outdoors versus indoors environmental settings on psychological and social outcomes of controlled exercise, International Journal of Environmental Research and Public Health, 13(4), 363, doi:10.3390/ijerph13040363; see also J. Kowal and M.S. Fortier (2007), Physical activity behavior change in middle-aged and older women: The role of barriers and of environmental characteristics, Journal of Behavioral Medicine, 30, 233–242. 105 When physical activity is prioritized definitively in this way: See W. Miller and P.R. Brown (2017), Motivators, facilitators, and barriers to physical activity in older adults, Holistic Nurse Practitioner, 31, 216–224. CHAPTER 6: Socializing and the Brain: Stay Connected to Improve Your Neural Connections 112 It also improves our overall health and affects our basic physiology across the life span: See Y.C. Yang et al. (2016), Social relationships and physiological determinants of longevity across the human life span, Proceedings of the National Academy of Sciences USA, 113(3), 578–583. 113 people who feel more supported have lower blood pressure: See B.N. Uchino et al. (1996), The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health, Psychological Bulletin, 119, 488–531; see also Y.C. Yang et al. (2016) above. 113 The size of our social network is also linked to health: See S. Cohen and D. Janicki-Devert (2009), Can we improve our physical health by altering our social networks? Perspectives on Psychological 15 Science, 4, 375–378. 113 negative encounters tend to stir up brain regions that are active when we experience physical pain: See N.I. Eisenberger (2012), The pain of social disconnection: Examining the shared neural underpinnings of physical and social pain, Nature Reviews Neuroscience, 13, 421–434. 115 emotional support from others quiets the parts of the brain that light up when we feel threatened: For a great review of this area of research, see N.I. Eisenberger (2013), An empirical review of the neural underpinnings of receiving and giving social support: Implications for health, Psychosomatic Medicine, 75, 545–556. 115 after considering effects of physical and mental activity, people who were most socially active: See B.D. James et al. (2011), Late-life social activity and cognitive decline in old age, Journal of the International Neuropsychological Society, 17, 998–1005. 116 Other research has found that social activity can enhance our executive function skills: See C.M. deFrias and R.A. Dixon (2014), Lifestyle engagement affects cognitive status differences and trajectories on executive functions in older adults, Archives of Clinical Neuropsychology, 29, 16–25. 116 there’s also evidence that being more social makes us feel like our memory is better: See H. Litwin and K.J. Stoeckel (2016), Social network, activity participation, and cognition: A complex relationship, Research on Aging, 38(1), 76–97. 116 people who have more socially active jobs are less likely to develop cognitive problems such as dementia: See E.A. Boots et al. (2015), Occupational complexity and cognitive reserve in a middle- aged cohort at risk for Alzheimer’s disease, Archives of Clinical Neuropsychology, 30(7), 634–642. 116 there’s evidence that we can make up for being less social at work: See R. Andel et al. (2014), The role of midlife occupational complexity and leisure activity in late life cognition, Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 70, 314–321. 117 scientists gauged how often people were in touch with friends or family members: See A.R. Teo et al. (2015), Does mode of contact with different types of social relationships predict depression in older adults? Evidence from a nationally representative survey, Journal of the American Geriatrics Society, 63, 2014–2022. 118 Some of the early knowledge in this area came from the so-called Nun Study: For a detailed description of this study and its findings, see D. Snowdon (2001), Aging with Grace: What the Nun Study Teaches Us About Leading Longer, Healthier, and More Meaningful Lives, New York, NY: Bantam Books. 119 Some of the more compelling studies have found that the more people you connect with on a regular or semi-regular basis: As one early example, see R.E. Holtzman et al. (2004), Social network characteristics and cognition in middle-aged and older adults, Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 59B(6), P278–P284. 119 the less likely you’ll show cognitive decline, and the longer you’ll live: See J. Holt-Lunstad et al. (2010), Social relationships and mortality risk: A meta-analytic review, PLOS Medicine, 7(7), e1000316, doi:10.1371/journal.pmed.1000316. 119 A study from the Rush Alzheimer’s Disease Center sought to understand whether a larger social network: See L.L. Barnes et al. (2004), Social resources and cognitive decline in a population of older African Americans and whites, Neurology, 63, 2322–2326. 119 Other work has shown that the risk of dementia is quite high in those with few or no consistent social contacts: See L. Fratiglioni et al. (2000), Influence of social network on occurrence of dementia: A community-based longitudinal study, Lancet, 355, 1315–1319. 