Canyon Ranch 30 Days to a Better Brain Chapter 1 HOW THE BRAIN WORKS
If you’ve been taking your brain for granted, you’re not alone. Most people assume their brain is working just as well as ever, even as they get older. But the reality can be far different.

The brain is a highly responsive organ that is involved in every internal function of the body, from regulating metabolism to controlling balance and coordination to governing our sex lives and, of course, all the activities associated with the senses and the mind, particularly mood and memory. The brain’s functioning is central to the concept of the mind-body connection, the way the body’s health responds to our thoughts, feelings, and actions. This connection illustrates how our emotional life can both positively and negatively affect our physical health and how our physical health can affect our mood and cognition. The truth is that the brain and the rest of the body are one unit of health; the brain is affected by many of the same diseases and conditions that distress our physical health. At the same time, it is also susceptible to aging and even injury.

Monitoring the brain’s health is not always as obvious or easy as evaluating changes to the rest of the body. Many of us notice the aches and pains as well as the signs and symptoms of physical aging. You know when you’ve put on weight even though your diet hasn’t changed, and you can tell when your joints hurt more than they did last year. But you might not notice that your thinking has slowed down or your attention is not sharp or your moods or anxiety levels have changed. This is mostly due to the fact that the brain is hidden from our view; we can’t see it aging as clearly as we can see the gray hairs coming in or our jawline slackening.

The brain also has enormous biological reserve, the extensive backup plan to keep all aspects of your health—physical as well as emotional—running smoothly. This reserve allows the body to continue functioning as we age and gives us a false sense of security in terms of our cognition; we actually can get by with substantial loss of brain function without realizing that changes have occurred. This reserve makes it very difficult to recognize if there has been a slowing in our mental capacity until there is a significant change. Yet unfortunately, once you do notice, it means that the underlying problem that has caused this change has been going on for a very long time.

The good news is that just like the rest of your body, your brain can get better. By starting a program based on improving your brain health now, you can begin to recognize subtle changes and have the opportunities to enhance your brain’s capabilities so that it can serve you well now and for years to come. Science has only just recently confirmed what we at Canyon Ranch have believed all along: your lifestyle can influence your health. This research has blossomed into a new field called epigenetics, which suggests that it is possible to alter one’s genetic destiny by changing nongenetic factors—such as lifestyle choices. These specific behaviors can actually cause a person’s genes to turn on or off without changing the underlying DNA sequencing. In other words, to a very large extent, you are in control of your own health. And nowhere is this more exciting to consider than in terms of your brain’s potential.

This book is meant to set you on the path to better brain health. We believe that this is the highest pursuit in wellness that you can become engaged with, because you really can’t be healthy without a healthy brain. And it terms of your longevity, your brain’s functioning is as important as that of any other organ in your body, including your heart.

We all hope for and have come to expect to live long lives. A hundred years ago, the average person could expect to live between forty-nine and fifty-one years. Today if you are in good health, it’s reasonable to assume that you will live well into your eighties and even beyond. Medical technology is one of the underlying reasons for this enormous increase: we have easy access to a host of treatments and procedures that can keep our internal organs and bone structure from failing. However, our ability to increase longevity has not fully addressed many of the problems associated with an aging brain. The truth is, half of the people who reach eighty-five years of age will have some form of dementia or cognitive dysfunction. This knowledge alone is exactly why improving brain health is so critical: we want not only to maintain a vibrant, healthy body for years to come but for those years to be of the highest quality. And the only way to ensure that is by maintaining—or even enhancing—a vibrant, healthy brain. By doing so, you’ll increase your capacity to live life to its fullest every day.
UNDERSTANDING YOUR BRAIN
The brain is a complex and sophisticated organ, and to work on improving its health, it’s important to understand both its structure and how it functions. On the smallest scale the brain is made of 100 billion individual neurons, or brain cells. Neurons are the electrically excitable cells that process and transmit information to each other through neurotransmitters, or brain chemicals. Together, these neurons and neurotransmitters form a specialized network that governs how we feel and think.

