American Chronicles JULY 29, 2013 ISSUE

Mentally FitWorkouts at the brain gym.BY PATRICIA MARX

Save paper and follow @newyorker on Twitter

D We humans are theonly animals whosebrains are known toatrophy as we growolder.CONSTRUCTION BYSTEPHEN DOYLE /PHOTOGRAPH BY GRANTCORNETT

o I seem smarter than I did a fewweeks ago? Since then, Ive spentmany hours in front of mycomputer, challenged by crucially

important questions, like which twobutterflies of the five that flickered onscreenfor seventy-nine milliseconds were thematching pair, whether the ripples that rippledacross the little magenta square went this way or that way, and how manymore drills I must complete before Im smart enough to date Harold Bloom.Remember when we called these sorts of activity video games and yelled atour kids for playing them? Now we refer to them as brain exercises, and wehope and trust that our digital exertions will make us as mentally agile as teen-agers wielding M27 assault rifles in Call of Duty: Black Ops II.

Teen-agers, I saidnot twenty-seven-year-olds. Thats because mostneuroscientists believe that by our late twenties the speed of our mentalprocessing has begun to ebb, and so has our attention prowess and ourworking memoryi.e., the scratch pad in our minds that allows us toremember information long enough to calculate the tip on the taxi fare or . . .wait, what was I saying? While it is consoling that our vocabulary improvesover the years, and that we oldsters are better at big-picture thinking and aremore empathetic, still, by the advanced age of twenty there is a very goodchance that our prefrontal cortex (the brains of the brain, responsible forproblem-solving, decision-making, and complex thought) has already begun toshrink. We humans, by the way, are the only animals whose brains are knownto atrophy as we grow older, andyay, us againwe are also sui generis insuffering from Alzheimers disease. As distinctions go, this may not be asauspicious as, say, the opposable thumb. Nor is it necessarily the first chapterof a story that ends with being found wandering through Central Park in yourpajamas. Im also not guaranteeing that this might not happen to you. At an

Alzheimers Association conference in Boston last week, researchersdescribed a newly coined condition called subjective cognitive decline.According to a front-page article in the Times about these ominous findings,People with more concerns about memory and organizing ability were morelikely to have amyloid, a key Alzheimers-related protein, in their brains. Forthe time being, there is nothing we can do about the amyloids, but in the pastfew years scientists and entrepreneurs have been claiming that there aremeasures one can take to minimize, slow down, or even reverse cognitivedecline. With my fingers crossed, I travelled around the country to meet someof these authorities and find out how I could turbocharge my brain.

As recently as a few decades ago, most biologists thought that the brain wasfully formed during childhood and, like a photograph after its been developed,was doomed to degrade thereafter, with neurons (nerve cells) fading likepigment on paper until you succumbed to senility. Today, we regardAlzheimers and other dementias as diseases, rather than as a consequence ofnormal aging. Moreover, we now consider the brain to be as labile as a digitalimage in the hands of a Photoshop fiend. The three-pound, pinkish-graywrinkly guck in your skull contains about a hundred billion neurons. Eachneuron can hook up with up to ten thousand others; hence, there are at least ahundred trillion neural connections in your brain, which is more than there arestars in the Milky Way galaxy. Not only does the brain have a lifelong abilityto create new neurons; like a government with an unlimited highway budget, ithas an endless capacity to build new roadways. Networks of linked neuronscommunicate chemically and electrically encoded data to one another (Hey,neuron, the keys are on the table) at junctures called synapses. Fresh neuraltrails are generated whenever we experience something newlearn the tango,try a liverwurst canap, take a different route to work. Repeat the activity andthe pathway will be reinforced. This is why London cabbies, whose jobrequires them to memorize a mesh of twenty-five thousand streets andthousands of landmarks, were found to have larger hippocampi than the citysbus drivers, who are responsible for learning only a few routes. (Thehippocampus plays a major role in memory.) The ability of the brain toestablish new connections is called plasticity, and brain-fitness exercises arepredicated on this mechanism. Working out has also been shown to revamp thebrain and prevent it from shrinking. Thats enough science for now. Lets getback to me.

