Linking Mental Health and Brain Health
by
 Paul D. Nussbaum |
Longtime ASA member Paul D. Nussbaum is a clinical neuropsychologist and adjunct associate professor in the Department of Neurological Surgery at the University of Pittsburgh School of Medicine. Focusing on brain health and on the lifestyle required to maintain a healthy brain, his research, writing and teaching involve key concepts for mental health professionals who work with older adults. In response to questions from Dimensions, Nussbaum offers a lively perspective on brain health as a strengths-based approach not only for those in midlife and old age, but also throughout the lifespan.
What is the concept of brain health -- and why is it important for mental health professionals who work with older adults?
Research indicates that the human brain has the capacity to reorganize, is dynamic and can actually generate new brain cells. These findings challenge traditional thinking about the human brain as a static, limited and rigid system. Inspired by this new perspective, the concept of brain health starts with a belief that the human brain is a miraculous, integrated, complicated and magical system -- a system that can be shaped for health and health promotion across the lifespan.
From this basic understanding, we build to positive behavior change in five key lifestyle domains that support and promote brain health: mental stimulation, physical activity, nutrition, spirituality and socialization. A proactive lifestyle in these is important for all ages, not just for older adults. The brain-health lifestyle will be most effective when implemented earlier in life. Aging successfully later in life depends on our behaviors earlier in life.
Brain health is a very useful concept for mental health professionals, who care for people with brains that are not functioning optimally or are unstable due to depression, schizophrenia, bipolar disorder, dementia, etc. Standard treatments for these conditions include medication and psychotherapy, whereas a more comprehensive brain-health approach could be used as an adjunct to this care. Intakes would include assessing strengths and weaknesses in the client’s lifestyle, then developing a plan for brain-health behavior change that would be measured over time.
What are some behaviors that promote brain health?
Research has demonstrated the brain-health advantages of specific behaviors in each of the five lifestyle domains that I mentioned. For mental stimulation, people can learn a second language. For physical activity, three-plus hours of aerobic exercise per week is beneficial. For nutrition, eat more fish and vegetables. For spirituality, meditate or attend regular worship services. For socialization, join a club or have a daily sit-down meal with others. These are just a few examples; for a detailed list, visit my website at www.paulnussbaum.com.
What role do genetics, environment and individual experience play in brain health for older adults?
We are shaped by both genetics and environment. Genetic expression can be changed by where we live, our experiences and what we eat. The important question is, “What triggers the gene?” Environmental factors are a key place where we can intervene to promote brain health: Enriched or complex environments that provide mental stimulation, beneficial physical activity, good nutrition, socialization and spiritual expression help develop brain reserve and healthy brains.
Enriched environments have the ability over time to shape genetics and who we are as a species. This is a lifespan issue, and I believe that your brain is not interested in chronological age. Indeed, chronological age is a made-up concept and does not deserve the attention we grant it. Everyone needs to be conscious of the environments we expose our brains to on a daily basis –- and by environment, I mean all the stimuli we experience.
How can professionals help their older clients in this area?
To be able to better teach their clients, mental health professionals who care for elders first must develop a basic understanding of the brain and must create a brain-health lifestyle for themselves. In working with clients, professionals then can help to identify the individual’s brain-health strengths and weaknesses and can prescribe activities to promote the behavior change necessary to build a healthy brain. Follow-up and measurement are important for reinforcement of positive change in the client.
How can we move from a brain-pathology perspective to a healthy brain focus?
At this point, awareness is a major issue in the cultural shift toward brain health. The consumer may already be ahead of the professional in this area. Professional organizations like ASA do provide avenues for learning about brain health, and such associations can do more by providing conferences on brain health, assisting with curriculum development in professional schools that focus on brain research, and even getting healthcare payer systems to recognize brain health as a wellness program similar to funded programs for cardiac and nutritional health.
Brain health is a growing force with increased national and international recognition. Society is awakening to the fact that our brain is the single greatest system in the universe and the most important part of our being. Still, we are at the infancy of this concept, and I expect we will learn much more about the sheer power of the brain not only to be shaped for health, but also to provide the answers for our most perplexing maladies and problems. What is thought to be science fiction today ultimately will be our reality!
Tobi Abramson is an adjunct professor at the New York Institute of Technology and the Brookdale Center on Aging, both in New York City.
Photo: Courtesy Paul D. Nussbaum
Copyright © 2007 American Society on Aging; all rights reserved. This article may not be duplicated or distributed in any form without written permission from the publisher: American Society on Aging, 833 Market St., Suite 511, San Francisco, CA 94103-1824; e-mail: permissions@asaging.org.