119 A fascinating study tried to determine whether social networks could buffer the effects of pathological changes: See D.A. Bennett et al. (2006), The effect of social networks on the relation between Alzheimer’s disease pathology and level of cognitive function in old people: A longitudinal cohort study, Lancet Neurology, 5(5), 406–412. 120 Some research has found that the more satisfied we are with others in our social networks: See H. Amieva et al. (2010), What aspects of social network are protective for dementia? Not the quantity but the quality of social interactions is protective up to 15 years later, Psychosomatic Medicine, 72, 905–911. 122 An early study in this area looked at the effects of social support on cognitive aging: See T.E. Seeman et al. (2001), Social relationships, social support, and patterns of cognitive aging in healthy, high-functioning older adults: MacArthur studies of successful aging, Health Psychology, 20, 243– 255. 122 While some work has found that more social support is related to better overall cognitive functioning: A variety of studies have clarified these relationships. See K.R. Krueger et al. (2009), Social engagement and cognitive function in old age, Experimental Aging Research, 35, 45–60; see also T.E. Seeman et al. (2011), Histories of social engagement and adult cognition: Midlife in the U.S. study, Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 66B, i141–i152; L.B. Zahodne et al. (2014), Which psychosocial factors best predict cognitive performance in older adults? Journal of the International Neuropsychological Society, 20, 487–495; and M.L. Zuelsdorff et al. (2013), Stressful events, social support, and cognitive function in middle-aged adults with a family history of Alzheimer’s disease, Journal of Aging Health, 25, 944–959. 123 Some research has found that our sense of being supported well by others: See T.F. Hughes (2008), The association between social resources and cognitive change in older adults: Evidence from the Charlotte County Healthy Aging Study, Journal of Gerontology: Psychological Sciences, 63B(4), P241–P244. 123 feeling the scales of social reciprocity tipping in our favor: See H. Amieva et al. (2010) above. 123 A large study that followed over 3,000 Mexican Americans over about 7 years: See T.D. Hill et al. (2006), Religious attendance and cognitive functioning among older Mexican Americans, Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 61(1), P3–P9. 124 volunteering helps the brain work better: See S. Park et al. (2017), Life course trajectories of later- life cognitive functions: Does social engagement in old age matter? International Journal of 16 Environmental Research and Public Health, 14(4), 393, doi:10.3390/ijerph14040393. 124 a study that examined whether participating in a volunteer program for elementary school children: See M.C. Carlson et al. (2008), Exploring the effects of an “everyday” activity program on executive function and memory in older adults: Experience Corps, Gerontologist, 48(6), 793–801; see also M.C. Carlson et al. (2009), Evidence for neurocognitive plasticity in at-risk older adults: The Experience Corps program, Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 64, 1275–1282; M.C. Carlson et al. (2015), Impact of the Baltimore Experience Corps Trial on cortical and hippocampal volumes, Alzheimer’s & Dementia, 11, 1340–1348. 126 we know that individuals who consistently have negative interactions are less able to regulate cortisol: See K.S. Rook (2015), Social networks in later life: Weighing positive and negative effects on health and well-being, Current Directions in Psychological Science, 24(1), 45–51. 126 One study followed middle-aged people over a 10-year period: See J. Liao et al. (2014), Negative aspects of close relationships as risk factors for cognitive aging, American Journal of Epidemiology, 180, 1118–1125. 127 research finds negative effects of social isolation on the immune system: See Y.C. Yang et al. (2016) above. 127 the health-oriented effects of isolation are not unlike those related to obesity or smoking: See A. Richard et al. (2017), Loneliness is adversely associated with physical and mental health and lifestyle factors: Results from a Swiss national survey, PLOS ONE, 12(7), e0181442. 127 older adults who are socially isolated are significantly more likely to die prematurely: See P.M. Eng et al. (2002), Social ties and change in social ties in relation to subsequent total and cause-specific mortality and coronary heart disease incidence in men, American Journal of Epidemiology, 155(8), 700–709. 127 people who report loneliness have been found to show more rapid cognitive decline than others: See N.J. Donovan et al. (2017), Loneliness, depression and cognitive function in older U.S. adults, International Journal of Geriatric Psychiatry, 32(5), 564–573; see also R.S. Wilson et al. (2007), Loneliness and risk of Alzheimer disease, Archives of General Psychiatry, 64, 234–240. 