Challenge Your Brain with Jodi Bornstein and Melissa Day

Disclimer: Unedited AI Transcript

Announcer (00:06):

You are connected and you are listening to specifically for seniors, the podcast for those in the Remember When Generation. Today's podcast is available everywhere you listen to podcasts and with video at specifically for seniors YouTube channel. Now, here's your host, Dr. Larry Barsh.

Larry (00:38):

This is the third episode in specifically for seniors podcasts in conjunction with Hebrew Senior Life and Orchard Code Series on cognitive fitness. In the first episode, we spoke with Dr. Alvaro Pasqua Leone on brain health and cognitive fitness. In the second episode of the series, we reviewed the relationship of physical exercise and brain health. Today, specifically for seniors welcomes Jody Bornstein wave Jody, so we know who you are. And Melissa Day, Melissa wave too for a discussion on challenging your brain and learning new things. Jodi is an occupational therapist with Hebrew Senior Life's Therapy host calls program. Jodi has published in the American Journal of Occupational Therapy, and for the last six years has been a guest faculty member at the Massachusetts General Hospital's Institute of Health Professions. Melissa Day has been a speech language pathologist for more than 30 years working in home care for the last 20 years. Both Jodi and Melissa have an interest in brain health and have been working with a dynamic interdisciplinary team at Chard Cove, a senior living facility near Boston on optimizing the pillars of brain health in the daily lives and culture of senior living. Welcome to specifically for seniors, Jodi and Melissa.

Jodie Bornstein (02:20):

Thank you so much for having us.

Larry (02:23):

Let's start by reviewing the concept of cognitive reserve. We've talked about that previously on other podcasts, but let's refresh our listener's memories on what cognitive reserve is.

Jodie Bornstein (02:41):

So cognitive reserve is basically the ability to build up your brain power so that if something were to happen, some pathology presents or an a problem in the brain, a disease process, an injury, that you create a new roadmap kind of in the brain to take over and compensate so that you can still function as optimally as possible. And by building up your cognitive reserve, is what we're gonna talk about today. There are so many different strategies to take, but it's a lifelong lifelong process that doesn't end at a certain age. It can continue throughout the lifespan.

Melissa Day (03:22):

And I think that's important too, like that we that we're talking about today and having that discussion about how important it is to work on building that cognitive reserve. And that's our whole focus, you know, we've been focusing on is how do we do that? How can we do that? You know, so that if God forbid there is a problem in the future, the brain knows how to get around it, per se, with that cognitive reserve. So it's your brain power buildup.

Larry (03:49):

It looks like we need a baseline to tell us where we're starting on our cognitive fitness. Are there ways of doing that?

Jodie Bornstein (04:04):

That's a great question. Larry, I think it's so important that you self-monitor, you know, you're really, we are our best, our own best view of our brains in that, in terms of our knowledge of what we're getting right, what we're getting wrong, what we're maybe struggling with, maybe a hunch that something seems off. But instead of waiting for those moments, I think it's really a good idea to tap into resources that we already have in our communities and that our primary care physicians are really well equipped to be, you know, at your annual visit, have a checkup of your brain health with your primary care doctor, or if you wanna do a little bit more, maybe have a referral to an occupational therapist or a speech therapist to come to the home. Our program, through Hebrew Senior Life, we go to the homes and we assess people right there in their living environment.

Jodie Bornstein (04:55):

We use some objective measures that I'll talk about. We also use a very functionally based approach, which I think is very helpful, very personalized approach so that we can assess and see, you know, hmm, maybe things are off a little bit or maybe things are way off, or you're doing just fine. And some of the, you know, objective measures that we use when we go in to visit with people. I use something called the short list test. It's this very quick screening tool for cognition. And I also use a very widely used tool called the mocha. It's the Montreal Assessment of Cognition. I am from Montreal, so I really do love that test in particular. It's a great tool and it's very commonly used so it's understood across the healthcare professionals what that score on the MOCHA would be. But besides those objective measures, I know that folks use the A A R P has a number of tools on their website to measure cognition and sort of do a self test at home that also has an ability to track your activities across what we call lifestyle interventions. And it provides a lot of games and intervention approaches that I think a lot of people use. It's very accessible. I think you can use it if you're a non-member and if you are a member of A A R P, there are a number of other tools that can be unlocked for you.

