Enhance Memory Fitness And Brain Performance With Ucla Neuroscientist Gary Small: Q&a Session

Below you can find part 1 series of transcript of our engaging Q&A session on memory, memory techniques and brain-healthy lifestyles with Dr. Gary Small, Director of UCLA's Memory Clinic and Center on Aging, and author of The Memory Bible.

Question: We'd like to thank Dr. Gary Small for joining us today and being willing to answer questions from all of you. Answer: I am delighted to be here.

Question: I'm in interested how Neurofeedback can enhance brain performance, and how it could help depression and ADHD. ? Answer: That depends on how you define "Neurofeedback."

Question: Let's reframe this: what about "biofeedback." We hear a lot about that. Can it be helpful for brain fitness? How would that work? Where is the current momentum, if any, in the market of brain fitness for healthy adults? Answer: Biofeedback has been a technique used for decades to help people improve both physical (e.g., lower blood pressure) and mental (relaxation) response. Thus, if it can help people achieve a relaxation response, then it could increase focus and attention and help with depression and ADHD.

Question: In the Memory Bible you recommend 5-10 minutes of mental aerobic a day. Is this enough? Also, do you think that any kind of mental exercise is good for everyone or should it be specific depending on one's goal? Answer: It seems that the brain fitness industry is focusing on brain games that provide exercises to stimulate various neural circuits, as well as to improve specific cognitive abilities, particularly memory. The amount mental aerobics each person wants or needs will vary. Some people have too much mental stimulation at work and need to relax instead. I agree that brain fitness exercises should vary depending on an individual's baseline abilities.

Question: Has there been any longitudinal research been published recently in support of a brain healthy lifestyle (diet, exercise, brain training, stress reduction, etc) to maintain or improve memory? Answer: Most studies on brain healthy lifestyle have been short-term; however, several groups are planning long-term Alzheimer's prevention trials, such as the research group at the Banner Institute in Phoenix, AZ.

Question: How valuable are brain games, really? Wouldn't brain fitness be more effectively achieved if people considered increasing the "challenge" of actual activities in their daily lives? Answer: The value of a brain game does depend on the level of challenge — we all need to find that "sweet spot," where the activity is challenging but not daunting. I like the idea of making the training more practical so that it applies to everyday life. The UCLA Memory Training programs were recently revised to focus on everyday memory challenges, such as names and faces and prospective memory (i.e., remembering to remember).

Question: How would you explain the reason of someone being brilliant in memorizing phone numbers, and simultaneously "extremely poor" remembering peoples names ? — what would be the solution to enhance memorizing names ? Answer: We all vary in our memory styles and personal interest in what we choose to remember. When we give new information meaning, it becomes more memorable. So the solution is in helping people to determine their memory goals and then teaching them specific techniques to achieve them.

Question: Could you recommend a comprehensive standard assessment that is available with-out restricted licensing? Answer: To my knowledge, all comprehensive assessments are licensed by the Amer. Psycho-logical Assoc. However, the CERAD delayed recall task is in the public domain. Another very useful assessment tool is the MOCA (available in multiple languages without a licensing fee at www.mocatest.org).

Question: (Sent too soon.) I was building to my question…Our classes are based on viewing a online video and then engaging the participants in individual creative activities followed by small group discussions based on prepared questions. My question is how this sort of engagement may compare with some of the brain games and exercises for helping seniors? We've gotten a question about "the elephant in the room"- namely, dementia and Alzheimer's Disease. Let's focus on that one a bit. Answer: It sounds like your classes differ from those we teach at UCLA (and license elsewhere). In our classes, we focus on developing specific and practical memory abilities. Your classes seem to develop cre¬ative abilities.

Question: How would one go about encouraging brain fitness games for those that are currently suffering from Alzheimer's disease? Answer: Alzheimer's disease and dementia is on everyone's mind and in the news every day. The 80 million baby boomers are beginning to turn 65 this year and reaching an age when risk increases.

Question: Gary, can you elaborate? We're all concerned about Alzheimer's. Is there some intervention that can prevent or delay it? Answer: Most brain fitness games have been developed for people who are not suffering from Alzheimer's disease. For someone with dementia, I would recommend more basic games. But a better approach might be to encourage them to spend time with family and friends or playing games they were familiar with before they became demented.

Question: What is your take on supplements for brain health (vitamin, fish oil, etc.)? Is a balanced diet enough? Should people take supplements without being tested for deficiency? Answer: We don't have a definitive long-term study to prove that we can prevent Alzheimer's disease, but epidemiological studies and short-term clinical trials point to healthy diet, physical exercise, stress management, and mental stimulation as important, as well as treating medical conditions like hypertension, not smoking, etc. I just finished writing a book on this topic, "The Alzheimer's Prevention Program," (available Jan 2012) for those interested in more detail on this topic.

Question: Is neuro feedback different from cognitive behavioral therapy and if so when does one use one over the other? Answer: Supplements are another issue. Our group is currently studying such interesting anti-amyloid and anti-inflammatory supplements as curcumin. We don't have results yet, but anyone who likes Indian food (which has curry) may get a brain boost from it.

Question: Dr. Small, Do you see any changes with regard to the discussion of what may delay or prevent AD or other dementia when the DSM removes the actual word "dementia" from the definitions? Answer: If you mean biofeedback when you say neuro-feedback, then it is different from cognitive behavioral therapy (CBT). In biofeedback, the individual gets feedback on a biological process (e.g., skin conductance, blood pressure) in order to control it. In CBT, the individual works with a therapist who helps provide specific strategies for thinking and behavioral to improve their mental state and relationships.

Question: Gary, in your opinion, is there too much, or too little, attention to Gingko Biloba (and other "alternative" remedies)? Answer: I don't think that changing the diagnosis from dementia to some other name will change the underlying research. It is just a semantic issue.

Question: What is the role of creative arts in cognitive enhancement for seniors with normal age-related deficits? Is it better to actual participate in some creative process (writing, painting, etc.) or is simply observing, thinking about, and discussing art sufficient mental stimulation? Answer: The latest large scale study of Ginkgo was negative. I don't think we can pay too much attention to any new lead that might help us delay dementia and cognitive decline.

Question: What about the broader field of complementary and alternative medicine? Do you see any directions that are promising there? Answer: I think it is helpful to encourage creative activities and help people participate rather than just observe.

Question: How about "Fish Oil" ? Answer: We now have an NIH institute dedicated to complementary medicine. I suspect that traditional Western medicine has a lot to learn from these older approaches but it is important to apply our scientific methods to determine whether something actually works (better than placebo).


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