A lthough the combination to my junior-high-school locker seems tobe indelibly lodged in some handy nook of my temporal lobe, rightnext to Motown song lyrics, could it be that elsewhere in my headnot everything is shipshape? Its a pretty regular occurrence for meto leave my reading glasses God knows where or lose my train of thought orhave trouble recalling the word phlogistonand, egads, what happened toall that stuff I used to know about Charlemagnes in-laws? In my darkestmoments, I imagine that my friends are humoring me when they insist thattheir amnesiac lapses are no less alarming than mine. (Have you eversqueezed toothpaste onto your contact lenses? a friend asked triumphantly.)Am I, like so many of my gang, just another one of the worried well? (A2011 survey found that baby boomers were more afraid of losing their memorythan of death.) Should I get out a crossword? Learn to play bridge? Chewgum? Take a nap? Drink more coffee? Eat blueberries? Give up tofu? Thereare studies that tout the rejuvenating benefits that each of these undertakingshas on the brain. What to do?

For starters, I visited the Cottage Center for Brain Fitness, in Santa Barbara,which is referred to as a brain shop by its founder and medical director,Kenneth Kosik. This establishment, set in a bungalow decorated with clientsartwork, aims to reset or, at least, stall the cognitive-countdown clock in orderto reduce your risk of decline, through a comprehensive program that includesexercise, physical therapy, massage, nutrition counselling, life coaching,software games, lectures, and other activities you might find at, say, senior-citizen day camp (cholesterol war, anyone?). Arriving in time for the dance-movement class, I joined a small circle of attendees as the instructor guided usthrough relaxation exercises (Well just close our eyes and send ourawareness to different parts of our bodies) and games (Im going to make ashape with my whole body, and then Ill turn to Sandy, whose job will be tocopy the shape with her body). There were three clients, ages sixty-eight,eighty-eight, and ninety. Kosik, a sixty-two-year-old with baby-blue eyes andthinning hair, told me that hed like to attract more people in their forties andfifties, which he regards as the optimal age for thwarting cerebralenfeeblement. Before I undergo a few neuropsychological tests, administeredby the centers integrative therapist, permit me another science-y interlude toexplain how the brain is able to countervail the effects of agingto someextent, and for only a limited period of time.

The notion that we can affect the resilience of our brain by investing in it earlyon, banking mental health as if it were a 401(k)to borrow an analogy fromSherrie All, another psychologist I met withhinges on the widely accepted

theories of brain reserve and cognitive reserve. Kosik explained these twokindred concepts to me during a rapid discourse that he called The History ofAlzheimers in Thirty Seconds, which lasted about half an hour. Heres theshort version: In 1988, several autopsies of elderly people revealed that,despite the presence in their brains of pathologies associated with Alzheimersdisease, these individuals, in life, had displayed no symptoms of dementia. Ithas been hypothesized that theyd been buffered from the effects of the diseaseby the extra neuronal capacity that they had been born with (brain reserve) orthat had accrued through years of intellectual and physical pursuits (cognitivereserve). Similarly, a study of six hundred and seventy-eight elderly nunsanalyzed essays theyd written in their twenties and found that the sisters whohad used the most linguistically complex sentences tended to have the lowestincidence of Alzheimers, which is why Ive added this unnecessarysubordinate clause even though its been a long time since I was in mytwenties. How is it that certain minds seem able to forestall senescence despitegenetic programming? The damage to the brain caused by Alzheimers can becompared to traffic jams caused by tractor-trailer accidents. Someone who hasa robust neural network can find ways around these obstructions using backroads.

