Hi, this is Ira Fleto, and you're listening to Science Friday.
Today on the podcast, Josh is struggling with alcoholism, so he moves back home to get sober.
“And then somewhat unexpectedly, he finds that his alcoholic-induced brain fog and memory loss”
are similar to what's happening with his four aging grandparents. Josh reads about the idea of something called cognitive reserve that doing brain stimulating activities can prevent or delay the onset of dementia symptoms. So he tries out some creative strategies to help both himself and his grandparents. That's the plot of the semi-autobiographical play, The Reservoir, the play received funding
from the Sloan Foundation, which also supports Science Friday. It's currently running at the Atlantic Theater Company and co-produced by the ensembles studio Theater in New York. Joining me now is the playwright, Jake Brash. He's based in Brooklyn.
Welcome to Science Friday.
Thank you so much for having me.
Well, I loved it. It's a terrific play. It's a timely play. It's semi-autobiographical. Tell me how you came up with the premise.
So I actually started with the Science. I was looking for something to pitch to the Sloan Foundation and they came across this concept of cognitive reserve. And looked at all of the factors that one can try to improve in order to delay the onset of Alzheimer's symptoms and realize that those are largely the things that one does to
get sober. So I started there and then quickly realized, oh my gosh, I'm writing about that year of my life. I don't think I would have otherwise, but the science was really what started it. Then, ultimately, I knew I wanted to write a play about intergenerational connection and
grandparents and how much I loved my grandparents and also how my family coaps with difficult things through humor. How did you go about weaving in the science? By that, I mean, did you really make sure the science was correct when you put it in there?
Or did you use a lot of literary license in this? I mean, I hope the science is correct. Please Sloan Foundation. I hope the science is correct. I, you know, first and foremost, it's a play, right?
“And I think it's important when you're trying to make art about science or sharing science”
that the story itself is the most important thing, that the characters are vivid and the
situations are interesting. For me, I think that the play asks a lot of questions more than it gives answers. And that's where art can actually specifically add to the scientific conversation when it's about doubt. When it's about these two diseases, alcoholism and Alzheimer's, that so much about them are
unknown in the scientific world. And I think posing a lot of the questions in this play around, maybe the science is this, maybe the science is that maybe we don't know, maybe we'll learn something in the future is really what it's all about more than getting the science riot that makes sense. Yeah.
And Josh comes to surprising conclusion in the play and that's that the higher the cognitive reserve, the sharper it falls, did you witness that in your own life? I did. So one of my grandmothers until 85 was completely with it, you know, still working. She had her doctorate in math, he was an electrical engineer, she was the most meticulous
organized, she ate well, she did everything correct, he was totally with it. And then at age 85, he kind of just dropped off the planet. And I had spent a lot of time thinking about how is that possible that she slept so quickly. And then coming across this concept of cognitive reserve, and like you said, the higher the reserve, the sharper the fall, I was like, aha, that's exactly what it was.
She developed so many pathways to the point that she was able to pretty much present as herself until she wasn't. Yeah, that character is right there in the play. You put her right in there. I did, I did, which is complicated and that character is very different from my grandmother
in some ways, but also very similar. And I feel terrified and thrilled to be able to share my family with the world. Well, I'm laughing because the play is filled with humor and on as you say, humor brings a lot of things you're able to discuss to the four, doesn't it? It does.
“I mean, I firmly believe that you have to laugh to cry and you have to cry to laugh, right?”
And for me, that sort of roller coaster of things being both funny and terrifying at the same time is what it feels like to be alive right now. And I think also it felt, it was acutely how I felt when I was in crisis trying to get sober. And so I think the play tries to kind of capture that energy and ask you questions like,
am I allowed to laugh at this, am I allowed to cry at this? And sort of mixes up the audience and off puts them in a way that I'm super proud of, but also is sometimes difficult in the audience to sort of figure out how to metabolize this story. Were you channeling Mel Brooks at any point?