Each neuron is composed of a cell body, dendrites, and one axon. More than 150 different types of neurons exist, so they are some of the most diverse cells in the human body. Dendrites and axons are thin structures that branch off the neuronal cell body. Each cell body is surrounded by multiple dendrites, but never more than one axon. In simplest terms, one neuron’s dendrite connects to another’s axon, but the two do not completely touch. With 100 billion neurons, this allows for 100 trillion connections between them. Each connection creates a synapse, the place where the chemical and electrical signals of the brain are sent and received.

The axon is protected by a myelin sheath, an insulation barrier much like the material surrounding an electrical wire. The myelin sheath helps the axon hold on to its chemical message until it’s delivered to the next cell.



A NEURON OR BRAIN CELL

The brain’s function is measured by how well your neuronal network is working: Are the neurons hooked up to each other in the right way? Are they making the same or new connections? Are there any short circuits? And most important, how quickly can they transfer information? This transmission is referred to as brain processing speed. Damage to any part of this system limits or prevents the neuronal message from transferring from one cell to the next. Speed, then, is important in the sense that it is necessary for maintaining the information traveling through the axon so that it can be relayed to the next neuron. A normal brain responds to stimuli at a speed of at least one-third of a second. Typically, we lose seven to ten milliseconds of brain speed per decade from age twenty on. The difference between a resourceful mind and senility is only one hundred milliseconds. When this loss occurs, the neurons can no longer fire their chemical messages fast enough to affect the actions they were governing. That is why as we age we move more slowly, misjudge distances, and make mistakes.

This loss of brain speed is one of the main causes of mild cognitive impairment, or MCI. People generally start to see these declines when they reach their seventies, yet they can begin to notice changes in their thinking in their forties. By the age of forty, 25 to 50 percent of Americans are already affected by MCI, even though less than 1 percent will show any symptoms. In an aging brain, the neurons themselves, the quality and quantity of their neurotransmitters, or the neuronal connections can be altered, and thereby affect your brain’s health. Brain cells die off, or their connections become broken, making it more difficult to retrieve stored information, or what we refer to as memories.

As we get older, we think that we are becoming more forgetful. The truth is that we don’t actually lose memories; instead, we lose the capacity and the speed required for retrieving them. The goal, then, for enhancing brain health is to maintain and improve these neurons, as well as their connections, for as long as possible, because an efficient brain is a smarter brain.

This strategy is particularly true when it comes to those myelin sheaths surrounding the axons. These protective coverings can disintegrate, and plaques made up of sticky proteins called beta-amyloid can build up on them. Or these axonal connections become entangled with accumulations of other proteins. Both of these scenarios are present in the diagnosis of Alzheimer’s disease, the most invasive form of dementia.


THE REGIONS OF THE BRAIN
Depending on where neurons are located in the brain, their function changes. For example, there are sensory neurons that respond to touch, sound, light, smell, and taste. Motor neurons receive signals from the brain and spinal cord, causing muscle movement. Each neuronal network creates distinct lobes, or regions of the brain, and each is responsible for different aspects of our mental, physical, and cognitive health. However, these brain regions are often responsible for multiple tasks, and their functions often overlap.

The brain is composed of three distinct parts: the cerebrum, the brain stem, and the cerebellum. The cerebrum, or forebrain, is the largest part of the brain. It is covered by the cerebral cortex. This is the collection of folded bulges—known as gray matter—that comes to mind when we think about the brain. These bulges increase the brain’s surface area and enable us to fit a great volume into a small area. Together, the cerebral cortex and the cerebrum play a key role in memory, attention, awareness, thought, language, and consciousness.



REGIONS OF THE BRAIN

The next region of the brain is the cerebellum. It is a ball of tissue below and behind the cerebrum that decodes sensory information and integrates it with your body’s muscles to coordinate movement. Finally, the brain stem links the brain to the spinal cord. It controls bodily functions such as heart rate, blood pressure, and breathing.
Analyzing the Cerebrum
The cerebrum is divided into two hemispheres, left and right, that are linked by a thick band of nerve fibers called the corpus callosum. Messages to and from one side of the body are usually handled by the opposite side of the brain, meaning the left hemisphere controls the right side of the body.

The hemispheres are identical in that they contain the same types of lobes. Each hemisphere is further divided into four lobes, all of which create and retrieve memories. From the descriptions below, you can see how their functions often overlap:

• The frontal lobes control thinking, planning, organizing, problem solving, short-term memory, and movement.

• The parietal lobes interpret sensory information, such as taste, temperature, and touch.