With this in mind, I was happy to hear that I aced the tests I took. I think youwould, too, if, for instance, you know the answer to the question What cityare we in?, can figure out what a banana and an orange have in common,copy a drawing of a cube, and have no trouble recognizing a rhinoceros. Onthe other hand, as Kosik said during my evaluation, compared with thediagnostic acumen of computer-based testing, every pencil-and-paper test is ablunt instrument. Kosik is part of a team that is developing an Alzheimers-prevention drug now being tested on members of an extended family in thevicinity of Medelln, Colombia, whose mutated genes doom them to anespecially virulent form of dementia that can show up in their brains as earlyas age thirty. In most cases, he said, heredity is not so deterministic. Everyonecan name at least six reasons why you should eat sensibly, reduce stress, andexercise, Kosik said. Now there is a seventh. If you are middle-aged,managing your blood pressure, according to Kosik, is probably the bestmeasure you can take to minimize your risk of vascular dementiathe secondmost prevalent type of dementia, after Alzheimers. Kosik is also emphaticabout the benefits of social interaction, citing a study that found that isolationamong seniors was linked with cognitive impairment. (Party on!) Im suresome of my colleagues in BostonKosik was previously at Harvard andTuftswould look at this as a fringe operation, a storefront with walnuts and

Gincense, he said of the Cottage Center. On the other hand, he continued,we can wait for science to come up with a cure or we can jump in and try tocreate an atmosphere that is conducive to good brain health.

Next, I stopped at the Brain Health Center, in San Francisco. I had toreschedule my phone appointment with Louisa Parks, a clinicalneuropsychologist and brain coach, who teaches memory tricks to patientswith cognitive deficits, because I forgot to call her. Remembering to rememberis called prospective memory, and one technique Parks recommends fortriggering it is to link the item thats threatening to vaporize in your mind withanother thats more rooted in your consciousness. That is to say, put yourhouse keys in the refrigerator next to your corned-beef sandwich (and thenremember which to eat). Parks leads six-week sessions with groups of clients,offering them tactics like these.

Parks hypothesized that, while I dont have a recall problem, I could brush upon focussing my attention. Before I could celebrate, she said that pretty mucheveryone has an attention problem, especially these days, whenstopchecking your e-mail!there are so many distractions. The act ofremembering, she said, has three stages: encoding, storage, and retrieval. Thesecond we cant control, and the third, barring a stroke or a neurologicaldisease, depends on the first. If the proper information isnt inputted into themachine, as it were, then good luck getting it outputted. Parks recommendsmindfulness training. This is a variation on Buddhist meditation, in which thepractitioner learns to pay attention selectively and, as she put it, to remain inthe present, rather than to wallow and worry about the past and catastrophizethe future. She guided me through an exercise that involved devoting mythoughts exclusively to my breath (not daydreaming about whether Im out ofpaper towels). If one masters single-minded breathing, a theory has it, one willalso become adept at concentrating on non-respiratory concerns. I am not goodat breathing. Many years ago, at a spa, I was yelled at for not breathingcorrectly, but thats another story.

uess what else Im bad at? Anxiety management. This was more orless the conclusion of the online Brain Fitness Check-up Iunderwent, which was designed by a Washington, D.C.-basedcompany called NeoCORTA. The checkup consists of a very long

questionnaire that takes about half an hour to complete. Most of the questionsare in the form of statements that you must respond to on a scale of verypoor to very good. For example: My ability to remember grocery itemswithout consulting a list is . . . , My ability to follow a map to a new location

I shouldnt betelling you, but theartists real name is

J. K. Rowling.BUY THE PRINT

is . . . There are also questions youve been asked a million times before onforms, like how many servings of fruits and vegetables do you eat per day?,and others that I bet you will encounter for the first time, such as I notice andhear sounds around me, just as others do. Based on my answers, NeoCORTArecommended a Personal Action Plan, whose suggested activities included TaiChi and volunteer work. The NeoCORTA Web site claims that the companystest is the quickest, easiest way to begin the brain fitness journey. (How Iwish that sentence had ended with journey to the Amalfi Coast.)

