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Brain Fitness for Older Adults

For readers of Alvaro Fernandez' blog on, SFA is pleased to provide the following answers to his "10-Question Program Evaluation Checklist."

Continuing Education Credit Information

An expert peer review process showed that 24.5 study hours are needed to complete the Brain Fitness for Older Adults professional education program. Therefore, it provides 24 hours (2.4 units) SFA continuing education credit. As with other SFA continuing education courses, Brain Fitness for Older Adults is being submitted for preapproval by other organizations. SFA expects continuing education credit awards from other fitness organizations to be 22 to 26 hours (2.2 - 2.6 CEUs).

  Note: This is a professional education program that includes practical application recommendations and implementation materials. Its intended primary user is the older adult physical activity professional, its eventual end-user a senior fitness client from the general population. Therefore, the following information characterizes the program from both points of view.

1. Are there scientists, ideally neuropsychologists, and a scientific advisory board behind the program?

This program describes already-published, peer reviewed, and independently assessed findings and methods developed by neuropsychologists, scientists working in related areas, and geriatric physicians, principally including: Fred H. Gage, Lawrence Katz, Michael Merzenich, Ian Robertson, Daniel Amen, William Rodman Shankle, Majid Fotuhi, Paul Bach-y-Rita, Alvaro Pascual-Leone, Donald Hebb, Roy J. Shephard, and Wojtek Chodzko-Zajko. It does not introduce new scientific information. Rather, it makes the existing body of knowledge more accessible to older adult physical activity instructors by presenting it in reader-friendly language compatible with their professional vocabulary and relating it to their work place so that they may responsibly inform their clients and put already-researched and critically examined approaches into practice in their classes. For a listing of this program's source materials, please click on BrainFitnessReferences.

2. Are there published, peer-reviewed scientific papers in PubMed written by those scientists? How many?

Yes, numerous.

3. What are the specific benefits claimed for using this program? What specific cognitive skill is the program training?

This program presents emerging evidence that suggests that regular physical activity itself is beneficial, particularly for the frontal lobes of the brain. To summarize briefly: In their exhaustive work on the subject, Exercise and its Mediating Effects on Cognition, the researchers Wojtek Chodzko-Zajko, Waneen Spirduso, and Leonard Poon note that the frontal lobes of the brain are key to human individuality and that "these are the very areas that recent research suggests receive the most benefit from exercise." In addition, this program also provides fitness professionals with a broader based approach to relevant activities planning. Basic anatomical, physiological, and functional foundations are provided through educational film and text publications. Building upon that understanding of fundamental principles, the program is not designed to train only one specific cognitive skill but, instead, to promote specific benefits targeted through specifically related methods. For example, teaching clients a new stress management exercise offers multiple specific benefits: (1) Because focus and attention are required, conditions are conducive for new learning experience; (2) Learning creates new neural connections in the brain and helps reinforce existing connections; (3) Repetition is used to physically practice the technique (repetition/practice further strengthening neural connections); (4) During the stress response, one of the hormones released is cortisol, which serves a necessary function by assisting with "fight or flight" increases of blood flow, heart rate, and mental awareness. However, when daily cortisol levels remain excessively high, this appears to damage the hippocampus and thereby potentially impair memory ability. Ironically, the very hormone that stimulates sharpness and memory during short periods of stress could ultimately destroy neurons of the hippocampus if present at elevated levels for prolonged periods. Therefore, it is important to manage stress effectively on a daily basis, and mastering new stress management techniques adds to the client's personal resources for doing so. Various other activity programming elements can also be implemented in order to foster specific benefits. For example, the benefit objectives of activities that promote increased social involvement and interaction, that call for the processing of novel stimuli, that progress to gradually more advanced levels of difficulty, that feature emotionally meaningful experience, or that supply the means to employ other well established criteria can be itemized as is done above in the case of teaching a new stress management exercise. That itemization is provided for every activity plan included in this program. The activities highlighted in this initial study package involve learning stress management techniques, although other types of activity series are under consideration for future development.

4. Does the program tell me what part of my brain or which cognitive skill I am exercising, and is there an independent assessment to measure my progress?

Yes, see number 3 directly above. A detailed rationale accompanies each activity recommended in this program. The activity plans are based on published findings and methods to which independent assessment measures have already been applied and well documented, and those references are cited. Contemporary cognitive, stress, and mood state testing may be utilized, as desired, to track individual outcomes. To that end, as well as to enable further independent study, reliable additional resources (including current contact information and web addresses) are provided by the program.

