CHAPTER 5

Mental Exercises That Build Your Cognitive Reserve

In a huge, airy loft on Kearny Street in downtown San Francisco, a young man is hunched over a computer screen. Near the top of the screen, a raindrop appears and slowly descends toward the bottom. Written on the raindrop is a bit of arithmetic. It says 9 + 2. The young man quickly punches the number 11 onto the keyboard, and the raindrop explodes into pieces.

Another drop appears. This one says 6 x 1. He punches 6 into the keyboard, and that raindrop explodes as well. Then another says 34 + 10, and he punches in 44. Away it goes. The drops start coming faster and faster, some on the left and others on the right. Intently focused, he reacts as quickly as he can, scoring points for each correct answer.

Next to him, a young woman is looking at a computer screen, too. But hers shows animated human figures. They appear to be customers at a food counter, and they are looking at her expectantly. She has to remember their names and what they’ve ordered. When she gets them right, she gets a tip.

Across the room, another woman is seated at a computer that is displaying three letters. It says “CAP.” She types “cape,” “caps,” “captain,” “capsize,” and “capture,” and then pauses to think of more words with the same three-letter beginning. The more words she comes up with within the allotted time, the more points she earns.

These people are not playing video games. They are part of a team of computer experts and graphic designers. They are working on a training program that builds what scientists call cognitive reserve. It is a new concept in neurology, and one that may help us hold on to memories for much longer.

Building Your Brain Circuits

Not long ago, researchers made a striking observation: Using special neuroimaging techniques, they looked into the brains of living people and found that many of them had quite a lot of amyloid plaques—the microscopic abnormalities that lead to Alzheimer’s disease. But despite their ominous-looking scans, some of these people showed no signs of any cognitive problems at all, so far as anyone could tell. They could balance their checkbooks and pay their bills, and they did not stumble over their grandchildren’s names.1 Despite changes in their brains, they somehow managed to keep their memories more or less intact.

How did they do it? The reason, scientists speculate, is intellectual stimulation. By giving their brains constant input over the years, they had built up so many connections between brain cells that they could compensate for losses later on. This is cognitive reserve.

Think of it like a highway. You’ve got your regular route that leads to your destination. But what if the road ahead is blocked? It helps if you know of a detour or maybe have a choice of several alternate ways you could take. Something similar happens in your brain. If you lose some brain cells or synapses, it is great if other cells or cell connections can get your messages through. The theory is that the more connections you have between cells, the more options you can use in case any start malfunctioning.

So how do you build cognitive reserve? The most obvious way is in your years at school. Yes, all that time plowing through books, working at the blackboard, writing essays, solving math problems, and studying for tests really does strengthen connections in your brain. Indeed, a large study of older adults living in Memphis, Tennessee, and Pittsburgh, Pennsylvania, showed that people with higher levels of education were more likely to retain their mental clarity into old age, compared with people with little education or low literacy levels.2 Other studies had shown much the same thing. Well-educated people have more “alternate routes” ready in case they need them.

Here’s what this might look like from your brain’s point of view: You’re out with some friends, and someone asks who starred in Gone with the Wind. “I can see her face,” you say. “But what the heck is her name? It’s on the tip of my tongue. She was one of the most famous actresses….”

If you had seen the movie, you may or may not remember the star’s name. But what if your brain happened to have laid down a few extra connections? Your brain suddenly starts coughing up all the bits of information it has stored, one linked to the next. The movie was set in the Old South… the plantation was called Tara… the Civil War was brewing… it came out just before World War II… what’s-her-name was in love with Ashley… Ashley went off to war… she ended up destitute and married Rhett Butler… frankly, my dear, I don’t give a damn… that was Clark Gable… Clark Gable and Vivien Leigh…. Oh yeah! That’s her!

It’s not pretty, but out of that salad of ideas comes the name you’re looking for. The more connections you’ve made, the more likely you are to remember things.

Education is good. But you do not need a PhD in nuclear physics. Whatever education you had or didn’t have in the past, the activities you do now can make a difference. In the Chicago study, even simple mental activities, if done often enough, helped prevent Alzheimer’s. That could mean reading a newspaper, a book, or a magazine; working a crossword puzzle; playing cards or checkers; going to a museum; and even watching television or listening to the radio—as long as it’s something else that gets your neurons firing. Over a four-year period in Chicago, people who were engaged in these activities the most cut their risk of developing Alzheimer’s by about two-thirds compared to people who got very little mental stimulation.3

That was encouraging. So a team of researchers developed a specific set of brain-training exercises to see if they could prevent mental decline in older folks. The project was called the ACTIVE study, short for Advanced Cognitive Training for Independent and Vital Elderly.4 The researchers, from Alabama, Michigan, Massachusetts, Indiana, Maryland, and Pennsylvania, invited a group of 2,832 older adults to participate.

