Features
Enhancing fall-back power of the brain
BY Dr B. J. C. Perera
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL)
Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.
It is a well-known fact that many organs of the human body have some reserve quantum to fall back on during situations where a human being is taxed above its usual calm existence. An excellent example of this is the human heart. In the resting status of the body. the heart beats at around 70 to 80 beats per minute. During strenuous exercise this rate could automatically go up to about 150 or even 200, bringing the reserve power of it into play. The cardiovascular reserve can go up to several times its usual tranquil capacity whenever called upon to provide that extra power.
The notion that the human brain too has fall-back reserve power is a thing that that may surprise many people. As most of us know, we associate the brain with the higher functions of the mind where intelligence and many other cognitive features associated with it make the Homo sapiens to be quite different and differentiate humankind from all other species of the animal kingdom. Yet for all that, with advancing age, impairment of memory is a thing that most people worry about.
By age 60, more than half of adults have concerns about their memory. However, minor memory lapses that occur with age are not usually signs of a serious problem, such as Alzheimer’s disease, but rather the result of normal changes in the structure and function of the brain. However, major and progressive memory loss is a devastating problem for the elderly. Yet for all that, we differ from each other in the way our thinking skills age. One explanation is that some people have better resilience to the effects of ageing because they have developed a better capacity or ‘reserve’ to cope with the changes in the brain that occur with age.
The intellectual power that we can fall back on is referred to as cognitive reserve. Cognitive reserve is the mind’s and brain’s resistance to damage of the brain. One could also rather loosely equate this phenomenon to the ability of the brain to improvise and find alternate ways of getting a job done. It reflects how agile a brain is in pulling in skills and capacities to solve problems and cope with challenges. It is a phenomenon that has to be nurtured and strengthened by learning and experience right throughout a lifetime. Cognitive reserve is developed by an era of education and curiosity right throughout life.
The impression of such reserve power of the brain was first realised and then explored in the late 1980s. That concept which was labelled as cognitive reserve originated when researchers described individuals with no apparent symptoms of dementia or deterioration of the higher functions of the brain who were nonetheless found at autopsy to have brain changes consistent with advanced Alzheimer’s disease. Such observations suggest that there does not appear to be a direct relationship between the degree of brain changes in any given individual and the outward signs of those changes that manifest as loss of cognitive functions.
It was then postulated that these individuals somehow did not show symptoms of the disease while they were alive because they had a large enough cognitive reserve to offset the damage and enable them to continue functioning as usual. The concept of reserve accounts for individual differences in susceptibility to age-related brain changes or Alzheimer’s disease-related pathology. There is evidence that some people can tolerate more of these changes than others and still maintain function.
This curious phenomenon led to intensive research that has shown that people with greater inherent cognitive reserve are better able to stave off or even keep at bay, the symptoms of degenerative brain changes associated with dementia or even some other brain diseases, such as Parkinson disease, multiple sclerosis, or a stroke. A more robust cognitive reserve can also help one to function better and for longer even when one is exposed to unexpected life events, such as stress, surgery, or toxins in the environment. Such circumstances demand extra effort from the brain, somewhat similar to requiring a car to engage another gear.
Research suggests that our level of intelligence, which traces back to childhood as well as our set of lifetime experiences, helps to build cognitive reserve and may account for differences in cognitive reserve between different individuals. The lifetime experiences include education, having an engaging occupation and taking part in stimulating activities; the latter ideally combining leisure activities, learning and social interactions.
The evidence that lifetime experiences help to build cognitive reserve comes from studies of large groups of people over long periods. Such studies have repeatedly found that these life experiences are associated with a slower rate of cognitive decline in normal ageing and reduced risk of developing Alzheimer’s disease.
In other words, higher attainment and engagement appear to protect cognitive function in ageing. Indeed, some studies have suggested that these life experiences may reduce the risk of Alzheimer’s disease by 35-40%. The changes in the brain that are seen in the disease may still occur, but these people cope better and will not ever be diagnosed because they do not present with any symptoms.
