Averting dementia goal of program built around brain games

By Tracie Dungan Monday, February 21, 2011

Photo by William Moore Sherri Napier, director of the Fayetteville Senior Activity and Wellness Center, handed out papers filled with brain games during Tuesday’s Super Noggin program.

FAYETTEVILLE — The class of 32, mostly silver-haired students, listened as the instructor explained terms like “neuroplasticity” and proceeded to tackle one brain-teaser after another.

“Your handout is upside down,” Sherri Napier said after handing out papers that, at first glance, appeared to have funny-looking type.

“I do not want you to turn it right-side up. Read it, starting from the bottom right hand corner and proceed to the left.”

On another handout, Napier directed the students: “Find the C in the sea of O’s.”

(There also was a sea of 9s overwhelming 6s and a haystack of M’s masking a few N’s.)

“Many of us look for ways not to challenge our minds,” said Napier, director of the Fayetteville Senior Activity and Wellness Center. “We are more comfortable with what we have already learned.”

Photo by William Moore Charlotte Tipton, 74, of Greenland participates in the Super Noggin program Tuesday at the Senior Activity Center in Fayetteville. Super Noggin is a program that helps improve brain fitness.

The brain games are just a few of a wide variety of mental exercises, memory-training techniques, puzzles and physical activities that are part of the “Super Noggin” class, a year-long program that began in January for the nine-county Area Agency on Aging of Northwest Arkansas, which is based in Harrison.

The program follows in the footsteps of a number of scientific studies in the past decade suggesting that Alzheimer’s disease and other dementias might be delayed or prevented through brain workouts, physical activity, social interaction, proper nutrition or restful sleep.

The most common form of dementia, Alzheimer’s disease, afflicts 5.3 million Americans – about 200,000 of them younger than age 65, according to a 2010 report from the Alzheimer’s Association.

The degenerative disease of the brain destroys memory and thinking abilities, and there is no cure.

The Fayetteville senior center is among the first groups to begin the program in the agency’s nine-county area, said Angie Dunlap, adding she believes the agency, which covers Baxter, Benton, Boone, Carroll, Madison, Marion, Newton, Searcy and Washington counties, is the first in the state to adopt it.

The Super Noggin curriculum was developed by the 501(c)3 nonprofit Leaf Ltd. of Oostburg, Wis., and involves training for its instructors.

It and programs such as Conductorcise are among a national trend toward more so called brain aerobics classes,as well as dance and healthy living classes for adults – particularly the elderly.

Super Noggin markets itself as suitable for adults of any age – a nod to the reality of early onset Alzheimer’s and other cognitive impairment that can strike the relatively young.

“It is not designed for those already diagnosed with cognitive decline,” the program says on its website, supernoggin.org, which has sections such as: “How can Super Noggin decrease my risk of Alzheimer’s?”

Not so fast, say scientific researchers who’ve studied the studies.

While brain fitness and similar courses likely can’t hurt, they’ve concluded, the hard science is not yet there to conclusively prove these activities will stop or slow Alzheimer’s or other dementias.

“Do we have the studies there to say they do? The answer is no,” said Laurie Ryan, program director for Alzheimer’s disease clinical trials at the National Institute on Aging, part of the National Institutes of Health in Bethesda, Md.

The studies that have indicated links between mental work and preventing dementias have been what are known as observational studies of people, she said.

That is not the same as a randomized clinical trial involving one set of people given a particular activity, treatment or medication and a second, “control” group that is given a placebo activity, treatment or medication. A number of such small- and large-scale clinical trials seeking the dementia answers are in the works, but the results are at least two years away.

“That’s the gold standard,” Ryan said Friday of clinical trials.

In August 2010, a “jury” of 15 impartial medical scientists placed on a panel by NIH arrived at the same conclusion after evaluating the studies, according to The New York Times.

But no one seems to be faulting the programs like Super Noggin for trying.

“There’s certainly no data that keeping mentally active hurts,” Ryan said. “And the epidemiological data suggests that keeping mentally active, keeping physically active and socially active are good for overall health. There’s also some suggestion that what’s good for the heart is good for the brain.”

Such activities also could ward off depression, she said: “Depression itself has been shown to be a risk factor for dementia. I think the jury’s still out on exactly why that is.”

The Area Agency on Aging’s Dunlap said her group decided to use some of its “health and wellness” funding on a brain health program. It researched some programs and settled on Super Noggin, spending about $5,000 on training expenses to get started. All together, it has received $30,899 for health promotion for fiscal year 2010-11 as part of the Older Americans Act of 1965.

The Super Noggin classes will take place mostly at local “senior centers,” she said, but also at places like the Schmieding Center for Senior Health and Education in Springdale.

In January, senior centers in Elkins, Fayetteville and Marion, Newton and Searcy counties started the program, with others in the remaining nine counties scheduled to rotate starting their programs between now and the rest of the year.

In the past, Dunlap’s agency had participated in another program involving “brain aerobics” puzzles and trivia questions it offered to its affiliates for their newsletters, she said.

“One of the best brain activities is ballroom dancing,” Dunlap said, adding that thinking about the dance steps combines with getting the body moving.

Super Noggin has physical aspects as well.

“Not only does your brain need that cognitive thinking to get those neurons firing – but it requires physical components.”

Napier told her Tuesday class that the ability of the brain to change and adapt is known as neuroplasticity.

To accomplish this, she assigned homework.

For the right-handed, it was writing one’s name 20 times with the left hand, and vice versa: “It takes practice – just like it took practice to learn to write in the first place,” she said.

The same goes for eating with a non-preferred hand, combing one’s hair, listening to music you normally don’t try and the order in which you tackle the aisles of the grocery store. Just generally, doing mundane tasks in a different way and shaking up the routine.

“Brush your teeth with a different hand,” Napier said.

Charlotte Tipton, 74, of Greenland said she learned about Super Noggin while participating in activities such as Wii bowling at the Fayetteville senior center.

“The Greenland Senior Center doesn’t have enough action for me,” joked Tipton, a native of Berlin, Germany, who has lived in Northwest Arkansas since 1958.

Tipton, who still speaks with a pronounced German accent, decided to give it a try. She planted herself on the front row of Tuesday’s class, leaned forward in her seat and participated actively in the discussions.

“I just said, hey, anyone can need help with their brains – including me,” she said with a laugh during a break in the lessons.

Tipton sometimes has trouble remembering names.

“Especially when you meet a lot of people all at once – oh my gosh,” she said.

Sometimes, even her friends’ names can escape her momentarily. “Maybe after this class, I will remember better.”

Phil and Dianne Zimmerman of Fayetteville said they were inspired to take the class after watching a public television documentary on brain fitness.

“We both have mothers who have signs of dementia,” Dianne Zimmerman said after class, adding that she learned from Napier the effect this could have: “Thirty percent is heredity.”

“We’re aiming for the 70,” chimed in Phil Zimmerman.

“Plus, it can’t hurt,” his wife added.