Each participant received up to ten training sessions in memory, reasoning, or processing speed. Some had to remember word lists or do other memory tests. Others were asked to identify patterns in series of letters or words (such as: a… c… e… g… i…). And still others were asked to remember the locations of items that flashed briefly on a computer screen and then vanished. The researchers also gave the participants booster training later on.

Five years later, the participants were tested. And indeed, they were noticeably sharper. How much sharper? They were able to essentially counteract seven to fourteen years of aging.

However, their mental strength was most evident for the specific areas in which they had been trained. If they were trained in memory, they did well on memory tests. If they were trained in reasoning, they did well on problem-solving tests. If they had worked on reaction time, they did well on speed tests. These are all separate mental functions, so it makes sense to have a variety of activities that exercise all your mental functions.

In the loft in San Francisco, that is exactly what the computer team is building. This is Lumos Labs, a company that has worked with scientists at major universities to develop a sophisticated set of web-based teaching tools that strengthen memory, attention, reaction speed, and problem solving.

Researchers at the University of New South Wales in Australia used these exercises to see if they could boost mental functioning for people with mild cognitive impairment. In thirty training sessions over twelve weeks, the participants worked on focusing their attention and improving their memory and reaction time. And, indeed, week by week, their performance on each task improved noticeably.

Many different research teams have been testing similar programs to boost flagging cognitive skills. Some researchers do their training in groups, others one-on-one. In 2010, researchers in Quebec sized up the results.5 And indeed, cognitive training seems to help. It boosts memory, as well as mood and overall quality of life.

To get a feel for this kind of training, take a look at the Lumosity website (Lumosity.com) or the Vivity Labs site (FitBrains.com). There are dozens of programs. Each one starts out very easy and gradually builds to whatever degree of complexity you could want. If you like, you can subscribe to these services and do the exercises on a regular basis. You can almost feel your brain creating new synapses as you go.

The Bilingual Advantage

One type of mental stimulation is particularly intriguing: being able to speak more than one language. Researchers in Toronto found that bilingual adults are able to buy themselves a little time when it comes to dementia. It is not that they are exempt from brain disorders. But whatever memory problems they may have show up about five years later compared with people who speak only one language.6

Similar findings turned up in other studies and with various languages.7,8 And when it comes to delaying Alzheimer’s disease, speaking three languages is better than two, and speaking four beats speaking three.7

This makes sense. After all, one of the most common complaints of people with memory problems is the inability to come up with words or names. They’ll pause, embarrassed, waiting for the words to emerge from wherever they have been hiding. But if you’ve been working all your life, not with just one set of words for everything but with two or three, you can imagine the circuitry that you’ve built up over the years.

Unfortunately, your long-forgotten high school French classes are not much use. What counts is actually using languages. That is what keeps the brain limber. We don’t yet know if acquiring a second language late in life is as good as growing up bilingual, but I’d suggest hedging your bets and ordering up some language discs or calling your travel agent and booking an immersion week abroad.

Of course, acquiring a new language and learning about other cultures is mind-expanding in every way, and nowadays it is easier than ever. You can tune in to television broadcasts in many languages. You can learn French by phone (www.FrenchByPhone.com), study Spanish or Chinese through song lyrics (www.Yabla.com), and learn Vietnamese basics through free online classes (EverydayViet.com). And you’ll find every imaginable language book and disc at bookstores and on the web.

Personally, I am hoping to get some credit for growing up in North Dakota, where everyone is essentially bilingual, thanks to the large number of people of Norwegian ancestry. Being bilingual in Fargo was actually quite easy, since we used the same words for nearly everything. “My, it’s cold!” would be translated as “Uff da!” If it were hot, we would wipe our brows and sigh “Uff da!” And if English speakers would observe, “Good heavens, that’s a pricey meal!” we would turn to each other with a very knowing “Uff da!” As you can see, we were even able to think bilingually from earliest age.

Our vocabulary did wander slightly further. We had lefse, a flat potato bread smeared with butter and sugar; krumkake, which means “bent cake”; and, if you had the courage, lutefisk, a cod gelatinized by a lengthy treatment with lye, a process invented centuries ago by someone whose descendants are no doubt still in hiding. Eating these foods would make you feel quite intercultural. Their effect on your brain, however, might undo whatever benefit you might get from bilingualism.

