Sunday, December 16, 2012

A Reflection on Meditation

Much of what I write in this blog seems to be about actions and plans that are relevant to all of us who are elding, regardless of whether we have future minders lined up.  We are all subject to scams.  We all will face health issues.  And we all face the prospect of cognitive decline.  The presence of minders will perhaps ease the effects of these issues, and therefore ease out minds, but they will not prevent the issues from arising.

Peace of mind in a mind that is not mindful may be peace of mind in name only.  But, then, if the mind is gone, who cares.  Right?  Is it possible that the anticipation of dementia is worse than the actual dementia?

I believe that cognitive decline, dementia and Altzheimer's are horrible.  So horrible that they are to be avoided at all costs.  And I believe that by believing that, I will do everything I can to avoid them.  While I understand that the absence of mindfulness might be incredibly sad but not bad as we think it is,  or that it is unavoidable, I cannot BELIEVE that lest I become slack in my efforts to avoid it.  This belief is my incentive for actions that strengthen the life of the mind and prevent a mind without life.

So, what does this have to do with meditation?  Well, here it is, in a nutshell:  research has indicated that meditation can promote positive emotional states and increased "connectivity" (see below), which in turn can have the prophylactic effect of strengthening the areas of the brain that are most susceptible to cognitive decline (see way below).  And, if I interpret Maria Konnikova correctly (see also below but not as way below as before) it promotes an understanding of Sherlock Holmes, one of my literary but non-literal heros, but without the use of either a pipe or a 7% solution.   (I have included below Ms Konnikova's opinion piece from the December 16 Sunday New York Times.)

So, seriously, I still believe the best strategy for elding successfully (see earlier posts for the definition of "successful") is to prepare to be self sufficient, self directed, self controlled, self confident, self helped.  That does not mean that we should not expect to require help.  Which means, we should know that we will need help.  But we should know, in advance of need, what help will be needed, where to find it, how to pay for it, and how to be in control of it.  Know, in advance, when to sell the car.  When to move into a CCRC.  When to find a primary care physician (hint:  BEFORE moving to Florida).

Meditation, concentration exercises, memory exercises, learning a language, are all just tools to achieve the goal of being a wise respected elder instead of a whacky old coot.

Well........, maybe a little whacky.