The basic perception of cognitive reserve suggests that the brain actively attempts to cope with brain damage by using pre-existing cognitive processing approaches or by enlisting compensatory mechanisms. This would allow an individual with higher cognitive reserves to handle it better to enable the individual to better cope with the brain damage than another with lower cognitive reserves.
It has now been realised that cognitive reserve can be enhanced by a programme of cognitive fitness. Such an initiative would develop the ability of the brain to deal with and function normally when it is induced to call upon the reserve power, especially when disease states take their toll. The very heart and the central cog of a coordinated brain health and cognitive fitness programme involves rather simple but all too familiar lifestyle changes. The cognitive reserve hypothesis gives hope that exposure to various sorts of stimulating activities can help us age successfully. It also leads us to ask what people can do to help increase their cognitive reserve.
It is still unclear what the exact ‘recipe’ for this is. The evidence from studies of large populations suggests that it is exposure to the experiences and activities discussed above across the lifetime that contribute to the reserve, but we do not yet know what specific activities would slow the rate of cognitive decline or reduce the risk of dementia.
Researchers at Harvard Medical School have identified six cornerstones to any effective brain health and cognitive fitness programme. These are as follows:-
Task 1:
Eat a plant-based diet. This is beneficial in many ways and building up cognitive reserves is just one of them. The diet needs to be a good balanced one to supply all macro and micro nutrients.
Task 2:
Exercise regularly. Like the vegetarian diet, this too has a multiplicity of positive benefits. Building up cognitive reserves is just one of them. The nature and severity of the exercise needs to be individualised. Some medical advice would certainly help in that venture.
Task 3:
Get enough sleep. It is well-known that sleep facilitates tissue repair. It is perhaps the same with the neurones and their connecting meshworks as well. A minimum of 6 hours is essential and it is quite good to have 8 hours of quality sleep.
Task 4:
Manage your stress. It has been proven that stress has deleterious effects on many systems of the human body. It is perhaps the same with the brain and the neural tissues.
Task 5:
Nurture social contacts. Good social connections may provide mental stimulation through complex interactions with others and hence build cognitive reserve and maintain healthy cognitive function. This is a very important component of the cognitive fitness initiative.
Task 6:
Continue to challenge the brain everyday. Just as much as regular exercise improves the physical functions and the physical strength of the body, mental exercises are well-known to be beneficial for the proper functioning of the brain. Research studies suggest that doing cognitive tasks that feel difficult, like problem-solving, learning something new, reading a newspaper article and discussing it with a friend, etc.., truly challenge the brain.
This multi-pronged plan includes and integrates proven approaches to committed changes being made in everyday lifestyles. It is advocated that by incorporating simple, specific changes into a daily routine, one could add years of enduring mental stamina and vitality. It is extremely important to realise that these factors are equal parts of a cohesive plan and that they do not work very well in isolation or when they are taken up just as one or two separate efforts. For example, simply eating more fibre or adding a morning walk to your routine is not enough to forestall mental decline. Instead, diet, exercise, sleep, stress management, social interaction, and mental stimulation, all work in harmony, just like in a concert, to yield the desired results.
All that we have undertaken during a lifetime of this worldly experience certainly helps in building up a mental and neurological reserve to enable us to successfully navigate through the drastic effects of age on our mental faculties. There is emerging evidence that even in older ages, commitment to the cause of enhancing that cognitive reserve would certainly help. Old age then becomes a really great pick-up or fizz time.
So, let us go for it.., everybody !!!
The author is grateful to his friend, Professor Nalaka Mendis, for rekindling the writer’s interest in Cognitive Reserve.
Sri Lanka needs to take full stock of its current economic situation and use to the maximum the potential in its GSP+ facility for export sector growth. In the process, it should ensure that it cooperates fully with the European Union. The urgency of undertaking these responsibilities is underscored by the issues growing out of the recent US decision to sweepingly hike tariffs on its imports, though differentially.
