Dr. Lars Nyberg (Umea University, Sweden), a former post doc at the Rotman Research Institute –  presented data from a large study that has followed the physical and cognitive health of over 4,000 adults aged 35 – 80 years during a two-decade period to see when brain failure starts to show. He found that the decline starts gradually around the mid 30s and then nose-dives around 60-65 years of age. But if there is a silver lining here, it is that all older adults are not alike in this trajectory. Studies have found variability of cognitive performance. In fact, there have been “rare” cases of spontaneous positive reversals of decline in this age group. Could cognitive training encourage this “reversal” in more adults? That is an exciting question that scientists are starting to probe.

One member of the audience suggested that the sharp decline in cognitive powers that appears to hit around age 60 or so, could be related to the time when older adults typically start to retire. Dr. Nyberg agreed that may be a possible predictor and would require more research. He added that science is already showing that “level of education” is a strong predictor of cognitive health in later years.

Dr. Art Kramer (University of Illinois), who is internationally renowned for his research looking at the effects of aerobic exercise on cognitive and brain health, opened his presentation with a simple but powerful refrain – “use it or lose it”  The good news, he said, is that levels of cognitive performance are “malleable” and “open to enhancement” throughout the human lifespan. That presents all of us with an incredible opportunity. The challenge, however, is to develop cognitive training exercises or games that don’t just target one specific cognitive domain (such as memory), but can generalize to other domains associated with “speed” and “reasoning” — all the cognitive functions we rely on everyday in our busy lives. How well do the current crop of brain fitness games work, he asked aloud . “The breadth of transfer of training to everyday life is usually quite narrow,” he cautioned.

What about video games? Dr. Kramer pointed to studies that have shown that playing commercial video games such as “Medal of Honor” seem to strengthen a variety of cognitive processes.  Moreover, the games are adaptive and increase in difficulty as the player gets better. A group of older adults were trained on the video game “Rise of Nations”, which is a time strategy game that requires the player to build a civilization.  It’s a strategic thinking game that challenges the player to  schedule, plan and manage resources.  The older adults were given 24 hours of training over a month. Results showed a positive effect across various cognitive domains.

Dr. Kramer also mentioned a John Hopkins study that measured the physical , cognitive and social benefits of older retired volunteers helping out in inner city schools in Baltimore for a minimum of 15 hours a week. The results were very positive. Baycrest is currently leading a study called BRAVO with boomer volunteers that sounds very similar.

Dr. Kramer has conducted research to see whether aerobic exercise in older adults can engender structural brain changes. Adults who participated in a  six-month exercise program showed increased volumes in grey and white matter, compared to a control group that wasn’t exercising. Hippocampal volume has also shown increases with aerobic exercise.  Even a regular and brisk walking routine can have benefits for cognitive and brain health.

***

Indeed, Dr. Monica Fabiani (University of Illinois), in her presentation, pointed to exciting new data showing that “fitness” and “education” have a protective effect in our brains. “We’ve found that grey matter is more preserved in people with increased fitness levels… and white matter is more preserved in people with higher education,” said Dr. Fabiani. Dr. Art Kramer’s presentation tomorrow morning will show more evidence of this, she added. 

Another piece of good news from presenter Dr. Roberto Cabeza (Duke University, Center for Cognitive Neuroscience) is that the aging brain has the ability to “compensate” for its own deficiencies by “reorganizing its functions”. Understanding these mechanisms of compensatory activity in the aging brain, and the factors that modulate them, will help in the development of effective cognitive rehabilitation approaches. Presenter Dr. Brenda Kirchoff (University of Missouri) presented promising data from her lab showing that when older adults are given memory training strategies, they can perform just as well as younger adults on the same mental tasks. But the challenge is to get older adults to continue to use these strategies spontaneously, without being reminded. Could fatigue be a factor here? “We need to figure out why,” said Dr. Kirchoff.

Afternoon session is about to begin…with a focus on the devastating disorders that can afflict the frontal lobes — schizophrenia, severe treatment resistant depression, and frontotemporal dementia (which can strike adults in their middle years).

On the media front,  National Post science reporter Tom Blackwell (who reported from the frontlines in Afghanistan last year) was at the conference today to interview Israeli scientist Dr. Ora Kofman about a unique study she led examining the effects of ongoing war trauma on cognitive functions in a group of healthy college students studying in a region near the Gaza border that was subjected to daily rocket attacks in 2007. 

CBC Radio Metro Morning host Matt Galloway will interview American scientist Dr. Helen Mayberg at 6:50 a.m. Thursday (CBC Radio One, 99.1 FM). Dr. Mayberg (Emory University School of Medicine, Atlanta) is world renowned for her research to understand the brain mechanisms that go awry with depression — and helped to pioneer a groundbreaking experimental therapy using deep brain stimulation in severely depressed patients.  She was a senior scientist and the Sandra A. Rotman Chair in Neuropsychiatry at Baycrest’s Rotman Research Institute earlier in the decade, prior to joining Emory.  Dr. Mayberg speaks at the conference on Thursday at 2 p.m.