The Power of Concentration

MEDITATION and mindfulness: the words conjure images of yoga retreats and Buddhist monks. But perhaps they should evoke a very different picture: a man in a deerstalker, puffing away at a curved pipe, Mr. Sherlock Holmes himself. The world’s greatest fictional detective is someone who knows the value of concentration, of “throwing his brain out of action,” as Dr. Watson puts it. He is the quintessential unitasker in a multitasking world.
More often than not, when a new case is presented, Holmes does nothing more than sit back in his leather chair, close his eyes and put together his long-fingered hands in an attitude that begs silence. He may be the most inactive active detective out there. His approach to thought captures the very thing that cognitive psychologists mean when they say mindfulness.
Though the concept originates in ancient Buddhist, Hindu and Chinese traditions, when it comes to experimental psychology, mindfulness is less about spirituality and more about concentration: the ability to quiet your mind, focus your attention on the present, and dismiss any distractions that come your way. The formulation dates from the work of the psychologist Ellen Langer, who demonstrated in the 1970s that mindful thought could lead to improvements on measures of cognitive function and even vital functions in older adults.
Now we’re learning that the benefits may reach further still, and be more attainable, than Professor Langer could have then imagined. Even in small doses, mindfulness can effect impressive changes in how we feel and think — and it does so at a basic neural level.
In 2011, researchers from the University of Wisconsin demonstrated that daily meditation-like thought could shift frontal brain activity toward a pattern that is associated with what cognitive scientists call positive, approach-oriented emotional states — states that make us more likely to engage the world rather than to withdraw from it.
Participants were instructed to relax with their eyes closed, focus on their breathing, and acknowledge and release any random thoughts that might arise. Then they had the option of receiving nine 30-minute meditation training sessions over the next five weeks. When they were tested a second time, their neural activation patterns had undergone a striking leftward shift in frontal asymmetry — even when their practice and training averaged only 5 to 16 minutes a day.
As little as five minutes a day of intense Holmes-like inactivity, and a happier outlook is yours for the taking — though this particular benefit seems to have been lost on Holmes himself, what with his bouts of melancholy and his flirtations with a certain 7 percent solution. A quick survey will show that the paradox is illusory: Holmes is depressed when there is no target for his mental faculties. Give him a project, and balance is restored.
But mindfulness goes beyond improving emotion regulation. An exercise in mindfulness can also help with that plague of modern existence: multitasking. Of course, we would like to believe that our attention is infinite, but it isn’t. Multitasking is a persistent myth. What we really do is shift our attention rapidly from task to task. Two bad things happen as a result. We don’t devote as much attention to any one thing, and we sacrifice the quality of our attention. When we are mindful, some of that attentional flightiness disappears as if of its own accord.
In 2012, researchers led by a team from the University of Washington examined the effects of meditation training on multitasking in a real-world setting. They asked a group of human resources professionals to engage in the type of simultaneous planning they did habitually. Each participant was placed in a one-person office, with a laptop and a phone, and asked to complete several typical tasks: schedule meetings for multiple attendees, locate free conference rooms, write a memo that proposed a creative agenda item and the like. The information necessary to complete those tasks? Delivered as it otherwise would be: by e-mail, through instant messages, over the phone and in person. The list was supposed to be completed in 20 minutes or less.
After the multitasking free-for-all, participants were divided into three groups: one was assigned to an eight-week meditation course (two hours of instruction, weekly); another group didn’t take the course at first, but took it later; and the last group took an eight-week course in body relaxation. Everyone was put through a second round of frenzy.
The only participants to show improvement were those who had received the mindfulness training. Not only did they report fewer negative emotions at the end of the assignment, but their ability to concentrate improved significantly. They could stay on task longer and they switched between tasks less frequently. While the overall time they devoted to the assignment didn’t differ much from that of other groups, they spent it more efficiently. They engaged, on average, in just over 40 discreet “tasks” — test-related behaviors that had a definable start and end time — spending approximately 36 seconds on each, in contrast to the 48 to 50 average tasks attempted by the other groups — with an average of only 30 seconds spent per activity. They also remembered what they did better than the other participants in the study.
The concentration benefits of mindfulness training aren’t just behavioral; they’re physical. In recent years, mindfulness has been shown to improve connectivity inside our brain’s attentional networks, as well as between attentional and medial frontal regions — changes that save us from distraction. Mindfulness, in other words, helps our attention networks communicate better and with fewer interruptions than they otherwise would.
In a 2012 study at Emory University, increased meditation practice was associated with enhanced connectivity between the dorsolateral prefrontal cortex, a part of the brain involved in attention monitoring and working memory, and the right insula, an area that is associated with how well we can monitor our own feelings and thoughts and that is considered a key waypoint between our two major attention networks, the default and the executive.
Not only could this increased connectivity make us better able to switch between tasks and monitor our own attention, but it is indicative of more effective overall management of our finite attentional resources.
Mindfulness training has even been shown to affect the brain’s default network — the network of connections that remains active when we are in a so-called resting state — with regular meditators exhibiting increased resting-state functional connectivity and increased connectivity generally. After a dose of mindfulness, the default network has greater consistent access to information about our internal states and an enhanced ability to monitor the surrounding environment.
These effects make sense: the core of mindfulness is the ability to pay attention. That’s exactly what Holmes does when he taps together the tips of his fingers, or exhales a fine cloud of smoke. He is centering his attention on a single element. And somehow, despite the seeming pause in activity, he emerges, time and time again, far ahead of his energetic colleagues. In the time it takes old detective Mac to traipse around all those country towns in search of a missing bicyclist in “The Valley of Fear,” Holmes solves the entire crime without leaving the room where the murder occurred. That’s the thing about mindfulness. It seems to slow you down, but it actually gives you the resources you need to speed up your thinking.
The difference between a Holmes and a Watson is, essentially, one of practice. Attention is finite, it’s true — but it is also trainable. Through modifying our practices of thought toward a more Holmes-like concentration, we can build up neural real estate that is better able to deal with the variegated demands of the endlessly multitasking, infinitely connected modern world. And even if we’ve never attempted mindfulness in the past, we might be surprised at how quickly the benefits become noticeable.
Until recently, our 20s were considered the point when our brain’s wiring was basically complete. But new evidence suggests that not only can we learn into old age, but the structure of our brains can continue to change and develop. In 2006, a team of psychologists demonstrated that the neural activation patterns of older adults (specifically, activation in the prefrontal cortex), began to resemble those of much younger subjects after just five one-hour training sessions on a task of attentional control. Their brains became more efficient at coordinating multiple tasks — and the benefit transferred to untrained activities, suggesting that it was symptomatic of general improvement.
Similar changes have been observed in the default network (the brain’s resting-state activity). In 2012, researchers from Ohio State University demonstrated that older adults who scored higher on mindfulness scales had increased connectivity in their default networks, specifically in two of the brain’s major information processing hubs. And while we already know that this kind of increased connectivity is a very good thing, there’s more to these particular results. The precise areas that show increased connectivity with mindfulness are also known to be pathophysiological sites of Alzheimer’s disease.
The implications are tantalizing. Mindfulness may have a prophylactic effect: it can strengthen the areas that are most susceptible to cognitive decline. When we learn to unitask, to think more in line with Holmes’s detached approach, we may be doing more than increasing our observational prowess. We may be investing in a sounder mental future — no matter how old we are.
Maria Konnikova is the author of “Mastermind: How to Think Like Sherlock Holmes” and a doctoral candidate in psychology at Columbia.




