Asked when her passion for psychology began, Dr. Sarah McEwen’s face lights up.
She reminisces fondly about a childhood memory, recalling going to school one day for Career Day. She was 10 years old, confidently dressed in a tweed suit, and ready to share with her peers her desire to one day become a psychologist.
Today she’s the same confident person with the same eager mind and hunger for discovery. Now she is armed with an impressive list of achievements; a PhD in cognitive psychology, 14 years of clinical research experience, 7 years as faculty at UCLA, more recent faculty experience at UCSD in the department of psychiatry, section editor for the peer-reviewed journal NeuroReport, co-founder of a fitness tech start-up called Genius Gyms, and now director of research and programming at the Pacific Brain Health Center (PBHC) at Pacific Neuroscience Institute (PNI).
Dr. Sarah McEwen, a woman who wears many hats, sat down with us to talk about her journey and path to PNI, current and upcoming research, and what her goals and visions are for the Pacific Brain Health Center.
From Career Day to PhD
Having grown up in Sacramento, Dr. McEwen found herself not too far from home at UC Davis where she studied psychology and human development. However, her sights ventured beyond the confines of California, and she left to study abroad in Ireland. After college she hit the ground running and found a job in a clinical neuroimaging research lab. Her work there helped understand what happens in the brains of young adults who were dealing with their first psychotic break and were in the early stages of losing touch with reality.
While in Ireland, she fell in love in more ways than one. Meeting her Irish husband there made the decision to continue her graduate education in Ireland an easy one. She completed her MSc and PhD in psychology specializing in cognitive neuroscience. During her thesis, Dr. McEwen conducted a study in a sample of school children aged 11-13, focused on understanding what brain functions cause psychotic-like symptoms in that age group. The study helped her distill her research goals, which would later lead her to PNI. It was the idea of bridging the gap between academic research and the underserved populations in the community.
As she speaks, Dr. McEwen’s energy and passion are magnetic. It is clear that she believes in what she does and has taken every step of her journey with confidence and conviction.
Path to PNI
After Dr. McEwen returned to California, she was selected for a T32 postdoctoral fellowship at UCLA, leading a neuroimaging study focused on the longitudinal tracking of youth at high risk of developing schizophrenia. From this study, she became interested in figuring out how to implement interventions during the earliest phases of illness with the possibility of preventing further cognitive decline.
Later, as research faculty at UCLA, Dr. McEwen received a K01 career development award from the National Institute of Mental Health (NIMH), and was the first to study the neurobiological effects of a combined exercise and cognitive training program in patients with psychosis. Through this work she found there was a need to translate this simultaneous exercise and cognitive training intervention therapy to other populations.
Dr. McEwen’s research results about the beneficial effects of combined cognitive training and exercise on the brain, were very interesting to geriatric psychiatrist David A. Merrill, MD, PhD, who was at UCLA as well at that time. They collaborated on an innovative study of simultaneous exercise and cognitive training in older adults who had subjective memory impairments and cognitive decline. When Dr. Merrill joined PNI as director of the Pacific Brain Health Center in March 2018, he recruited Dr. McEwen without hesitation to continue her work at PNI.
Dr. McEwen adds that she will be conducting an extension of this trial at PNI and is excited to continue collaborative research and innovation with the John Wayne Cancer Institute and PNI teams.
Research at Pacific Brain Health Center
A major area of research focus is Alzheimer’s disease (AD), and as director of research and programming, Dr. McEwen’s desire to delve into the whys and hows of the disease has only increased since joining PNI in August 2018. She says that research is still in its infancy with regard to understanding what causes AD and which underlying mechanisms are at play.
The fact that 98% of drug trials for AD have failed underscores the urgency and importance of Dr. McEwen’s research. Her goal is to challenge the current traditional and unfortunately inadequate approach, where single drugs are used to target the symptoms of AD. To her, the high percent of failure is due to the overall lack of understanding of AD at a molecular level within the medical community. Focused and passionate, Dr. McEwen is determined to find better solutions – ones that actually work.
Another exciting area of research is dedicated to the prevention of Alzheimer’s disease, other dementias and neurocognitive decline. Dr. McEwen envisions studies that would ideally enroll participants for 5, 10, or 20 years to be tracked longitudinally over time. With the increase in aging populations, there are more dementia diagnoses and a prevention model to delay or stave off the progression the disease, or even prevent onset would be a huge breakthrough.