These were principal ‘takes’ for participants in the Pathfinder Foundation’s Ambassadors’ Roundtable forum held on April 8th at the Colombo Club of the Taj Samudra. The main presenter at the event was Ms. Carmen Moreno Raymundo, Ambassador of the European Union to Sri Lanka and the Maldives. The forum was chaired by Ambassador Bernard Goonetilleke, Chairman, Pathfinder Foundation. The event brought together a cross-section of the local public, including the media.
Ms. Moreno drew attention to the fact Sri Lanka is at present severely under utilizing its GSP+ facility, which is the main means for Sri Lanka to enter the very vast EU market of 450 million people. In fact the EU has been Sri Lanka’s biggest trading partner. In 2023, for instance, total trade between the partners stood at Euros 3.84 billion. There is no greater market but the EU region for Sri Lanka.
‘However, only Sri Lanka’s apparel sector has seen considerable growth over the years. It is the only export sector in Sri Lanka which could be said to be fully developed. However, wider ranging export growth is possible provided Sri Lanka exploits to the fullest the opportunities presented by GSP+.’
Moreno added, among other things: ‘Sri Lanka is one among only eight countries that have been granted the EU’s GSP+ facility. The wide-ranging export possibilities opened by the facility are waiting to be utilized. In the process, the country needs to participate in world trade in a dynamic way. It cannot opt for a closed economy. As long as economic vibrancy remains unachieved, Sri Lanka cannot enter into world trading arrangements from a strong position. Among other things, Sri Lanka must access the tools that will enable it to spot and make full use of export opportunities.
‘Sri Lanka must facilitate the private sector in a major way and make it possible for foreign investors to enter the local economy with no hassle and compete for local business opportunities unfettered. At present, Lanka lacks the relevant legal framework to make all this happen satisfactorily.
‘Sri Lanka cannot opt for what could be seen as opaque arrangements with bilateral economic partners. Transparency must be made to prevail in its dealings with investors and other relevant quarters. It’s the public good that must be ensured. The EU would like to see the local economy further opening up for foreign investment.
‘However, it is important that Sri Lanka cooperates with the EU in the latter’s efforts to bring about beneficial outcomes for Sri Lankans. Cooperation could be ensured by Sri Lanka fully abiding by the EU conditions that are attendant on the granting of GSP+. There are, for example, a number of commitments and international conventions that Sri Lanka signed up to and had promised to implement on its receipt of GSP+ which have hitherto not been complied with. Some of these relate to human rights and labour regulations.
‘Successive governments have pledged to implement these conventions but thus far nothing has happened by way of compliance. GSP+ must be seen as an opportunity and not a threat and by complying with EU conditions the best fruits could be reaped from GSP+. It is relevant to remember that GSP+ was granted to Sri Lanka in 2005. It was suspended five years later and restored in 2017.
‘The importance of compliance with EU conditions is greatly enhanced at present in view of the fact that Sri Lanka is currently being monitored by the EU with regard to compliance ahead of extending GSP+ next year. A report on Sri Lanka is due next year wherein the country’s performance with regard to cooperating with the EU would be assessed. The continuation of the facility depends on the degree of cooperation.
‘A few statistics would bear out the importance of Sri Lanka’s partnership with the EU. For example, under the facility Sri Lanka benefits from duty free access in over 66% of EU tariff lines. The highest number of tourist arrivals in Sri Lanka in 2023 was from the EU’s 27 member states. Likewise, the EU’s 27 member states rank second in the origin of inflows of foreign exchange to Sri Lanka; with Italy, France and Germany figuring as the main countries of origin. Eighty five percent of Sri Lanka’s exports to the EU market benefits from GSP+. Thus, the stakes for the country are high.’