A Simple Memory Aid: Linking

It’s 4 a.m. and you were just jerked out of dreamland by the realization that it’s tax day and you have not yet mailed in your return. “Uh-oh,” you’re thinking. “Good thing I remembered.” But as you lie there, it hits you that you also need to pick up your shirts at the cleaners and get the car inspected before you go on vacation. It’s a lot to remember in the middle of the night. You hate to turn on the light and root around for a pen, knowing you’ll never be able to go back to sleep, but you don’t dare forget.

This sort of thing happens to us all the time. We need to remember something important, but it’s not a handy time to deal with it or to write it down. Let me show you a simple trick.

We’ll take a lesson from Ben Pridmore. Ben lives in Derby, in northern England, and he is a memory champion. Ben can memorize a pack of fifty-two cards in less than thirty seconds. You can shuffle them any way you want, hand him the pack, and, after glancing through it, he will look you in the eye and tell you, “two of clubs, queen of hearts, ten of diamonds,” and so on through the whole pack, every card in perfect order.

Shuffle again, and Ben will do it all for you once more. How does he do this? Ben is quite happy to tell you: He links mental images.

Here’s a simple example: Start with a visual image. It could be any object that you can easily remember and that you associate with things that need doing. For me, that’s my little black schedule book where I keep my weekly agenda, phone numbers, and so on. If I happen to wake up in the middle of the night and need to remember something, I start with a mental image of my schedule book. Then I make an image of whatever I need to remember and attach it to the image of the book. So “tax” could become an image of thumbtacks, and I might imagine them sticking into the black schedule book. To make them especially memorable, I’ll imagine bright pink or glowing orange tacks. Waking up later, I’ll say to myself, “What was I supposed to remember?” I’ll go to my mental image of the schedule book and see the odd image of pink thumbtacks and soon realize that I am supposed to send in my tax return.

Let’s go a step further. You can link images in a chain. So if I have to remember to mail in a tax return, pick up my shirts, and have the car inspected, the mental image will start with my schedule book, which is the anchor I use every time. Then I’ll mentally stick tacks into it and make them a bright memorable color. Then one of the tacks will be nailing a shirt to my schedule book. I’ll make the shirts a very memorable color, too. So glowing orange tacks will be sticking a gaudy green shirt to my schedule book. Then I’ll add a car that will be driving out of one of the sleeves in a big cloud of smoke. The images should not be logical or mundane. The more nonsensical and graphic they are, the more memorable they will be.

All of this takes just a few seconds. And if the images are striking enough and connected to each other, you can doze off to sleep and easily remember everything later on. Try it, you’ll see.

So what does Ben Pridmore do? His system for creating images is considerably more complicated than my middle-of-the-night tacks and shirts, and it requires a bit of practice. But it’s basically the same idea. Instead of using a black schedule book as a starting mental image, he mentally “places” images in his grandmother’s house, with one image leading to the next.

The images themselves come from a sort of language he devised, in which the playing cards’ suits and values spell out the names of simple objects. And it is these objects that he mentally “places” at the various points in his mental journey through his grandmother’s house. If you’d like to learn Ben’s “language,” you’ll find it on the Internet, at memoryconsulting.com/pridmore.htm.

This is obviously much more challenging than remembering a few simple errands. But it works. Using similar methods, Ben has memorized the value of pi—that mathematical value that our geometry teachers felt was so important—out to 50,000 digits. He starts out with 3.14159… and doesn’t quit for hours.

There is certainly no need for you to go to such lengths. But I raise this to make a point. Your memory is not a jumble, like a laundry basket or a drawer of socks. When your brain stores things away, it connects them in a chain. And remembering them depends on connections, too. Ben could not remember a single card without connecting it to something—some kind of mental image. By linking each new memory to an existing one, the process can go on, more or less indefinitely.

Here’s why this matters. Have you ever been introduced to someone and you soon realize that you had forgotten his or her name as soon as you heard it? That’s because you tossed the name into your mental laundry basket, hoping you could find it later. But your brain does not work that way. Any new name, fact, date, phone number, or anything else that is not linked to a preexisting spot in your brain will immediately just slide right out.

So as you say, “Pleased to meet you, Sidney,” you’ll need to connect your new friend’s name to something. Picture him at the Sydney opera house with its famous scalloped roofs, or imagine him skidding on his knees—anything that brings SIDNEY to mind. Make it graphic (you don’t have to tell him what you came up with).

Professor Jackson can have a ball and jacks on his head (in your mind). Again, the more graphic it is, the better. Later on, chances are you’ll remember their names.

