Geriatric psychiatrist Dr. Eric Lenze wants to help people who have become increasingly forgetful and have other mental slowdowns — pretty much anyone over 65.
But more specifically, he wants to know how any help works and can it work better. That’s why he and his team of researchers are recruiting about 300 people for the MEDEX study — mindfulness, health education and exercise — under way at Washington University School of Medicine.
Lenze explained, most people start having mental declines after their 30s. But in the 60s, it’s noticeable. “This is an age when most — if not all — older adults start to have some slower or worsening of cognitive functions,” Lenze said, “namely memory, processing speeds as in how quickly you can come up with information in your head …”
Volumes of studies show that exercise and meditation help improve aging. The MEDEX study hopes to learn how and why.
“We know less than we’d like to think we know about the benefits of these things,” he said. “So this study is, first and foremost, trying to provide some clarity as to the brain benefits of these things, exercise and mindfulness (meditation) in particular.”
The study, about a year and a half old, already has learned a lot, Lenze said.
Exercise • 150 minutes of moderate exercise per week as prescribed by experts. Among the benefits, “It seems that engaging in regular exercise for an older adult may increase certain brain fertilizers,” he said. “What we call neurotrophins are increased in the brain by exercise. On the flip side, they’re reduced by being sedentary or overly stressed out.” Also, exercise increases efficiency of using insulin and other metabolic functions, he said. “Many of these benefits happen instantly,” he said.
Mindfulness • “Mindfulness means being in the present in a nonjudgmental way,” Lenze said. An example, “If you’re driving in your car, stressing about, ruminating about deadlines, about past things, mistakes, that’s not being mindful. But if you’re engaged in something that really engrosses you in the present, for instance, a challenging hobby, where you focus on the here and now, that’s being mindful.” Still, what about those bad memories that just invade your consciousness, even though they’re over and sometimes decades old? “Mindfulness reminds us these are just thoughts; as quickly as they come into my brain, let them pass right out again, rather than getting stuck on them,” he said. While you might say easier said than done, it seems that daily training and practice through meditation, one can develop the skill of being able to shake off bad memories.
“Mindfulness is paying attention on purpose, moment by moment, without judgment,” said Bridget Rolens, mindfulness instructor for the study. She leads a portion of the participants in two-hour, weekly sessions.
Health education • This is the “commonality of working together as a group, improving yourselves, becoming educated about healthful activities, such as interacting with doctors, medications and their side effects …” Lenze said. “It’s how to communicate with the medical profession … based on as people become older and develop medical conditions, we learn to manage those conditions.”
Put them all
together, and …
One of the targets: “We are examining whether their benefits are (cumulative). Does someone get twice the brain benefit if they engage in exercise plus mindfulness training? It might seem intuitively so, but there are other examples in medicine where this is not true,” Lenze said. “For example, doubling your exercise regimen does not double its benefits for health — unless you are exercising only a very tiny amount.
“The study is unique in answering this question. It is also unique-ish in the size of the study. To my knowledge, there are no studies of this size, past or present, that have examined the brain benefits of these interventions.”
Another study is under way at the University of California at San Diego were they’ve targeted 290 people.
To measure the effects in the study here, researchers will administer physical and written exercises. Those include participants keeping logs, taking written tests and undergoing magnetic resonance imaging (MRI) scanning to examine how the structure of the brain changes as people develop new skills.
The study is funded by a $15 million grant from the National Institute on Aging, a branch of the National Institutes of Health.
An early participant, Robert Kindle, 68, of Kirkwood, found the stress from his decades of climbing the corporate ladder failed to retire with him. He was increasingly cranky with a short fuse.
During a visit to his physician maybe a year and a half ago he saw a flier on the study that addressed his issues of forgetfulness and cognitive decline.
“I’m over 65, I’m retired, I had time,” he said. He didn’t exercise much, if at all, and had never heard of mindfulness meditation, or at least never paid much attention when it was mentioned.
After nearly 18 months in the study, he finds that things that once set him off no longer send up his heart rate and blood pressure. He exercises regularly. He’s feeling better, and his family says he’s a lot easier to live with.
Kindle says he’s taking away a lot more from the study than he expected. “Our study group has gotten very close,” he says. “Definitely. We’re having a Christmas party.” Other plans include regular reunions.
Otherwise, He’s surprised at how easy the process has been. He recalls a day, when, “I’d get mad at the radio and throw it. The only thing that happened was the radio was broken,” he said.
“Everything is not a crisis.”