Why is being a nervous wreck so badfor the brain? To find out, I spent acalming day at the Chicago Center forCognitive Wellness, a two-room suitein a building in Evanston, Illinois,above the World of Beer. The clinic,founded by a psychologist named

Sherrie All, and jointly run by her and her associate, Jennifer Medina, offersone-on-one cognitive-wellness coaching, in which stress reduction plays a bigpart. (Fermented beverages are not involved.) Americans are fat andsedentary, and were stressed out, and none of that is good for our brains, Allsaid. Thats why I developed my holistic approach. All hopes to open achain of brain spas, a hard venture to pull off, because most insurancecompanies dont cover this type of preventive care, and because many peopleare not aware of the potential benefits. We get discouraged about the market,but fifty or sixty years ago there wasnt a physical-fitness industry, she said.

Under her supervision, I took another battery of tests. If the rate at which Imable to strike the computer space bar during a thirty-second interval is ameaningful measure, then I could use a little remedial help on my motortapping skills. (So long, drumming career.) After Id repeatedly pressed theleft arrow and the right arrow, depending on whether an onscreen dot turnedred or green, and after I recognized the emotions on a series of line-drawnfaces (I confused disgust and anger), and after I pressed the space barwhenever I saw the word press if the letters were green and not if the letterswere red, Medina and I met in the therapy room (brown sofa, brown rug),where we talked about the evolutionary reasons for stress, which she referredto as Dr. Evil, and how it affects our memories. To recap: sometimes stress isgood. As anyone who has ever had to fend off a woolly-mammoth attack willtell you, the hormonal cascade that is generated in a state of emergency byyour bodys sympathetic nervous systemthe so-called fight-or-flightresponseempowers you to act with preternatural energy and vigilance.

Fast-forward hundreds of thousands of years, and we dont have to fightpredators for our food, Medina said. We still have a fight-or-flight response,but its not purposeful when youre standing in line waiting for the clerk tohurry up. When stress is long-lasting, it is like using a nuclear reactor tooperate your hair dryer. After being persistently bombarded by cortisol,neurons eventually wither and your hippocampus shrivels. The end.

Well, not so fast, says the team at Heartmath, a company that sells stress-reducing devices that are designed to teach you Inner Balance, give you amore positive outlook, increase mental clarity, and improve your memory. Allyou have to do is clamp a pulse sensor to your ear and think happy thoughts.The product that I sampled is called emWave Desktop. This is a softwareprogram that translates information about your heart rate as it is beingcollected by the ear thingamajig, and displays the data on your computer in theform of animated graphs, sine curves, and inspirational scenes of plantssprouting in a garden, gold filling a pot at the end of a rainbow, an oversizedchild radiating psychedelically colored light beams toward planet Earth, andthe like. It is a G.P.S. for the soul. The goal is to achieve maximum coherence.According to Rollin McCraty, the director of research at Heartmaths academicarm, coherence is a state that builds resiliencypersonal energy isaccumulated, not wasted. Got that? Seeking enlightenment, I spent a fewhours on the phone with Gaby Boehmer, the companys director of publicrelations, and Tom Beckman, a biomedical engineer by training, whoseresponsibilities at Heartmath include instructing health-care professionals inthe use of emWave. It is like building emotional muscle, Boehmer told me.When you are in a state of coherence, the heart and brain and nervous systemare working synchronistically, Beckman added. Apparently, you reach a stateof heart-rhythm coherence when youre feeling positive emotions. The reasonwe focus on the heart to facilitate brain fitness is because the heart is sendingmore information to the brain than vice versa, Beckman said. During myemWave tutorial, I was advised to focus on the center of my chest andrexperience a positive feeling, by recalling, for instance, a special place orpet. The best I could do was fantasize about finishing the emWave session. Itdid the trick. My heart was so well behaved that the little thermometer in thecorner of my screen registered green seventy-seven per cent of the time, andBeckman said, Good job. Im impressed with your coherence.