Larry (06:22):

There's some scientific evidence that the more you challenge and stimulate your brain, no matter your age, excuse me, you can continue to build your cognitive reserve. There are three cardinal rules of mental stimulation. Can you review those for us?

Jodie Bornstein (06:44):

Yeah. I actually think you brought up such an important point because we used to think before I reviewed the three principles, we used to think that the brain, you know, we sort of, you can't teach an old dog new tricks or you can't learn something new at a certain stage, and the brain was sort of stagnant. And that's not the science anymore. The science is showing that the brain is certainly more plastic than we thought, and is capable of change and is continuing to be able to build up that cognitive reserve throughout the lifespan. And the three really guiding principles that we use are very simple, but they're, they're really important. So the first one is to make sure you try something new, something brand new. Learn a new language or try a new skill. Maybe join a gardening club if you were never a gardener, take a painting class.

Jodie Bornstein (07:34):

But I think it has to be something that you're interested in, otherwise you're not going to stick with it. But trying something new, a new fresh approach to something. The second guiding principle is to challenge yourself. So you might wanna continue to progress in an activity that you're already very good at doing, but you wanna up your game a little bit. Give yourself a bit more of a challenge. So you know, you're great at doing a certain crossword puzzle. I like the the New York Times mini, but maybe do the weekend ones that are a little bit more complex or try a different type of word puzzle. And then the third guiding principle is, I think the most important is that you need a variety of brain workouts. So just like when you go to the gym, we have arm day, we have leg day, you do cardio. I think in brain building exercises, you need to have a wide variety so that you're really challenging your brain from so many different aspects.

Melissa Day (08:33):

And I think like looking at the brain and, and recognizing just how complex, we're talking about billions of neurons, you know, so having the variety, you're challenging your brain across different modalities and and that is so, so important to build those connections between the neurons and the brain. You know, getting up into the, the billions and trillions of networking that these do, these neurons do to build that strength across the board. So shake up your brain and put that variety and spice it up so that brain is challenged on so many different levels.

Larry (09:14):

Jody brought up a minute ago doing crossword puzzles. There are a bunch of low tech ways to challenge your brain without turning on a computer. Exactly. can you tell us about some of those?

Melissa Day (09:33):

Oh, sure. <Laugh>. So I think too, because some people do get overwhelmed with the thought of, oh, I have to go on a computer and do this now. You know, so you don't necessarily have to get complex. You can go from basic, like crossword puzzles. I love to do you know spot the difference. Remember, I remember even being a kid walking and doing the highlight books and, you know, looking at the, the, you know, pictures and saying, can, can you find these hidden objects in the pictures? You know, can you find the subtle differences in these pictures, you know, to challenge that ability to focus and concentrate. My mother turned 81 this past weekend and she has now, she has a whole puzzle table set up where she does a different puzzle every time. You know, even listening to music, you know, dancing, you know, some basic things that just get that brain thinking, get that brain moving. So it doesn't have to be this high tech computer stuff, you know, part of that variety is bringing some of the basic things, but doing the, I love doing puzzles myself, <laugh>, you know,

Jodie Bornstein (10:43):

There's so many things and there's puzzles and card games, you know, is an excellent game to play. But poker any, any car game that's sort of new for you or fresh or that you enjoy doing is terrific. Board games, if you want. I was

Melissa Day (10:59):

Gonna say monopoly, <laugh>. I love Monopoly.