Wednesday, October 24, 2012

Exercise Might Beat Puzzles for Protecting the Aging Brain

The subject of this blog has been (mostly) strategies for enjoying eldrification without the assistance of those wonderful bundles of genetic material called "adult children."  The mind is a complex and wonderful tool (I have a joke about that, but later).  We are far from understanding how and why it works.  Here is a piece from the Wall Street Journal about one aspect of keeping your tool firm and sharp.

(Not THAT tool!  I mean your MIND!)

From the Wall Street Journal:


Exercise Might Beat Puzzles for Protecting the Aging Brain



By JENNIFER CORBETT DOOREN

To help stave off the cognitive decline of aging, you might want to drop the crossword puzzle and head out for a brisk walk or a bike ride.

In a study published in the journal Neurology of almost 700 people born in 1936, researchers found physically active people showed fewer signs of brain shrinkage and other deterioration than those who got less exercise.

At the same time, social and intellectual activities such as visiting family and friends, reading, playing intellectually stimulating games or learning a new language did nearly nothing to ward off the symptoms of an aging brain, the study said.

"People who exercise more have better brain health," said Alan Gow, one of the study's researchers and a senior research fellow at the University of Edinburgh in Scotland.

The researchers noted, however, that "the direction of causation is unclear," meaning they couldn't tell if a healthier brain was a result of physical activity, or if people showing signs of cognitive decline weren't able to exercise. Other studies have also suggested exercise can improve brain health. Exercise increases circulation in the body and helps bring more oxygen, glucose and other needed substances to the brain.

This research is just the latest looking at cognitive function in the so-called Lothian Birth Cohort, which involves a group of people born in 1936. In 1947, almost all 11-year-old children attending school in Scotland were given intelligence and mental-health tests.

Researchers at the University of Edinburgh then recruited people from that age group who underwent those intelligence tests when they were about age 70. Participants filled out questionnaires about the types and frequency of leisure and physical activities they participated in. Physical activity was rated on a six-point scale with the lowest being "moving only in connection with necessary household chores," to heavy exercise or a competitive sport several times a week. Then at about age 73, 700 study participants were given a magnetic resonance imaging (MRI) brain scan. Brains normally shrink with age.

"What we want to do is understand more about how people age better with respect to cognitive function," Dr. Gow said.

Researchers found that higher levels of physical activity were associated with less brain atrophy, or shrinkage, and less brain damage. They found no link between brain health and leisure activities.

"We are coming to appreciate the fact that people who remain physically active are less likely to show cognitive decline," said Stephen Rao, the director of the Cleveland Clinic Schey Center for Cognitive Neuroimaging. Dr. Rao, who wasn't involved in the Scottish study, noted, however, that it looked at exercise and other activities at one point in time rather than over a lifetime. Dr. Rao is completing his own study comparing exercise and cognitive training in a different group of people.

Dr. Gow said previous research with the Lothian group suggested people who participated in more social and intellectual activities at age 70 and had better cognitive abilities were the ones who scored higher on mental ability tests at age 11.

Study participants are currently in the process of undergoing a second MRI scan now that they are age 76. Researchers said they plan to compare the two scans to see if links between exercise and better brain health hold up.


(But, doesn't using THAT OTHER tool constitute EXERCISE?)

Michael




Monday, October 22, 2012

Care by Consensus

In March I wrote about the idea of establishing a Board of Advisors to help guide us through the elding years and keep us from scams (see "Getting Scammed", March 4, 2012).  Here is a link to the New Old Age blog on the NY Times that discusses the similar concept of establishing a care committee to manage your care when there is no one else to watch out for your interests.  It was written shortly after my post (I only just now found it), so obviously they copied my idea.

http://newoldage.blogs.nytimes.com/2012/03/21/care-by-consensus/

Embedded in the blog is a link to a law firm that has drafted a Care Committee Agreement.  Here is the link:

http://cohenoalican.com/resources/118-forms/1212-care-committee.html

If you can't find it, let me know.  I have downloaded a copy.

I think it is a good idea.  The trick will be finding the right responsible advisors.

Michael



Friday, October 19, 2012

This has nothing to do with aging alone, but.....

...its just to good to pass up.  It is a video of an invocation given at a conference of Home Instead Senior Care franchisees.

The Home Instead Senior Care family network of locally owned franchise offices is an in-home care agency, to help elders in their home as they grow older.

Watch it all.  Well done.