To everyone who has solved todays crossword puzzle: Sorry, but that is noguarantee that you will end up less nutty than the rest of us. Alvaro Fernandez,the C.E.O. of SharpBrains, a market-research firm concerned with brainhealth, told me, Once someone has done hundreds or thousands of them, the

Smarginal benefit tends toward zero, because it becomes just another routine,easy activityprobably a bit more stimulating and effortful than watching TV,but not enough to bring benefits other than becoming a master at crosswordpuzzles. If youre practiced enough to know that an auk is a diving seabird,its time to learn sign language or take up the tuba. Fernandez, like manyothers, recommends engaging in unfamiliar challenges. If you take thiscounsel to the extreme, there is neurobics, the mental-calisthenics regimenpopularized by Lawrence Katz and Manning Rubin in their book Keep YourBrain Alive: 83 Neurobic Exercises to Help Prevent Memory Loss andIncrease Mental Fitness (1999). In order to qualify as a neurobics exercise, atask must involve one or more of your senses in a novel context and breaka routine in an unexpected, nontrivial way. Guess which exercise among thefollowing was not conceived of by Katz and Rubin: shower with your eyesclosed, brush your teeth with your nondominant hand, wear earplugs to yourfamily breakfast, wear mittens while driving, turn your family photos upsidedown, shop at an ethnic market, eat waffles for dinner. Answer: they are allbona-fide neurobic exercises.

taving off dotage is not cheap. According to a recent report issuedby SharpBrains, the amount spent on brain fitness in 2012 was morethan a billion dollars, and by 2020, it is estimated, that figure willexceed six billion dollars. Most of the merchandise is some kind of

software.

Adam Gazzaley is a neuroscientist and the co-founder of Akili InteractiveLabs, an outfit that is hoping to develop the first therapeutic F.D.A.-approvedvideo games. Brain fitness of tomorrow will be created in rooms like this, hetold me, during a tour of the neuroimaging center that he directs at theUniversity of California, San Francisco. The Virtual Simulation room was sominimally appointeda couple of flat screens and a few headsets withelectrodes lay aboutthat it looked as if it had been burglarized. Weredeveloping neural stimulation, including T.D.C.S.transcranial direct-current stimulationand hoping to integrate them into a multimodalapproach that rewires the circuits of the brain. In other words, the video gameof the future will not only sense what is going on in your brain but also makeyour brain more plastic by shooting electricity through it. Remember whenyour mother told you not to sit too close to the TV? Now youre part of theTV.

Ihave read studies in which it was concluded that playing brain gamesimproves your working memory, sharpens your attention, builds yourfluid intelligence (the ability to solve novel problems and think logically),boosts your I.Q., rolls back the clock ten years in terms of memoryperformance, delays mental decline by seven years, decreases your risk of anautomobile crash, revs up skills that would make you a more reliable air-trafficcontroller, and makes you much sexier (not really). I have also read studiesthat disputed each of these studies. Fernandez, of SharpBrains, told me, Ifyou find a game that addresses a relevant cognitive or emotional bottleneck,you can make a difference in your quality of life in ten to fifteen hours oftraining.

Which to choose? To name just a few: Cogmed, Lumosity, Brain Games,Jungle Memory, CogniFit, MindSparke, MyBrainSolutions, Brain Spa,brainTivity, Brainiversity, Brain Metrix, Mind Quiz: Your Brain Coach, BrainExercise with Dr. Kawashima, Nintendos Brain Age, MindHabits,NeuroNation, HAPPYneuron. There seem to be enough products to give eachof your synapses its very own personal-training program. They vary in price(many are free; Lumosity is a subscription that costs fourteen dollars andninety-five cents a month; Cogmed costs around fifteen hundred dollars, whichentitles you to a five-week coach-supervised session and access to twelvegames); intended customer (e.g., Dakim BrainFitness is meant for people oversixty); and purpose (some emphasize particular brain functions, such asworking memory or emotional regulation; others are more all-encompassing).

