There are lots to discover
André Aleman is professor of Cognitive Neuropsychiatry at the Department of Neurosciences of the UMCG and the Department of Psychology of the University of Groningen. We had a nice interview on brain with him after his speech in ‘Aklınla Yaşa – Smart Ageing’ symposium, which is organized by Maltepe University Active and Smart Ageing Center.
- How would you describe ‘Elderly Person’? How were you motivated to work on elderly people at the first stage?
We are referring to the elderly aged 65 and above. I had elderly people in my environment like my grandfather. I was quiet interested how he aged to 70 and how he had such a good cognitive ability. He was interested in a lot of things like sports, he was playing bridge. For me it was fascinated to see how he could be so mentally well.
- Have the scientists solved the brain discovery?
It is difficult to say that. You do not know what you do not know. On the other hand there is a lot of knowledge about the brain. We know how the visual cortex work and how we see things. Apes have the visual cortex also and we did lots of research on animals. We know less about the frontal part, which is the most human part. It is bigger in humans. It has to do with thinking and planning, organizing or doing things.
This part is not specialized like the other parts of the brain. For ex. face perception, one part of the brain does the face recognition for ex. The frontal cortex is more altogether. Hundreds of thousands of brain cells are working together to do the complex tasks.
We have a lot of things to discover, yet. My target is to understand the psychiatric disorders and ageing in order to help people to have higher quality of life. I’d like to help elderly people who already have some memory problems, to help them to prevent it before they have dementia.
- What is the difference between dementia and Alzheimer?
Dementia is a broader concept. All cognitive decline that continues is called dementia. If people cannot take care for themselves, if they are not independent, it is called dementia.
- Stephen Hawking has the ALS disease. He had a project with Intel. By using brain waves he could write and do functional things. Would you please give some examples of the innovations that the science is working on?
Science is working on this brain and computer interface but it is still very hard because the brain input is like thousands of small occurrence and it is very hard to decode them. Some people are in coma and their relatives sometimes claim that they had some contact with the patient but the doctors say usually to them it is not possible. In Belgium they are making progress. They use brain imaging EG and brain scanning MRI they ask the patients ‘Play tennis in your head’ or ‘Walk through your house’ and they see a different pattern of brain activity and this is the 30% same pattern of healthy people. This means they are conscious, otherwise you cannot do this. Now it is possible to communicate with those people. It takes more time. For ex. you ask them ‘Do you want food?’ If yes, play tennis if not walk through your house. So, you can get an answer by looking at the brain pattern.
- Is brain control possible?
In theory it should be possible but it is very difficult to get a real pattern of a thought for ex. you need a very complex interaction within lots of brain regions in a very specific way; thousands of neurons should be active at the same time in a specific pattern. It is extremely difficult to get that pattern. What we can do for ex. is brain stimulation with a magnetic coil. We put on the head we stimulate on a motor cortex. Then you will move your finger and I can stimulate the whole path way to move your finger. It is very interesting. It does not matter that you want it or not, we think and your finger moves. But we cannot do a whole action. It is much more complicated.
- Then it is a myth that the soldiers are being controlled technically and motivated to go to war.
It is a myth, yes. But it can be possible in the future, you never know!
- Nowadays, futurists talk about 2nd version of Human, printing ears and eyes and replacing them with the original ones. How will the brain react to this kind of innovations?
Well, there is an ethical point. Researchers are able to make some organs. They can use stem cells to get an organ in the lab. They can even maybe make a little brain. If you can make a brain, it could have consciousness. That is strange. So, there should be some ethical boundaries to it, whether this is allowed or not. You can have a conscious brain without a body.
- So, you can program it then?
Yes, it may be possible to program. Somewhere we should have boundaries. There are boundaries today to do experiment on apes for ex. They may have some level of consciousness and we have to respect that. In that sense you cannot create a brain and do whatever you like.
- You have a book translated into Turkish ‘Our Ageing Brain’. You have given a speech as the key-note speaker in the Smart Ageing Symposium that the Maltepe University Active and Smart Center. How has your way crossed with Turkey?
My book was published first in Holland and has been sold 40.000 copies. Then it was translated into different languages like German, French, Russian, Korean, Turkish etc. There is an interest on this topic obviously. So, my knowledge was interesting for the Maltepe University as they are establishing an institute on this topic. I had a presentation in the symposium. The project is ‘Smart Ageing’ and it is about the life style and optimize the ageing or at least to decline it. Such works are very necessary.
- What is ‘Smart Ageing’ from your point of view?
It is focusing on the healthy life style, which is the most important thing. A lot of people know what is healthy living, for ex. It is known that smoking is bad for health but even though they do it. There is a will power here also but most of the people really do not know how bad it can be. People know that smoking is bad for your lungs but they do not know it is bad for the brain too. It increases your risk for Alzheimer and it is a very high risk factor for Alzheimer. If people were aware of that, they may be have more reasons to stop it. Healthy living is one of the most important thing in life. It includes also physical activity like walking around and metal activity like reading books for ex.