• The occipital lobes process visual information and link that information with memory.

• The temporal lobes process smell, taste, and sound. They also play a role in memory storage.



LOBES OF THE BRAIN

Within the middle region of the cerebrum lie several small structures that form the limbic system, which is involved in many of our emotions and motivations, including fear, anger, and pleasure. Certain structures of the limbic system are involved in creating and maintaining memory.

Amygdala: This is located in the temporal lobe and is responsible for determining how memories are stored and where the memories are stored in the brain. It is thought that this determination is based on the emotional response an event invokes.

Hippocampus: This is where short-term memories are stored before they are moved to the appropriate lobes of the cerebrum, and it organizes how memories are retrieved when necessary. Damage to this area of the brain may result in an inability to form new memories; the hippocampus is one of the primary areas of the brain affected by Alzheimer’s disease.



THE LIMBIC SYSTEM

Hypothalamus: This controls emotions, eating, and sleeping. About the size of a pearl, this structure, in concert with the pituitary gland, indirectly affects adrenaline production when needed for the control of emotions. Adrenaline is a hormone involved in making you feel exhilarated, angry, or unhappy, as well as activating the fight-or-flight response.

Thalamus: This transfers messages from the spinal cord to other areas within the hemisphere.
AN AGING BRAIN IS A SMALLER BRAIN
Healthy brains can maintain their original structure, but an aging brain is drier and smaller than a young brain. By the time you reach your seventies, the brain will have shrunk about 10 percent and will look more wrinkled than a younger version. The change in the size of your brain doesn’t cause pain, and you can’t feel it occur. And because the brain is encased in the skull, you can’t see these changes, either.

When Does Decline Begin?

According to the Baltimore Longitudinal Study of Aging, adults reach their physical peak somewhere between ages twenty-eight and thirty-two. Beyond that, your brain will age either at the same rate as the rest of your body or faster or slower. Damage or dysfunction in any one of the regions ages the brain, sometimes faster than your chronological age. This means that a head injury—even one sustained when you were younger—can affect your thinking later in life, aging your brain faster than the rest of your body.

One way to identify a prematurely aging brain is through your sense of smell. Losing it is one of the first signs that there is a problem with the brain and can predict memory loss. Sense of smell declines because the type of cells in the nasal cavity of the brain (known as granule cells) are the same type as the cells in the hippocampus, where short-term memories reside, and both these cells age at the same rate.

The entire brain is surrounded by blood vessels that continuously nourish it and by cerebrospinal fluid, which bathes, protects, and cushions it. The ventricles, the areas beneath and around the brain, produce a bath of cerebrospinal fluid that moves all the way around the outside of the brain and the spinal cord. As the brain shrinks, the ventricles enlarge by filling the void with fluid. Enlarged ventricles may be an indication of brain shrinkage and are a common finding in those with dementia.
THE BASICS OF BRAIN CHEMISTRY
The structure of the brain tells only half the story; the rest of brain health is related to how the brain functions. The neurotransmitters, the chemical messengers sent between the neurons, are created in the cell body and transported from the axon into a synapse, where they bind to chemical receptors located in the dendrites. You can think of a neurotransmitter as a key and a receptor as a lock: together, they open the door. We also know that the same type of key can be used to open many different types of locks, and some locks may accept a number of similar keys. The effect on the target neuron—what happens once the door is opened—is determined not by the source neuron or by the neurotransmitter but by the type of receptor that is activated. In a healthy brain, the acceptance of these neurotransmitters occurs in a smooth, rhythmic flow. However, the delivery or production of these brain chemicals can become unbalanced and dysfunctional, affecting our health as well as our mood, memory, and attention.

Scientists are still identifying all of the neurotransmitters, and we currently know of at least fifty different types. The ones that we know the most about include:

Acetylcholine: Plays a very important role in memory. It conducts sensory input signals and stimulates muscular movement.

Adrenaline: Also referred to as epinephrine. It increases heart rate, sharpens reflexes, constricts blood vessels, dilates air passages, and participates in the way we respond to stressful situations, including the fight-or-flight response.

Dopamine: Helps control the brain’s reward and pleasure centers. It enables us to not only see rewards but take action to move toward them. Dopamine also helps regulate movement and emotional responses.