Jodie Bornstein (11:04):

I like, I love languages. And we can talk a little bit more about the high tech app aspects of learning a new language, but if you already were speaking a language of, you know, several years ago and you wanna pick it up again, there's, you know, the ability to read a book or an article in a different language is a great idea. Just reading in general is a super low tech brain activity. I like book clubs because it adds a real social aspect. We can talk a little bit more about that in terms of brain pillar, health and socialization and decreasing loneliness is so important. So having a book club, being able to travel, and I know Uhhuh during the pandemic travel is limited. Sometimes as we get older. Travel is a little bit more complex. But traveling within your own city, going to a new site or a new, a new place just to look around and see something new and a variety of interesting things to look at and learn about is great. Participating in the arts. So going to a theater, going to concerts again at different museum, something out of your regular routine is really great. Participating in an art class, learning how to paint, learning how to draw. You can say, oh, I'm not, I'm not already know artsy at all. I can't do this. How do you know? You know, pick up a, a paintbrush, try learn

Melissa Day (12:26):

Booking classes. You know, that's following directions. You know, you have to follow a recipe. All the things that you, you think you're doing some basic things, but you don't realize how many steps in are involved in that for your brain. So even doing a low tech thing that we think isn't much, you know, there's so many steps in even a basic, basic task like opening the door, you know, hearing the doorbell and getting up and opening the door. You know, it seems like such a basic task, but when you think about all the things that the brain has to kind of incorporate visually and hearing the door doorbell and the physical aspect of it. So even the most basic task challenges your brain, you know, on a level that we don't even recognize. So staying active and just doing even the basic things, challenges that

Jodie Bornstein (13:22):

I like music, listening to music, playing music while you're at home and getting ready in the morning or just kind of relaxing can affect your mood, your energy level. Learning how to play a new instrument or picking up an instrument that you haven't touched in 40 years and have somebody at a site in Brooklyn and working with who's staring to play the clarinet again, that she hasn't touched her in 50 years, but this is

Melissa Day (13:45):

A goal. Memory <laugh>. Yeah,

Jodie Bornstein (13:47):

That's terrific. Take part in a singing group or a dance class. Like Melissa said, these are all

Melissa Day (13:53):

I went back to do adult tap classes and you know, I, I took tap as a kid and I was just like the same thing like you're saying, Jody. I'm like, am I gonna remember like, is it gonna, am I gonna remember? I was amazed. It was all still up there. It was all still up there.

Jodie Bornstein (14:12):

Well, and it's bringing fresh lots challenging for the brain to start something new again. And it's exciting and it's fun. Yeah.

Larry (14:20):

Okay. Melissa, the stage is yours.

Melissa Day (14:24):

<Laugh>. Hey, I went up on stage in my daughter's dance recital and I was in, I was in my mid forties at the time, and my sister is in her mid fifties at this point, and she still does professional dancing competitions. So doesn't matter how old we are, we just gotta keep challenging ourselves to do things different and have some fun while doing it. <Laugh>

Larry (14:49):

I think fun is critical in all of this. That's

Jodie Bornstein (14:55):

What you use. Cause it has to be right. It has to be both fun and meaningful to you because if it doesn't mean anything to you and you have really no interest, just because you're checking a box to say, this is good for my brain health, okay, maybe you'll do it for a week, but that's not sustainable. You're not gonna be interested. It's not gonna have value, and then you won't keep it up and it's really not going to impact you the way something would, if it were truly meaningful and truly fun or interesting for you.

Larry (15:24):

Before we get onto computer based brain training, you brought up something interesting that I was gonna mention later, Jodi, that these brain training games, whether they're low tech or high tech, are most effective when they use in conjunction with other facets of cognitive health. You mentioned socialization.

Jodie Bornstein (15:51):

Yes. I think one of the, you know, most important aspects of brain health and overall health actually is your measure of loneliness. That doesn't mean if you live alone because plenty of people live alone and don't feel lonely. But plenty of people, you know, will describe themselves as feeling lonely, particularly during the pandemic. And even still now we're seeing the effects of it. So a way to kind of embed some social aspect into your cognitive optimization or brain games. I love adding a social element and not everybody, I really do say this is an important piece. Not everybody is a social animal who loves to be out there with lots of people. I have plenty of folks who I work with who say, you know what, I really, I don't enjoy that. It makes me nervous. I'm kind of a quieter person. Is that gonna really affect my brain health?