- Is Alzheimer more DNA related?
Most forms 40% explained by genetics. 60% of it is explained by environment like life-style and stress but it is complicated, there is an interaction between the genes and the environment. One study in USA showed that if you had one gene which enhances a risk for Alzheimer, which is called APOE4, if you lived in a big city with a lot of crime, killings and whatever presumably you have more stress, those people have much higher risk for the disease then the people with the same gene, who lived in a very quiet and nice environment. Your gene is activated according to the environment differently. Obviously the stress has a very bad effect on the brain.
- When we are talking about the environment, what is the effect of big cities on our brain health?
There are some studies showing that there is more stress in big cities, especially chronic stress, which has a negative but again it depends on the genetic of the people. Some people are more sensitive about the stress and other people are less sensitive. So neurotic people for example may be more sensitive. Their amygdala, brain structure over activates and it has been shown that people are living in cities may have an over activated amygdala more than the people living in rural area. Chronicle stress is bad for your brain and it may enhance Alzheimer. It is complicated because cities have positive effect on people also. They can reach lots of activities, hospitals etc. If you are in a rural area, you need to travel a lot and travelling triggers a stress. It is no easy to say big cities are bad. If he city has green and if the people have pets, that can also make life much more easy going, less stressful.
- Is there a difference of handling the stress between elderly and young people?
Elderly people have more emotion regulation abilities. They know how to deal with emotions. They have more difficulty to inhibit negative sound, noise for ex. If a young person reads a book with all the noises around, it will cause no problems but for elderly people it may be more difficult to filter the noises. It can be stressful if you cannot concentrate on. It can happen with the thoughts also. If you have concerns about your family etc. elderly people have more difficulty to inhibit those concerns then younger people. So, in the long run elderly people are better in handling the emotions and stress then younger people. In age 60 they are better handling the stress but when they become 75, they may have more difficulties handling the stress. When they go to a family party, they may get tired and go home early. It is too much information for them.
- In Okinawa people leave longest lives in the world. You mentioned earlier that DNA’s effect is 30%. Is the rest diet and island effect?
Okinawa diet is calorie restriction. You eat less calorie. If you eat just enough to keep alive, maybe less than half you eat usually, you live three to five years longer but you are feeling hungry all the time. I’ll not recommend it. Body has a reaction and it wants to survive, put all the cells to a lower level need less and one way the other you live longer. In Okinawa diet they eat enough. They eat products from the sea like vegetables from the sea, they have very low calorie but you feel you have eaten enough. They eat red meat rarely. That is a good diet.
- When Okinawan people move to USA, they lose this effect. Would you please explain how this is possible? We have lots of island but we do not have that. What is special on the island?
Actually people living on island are healthier for ex in Sardinian, also in California there is also a region. They are called as ’blue zone’. There is less stress in the society. People are easy going. I have been in Okinawa one time. I was in the hotel and of course people were not speaking English. I just asked for a supermarket and there were other guests in the hotel from Okinawa and they said ‘Well, come with us and we will show you where it is.’ They took their time to go to a supermarket with me. In Holland nobody would have time to do such a thing. They are laid down and everybody has time.
- If we move to Okinawa, will we live longer?
If we move there and follow the diet, we will live longer certainly. There is a negative side now about young people. There are lots of fast-food restaurants there. Maybe in the future Okinawa may lose this feature.
- In your book you mention about the brain professor at age 84 Marion Diamond and her 5 main strategy about Smart Ageing.
Yes, the five main steps are diet, physical activity, challenge, newness and love.
- Does technology have a positive effect on our brain?
I think it has a positive effect. There are studies done with young people. Mental speed is increasing during they are playing computer games and their speed increase when they are in the traffic also. That is good. However there is also a downside. They can be more superficial, they can do lots of things at the same time but they lose their concentration immediately so they cannot read an article for example. For some subjects they need some knowledge, politics for ex. They need to read longer texts and understand them. The schools still focus on keeping the attention for longer time. Families can promote reading books, young people do not read books anymore. They just read short messages in social media. Some studies show that reading books increase your ability to memorize things also. They have no memory problems because they are young but we see they have less information stored. In Holland in medical education there was a time that students did not need to memorize a lot. They could look it up in the internet etc. Then they discovered that when a doctor is with a patient it is more practical that doctor can combine different information and give a decision. Otherwise he has to go back to his office and look up all the things. Then they changed the medical school education system and students still need to learn a lot. I would also prefer a doctor who knows what he is doing. One day there may be no internet available, doctor will not be able to solve the problem. So, it is still important that we store and make connections between different subjects.
Thank you very much for this great interview.
It is my pleasure.