Gamma-Aminobutyric Acid (GABA): An amino acid that acts as a neurotransmitter. It has a calming effect on the brain, blocking nerve impulses. Without GABA, nerve cells fire too often and too easily. Anxiety disorders such as panic attacks, seizure ailments, and other conditions, including cognitive impairment, are all related to low GABA activity.

Noradrenaline (Norepinephrine): Has a stimulating effect, fosters alertness, and plays an important role in long-term memory and learning. Optimal levels of this neurotransmitter can stimulate a sense of well-being, yet an excess can fuel fear and anxiety.

Serotonin: Is involved in about one quarter of all our biological processes. Serotonin has been shown to play a role in modifying mood, particularly with depression.
AN AGING BRAIN CAN AFFECT YOUR LIFE
When your brain ages significantly, you may begin to feel or act differently. Some people notice that they feel tired all the time, either because their sleep is disturbed or because they are simply always fatigued. Others begin to feel more anxious or less connected to friends and family, and become unmotivated—and sometimes mentally unable—to leave the home. You might feel more forgetful or lack the ability or desire to plan, execute, or have abstract thoughts. Your attention may wander, along with your balance or hand-eye coordination. You may notice that things you used to be able to do quickly are taking longer, including your reaction time, ability to solve problems, or facility in learning new tasks.

Changes in the brain can affect your weight, your bone density, and your muscular control. What’s more, when you become withdrawn and don’t want to leave your home, you won’t get enough exercise, and your muscles will atrophy. Simply put, an aging brain can make you look and feel much older than your chronological age.

Your brain’s health exists on a spectrum. At one end is fully functioning activity—what we call a youthful brain. MCI is located along the arc, and unless your brain’s health is shored up, it will continue to diminish until full dementia occurs. Dementia is defined as a loss of brain function that significantly affects memory, thinking, language, judgment, and behavior. The farthest point on the spectrum is where Alzheimer’s disease (AD) can reside. Alzheimer’s disease is actually a type of dementia and is an incredibly debilitating condition that is directly connected to an aging brain.

However, we can prevent and even delay the cognitive impairment that leads to AD. The goal of this book is to teach you how to delay MCI so that it won’t change your life until you are in your nineties instead of your seventies. If we can address the earliest, mildest losses of cognitive function, you’ll have the best opportunity to make a positive difference in how you enjoy the rest of your life.
THE DIFFERENCES BETWEEN DEMENTIA AND ALZHEIMER’S DISEASE
We all experience “brain blips” from time to time: forgetting where we put eyeglasses, overlooking items on a shopping list, or even walking into a room and losing track of why we are there. But at what point is misplacing your car keys considered a hallmark of old age or something worse? And are brain blips the first sign of an aging brain?

Some changes in brain function occur as a part of natural aging. For example, at age sixty, as compared to twenty, it may take a little longer to think on your feet and remember something. When these blips occur with great frequency, you may be experiencing the neurological condition called mild cognitive impairment. When this happens, lapses in finding words and recalling names are common, along with other difficulties that can include failing to remember appointments or losing one’s train of thought in the middle of a conversation. Though MCI is not as severe as full-blown Alzheimer’s disease, many believe it is the beginning of a spectrum that leads to other forms of dementia. The good news is that this type of impairment can, in most cases, be rectified by following a health plan like the one outlined in this book.

However, people with Alzheimer’s disease will exhibit certain classic features or behaviors that are caused by the disease and become more pronounced as the disease progresses. We call these changes the Four As of Alzheimer’s, and they are directly related to the lobes of the brain where aging or damage has occurred.

Amnesia: The inability to use or retain memory, including short-term and long-term memory. True amnesia may lead someone to confusion, where the person suffering repeats questions such as “Where am I?” “Who are you?” Amnesia occurs when there is damage to the frontal lobes.

Agnosia: The inability to recognize or deal with common objects and/or people. Those suffering with agnosia may become lost even in a very familiar place. They may confuse common household items, store belongings in seemingly strange places (i.e., putting away a frying pan in the freezer), and confuse even the closest family members. This process is associated with increased damage to the frontal lobes, the occipital lobes, and the temporal lobes.

Aphasia: The inability to use or understand language. Aphasia begins with the sufferer using the wrong word or losing his or her train of thought, or providing a description of an object or place because he or she can’t access the right word. Aphasia is associated with damage to the temporal and frontal lobes.