Michael

Thursday, October 18, 2012

Reverse Mortgages

This is a link to a blog post (The New Old Age, NY Times) on reverse mortgages, with a link to the full article in the New York Times. I have saved the article to read when I am older.  As of this writing, a reverse mortgage is not part of our elding strategy.  I think we can do better than that.


http://newoldage.blogs.nytimes.com/2012/10/15/growing-concerns-about-reverse-mortgages/

Michael

Guess we're not the only ones thinking about this.

Here is a link to a piece in the NY Times written by Kelly Flynn titled "But Who Will Care for Me?"  Kelly writes about finding herself in a familiar situation;  Aging, and childless.






It is a well written piece, and she seems to be worried about how to deal with the things we have been discussing here for a while.  But what I find really interesting about this piece is the tone of the comments written by others.  Some are critical of the decision (in those cases where it is a decision and not something that just happened) to not have children.  (See my earlier post concerning our decision to not have children.)   There were also comments such aas the following:

Sorry, but anatomy is destiny.
A woman was given a womb to hold a child.
A woman was given breasts to nurture that child.
A woman who makes a decision not to have any children becomes a study in tragedy and sorrow when she ages in an empty home.
So sad. So tragic. So selfish.
Are we talking about a woman, or a horse?

Others commented on the unreliability of children to provide happiness and security as their parents eld.  Some where happy to have husbands and families, some happy that they did not have to suffer the indignity of an ailing or un-faithful husband or ungrateful kids.

I guess my point is that in thinking about eldering without childering, there is a danger in getting hung up on decisions of the past, to foal or not to foal, circumstances that may have prevented or encouraged foaling, an involuntary act of conception that resulted in unanticipated or premature foaling.  Hey, snap out of it!  Looking back, looking for regrets, for missed opportunities, for things that might have been had not something else been instead, only promotes sadness.  And sadness does not get us where we want to go.

Here we are looking for strategies that will result in a happy elderhood.  I propose that an important aspect of an effective strategy is the ability to look forward, with enthusiasm and anticipation, not fear or regret.

  • Yes, I will likely move into assisted living some day.
  • I will meet new people there.
  • Some will be incredibly annoying
  • Some will not appreciate my humor or like my curried skittles.
  • Some will become my best friends.
  • I will cry when friends pass on.
  • I will look back on our times together and smile, not with regret but with gratitude that we had a some great, interesting times.
Attitude is key.  Developing the habit (Oh, God, not with the HABITS again!) of a positive outlook is key.  If you must look at the movie of your past, think of it as a comedy.  Smile.  Laugh.  Then look forward.

"We did not have any kids.  I did have a foal once.  Named him Hargus.  Boy, what a stupid kid I was back then.  Hey, Kelly, want a beer?  Lets play some dominos!"

Michael





Monday, October 15, 2012

The Keys, Please.

Below is a link to an NPR piece (yes, I listen to NPR for news, but I do browse the "other medias" as well) on the pending surge in us older folks out on the streets driving our 20 year old Audi's.  The serious question (one I have touched on in these posts before) is, "when it comes time to give up the keys, who will tell us, the tellees, who have no tellers handy in the family, that time is up?"

Bunni Dybnis, a social worker at the Los Angeles-based geriatric care service LivHome, says this is typically how older drivers decide to give up the car keys: Their child or grandchild intervenes. "I could probably say it's 99.99 percent not the older adult saying, 'I want to stop driving; help me,' " says Dybnis, because giving up driving feels like giving up one's independence.

Here is what I plan to do.  I have already established the HABIT of getting an annual physical exam by my primary care physician.  My next exam is some time in March or April (it is iBuried somewhere in my iPhone iCalendar).  At that exam I intend to ask my PCP to incorporate the following steps into the exam program:  a)  discontinue doing a P.S.A. exam at age 65, and b) if possible, in this state, if he sees any signs of diminished capacity that could affect my ability to drive safely, to prescribe a driving test or class.  Since I also see a neurologist once a year, I will ask her to do b) as well (she has never offered to do a), much to my relief).

Actually, first I will ask them if it is wise to ask them to do this, as I don't want to screw up my medical records and insurance.  But I think this is the second most important thing to do about driving skills.  The first is to develop the HABIT of objectivity concerning driving.  Even now, in my prime, I can look into the rear view mirror and tell myself "That other driver was NOT an asshole.  I was the asshole in this situation.  DON'T DO THAT AGAIN!"

This habit is reinforced by SheWhoMustBeObeyed, who frequently says this, sometimes just the second sentence, even when I am not driving.

The link:

http://www.npr.org/blogs/health/2012/10/08/162392507/when-should-seniors-hang-up-the-car-keys?ft=3&f=111787346&sc=nl&cc=es-20121014

Michael