Jodie Bornstein (16:43):

And I find sort of low cognitive, no low social demand activities where they could be around other people and they don't have to be engaging in a very dynamic way, but it still will impact them. And it might reduce feelings of social isolation. So sitting in a coffee shop where there are other people around, and you may have to exchange pleasantries of saying, hello, good morning, how are you? Oh, good weather. Finally, the sun is out. You know, these things matter in your day. Maybe using a more high tech game, which we're gonna talk about, sharing that with family or friends. I scored this on my Wordle game today. How did you do? There's your interaction. It brings a social element, an element of community togetherness that will reduce social isolation, which I think is a really very important topic to think about in overall health and particularly in brain health.

Larry (17:37):

Okay, let's talk about some of the computer based programs.

Jodie Bornstein (17:44):

Okay, so if you're a listener of npr, they talk about Lumosity is one they talk about Brain hq I believe is advertised a lot. Those are some of the ones you can do. There's some aspects that are free and some aspects of it that you have to pay for, subscribe. And again, I do wanna say this is just one element of optimizing your brain health, right? These are online games or subscription based services that you don't feel like you have to subscribe to these in order to work on your brain health. You must sit at your computer all day and work on these. But that being said, if you wanna take 15 minutes a day or 90 minutes a week to work on some of these games it really will give you something, you know, stimulating to work on. And there are so many different aspects to each of these online games where they can focus specifically on visual memory or maybe auditory memory. There's even a game that says, do you have trouble remembering what to get at the grocery store? Will you go to the grocery store for this specific item and return home without that specific item? There's a game. It happens to me all the time. I think it's very normal. <Laugh>

Melissa Day (18:59):

Very normal. Jodi very normal.

Jodie Bornstein (19:01):

But if you wanna work on that, if that is annoying to you or it troubles you, there are, you know, virtual games to work on and retaining these lists or working on your visual memory, your attention trying to remember people's names. I think that's something that socially is very embarrassing for people. They'll say, I don't wanna go to dinner because I can't remember somebody's name, or I'm not sure who I'm gonna be with at the end of the day, and it's embarrassing for me. So they start to retreat socially. And that's a problem. So, you know, Lumosity Brain HQ are some of the ones that are both free and subscription based, that are people really enjoy using. 

Melissa Day (19:42):

And I think the computer allows us too, to engage people and keep their attention. I'm gonna age myself again and say, yes, I, I, I did this before computers took over took over. So I, I have the experience of kind of when we used to do a lot of paper pa pencil and paper tasks, and it was harder to keep people's attention and keep people's focus on that. You know, now with the computer, you know, the, the lights, the sounds, the everything allows me to grab people's attention so they can stay on it. I found when we did a lot of the paper and pencil stuff, people, you just couldn't engage the people. You couldn't. So the computer stuff I found in my experience with people is people really like it. It's game like, so you don't feel like you're kind of back in school being tested.

Melissa Day (20:32):

You know, it's kind of like a game like capacity where people are actually having fun doing these tasks and therefore they stay on it and they see the benefit, they see the thinking sharper that they're processing information a little bit faster. So I feel like the computer really allows us to engage you, you know, find that thing on the computer. Like you said, even I always say to people, even the fact that you're trying, it hits one of those boxes of changing it up, right? So don't worry about scores or anything when you're doing these tasks. Or I always say to my patients, did it make you stop and think, did you use your brain today? So that's the goal, you know, is, and, and like Jody keeps focusing on, is varying it up, you know, so these tasks, you know, every day they, they're giving you a different task to do on a lot of these things. So it's hitting that variety and hitting, you know, work on attention one day, you know, work on your memory the next day, work on processing another day, and, you know, hitting in all areas of that variety while engaging them and keeping them on that, you know with the colors and the sounds and the everything so that people do stay at it and do work at it,

Jodie Bornstein (21:43):

Are so many mainstream apps that friends and family also use. So it doesn't look like you're carving out this specific, I am now 84, so I must focus on my, no, I mean, I'm in my forties and I do these games all the time and I compete. I'm a very competitive person, my brother and I,

Melissa Day (22:02):

Worst scores you're going down

Jodie Bornstein (22:03):