I chose BrainHQ, a platform offered by Posit Science, a San Franciscocompany, which was one of the first to enter the brain-fitness realm. Posit wasco-founded in 2003 by Michael Merzenich, a neuroscientist. The programspecializes in speeding up the rate at which the user processes information,making your brain operate more like I.B.M.s Watson supercomputer than likemy laptop. Why do you lose your memory? Merzenich asked. You dontforget because the brain has forgotten to remember. You lose your memorybecause the brain is representing the things you are seeing and hearing andfeeling less saliently. When youre young and you see something surprising,your eyes are attracted to it. You are bright-eyed, literally. Your eyes take aseries of snapshots that reveal information about whats out there. Seventy-year-olds might not see whats there, and if they do see it theyll turn theirwhole heads and stare, instead of darting their eyes. Merzenich went on toexplain that the peripheral vision of a sixty-year-old is only three-quarters aspanoramic as that of a twenty-year-old. We want to train your eyes to bemore childlike, he continued. We can take a person at any age and restore

their sparkiness. Merzenich told me that recent findings have shown that aPosit program similar to the one Id be trying effectively reversed cognitiveaging by eleven years, on average, after only ten hours of training. Great! If Icomplete the program a bunch of times, I can find out who I was in a previouslife.

I trained for an hour a day over a six-week stretch (thirty minutes a day iscustomary, but I was on an accelerated schedule). In all, there were fifteenexercises. Some, like Target Tracker, were meant to augment attention. Anumber of identical jellyfish appeared onscreen, followed by a fluther of moreidentical jellyfish, all of them moving as if they were playing musical chairs.When they stopped, I was asked to pinpoint the original bunch. When Igraduated to higher levels of the exercise, the jellyfish moved faster andbecame more translucent. When I beat a benchmark Id previously set,fireworks exploded. Im ashamed to admit how proud I felt. On the other hand,an alertness exercise, Freeze Frame, rattled me so much that I consideredgiving the emWave a second chance. It entailed unhesitatingly tapping thespace bar sometimes and refraining from pressing the space bar at other times,depending on which photograph flitted across the screen. One of the toughesttests was Card Shark, a version of the classic n-back test, whereby the subjectis presented with a sequence of itemsin this case, playing cardsand askedto indicate when the current card matches the one n steps back. The n-back is amemory-building tool that has been shown to raise I.Q. Among the many teststhat I genuinely liked was Recognition, a People Skills exercise in which aface, cropped at the hairline, is flashed onscreen for a few milliseconds, afterwhich you must select the one you saw from an array of faces. As youprogress in this task, the angle of the faces becomes more oblique, the numberof faces in the grid increases, and the target face appears for shorter burstsavirtual speed cocktail party, but without the crostini and the mojitos.

How did I fare over all in this self-help adventure? Judging from the series ofquestionnaires I filled out during the course of my training, my moodbrightened, my sleep was more restful, and I felt more confident. I may alsohave become a bigger liar on questionnaires, but that was not evaluated. As forthe exercises, my scores were higher across the board. In an e-mail summingup my progress, Merzenich wrote, Your advances on these exercises comefrom brain remodeling. If we had recorded from/imaged your brain before andafter training, we could have easily shown that you now have a better(stronger, faster, more reliable, more accurate) brain. (Wouldnt they makedandy wallet photos?) Compared with my poky old brain, my souped-up brain,according to Merzenich, has more synapses, better wiring, stronger

Patricia Marxhas beencontributing toThe New Yorkersince 1989.

connections, and more forceful activity. (Doesnt that sound like an ad for afive-thousand-dollar stereo?) He said that my enhanced brainpower should lastseveral years, after which I could slip back past the neurological position thatyou were at when you began this training.

Im not sure I noticed my newfound cognitive abilities in my everyday life.Its hard to be both scientist and lab rat. On the positive side, I am slightly lesstroubled about the size of my hippocampus. On the negative side, why did Isprinkle NutraSweet on my broiled salmon last night?