Brain Training Prevents Mental Fragility And Falling

By AccentCare

shutterstock_547269766Some seniors can experience the mental difficulties of old age, like forgetfulness or poor attention span. Yet others somehow manage to remain mentally sharp, even well into their 80s. Some call these people “superagers”; those whose memory and attention is well above average for their age, on par with healthy, active 20 and 30-year-olds. 

Facilitating mental exercises allows for more fulfilling activities and life enrichment and can reduce falls and harmful situations, ultimately lowering rehospitalizations.

So, why do some elders remain mentally agile while others struggle with dementia and loss of acuity? There are several reasons:

  • As a person gets older, changes occur in all parts of the body, including the brain. Certain parts of the brain shrink (such as the prefrontal cortex and hippocampus); both areas are important to learning, memory, planning, and other complex mental activities. 
  • In some people, structures called plaques and tangles develop outside of and inside nerve cells of the brain, which in large amounts, can result in dementia (such as Alzheimer’s disease). 
  • Lastly, as people get older, research shows that they tend to avoid unpleasant situations, such as any discomfort or frustration associated with mental exertion. If people consistently sidestep the discomfort of mental effort, it can be detrimental to the brain. All brain tissue wastes away from disuse. If you don’t use it, you lose it.


Falls Among the Aging Are All Too Common

In both inpatient and long term care settings, falls happen at staggering rates:

  • Studies have found that falls occur in hospitals at the rate of 3-5 per 1000 bed/days
  • AHRQ estimates that 700,000 to 1 million hospital patients fall per year
  • Up to half of the 1.6 million long term care residents experience a fall each year 

In a value-based care environment, avoiding falls can lead to higher quality outcomes and cost savings. But what causes them to occur at such significant levels?


Can Brain Activity Lead to Falling?

Aside from memory problems, changes in brain activity can influences one’s chances of falling: 

The ability to keep balance and avoid falling depends not only on leg strength, but also on complex and simple reaction times, known as ‘brain speed’. The faster one’s brain can move between events (identifying a loss of balance and executing a safe alternative to maintain balance), the better off people are in avoiding falls. In other words, when some people fall, their brains may not be keeping up with what is happening and unable to quickly recover from a loss of balance.

People whose brains work hard when trying to complete complex activities (such as walking and talking at the same time) may have a higher risk of falling than those individuals who do both tasks with ease. When elders perform any cognitively demanding task, their brains become more active to handle the challenge. Walking and talking at the same time requires greater attention. Thus, more brain effort is expended, which in some individuals can lead to falling. 

Alzheimer’s disease (AD) is a disease associated with a loss of memory and intellectual abilities. The risk of developing AD increases with advancing age and gradually gets worse over time. One of the most common safety problems in persons with AD is that of falling. It’s estimated that up to 60% of persons with AD experience one or more falls annually because of poor mobility, which includes the ability to walk safely and maintain good balance. Persons with AD tend to exhibit marked impairments with both. This places them at increased fall risk.  


Help Engage The Brains of Those In Your Care

  • Just like physical exercise, mental exercise is good for for seniors. Mentally stimulating activities help preserve brain function. Keeping your mind engaged increases the brain’s vitality and helps build its reserves of brain cells and connections. 
  • Promote stimulating activities that they enjoy; reading, writing, puzzles, crosswords, etc. Any mentally challenging activity will keep a mind sharp.
  • Critical brain regions are stimulated by engaging in physical and mental tasks requiring effort. In other words, vigorous exercise and strenuous or challenging mental effort (such as swimming daily if possible or learning a foreign language or taking an online college course), helps keep the brain youthful and sharp.
Encourage Healthy Eating

  • Free radicals are a normal by-product of the body's metabolism. Normally, free radicals serve important functions, such as helping the immune system fight off disease. However, free radicals can also damage the brain and contribute to memory loss.
  • Eating a healthy diet helps maintain brain health.  For example, eating fruits and vegetables (that have high levels of disease-fighting antioxidants) helps counteract disease-causing free radicals throughout the body, including the brain.


Help Them Stay Social

  • Help seniors to connect with family, friends and their community. Isolation can be a threat to brain health, and can be prevalent in long term care. Staying engaged with family and being active in the community can keep the brain active. The more social connections someone has, the better they are at preserving mental function and memory.
  • Social interaction engages areas of the brain that are involved in memory and attention, the same mental processes that are used in many cognitive tasks. 


Get a Check-Up from the PCP, Home Health, or Hospice Team

  • Routine preventative care is key to mental acuity and avoiding falls. Certain conditions can affect brain health including diabetes, stroke, vitamin deficiency, thyroid disease and high blood pressure. Controlling risk factors for chronic disease (such keeping blood cholesterol, blood pressure at healthy levels and maintaining a healthy weight) is good for brain health.
  • Certain medicines, such as sleep and anxiety drugs can also affect mental ability. Ask a doctor to review all medications on a regular basis.


An Ounce of Prevention is Better Than a Pound of Cure.

Investment in simple activities of daily living and providing mental stimulation is a low cost way to help minimize falls, increase quality, and lower costly rehospitalizations. Coupled with other layers of support like personal care, home health, and hospice care, it can be an effective strategy for aging in place.



This article was adapted from content written by Rein Tideiksaar Ph.D., PA-C. Rein is the president of FallPrevent, LLC, Blackwood, N.J., a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr. Tideiksaar is a gerontologist (healthcare professional who specializes in working with elderly patients) and a geriatric physician's assistant.


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