127 those with a limited social network show a significantly increased risk of developing cognitive impairment: See L. Fratiglioni et al. (2000) above; see also S.S. Bassuk et al. (1999), Social disengagement and incident cognitive decline in community-dwelling elderly persons, Annals of Internal Medicine, 31(3), 165–173. CHAPTER 7: The Benefits of Giving Your Brain a Workout: Mental Activities and Hobbies to Embrace 134 we see that people without a lot of early-life education: See M.E. Lachman et al. (2010), Frequent cognitive activity compensates for education differences in episodic memory, American Journal of Geriatric Psychiatry, 18(1), 4–10. 135 A promising early study followed more than 1,700 cognitively healthy people over time: See N. Scarmeas et al. (2001), Influence of leisure activity on the incidence of Alzheimer’s disease, Neurology, 57, 2236–2242. 135 Other seminal research—an extension of the classic Nun Study: R.S. Wilson et al. (2002), Participation in cognitively stimulating activities and risk of incident Alzheimer disease, JAMA, 287(6), 742–748. 136 And a review and meta-analysis of many studies in this area: See L.A. Yates et al. (2016), Cognitive leisure activities and future risk of cognitive impairment and dementia: Systematic review and meta- analysis, International Psychogeriatrics, 28(11), 1791–1806. 136 being involved with a hobby of interest is associated with better overall health: See S.D. Pressman et al. (2009), Association of enjoyable leisure activities with psychological and physical well-being, Psychosomatic Medicine, 71(7), 725–732. 136 less mental activity has been linked to atrophy of the medial temporal lobe: See D. Yoshida et al. (2012), The relationship between atrophy of the medial temporal area and daily activities in older adults with mild cognitive impairment, Aging Clinical and Experimental Research, 24(5), 423–429. 136 reading books, newspapers, or magazines has been found to be particularly important in reducing dementia risk: See N. Scarmeas et al. (2001) above. 136 Reading on a regular basis might even have a more protective effect on the brain than the years of education: See M.A. Lopes et al. (2012), High prevalence of dementia in a community-based survey of older people from Brazil: Association with intellectual activity rather than education, Journal of Alzheimer’s Disease, 32(2), 307–316; see also M.E. Lachman et al. (2010) above. 137 Other studies have found that reading reduces the risk of developing milder cognitive problems: See Y.E. Geda et al. (2011), Engaging in cognitive activities, aging and mild cognitive impairment: A population-based study, Journal of Neuropsychiatry and Clinical Neurosciences, 23(2), 149–154. 137 and improves our ability to appreciate others’ perspectives: For a study examining the role of reading fiction and nonfiction on theory of mind (our ability to take others’ perspectives in different ways), see D.C. Kidd and E. Castano (2013), Reading literary fiction improves theory of mind, Science, 342(6156), 377–380. 137 a specific study that supports the powerful brain effects of being a cruciverbalist: See J.A. Pillai et al. (2011), Association of crossword puzzle participation with memory decline in persons who develop dementia, Journal of the International Neuropsychological Society, 17, 1006–1013; see also T. Hughes et al. (2010), Engagement in reading and hobbies and risk of incident dementia: The MoVIES Project, American Journal of Alzheimer’s Disease and Other Dementias, 25(5), 432–438. 138 Maybe you like playing cards or checkers: See E. Jonaitis et al. (2013), Cognitive activities and cognitive performance in middle-aged adults at risk for Alzheimer’s disease, Psychology and Aging, 28(4), 1004–1014. 138 Another study investigated common leisure activities like reading: J. Verghese et al. (2003), Leisure activities and the risk of dementia in the elderly, New England Journal of Medicine, 348(25), 2508– 2516. 17 1 ZELFSTUDIEVRAGEN WEEK 1 - INTRODUCTIE Tijdens deze periode zul je elke week in voorbereiding op het werkcollege aan de slag gaan met zelfstudievragen voor het verwerken en toepassen van de literatuur. Deze blue zones zijn streken op aarde waar mensen wonen die vaak 100 jaar of ouder worden, in goede gezondheid. Dat ze zo oud worden in goede gezondheid, is bijzonder. De leeftijd waarop een gemiddelde Nederlander met één of meer chronische aandoeningen te maken krijgt ligt al gauw rond het vijftigste levensjaar. Zoals je zult lezen komt het belang van sociaal contact veevuldig terug, vandaar dat we hier ook dieper in duiken aan de hand van het boekhoofdstuk van Randolph (2019). 1.1 Zelfstudievragen Vraag 1 Na onderzoek is gebleken dat er een aantal overeenkomsten te onderscheiden zijn in de leefstijl van de inwoners van de blue zones. Hier kwamen 9 leefstijlkarakteristieken uit naar voren die kenmerkend zijn voor deze gebieden, de zogenoemde ‘Power 9’. Ga voor jezelf na in hoeverre de elementen van de ‘Power 9’ terugkomen in jouw eigen leven/leefstijl. Noteer op welke gebieden je de overeenkomsten ziet, en ook op welke gebieden je nog mogelijkheden tot verandering ziet. Leg je antwoorden uit aan de hand van concrete voorbeelden. Vraag 2 Sociale connecties blijken een positieve invloed te hebben op het brein. Daarentegen worden in het hoofdstuk van Randolph (2019) ook de negatieve effecten van sociale conflicten en sociale isolatie op het brein besproken. Beschrijf voor zowel sociale conflicten als sociale isolatie het