And our mini New York Times scores every morning. And I think it's important. It adds a social aspect, but I will highlight, you know, there's, it gives us an opportunity to find very interesting things online as well. I, I'm working with a gentleman who unfortunately has, I would call mild to moderate cognitive impairment now. And, you know, it's not recommended that he drive anymore, but he used to be a pilot. And so I found the game flight simulator, which is really, to be honest, my 12 year old son is obsessed with airplanes and he has had flight simulator and I have taken off and landed in very interesting places. And this gentleman is building like a cockpit in his home, and it is the right challenge for him. And it's so interesting and so engaging. So there are so many opportunities with some of the higher tech to engage in something very meaningful and maybe a pastime that you used to be able to do in person.

Jodie Bornstein (22:59):

And you can't do that anymore for safety reasons, like flying an airplane. So there are so many opportunities, but some of the low easy ones like wordle, the crossword times, there are it's called matches too. It's the ability to ma it's like a matching game. I, we talked about languages a little bit before. I love language apps to help you learn a new language or help you work on a language that you've already maybe learned many, many years ago and have forgotten. So I use things like Duolingo and babble. I have a woman I'm working with now who also is mild to mo moderate cognitive impairment, and she is learning how to speak Yiddish. That was a lifelong goal for her. She does it in bite sizes, five minutes a day. And it's enough, it's challenging, it's fun. There's always a giggle at the end. And she says, I really dunno if I'm gonna learn this. But then she does. So, yes.

Melissa Day (23:54):

And Jody, I checked with my, my mother's been learning. I told you French and my mother's 81, and I checked with her, it is the duo lingo that she's using, you know, and, you know I, I chuckled when she said that. And, and my mother is 81 in learning a foreign language and actually has learned a foreign language, which is actually pretty fluent at this point. And she's got her cute cards and her note cards. And I was actually able to pass those note cards to somebody else here in this building. I said my mother's done with her her French cue cards. So I've passed 'em along to one of the residents here after our last talk, Jody, that, that, that showed some interest. So we passed along the cue cards, <laugh>

Jodie Bornstein (24:36):

Learning a new language. Also, Larry brings about the opportunity for some social engagement if you're interested. So maybe you can find friends who are also learning the same language or who used to speak this language and maybe have, you know, let's say a French group once a week or at dinner. I have a couple who I'm working with also in Brookline, Massachusetts, who now will have once a week the wife is in, has some cognitive impairment. Once a week they will have dinner and speak only in Spanish with each other. <Laugh> just for that added element. I think it's really, it's a super way even watching if you wanna do something more passive watching Netflix, but you know what, put your subtitles on. Maybe watch Netflix in a different language, the TV show in a different language with English subtitles, or watch in English with your, whatever language you're learning with those subtitles. So you're stimulating your brain. It's just a fun and interesting way to do things.

Larry (25:29):

And for all the listeners who are rushing to write all this down as the links for all of these games, I will put them in the show notes down below so it'll be easily accessible.

Jodie Bornstein (25:45):

Perfect.

Larry (25:46):

Now, on a personal basis, there is one computer based program that you didn't mention.

Jodie Bornstein (25:53):

Oh, podcast

Larry (25:54):

<Laugh> and <laugh>. There you go.

Jodie Bornstein (25:58):

Larry. After we spoke, I added it to my talk that I give about brain health. And now I start, usually I start off, I thought it was obvious to this audience, <laugh>, yes, I love podcasts. I listen to them when I'm running, when I'm walking my dog, when I'm cooking. It is a phenomenal, phenomenal brain health activity, especially this podcast, <laugh>.

Larry (26:20):

Thanks for the plug. Actually, this podcast was started in the midst of the pandemic when we weren't allowed to socialize, and where there were very few people to talk to around you. So I went out looking for people to talk to <laugh> and did it on a podcast. Good. We're, we're, we're hoping to go live. When I get a little bit more courage about live podcasts with all the technical problems, <laugh>, that other podcasts, wink, wink, nudge, nudge have how <laugh> one, one of my favorite podcasts that I would recommend to anybody is Wait, wait, don't tell me on npr. It's it's a hoot.

