Physical & Cognitive Health Program

Clinical Services OverviewSpecialty ProgramsCognitive Brain Health Program

Improving brain functioning through personalized physical exercise and targeted neurocognitive training programs.

Imagine if you went to visit your doctor and instead of prescribing a long list of medications with hefty side effects to help your brain health condition, you got a prescription for exercise. This is now becoming common practice in doctor’s offices all over the world.

Prescription pill bottle

Physical activity interventions are becoming a well-established non-pharmacological, non-invasive, affordable and low-risk option for the treatment and management of almost all late-life mood and cognitive disorders.

Did you know that going for a walk could actually help preserve your cognitive functioning as you age? A large body of evidence suggests that regular physical exercise can improve your thinking skills, specifically enhancing memory, attention, and executive functions in older adults and furthermore is associated with a 35–38% reduction in the risk of cognitive decline and dementia. Nearly one third of the Alzheimer’s disease (AD) cases are thought to be attributed to modifiable risk factors related to lifestyle habits, including physical activity and cognitive stimulation.

Memory Assessment Questionnaire

A Smarter Way To Exercise

Recent studies have shown that performing the same routine cardio exercises may not be enough to pump the breaks on age-related neurodegeneration. These studies provide important insights into the benefits of exercise in improving cognition with reulting structural modifications in the motor cortex. The changes that occur in the brain appear to be dependent on the kind of exercise being performed such as pure aerobic (i.e. walking, swimming, cycling) or more skilled-based, cognitively engaging exercise.

Aerobic exercise increases the density of blood capillaries (angiogenesis) and brings about the birth of new neurons (neurogenesis).

Skilled-based exercises increase neuronal sprouting and synaptogenesis, important for re-establishing brain circuits impaired in disease states and required for normal cognition.

Therefore exercise programs that implement physical training along with targeted neurocognitive skills training (rather than each alone) show greater promise in improving cognitive function in healthy older adults and furthermore in individuals with memory complaints, mild cognitive impairment and dementia.

Our personalized, precision medicine approach to physical and neurocognitive health

  • We conduct a comprehensive physical fitness and neurocognitive assessments
  • We conduct motivational and personality interviewing along with goal-setting to understand your behavioral preferences and design your personalized program.
  • You are assigned to one of our behavioral health coaches who will provide you with a customized Cognitive and Physical Exercise (CogPE) therapy program.
  • We conduct regular follow-up physical and cognitive assessments to track your progress.

Health and Exercise Questionnaire

Lifetime Physical Activity Assessment

Movement as Medicine

Physical and Cognitive Brain health

Our brain programming specialist, Dr. Sarah McEwen has developed the highly innovative Movement as Medicine exercise therapy program. This program is open to all patients looking to increase their cognitive functioning, improve their mood, and maintain their physical health who are in good physical standing with clearance from their physician to engage in a moderate exercise program.

Our exercise programs are implemented by an experienced team of certified behavioral health coaches and personal trainers who work with you to develop individualized exercise programs to meet your physical and clinical needs. We also use advanced wearable sensors and technology to provide a comprehensive treatment program and continuum of care outside of the clinic to ensure you are getting the maximal benefit from our programs while in and outside of the center.

Cognitive Training

Cognitive Training

Goals

  • Practice memory and related processes to stimulate brain health

Methods

  • Daily, structured, validated, online brain training ‘games’

Cautions

  • Excessive computer use can lead to eye strain, fatigue, anxiety, and insomnia

Reasoning

  • Use it or lose it
  • Practice makes perfect

Resources

References

Smith GE, Housen P, Yaffe K, Ruff R, Kennison RF, Mahncke HW and Zelinski EM. A cognitive training program based on principles of brain plasticity: results from the Improvement in Memory with Plasticity‐based Adaptive Cognitive Training (IMPACT) study. J Am Geriatr Soc. 2009; 57:594‐603.

Cognitive Stimulation

Goals

Daily stimulating activities for cognitive health

Methods

  • Varied reading and/or book club(s)
  • Attending musical concerts and plays
  • Playing card games (e.g., solitaire or bridge) and/or board games (e.g., Cranium)
  • Doing crossword, Sudoku, and jigsaw puzzles
  • Active hobbies like woodworking, painting, and knitting

Cautions

  • Stressful activities can neutralize or counteract the positive effects

Resources

  • Language or music classes

Education

Goals

  • Build ‘cognitive reserve’ to protect brain from functional decline with aging

Methods

  • Adult extension classes
  • Language or music classes

Reasoning

  • Mentally stimulating educational experiences help build and maintain memory
  • Low educational achievement is a modifiable risk for developing Alzheimer’s

Exercise

Goals

  • Improve cardiovascular and musculoskeletal health while boosting brain health

Methods

  • 30 minutes/day of moderate aerobic training > 5 days per week or
  • 15 minutes/day of vigorous aerobic training > 5 days per week plus
  • 2 days/week of strength training for all major muscle groups plus
  • > 2 days/week of balance training for legs and core muscle groups

Reasoning

  • Brisk walking > 1 mile a day increases hippocampal volume (a mood and memory area of the brain and lowers the probability of mild memory loss changing to Alzheimer’s.

Resources

Go4Life: National Institute on Aging Exercise Program

References

  1. Aguiar P, Monteiro L, Feres A, Gomes I and Melo A. Rivastigmine transdermal patch and physical exercises for Alzheimer’s disease: a randomized clinical trial. Curr Alzheimer Res. 2014; 11:532‐537.
  2. Smith JC, Nielson KA, Woodard JL, Seidenberg M, Durgerian S, Hazlett KE, Figueroa CM, Kandah CC, Kay CD, Matthews MA and Rao SM. Physical activity reduces hippocampal atrophy in elders at genetic risk for Alzheimer’s disease. Frontiers in aging neuroscience. 2014; 6:61.

Health and Exercise Questionnaire