Health: Brain Savers

Literary biographer Leon Edel used to keep a small painting by Bloomsbury artist Duncan Grant hanging just inside the doorway of his home office in Honolulu. "Grant painted that when he was 90," Edel, then 72, told an interviewer. "I keep it there to remind myself that a man can be productive at 90."

By the time of his death, Edel had edited his Pulitzer prizewinning biography of Henry James from its original five volumes down to two and then to a single volume and had written four more books, including his war memoirs. He died four days short of his 90th birthday.

William Paley was still running CBS at 89. Picasso turned out 140 canvases at 88 and was still painting when he died at 92. Great minds aside, how long is a good mind good for? And what can the rest of us do to keep our minds alert and active, to safeguard our gray matter from the inevitable cognitive decline associated with aging?

Experts say this decline--starting with intermittent "senior moments" and potentially progressing to full-blown Alzheimer's disease--is due to myriad factors, with things like genetics and lifestyle choices determining how far down the forgetful road we go. And those choices can be every bit as powerful a positive force as genetics can be a negative one.

Take the case of the identical-twin 81-year-old sisters reported by Dr. Gary Small in The Memory Bible: An Innovative Strategy for Keeping Your Brain Young (Hyperion), due out next month. One sister lived a "hard life," smoking, drinking heavily, eating a high-fat diet and exercising little, if at all. She started experiencing mild forgetfulness at 77, followed by difficulty balancing her checkbook, completing crossword puzzles and addressing Christmas cards. Soon she developed Alzheimer's. The other twin was a social drinker who never smoked, adhered to a diet low in starches and animal fats, and exercised. She too began experiencing mild forgetfulness in her 70s but didn't decline further.

Some of us will go beyond the level of the second twin, to what is known as mild cognitive impairment, and some all the way to dementia, the most common form of which is Alzheimer's. But most of us won't--and need not. "People used to think that senility was a normal part of aging," says Small, a professor of psychiatry and aging at the University of California, Los Angeles. "Now we see it's a disease. If we all lived long enough, we'd all get Alzheimer's disease if we did nothing about it." The good news: we can do something about it.

The new strategies are based on recent research findings. The most striking are those showing that, where the brain is concerned, the familiar exhortation is right: use it or lose it. The Religious Orders Study, headed by Dr. David Bennett, director of the Rush Alzheimer's Disease Center in Chicago, looked at 700 elderly, dementia-free Roman Catholic nuns, priests and brothers. Each was asked about time spent on various activities, among them viewing television; listening to the radio; reading newspapers, magazines and books; playing games such as cards and checkers; doing crossword puzzles; and going to museums.