Memory experts connect people’s names to some aspect of their faces—their noses, their eyes, their ears, or whatever. For example, meeting a man named Robert, you notice that he has a rather long nose. It’s nothing out of the ordinary, but it is the first thing you saw. That’s where you’ll hook your mental picture. So, to suggest “Robert,” you could make an image of a robber and link it to his nose.

The key is to make the images really striking. That means colorful, illogical, sexy, aggressive, or anything else that brings emotion into the mix. So picture a long chain of robbers in striped prison suits running in one nostril and out the other. Bring it into sharp focus. Picture the robbers leaving muddy footprints on his face as they run. Pump up the imagery. When you next see Robert, this image will pop into your mind and will suggest the name.

Mundane images do not work; they trigger the brain’s delete button. If that surprises you, think about what your brain conjures up in dreams. Did you ever dream that you did your grocery shopping? Or that you went to work and had a good couple of meetings? Or that you had a successful golf game, that you had a nice dinner with friends, or that you read the newspaper? The answer likely is no, because your brain’s scriptwriter thought that all these ideas were too dull and dumped them in favor of images that are poignant, funny, sexy, or loaded with emotion in some other way. Positive emotions are best, because you will want to retain them. If you want to remember something, color it in some way that makes it striking.

There are many books on these techniques. One of the best is Benjamin Levy’s Remember Every Name Every Time (Fireside, New York, 2002). You’ll also find a concise guide to many memory methods in Tony Buzan’s Use Your Perfect Memory (Plume, New York, 1991).

A Touch of Humility

As exciting as the concept of cognitive reserve is and as useful as memory exercises can be, they do not take the place of physically taking care of yourself. That means eating healthfully and exercising to the extent you can. If you are not eating well—if you are dosing your brain with “bad” fats and toxic metals—the cognitive reserve you have built can be easily and quickly destroyed. Ditto if you are sitting idly instead of getting your heart pumping on a regular basis.

My father went to medical school, finished an internal medicine residency, plowed through every issue of JAMA and the New England Journal of Medicine, and read the local newspaper every night. Yes, it was the Fargo paper, but it still counts. He built up an enormous cognitive reserve.

But he also grew up on a cattle ranch and never left the taste for beef behind him, except for a few years when my mother managed to convince them both to eat better, before a move into a retirement home made them abandon healthy eating in favor of whatever was on the enjoy-your-golden-years menu for the day. His diet overdosed him with saturated fat and cholesterol, along with iron, copper, and zinc, and after dinner his stomach pains led to his habitual dose of aluminum-containing antacids. His cognitive reserve was like a house on stilts hit by a tsunami. As his memory and emotional control began to leave him, you could almost see the neurons losing their grip on each other.

You want to prevent all of that. That means eating for excellent health, as we’ve seen in the preceding chapters. It also means using every opportunity to give your brain the stimulation it craves, whether that means a newspaper, a crossword puzzle, a class, or a news program. And why not go another step and jump into a challenging and fun online program, or see if a foreign language appeals to you? No matter what your age or past experience, you can find something you like.

By the way, Ben Pridmore is not the champion in all aspects of memory. There is actually someone who can beat Ben. In Kyoto, Japan, researchers developed a computerized short-term memory test where Ben was resoundingly beaten. The computer program consisted of numbers that flashed momentarily in various places on a screen and were then suddenly replaced by blank squares.9,10 The subject’s task was to touch each square in what had been the correct numerical order. One, two, three, four, and so on.

Ben sidled up to the computer and did his very best. He was, in fact, very good. But Ben was resoundingly beaten by the local hero, Ayumu. And Ayumu was exactly seven years old at the time. His accuracy was far beyond anything Ben could approach.

Ayumu is a chimpanzee. In the laboratory of Dr. Tetsuro Matsuzawa, Ayumu competes against college students and anyone else who dares try. What Dr. Matsuzawa knows—and now all neuroscientists know—is that chimpanzees are much better than humans at memory tests like this, and no one beats Ayumu. It turns out that just as dogs detect smells and sounds that are out of humans’ sensitivity range and starlings coordinate their flights millisecond by millisecond, chimpanzees have their own set of neuropsychological strengths that make us look like beginners.

If you’d like to try to beat Ayumu’s average, Lumos Labs has prepared an online version of the test he is so good at. You’ll see it at http://games.lumosity.com/chimp.html.

Of course, Ayumu has had a lot of practice, and figuring out what the humans around him are doing and saying has helped him build up a heck of a lot of cognitive reserve. Not to mention his diet. All those fruits and vegetables, with no meat, dairy products, or fatty foods, keep him fit, too.