Apraxia: The inability to use or coordinate purposeful muscle movement.

What Does Cognitive Decline Look Like?

There are at least four types of cognitive decline:

• Changes in memory

• Changes in attention and focus

• Changes in personality and temperament

• Changes in IQ

In the early stages of apraxia, the sufferer may reach for an item and miss it. Eventually balance becomes affected, leading to an increase in the risk of falls and injury. Apraxia is linked to damage to the parietal lobes, the cerebral cortex, and the occipital lobes.
HOW MEMORY WORKS
Memories are the functional building blocks of the brain—the brain literally grows as it is exposed to new stimuli, and records that information as memories. Memory is the process of storage and retrieval of information and experience and resides in vast chains of brain cells—neuronal networks—rather than a single brain cell. Each cell holds only a portion of information, and you need to be able to connect these cells to access memories. Many functions of the brain are really just complex memory processes, which are regularly reworked because of new learning and emotional growth. But if we cannot receive information we cannot process it or store it.

Brain processing speed affects the way you retrieve your memories. Again, it’s not really that you lose memory; it’s just that the time it takes to retrieve the memory increases and the extent to which we can retrieve decreases. If you have fewer neuronal connections, you have limited options in terms of how you retrieve memories.

There are many ways to categorize memory, including short-term and long-term memory, as well as memories related to your senses.

Long-Term Memory: When you hear a certain song from your teenage years, it may take you back to your senior prom. Or a certain smell can take you back to your mother’s kitchen. These are long-term memories, and they demonstrate that there are many tools your brain can use to store and remember data. For example, when you lose your keys (as we all do), most of us think of where we saw them last. But if you chose a different trigger, like the feeling of the key in your hand, you might be able to call on the memory differently.

Verbal/Auditory Memory: The ability to absorb and retain verbally presented information. Verbal memories are thought to be stored in the temporal lobes. Roughly 20 percent of learners have high auditory skills, and these people are able to compartmentalize complex material, but are less confident in their own memory.



MEMORY IS STORED WITHIN THE BRAIN’S LOBES

Visual Memory: The ability to absorb and retain information such as colors, shapes, designs, pictures, and symbols. The occipital lobes are responsible for this type of visual training. The majority of people (more than 65 percent) learn through visual memory. These are the people who typically learn quickly and are able to see the “big picture” of life.

Kinesthetic Memory: Kinesthetic memories are based on your physical relationship to the world. They help keyboard users type rapidly without having to look at the keys, just as musicians can play their instruments without consciously having to think about the necessary movements. And this kind of memory can help people to find something again, by remembering the location where they put it.

Immediate Memory: Lasting only thirty seconds, immediate memory is composed of verbal and visual memory and is an indication of one’s learning capabilities and alertness. Immediate memories are briefly stored in the parietal lobes.

Working Memory: The ability to retain information. Working memory involves bringing together old and new data. The frontal lobes manage motor control, concentration, problem-solving skills, planning, and retention of knowledge, all functions of working memory.
THE PROBLEM WITH A LACK OF ATTENTION
Feeling less focused doesn’t necessarily mean that you are not as smart as you used to be; in fact, it’s the people with above-average intelligence who are the first to notice a change in their attention. For example, driving accidents are some of the greatest mortality risks among older adults, and many of them are caused by the following attention errors.

Omissions: a lack of response to a stimulus, such as forgetting to take your foot off the gas pedal.

Commissions: an inappropriate response to a stimulus, such as making a left turn into oncoming traffic.

Reaction Time: an unusually long delay in response to a stimulus, such as driving slowly or hesitating to change lanes.

Variability: an inconsistent response to a stimulus, such as the inability to maintain safe driving speeds on a highway.
CHANGES IN IQ
There are many different ways to define and measure intelligence, because it involves disparate kinds of thinking and uses many parts of the brain. Intelligence combines processing speed, memory, empathy, creativity, and the ability to put all of these together. Some of these abilities are encoded in your DNA, while others are shaped by your individual experiences, learned behavior, and practice. As we get older, the brain loses processing speed. However, in order to preserve or enhance our intelligence, we need to maintain a quick and creative brain.
THE PROMISE OF NEUROPLASTICITY
As scientists, doctors used to hold as a universal truth that we were each born with all the brain cells we were ever going to have or need. While other parts of the body were able to regenerate with age, the cells of the brain would progressively die off as we age. And once they died, they would be gone forever, and there was nothing we could do about it. In this model, the brain was perceived as stagnant, unable to grow, and a decline in brain function with age was inevitable.