Oh, definitely.
I mean, there is a grandparent.
I would say that that leans on the borst belt of it all, hopefully in a way that's a little bit off-center, but yes, I mean, like, I knew if I was going to write a play about my family, I had the land be jokes. humor is the currency in my Jewish family. If you're not funny, what are you doing?
I get it. I get it. Did working on this play make you think about aging or memory in a different way, now that it's all over? It did.
I mean, I think the two things that I think about the most are, firstly, the good part
“and the bad part of aging is that the only thing one can do is lead a curious, open, full”
life. And the good part about that is that, like, we all know how to do that, right? That's the best thing you can do to protect yourself from the onset of dementia or all of Alzheimer's or even just normal aging is just to do all the things that we already know how to do.
The other things that it may be realized is sort of how non-linear memory loss can be, right, that sometimes folks hold on to some things while other folks hold on to different things, right? The path of it is so mysterious. And we can only really conceptualize of memory loss as knowing what we don't know, right?
The problem is that we only have our brains to figure out how much memory we have lost.
And of course, it's the things that we don't know that we don't know that are most haunting. I've been thinking about not only around Alzheimer's, but also around alcoholism and black out-sand addiction-related memory loss. Have you heard from anybody who's seen the play and said, you know, that's me or that's
my grandparents. Deeply. You captured them perfectly. Deeply. I mean, so many folks, I go out into the lobby after this show and there are folks sobbing
and calling their grandma's right there in that, right, which I feel thrilled about sort of facilitating more about intergenerational connection.
“And I think it also makes me feel less alone, right?”
There's not that much art out there that is specifically about grandparent grandchild
relationships. There's a lot of parent-child plays, there's a lot of plays in which the one grandparent is rolled on, you know, in the wheelchair for their sort of bit part, but this is a play that centers for older, hilarious, horny, wild senior citizens. And I'm super proud of that, and I think a lot of audience members see their families up there
on stage. Well, Jake, congratulations, cuts it to great play and I hope a lot of people go to see it. Oh, thank you so much, Ira. Jake Brash, Brooklyn-based writer of The Reservoir, a play-the-ensemble studio theater
is co-producing with the Atlantic Theater Company and the Alfred P. Slow Foundation. It's now running at the Atlantic Theater Company in New York and a reminder that the Sloan Foundation is a contributor to Science Friday. After the break, a new study that finds that a special computer-brain exercise reduced the mentor risk by 25% will tell you where to find it.
Since the coining of the term cognitive reserve roughly three decades ago, researchers have been working to figure out what exactly might protect the aging brain against cognitive decline in dementia. A new study followed a diverse group of older adults for 20 years, and they found that a modest amount of specialized cognitive training reduced dementia risk by 25% boy.
That is a big number. Joining me now to discuss these significance, Dr. Marilyn Albert, professor of neurology and director of Alzheimer's Disease Research Center at Johns Hopkins Medicine based in Baltimore, Maryland, look up to Science Friday. Thanks so much.
It's wonderful to talk with you. Nice to have you. For you, what is your biggest takeaway from this study?
“So I think the most important thing is that this was a gold standard study in the sense”
that people were randomized to different interventions, and we found that this particular kind of training that's called speed of processing training, lowered risk for a diagnosis of dementia by 25% over the course of 20 years. Wow. So they were doing this for how long?
That's what's so interesting about the findings. So the people in the study did this cognitive training for a relatively modest amount of time. In the beginning, they did it twice a week for an hour at a time for six weeks, and then a year later they did it a few more times, and then three years later they did it more times.
What the study found was that if you did the training not only in the beginni...
also in those follow-up sessions, which were called booster sessions, then you had this reduced risk of dementia over the course of 20 years. You sound like you were very surprised by these results. I think everybody was surprised by the magnitude of the results. 25% lower risk is really quite a lot.