effect op het lichaam/brein. Vraag 3 Eenzaamheid onder ouderen is een groot groeiend probleem. Je werkt als Toegepast Psycholoog bij een organisatie die zich inzet voor ouderen die zich eenzaam voelen. Op basis van het hoofdstuk van Randolph (2019), wat zou je de organisatie aanraden en waarom? Vraag 4 De blue zones bieden ons waardevolle inzichten en concrete leefstijladviezen. Tijdens deze periode gaan we een aantal leefstijlgebieden verder uitdiepen: beweging, voeding, aandacht en ontspanning en slaap. Hierbij gaan we op zoek naar meer concrete adviezen maar onderzoeken we daarnaast ook hoe deze leefstijlfactoren van invloed van op (brein)gezondheid en welke processen hierbij betrokken zijn. Wat zou jij graag over willen leren over deze thema’s? Waar ben je nieuwsgierig naar? Schrijf dit voor jezelf op en neem je antwoorden mee naar de eerste les. ZELFSTUDIEOPDRACHT WEEK 1 2/2 18 WEEK 2 Brein, gedrag en veroudering 19 20 ANRV364-PS60-07 ARI 24 November 2008 18:45 ANNUAL REVIEWS Further The Adaptive Brain: Click here for quick links to Annual Reviews content online, including: Aging and Neurocognitive Other articles in this volume Top cited articles Top downloaded articles Scaffolding Our comprehensive search Denise C. Park1 and Patricia Reuter-Lorenz2 1 The Center for Brain Health, University of Texas at Dallas, Dallas, Texas 75235, email: [email protected] 2 Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109, email: [email protected] Annu. Rev. Psychol. 2009. 60:173–96 Key Words The Annual Review of Psychology is online at default network, dedifferentiation, hippocampus, compensation, psych.annualreviews.org cognitive reserve, frontal activation This article’s doi: 10.1146/annurev.psych.59.103006.093656 Abstract Copyright c 2009 by Annual Reviews. There are declines with age in speed of processing, working memory, All rights reserved inhibitory function, and long-term memory, as well as decreases in brain 0066-4308/09/0110-0173$20.00 structure size and white matter integrity. In the face of these decreases, functional imaging studies have demonstrated, somewhat surprisingly, reliable increases in prefrontal activation. To account for these joint phenomena, we propose the scaffolding theory of aging and cognition (STAC). STAC provides an integrative view of the aging mind, suggest- ing that pervasive increased frontal activation with age is a marker of an adaptive brain that engages in compensatory scaffolding in response to the challenges posed by declining neural structures and function. Scaffolding is a normal process present across the lifespan that involves use and development of complementary, alternative neural circuits to achieve a particular cognitive goal. Scaffolding is protective of cogni- tive function in the aging brain, and available evidence suggests that the ability to use this mechanism is strengthened by cognitive engagement, exercise, and low levels of default network engagement. 173 21 ANRV364-PS60-07 ARI 24 November 2008 18:45 longevity. By 2050, there will be many more Contents older adults in wealthy, developed countries (26%) than children under 15 (about 16% of INTRODUCTION.................. 174 total population) ( J. E. Cohen 2003). The ag- BEHAVIORAL MECHANISMS ing of the population represents both an oppor- OF COGNITIVE AGING........ 175 tunity and threat for society. The opportunity AGING AND THE STRUCTURE comes from the tremendous reserve of human OF THE BRAIN.................. 177 capital and experience represented by older cit- Volumetric Data................... 177 izens; the threat emerges from the disconcert- White Matter...................... 177 ing fact that at this time, adults aged 85 and Relationship of Structural Measures older have a dementia rate (typically in the form to Cognition.................... 179 of Alzheimer’s disease) of nearly 50% (Hebert Dopaminergic Receptors........... 179 et al. 2003), with a very high cost to affected FUNCTIONAL IMAGING AND individuals and families, as well as to limited VIEWS OF THE medical resources. At present, it is fair to say AGING MIND................... 180 that neurocognitive frailty is the biggest threat Prefrontal Bilaterality.............. 180 to successful aging in our society. Compensation for What?........... 181 Fortunately, as our aging population has THE SCAFFOLDING THEORY grown, so has our knowledge about the ag- OF COGNITIVE AGING........ 183 ing mind. For the past 25 years, our under- Scaffolding is a Dynamic, On going standing of the behavioral changes that occur Property of an Adaptive Brain... 183 in cognition with age has increased tremen- Prefrontal Cortex is a Primary Locus dously, and in the past 10 years, the advent of for Scaffolding.................. 185 neuroimaging tools has ushered a truly stun- Scaffolding is a Neurocognitive ning increase in what we know about the aging Response to Challenge.......... 185 mind. Neuroimaging techniques such as struc- Scaffolded Networks are Less tural and functional magnetic resonance imag- Efficient than Honed Cognitive ing (fMRI) and positron emission tomography Networks....................... 186 (PET) allow us to see how both brain structure The Aged Brain is Less Efficient at