Luckily for us, scientists and researchers did not take this “truth” for granted. The latest advances in brain imaging have shown that the brain can grow new cells, just like every other organ in the body. You see new cell growth on your skin every time you get a cut and it heals. The same may hold true for some cells of the brain.

The ability of the brain to change and grow is known as neuroplasticity. Plasticity does not refer to being synthetic, or fake. Instead, it refers to being moldable, pliable, and repairable. In this sense, it means that the brain has the capacity to repair itself—to change and grow—through the creation of new neurons and neuronal connections.

Neuroplasticity occurs through a process we call neurogenesis: the creation of new neurons. As these brain cells increase and make new connections, you can continue to learn, improve your thinking and your mood, create new memories, and retain cognition well into your old age. In short, we are not predestined to have dementia. You can even train your brain and enhance its abilities, including getting smarter, as you get older. Last, neurogenesis has a positive effect on your overall health, because what is good for the brain is good for the body.
HOW DO WE KNOW NEUROPLASTICITY REALLY EXISTS?
Neurogenesis makes sense theoretically because we can, and do, learn new things all the time. We master new skills, create new relationships, and hone our understanding of both history and current events to make sense of our world. What’s innovative is that we now have a scientific pattern that explains new learning as new brain connections.

But for those who need more proof, science has proven neurogenesis exists in relation to our sensory perceptions. In a study financed by the National Institutes of Health (NIH) and published in the Journal of Neuroscience, researchers found that when one sense is lost, the corresponding brain region can be recruited for other tasks: those cells don’t waste away and die. In deaf people, the part of the brain that is supposed to handle auditory processing is instead recruited to enhance the other senses. Other studies have shown that structural changes in the auditory cortex are noticeable in the brains of deaf children from a very early age. As reported in the New York Times, the bottom line is that losing one sense can cause the brain to become rewired, which is neuroplasticity in action.
REVERSE AN AGING BRAIN NOW: IT’S NEVER TOO LATE TO START
The goal of enhancing brain health is to improve anatomy as well as brain chemistry—both structure and function—by increasing our capability for neurogenesis. At Canyon Ranch, we believe that these kinds of improvements can be made through simple changes in lifestyle. While your genes do play a role in your overall health, many preventive therapies exist that can allow you to keep your brain healthy as you age. This is where epigenetics comes into play—lifestyle changes will transform your health to create a whole new destiny.

The health of the brain is a result of all the positive and negative impacts we’ve encountered over the course of our lives. The negative aspects include poor health, physical injury like a concussion, and simply following a poor diet. So it’s never too early to start to heal the brain, and it’s never too late. The truth is, some damage can be repaired if you start to take care of your brain long before you experience the symptoms of cognitive decline. If you don’t address these issues, the damage can become permanent. At Canyon Ranch, we prefer to prevent problems with the brain rather than reverse them: it’s a lot tougher to reverse damage than to thwart damage.

The goal we are trying to achieve is optimal well-being. In order to reach that, we’ll teach you easy ways to be a little more diligent about your lifestyle. We know that people have not lived perfect lives. We can’t erase the past, and we certainly don’t want to. But at the same time, we’re not here to add to your levels of stress. So the first step to better brain health is to take a deep breath and realize that you don’t have to be perfect now, either. The rest of this book will teach you what you need to know to become healthier in every way. All we’re asking is that you start to take the steps needed to put you on this path. Whatever stage of health you are at right now, you can begin this program.

Over the next thirty days, you’ll learn how your current lifestyle may be contributing to poor brain health, or if you are already doing the right things to enhance your cognition. The next chapter discusses physical issues that may be contributing to a decline in brain function. To think of the brain without considering your current physical health is to misunderstand the brain in its entirety. You’ll learn that if you take care of your body, you’ll have enhanced brain functioning. And when you take care of your brain, you’ll have enhanced overall health. The Canyon Ranch philosophy is to address all aspects of your health together—holistically—and when you do that, you’re going to see results.