Jodie Bornstein (27:14):

It's really, it's, I love that one too. It's great. There are so many interesting podcasts available. I did wanna mention also masterclasses that people can take online as well. And that's something of topic of interest. If you're interested in cooking or photography or art, you can pick somebody pretty famous, usually <affirmative> and subscribe to their masterclass and take it from your living room or your kitchen. And you're comfortable there, but you're learning something new and it's engaging and challenging and fun.

Larry (27:45):

And it's a wonderful way to learn subjects that you just Right. Couldn't have the opportunity to learn about. Right.

Jodie Bornstein (27:55):

But it has to be a variety. It has to be meaningful to you. Again, having an accountability partner say, Hey, did you do this today? Did you do this? Yeah. And just making sure that you really are engaging as much as possible, but it's not fake because it won't work. It has to be something that comes from within.

Larry (28:15):

And my personal favorite is learning something new that you have no idea how to do. Like doing a podcast at age good for you. At age 87 is so the challenge of learning something you know nothing about and finding your way through. Yeah. The technical problems that come up when you're trying to do a podcast. Well,

Melissa Day (28:49):

I can imagine

Larry (28:53):

It's, it it's a learning process. Anything we miss?

Jodie Bornstein (28:57):

Yeah, no, I think it's really just, we have to remember that the cognitive piece is one, one pillar of what we focus on. The six pillars of brain health. You know, we really wanna focus, we talked about the social element, we talked about having, I don't know if we talked about it, but really meaning and purposeful living is important. Physical fitness, cognitive challenges, sleep and nutrition. These are the sort of six lifestyle pillars that you really need to focus on for your overall health, and particularly for your brain health

Melissa Day (29:30):

And quality of life. You know, the, your overall quality of life. I always say the ba the brain runs the whole shebang, <laugh>, you know, so if, if we keep this strong, we do everything better. Everything's easier to do when your brain is at acting as a well-oiled machine. So

Jodie Bornstein (29:49):

Using, but, but it's important to remember, right, Melissa, like even if something is wrong with you, that doesn't, your brand plasticity doesn't stop. Yeah. So you have to find, or your family members or your providers need to find just the right challenge for you so that you can keep up building that cognitive reserve even in the face of some impairment. So even if you do, let's say, have that dreaded diagnosis of dementia, that's not time to wash your hands and say, well, that's it. No way that I don't buy it. You need to keep working on this and finding the right people to support you in your journey so that you can find just the right cognitive challenge and feel successful and actually engage. And you can do that at a multiple multiple levels. Doesn't have to be a very high level task. It can be a lower level if that's where your brain is at right now.

Melissa Day (30:39):

And I think that's the different thinking that you, you had said before too, is, you know, I, I used to have a lot of people that said, you know, I'm retired now. I don't wanna have to do that stuff. I just wanna relax. And it, it's actually just the opposite, right? We used to think we used to have that way of thought, but you know, you can't learn as you get older. Now, that is such a fallacy, like you said, Jodi, that you can learn at any age. I mean, look at what you've done with this podcast. You know? I mean, that is un unbelievable you know, challenge that brain keep going at all ages.

Larry (31:18):

Yeah. And maybe we should get rid of the word retire.

Melissa Day (31:21):

Exactly.

Larry (31:23):

And find the new

Jodie Bornstein (31:25):

Retrain

Larry (31:26):

For, for the stage of life that some of us are.

Jodie Bornstein (31:29):

I think it should be a retraining. You're doing some retraining and you're, you're new training, new beginnings,

Melissa Day (31:35):

New beginnings of challenging your brain in different ways than maybe you did before. But yeah, keep learning. Keep learning.

Larry (31:43):

Melissa, Jody, this has been a joy. Thank you for being on specifically for seniors.

Jodie Bornstein (31:50):

Thank you for having us and keep up with this great podcast,

Larry (31:55):

<Laugh>. Thanks again for the problem.

Melissa Day (31:57):

Thank you.

Larry (31:58):

Okay.

Announcer (32:03):

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