5. Is it a structured program with guidance on how many hours per week and days per week to use it?

The intended audience for this program is professional older adult fitness instructors and trainers rather than lay persons. Fitness personnel meet with clients on a regular, ongoing schedule which enables them to introduce and supervise the practice of new activities on a continuing basis accordant with cognitive fitness principle and theory. However, because the training sessions must include time for physical conditioning and because training schedules vary (some meeting twice per week; others three, four, five or more times per week), one-size-fits-all program structuring is inapplicable. Consequently, this program is not designed to be, nor represented to be, the only mental challenge and stimulation that need be undertaken by an individual. Instead, it provides a series of scientifically supported activities to be undertaken or skills to be learned and practiced in the physical activity setting as part of an overall health and fitness promotion program. A new activity is provided for each of 25 fitness sessions, along with advice for assigning related at-home tasks (for example, daily practice), for repeating and/or building progressive levels of difficulty into previously initiated activities during subsequent training sessions, and for providing sound cognitive fitness information to aging clients. In addition, fitness professionals are supplied with detailed guidelines and planning instruments for the critical scrutiny, design, and implementation of their own activity concepts. The structure of this program is deliberately flexible in order to meet the needs of varying fitness training formats, and the complete program was specifically developed to give fitness professionals the tools they need to responsibly lead, model, motivate, and encourage seniors to pursue meaningful cognitive fitness activity on a long-term daily basis.

6. Do the exercises vary and teach me something new?

All of this program's ready-to-implement activity plans, plus all of its additional suggestions for activity plan development, impose both novel experience and learning challenges.

7. Does the program challenge and motivate me, or does it feel like it would become easy once I learned it?

All of this program's ready-to-implement activity plans, plus all of its additional suggestions for activity plan development, call for learning something new or for increasing a previously learned skill's level of difficulty.

8. Does the program fit my personal goals?

This program provides a broad spectrum of potential benefits, ranging from stress and anxiety management to preserving or improving memory function. Fitness professionals are instructed to expose their clients to an assortment of activities, advising and assisting them in pursuing the avenues that meet their personal goals.

9. Does the program fit my lifestyle?

The delivery of the activities described by this program, which as previously stated is directed toward fitness professionals, can be expected to be especially suitable to the lifestyle preferences of end-users who value and enjoy attending their regular health promotion and physical conditioning sessions. As opposed to very intensive programs designed to produce dramatic short-term results, this program supports integrating mental challenge and stimulation into everyday life as a permanent and enduring aspect of one's physically, socially, and intellectually active lifestyle. Therefore, it will be more appealing to persons seeking desired effects over time. In regard to the primary user, the physical activity professional, this program was especially created to compliment his or her lifestyle: (1) Because fitness instructors and trainers are typically busy, the study process follows a well organized, self-paced distance education format that can be completed conveniently at home; (2) Because they must earn a minimum of 20 contact hours of continuing education credit each credentialing renewal period, it exceeds that threshold (24.5 credits); (3) Because fitness education has traditionally emphasized the musculoskeletal, pulmonary, and cardiovascular systems, many physical activity professionals are not yet confident in a topic area which is generating great interest now, so this program provides them with a study of the basic anatomical, physiological, and functional information they need in order to be conversant on the subject and lays the groundwork they will need to pursue more in-depth knowledge; (4) Because many senior fitness professionals are interested in cognitive health and have expressed that interest to this association, along with the desire to responsibly incorporate brain fitness activity into their health-fitness services, this program responds to that goal; (5) Because the senior fitness drop-out rate is too high, professionals are always looking for new ways to enhance their services and keep their classes interesting in order to promote client adherence and compliance, so this program provides them with a new resource in that endeavor; (6) Because clients ask senior fitness professionals about many health and fitness related matters, they serve in a capacity as educators and are now frequently being asked about brain fitness; they want to be able to provide accurate answers and helpful information, so this program provides them with the tools they need to do so. On the other hand, this program would not satisfy the lifestyle preferences of professionals who favor live workshop continuing education courses.

10. Am I ready and willing to do the program, or would it be too stressful?

Although moderately challenging, the activities outlined in this program are designed to be interesting and enjoyable and in no way unduly stressful. They are consistent with, rather than in conflict with, the process of neurogenesis.


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