In other news…Rotman scientist and musician (pianist) Dr. Takako Fujioka will entertain at tonight’s conference gala with a jazz quintet. Conference attendence crested today at 675, with many clinicians coming out for the final three days of presentations. For the first time in its history, the annual Rotman Conference has provided on-site childcare for attendees that is getting rave reviews from both parents and the “junior” frontal lobe tykes. One parent was overheard to say, “The childcare is amazing…it’s beyond my expectations!”

On tap tomorrow at the conference…sessions on aging and prefrontal function, and psychiatric and neurological disorders.

Second keynote Dr. Giacomo Rizzolatti (Italy) – a pioneer in the concept of “mirror neurons” — will lead off Wed sessions at 8:30 a.m. His work relates to the distinctly human trait of empathy and understanding the intentions of others. His presentation is widely anticipated by the close to 700 clinicians, scientists and academics attending. Unfortunately Dr. Steven Anderson (U of Iowa) cannot make the conference to present on social outcome following childhood damage (originally scheduled for 9:15 a.m.). But Dr. Kevin Ochsner (Columbia U) will present on the role of our prefontal cortex in empathy & emotion, after Dr. Rizzolatti.

Dr. Jennifer Beer (U of Texas), who made the front page of yesterday’s Globe&Mail with her fascinating research into why some people have an excessive and unrealistic “rose colored” view of themselves – will deliver her much anticipated presentation Wed morning.

On Wed afternoon (1:30 p.m.), Dr. Jordan Grafman (National Institute of Neurological Disorders & Stroke) looks at brain areas that are recruited by our moral, political and religious belief systems.

Of the many fascinating science posters being displayed this week in an adjoining room to the main John Bassett Theatre, media are showing interest in poster #134 titled “Red Alert”. Researchers examined the impact of war-related stress on cognitive functions in students studying in region prone to rocket attacks.  The study found subtle but significant cognitive impairment in otherwise healthy students. This poster is selected to be moderated at the Thursday evening poster session, 5 p.m. – 6:30 p.m.

Dr. Joaquin Fuster’s keynote set the stage for the conference, with an excellent overview of the “way we see cognitive functions of the prefrontal cortex (PFC) in the 21st century”.  He called the PFC a “super enabler” . He also suggested it does not develop completely until the third decade of life.

Dr. Knight told Global News that neuroscience now has the tools to measure connectivity in ways it couldn’t do before. He hinted he may present some surprising data in his talk on Friday @ noon to close the conference.

I caught up with Dr. Stuss in the busy final days before lift off Monday. He said this is a “more hopeful” frontal lobes conference than the last one in 2000. Brain plasticity has opened the door to the exciting possibility of cognitive rehabilitation or cognitive training, he says. We now know that the older brain can grow new cells, reorganize itself after damage, and that as we get older brain functions can be partially restored with proper exercise, sleep and eating habits, as well as learning new techniques.  

At the other end of the age spectrum, with children and adolescents, we now have a much greater depth of understanding from both a science and clinical perspective as to how the frontal lobes develop from the moment of birth through the first 20 years of the maturation cycle. We now know there are “multiple sensitive periods” in which environmental exposures or experiences — that have little effect on the adult brain — can seriously impair the developmental trajectory in young brains. Injuries to the FL in the early years can have life long consequences — lead to difficulties in school and with behaviour and socialization. As Australian neuroscientist Dr. Vicki Anderson will make clear in her presentation (Monday afternoon 3:30 p.m.)…”younger is worse”!

The Keynotes…
Dr. Stuss describes first keynote speaker Dr. Joaquin Fuster (U of California, LA) as “one of the deans” of the frontal lobes. Dr. Fuster speaks Monday morning at 9 a.m .  Second keynote Dr. Giacomo Rizzolatti (U of Parma, Italy) speaks Wednesday morning at 8:30 a.m. Dr. Rizzolatti has done “wonderful work” on the mirror neurons – the idea that our brains fire in synchronicity with other people, which supports the concept of empathy — understanding the intentions of others.  He is a true “pioneer” in Theory of Mind research. Dr. Knight (U of California at Berkeley) is third keynote who will wrap up the conference with his final thoughts on Friday March 26 at noon.

***Last minute change – Baycrest clinician-scientist Dr. Tiffany Chow, who is a leading expert in the diagnosis of early dementias, is doing the presentation on frontotemporal dementia in place of Dr. Bruce Miller (U of California, San Francisco) on Thursday at 2:30 p.m.  FTD is a devastating dementia that hits adults as young as  their 40s!

Organized by Donald T. Stuss, PhD and Robert T. Knight, MD