Digital technology is everywhere so why not use it for good in the form of digital therapeutics? More research needs to be done looking into the benefits of physical and mental exercises done together. Most people know that they need to exercise, but making time seems to consistently be a problem. These days, Dr. McEwen says, most people know how to use technology, including much of the aging population. There are all kinds of interventions that can be offered, but it is up to individuals to take the initiative and motivate themselves to do it. Dr. McEwen’s program will allow patients and caregivers to meet with brain health coaches on a regular basis to stay motivated and engaged, and create actionable plans. By reprogramming the brain and leveraging technology in the form of mobile phone digital apps to support what individuals are doing in the clinic, she believes that brain health coaching will become a regular part of people’s everyday lives.
When posed with the question of why she chose to work with PNI, her answer is simple – she saw an unmet need in the community that PNI is uniquely equipped to meet. Throughout her academic career, she found that academic institutions do not appreciate the individual or the holistic environment they live in. With the help of funding support, she wants to work with people in their own communities and implement novel interventions that have previously been restricted by funding or limited access. She sees the difference these interventions have made in her patients and wants to help as many people as she can.
There is a lot of focus on mechanisms in the research world, but she prefers a naturalistic approach – brain programming – and the idea of doing research in a community setting. In this way, she is able to actually see the improvements in people’s lives and make human connections. Like so many people, neurological issues have hit close to home for Dr. McEwen. Family members having suffered with Lewy body dementia, Parkinson’s disease dementia, and cognitive side effects of oncology treatments. She matter-of-factly explains, there is no point in developing treatments if not to change lives.
The Deck is Not Stacked
Dr. McEwen wants people to know that when it comes to brain health and aging, it is not all genetically predetermined, or that decline is inevitable. She argues that informing individuals about their current behavioral and biological status is very useful. Then providing them with evidence of targeted interventions that can change the structure and function within the brain are empowering ways to get people to change their behaviors which lead to better brain health and wellness.
She does what she loves and practices what she preaches. Running on the beach and listening to podcasts is something she practices regularly, as well as cycling with her two young boys as they practice language verbal fluency – making up songs about what they see – and spatial navigation skills on their ride into school. She pushes herself every day to set the example that combined exercise and cognitive stimulation is normal and not something that should be prohibitive to implement in everyone’s daily lives.
Her motto is to do whatever physical activity you enjoy, that gets your heart rate up to a place where you cannot hold a conversation – this level of intensity supports brain health – and augment it with additional novelty, variability and cognitive stimulation to create a personal and sustainable training regimen that will help to decrease the potential for cognitive decline.
To get clients started at on the Physical and Cognitive Health Program at the PBHC, Dr. McEwen has all her patients go through a thorough physical history and intake procedure with her brain health coaches. In conjunction, she orders in-depth cognitive tests and physical diagnostics, to understand each individual’s unique starting point. She then designs a specialized program just for them which also includes weekly 1-on-1 CogFit training with an in-house personal trainer to keep them physically and mentally stimulated.
Dr. McEwen is encouraged and extremely hopeful that she will be able to educate people all over the world on the results of combined exercise and cognitive training. We have the tremendous power to change our brains and thrive as we age, she adds.
As per usual, Dr. McEwen has hit the ground running again at PNI’s Pacific Brain Health Center. Working alongside her brain health team colleagues, she offers collaborative consultations to patients dealing with a wide array of neurological and brain health related diseases, and encourages them to put both their physical and mental powers into action.
For more information about the Pacific Brain Health Center, please contact us at 310-582-7641.
Nicolette Mena is the PNI Foundation Program Coordinator and is involved with all administrative and operational aspects of the Pacific Neuroscience Institute Foundation. She focuses on raising awareness of PNI, through composition of blog posts, video appeals, newsletters, and materials for the bi-annual magazine. Fundraising is Nikki’s priority, with her efforts geared toward grant writing and coordination of outreach events. She works closely with medical experts, Saint John’s Health Center Foundation’s development team and PNI Foundation’s Directors to expand PNI’s brand both domestically and internationally.