Meanwhile, President, In-house Counsel & Legal Advisor, The European Chamber of Commerce of Sri Lanka, John Wilson said: ‘GSP+ should be seen as not only an opportunity but also as a necessity by Sri Lanka in the current international economic climate. ‘Implementation of local laws is what is needed. Considering the pressures growing out of the US imposed new tariff regime, a good dialogue with the EU is needed.
‘Sri Lanka’s level of business readiness must be upped. Among the imperatives are: An electronic procurement process, Customs reforms, a ‘National Single Window’, stepped-up access to land by investors, for example, a clear policy framework on PPPs and reform of the work permits system.’
It ought to be plain to see from the foregoing that Sri Lanka cannot afford to lose the GSP+ facility if it is stepped-up economic growth that is aimed at. It would be in Sri Lanka’s best interests to remain linked with the EU, considering the aggravated material hardships that could come in the wake of the imposition of the US’ new tariff regime. Sri Lanka would need to remain in a dialogue process with the EU, voice its reservations on matters growing out of GSP+, if any, iron out differences and ensure that its national interest is secured.
Chit-Chat
Chiara Tissera
Mrs. Queen of the World Sri Lanka 2024, Chiara Tissera, leaves for the finals, in the USA, next month
I had a very interesting chat with her and this is how it all went:
1. How would you describe yourself?
I am a sensitive and passionate individual who deeply cares about the things that matter most to me. I approach life with a heart full of enthusiasm and a desire to make meaningful connections.
2. If you could change one thing about yourself, what would it be?
Actually, I wouldn’t change a thing about myself because the person I am today, both inside and out, is the result of everything I’ve experienced. Every part of me has shaped who I am, so I embrace both my strengths and imperfections as they make me uniquely me.
3. If you could change one thing about your family, what would it be?
If there’s one thing I could change about my family, it would be having my father back with us. Losing him six years ago left a void that can never be filled, but his memory continues to guide and inspire us every day.
4. School?
I went to St. Jude’s College, Kurana, and I’m really proud to say that the lessons I gained during my time there have shaped who I am today. My school and teachers instilled in me values of hard work, perseverance and the importance of community, and I carry those lessons with me every day. I was a senior prefect and was selected the Deputy Head Prefect of our college during my tenure.
5. Happiest moment?
The happiest moment of my life so far has been winning the Mrs. Sri Lanka 2024 for Queen of the World. It was a dream come true and a truly unforgettable experience, one that fills me with pride and gratitude every time I reflect on it.
6. What is your idea of perfect happiness?
Happiness is a deeply personal and multifaceted feeling that often comes from a sense of contentment, fulfillment and well-being. For me, perfect happiness is in moments of joy, peace and accomplishments … and also being surrounded by my loved ones.
7. Are you religious?
Yes, I’m a very religious person. And I’m a firm believer in God. My faith guides me through life, providing strength, dedication and a sense of peace in every situation. I live by the quote, ‘Do your best, and God will do the rest.’
8. Are you superstitious?
I’m not superstitious. I believe in making my own decisions and relying on logic and faith rather than following superstitions.
9. Your ideal guy?
My ideal guy is my husband. He is compassionate, understanding and is always there to support me, no matter what. He’s my rock and my best friend – truly everything I could ever want in a partner.
10. Which living person do you most admire?
The living person I admire the most is definitely my mummy. Her strength, love and unwavering support has shaped me into who I am today. She is my role model and she inspires me every day with her wisdom and kindness.
11. Your most treasured possession?
My most treasured possession is my family. They are the heart of my life, providing me with love, support and strength. Their presence is my greatest blessing.
12. If you were marooned on a desert island, who would you like as your companion?
I would like to have my spouse as my companion. Together, we could make the best of the situation, supporting each other, sharing moments of laughter and finding creative ways to survive and thrive.
13. Your most embarrassing moment?
There’s quite a few, for sure, but nothing is really coming to mind right now.