You probably know that the cost of dementia every year is about $400 billion, and if we could reduce that by 25%, it would be wonderful. I would say that I wasn't surprised that of the three different kinds of cognitive training
that were examined, the speed of training was the one that turned out to be the most important
because there had been other studies from this group showing that the speed of training was more beneficial.
“Well, now you have to describe for us what the speed of training is all about.”
Yes, so it's relatively simple. People sat at a computer. They saw two objects in the center of a screen and were asked to say which of the two they were, for example, as a car or a truck, and then around the outside there was a sign that they had to identify in space, and you had to switch your attention between what was
happening in the center and what was happening around the outside, and if you did that,
it got harder, so then there were distractors around the outside that made it harder for you
to locate the sign in space. So it's what we call a task of divided attention because you're switching your attention back and forth, and also it adapts to your ability. So if you did it well, it got harder if you had trouble, it got easier.
“Don't we know why it's working, what the training does to the brain?”
I wish we did know what the training does to the brain. These studies were started over 20 years ago when we didn't have the kind of imaging that we have now that might enable us to answer that question. My guess is that the training is increasing brain connectivity, and that with the booster
sessions, that sort of reinforces that brain connectivity, and for reasons we don't completely
understand that had a long lasting benefit of protection. But that's just a guess. There's a lot more we need to learn about how this training affects the brain and how it's effective. How does it compare to other things that we know that they say to do for brain health,
like eating healthy, doing crossword puzzles, playing chess, socializing, exercising, things like that? Well, that's a really good question. We know that from this particular study, that this training was beneficial above and beyond what people were doing in their daily lives.
We can assume that the people in this study were doing crossword puzzles. They were being physically active. They were trying to eat a healthy diet, many of them, but that this training benefited them over and above that. But of course, this particular study didn't compare this brain training to those kinds
of daily activities. Can you put this in context for as a broader context of our understanding of dementia and Alzheimer's
“does this up end or does it confirm previous research in the field?”
What this is telling us is that there are lifestyle factors that are murderifiable that might reduce your risk for dementia. It doesn't in any way up and what we know, but the study suggests that there might be things that you could do in your daily life that could, if not directly affect that pathology, provide some sort of buffer or a brain reserve, that that's, I think, the major suggestion
that we wouldn't come away with. Is there any way for people to get this at home to do it at home? Yes, in fact, there is a way for people to do this at home. There is a company that I have no association with called posit science, and they have a suite of cognitive training tasks on their website.
And one of them is called double decision. And double decision is almost identical to what was used in this study.
What age do people need to do this and what age were they in your study?
The people in the study were 65 and older.
The age range was quite large. The average age was about 74.
“And we did in this analysis look to see whether or not the age of the people made a difference”
and it didn't.
So what that suggests is that as a group everybody over the age of 65 might benefit.
This is just fascinating. Let's talk about the future. You say you don't know what goes on in the brain that makes this work. Is there a way of finding out? Well, I'm hoping that this finding will stimulate a lot of research in this area because
we've had ideas that this kind of lifestyle intervention would be beneficial for the diagnosis of dementia.
This is the first finding of this sort.
I think we can do a lot of studies that are maybe more short term to see what's happening in the brain when this kind of training is done.
“And I'm hoping that that's what will happen in the future because if we have a better”
idea of the mechanisms, then we might even be able to develop even better interventions. This is just fascinating. Thank you for taking it time to be with a state doctor Albert. This is my pleasure, I think this is an important finding and I'm hoping that people hear about it and will try to take it into their daily lives.
Yeah, well, a lot of people will now that you've joined us, Dr. Marilyn Albert, professor of neurology, director of the Alzheimer's Disease Research Center at Johns Hopkins Medicine that's of course in Baltimore, Maryland.
“By the way, if you want to find that special computer exercise that reduced dementia risk”
by 25%, we've got it on our website, a link to it at sciencefriety.com. This episode was produced by ShowShunaBucksBam, I'm Arreflato, we'll catch you next time.