14. Done anything daring?
Yes, stepping out of my comfort zone and taking part in a pageant. I had no experience and was nervous about putting myself out there, but I decided to challenge myself and go for it. It pushed me to grow in so many ways—learning to embrace confidence, handle pressure, and appreciate my own uniqueness. The experience not only boosted my self-esteem but also taught me the value of taking risks and embracing new opportunities, even when they feel intimidating.”
15. Your ideal vacation?
It would be to Paris. The city has such a magical vibe and, of course, exploring the magical Eiffel Tower is in my bucket list. Especially the city being a mix of history culture and modern life in a way that feels timeless, I find it to be the ideal vacation spot for me.
16. What kind of music are you into?
I love romantic songs. I’m drawn to its emotional depth and the way they express love, longing a connection. Whether it’s a slow ballad, a classic love song or a more modern romantic tune these songs speak to my heart.
17. Favourite radio station?
I don’t have a specific radio station that I like, but I tend to enjoy a variety of stations, depending on my mood. Sometimes I’ll tune into one for a mix of popular hits, other times I might go for something more relaxing, or a station with a certain vibe. So I just like to keep it flexible and switch it up.
18. Favourite TV station?
I hardly find the time to sit down and watch TV. But, whenever I do find a little spare time, I tend to do some spontaneous binge – watching, catching whatever interesting show is on at that moment.
19 What would you like to be born as in your next life?
Mmmm, I’ve actually not thought about it, but I’d love to be born as someone who gets to explore the world freely – perhaps a bird soaring across continents.
20. Any major plans for the future?
Let’s say preparing and participating in the international pageant happening in the USA this May. It’s an exciting opportunity to represent myself and my country on a global stage. Alongside this, I am dedicated to continuing my social service work as a title holder, striving to make a meaningful difference in the lives of others through my platform.
The formation of wrinkles and fine lines is part of our ageing process. However, if these wrinkles negatively impact appearance, making one look older than they actually are, then trying out some homemade remedies, I’ve listed for you, this week, may help in giving your skin a fresher look.
* Banana:
Bananas are considered to be our skin’s best friend. They contain natural oils and vitamins that work very perfectly to boost our skin health. Skincare experts recommend applying the banana paste to the skin.
Take a ripe banana and mash a quarter of it until it becomes a smooth paste. Apply a thin layer of the banana paste on your skin and allow it to sit for 15 to 20 minutes before washing it off with warm water.
* Olive Oil:
Olive oil works as a great skin protector and many types of research suggest that even consuming olive oil may protect the skin from developing more wrinkles. Olive oil contains compounds that can increase the skin’s collagen levels. Yes, olive oil can be used as a dressing on your salads, or other food, if you want to consume it, otherwise, you can apply a thin layer of olive oil on your face, neck and hands and let it stay overnight.
* Ginger:
Ginger serves to be a brilliant anti-wrinkle remedy because of the high content of antioxidants in it. Ginger helps in breaking down elastin, which is one of the main reasons for wrinkles. You can have ginger tea or grate ginger and have it with honey, on a regular basis.
* Aloe Vera:
The malic acid present in Aloe Vera helps in improving your skin’s elasticity, which helps in reducing your wrinkles. Apply the gel once you extract it from the plant, and leave it on for 15-20 minutes. You can wash it off with warm water.
* Lemons:
Lemons contain citric acid, which is a strong exfoliant that can help you get rid of your dead skin cells and wrinkles. Also, as an astringent and a cleansing agent, it helps to fade your wrinkles and fine lines. You can gently rub a lemon slice in your wrinkled skin and leave it on for 10-15 minutes. Rinse afterwards and repeat this process two to three times a day.
* Coconut Oil:
Coconut oil contains essential fatty acid that moisturises the skin and helps to retain its elasticity. You can directly apply the coconut oil, and leave it overnight, after gently massaging it, for the best results.
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