Brain Training for Parkinson's: Unlocking Mental Agility and Cognitive Resilience Through Games and Mindfulness

Are you ready to elevate your mental agility and thrive despite Parkinson's? I'm Chris Kustanbauter, and I've crafted an episode that's a testament to the brain's adaptability and strength. Imagine fortifying your cognitive capabilities through a blend of exercise, strategic gaming, and innovative rehabilitation techniques. This is not just a promise; it's a journey we embark on together, with science-backed strategies to combat cognitive impairments and keep our mental engines revving.

This episode is a treasure trove of anecdotes and insights into the world of brain training. From the strategic depths of chess to the quick wit needed for trivia, we explore how these games do more than entertain—they enhance memory, focus, and even social connections. And for those of us with a competitive streak, I share some hilarious moments where even Pictionary can turn into a battleground of intellect and laughter. But it's not all about the competition; meditation and mindfulness emerge as unsung heroes, offering a serene counterbalance to the sometimes frenetic pace of cognitive exercises.

Wrapping up, we delve into the heart of cognitive rehabilitation exercises tailored for Parkinson's. I take you through my personal experiences with these exercises, designed to sharpen attention, working memory, and executive function. Each suggestion is more than a drill; it's a step towards building resilience in our brains. With these practical tools, we learn how to integrate them into daily life, turning routines into powerful moments of cognitive enhancement. Join me, and let's unleash the full potential of our minds together.

#ParkinsonDisease #CognitiveWellness #BrainHealth #Mindfulness #BrainTraining #CognitiveAgility #cognitive training #brain games #Trainyourbrain #neuroplasticity #liveparkinsons #exceptionallife

References:
Exercise Therapy to Prevent and Treat Alzheimer's Disease, Hamed Pahlavani, frontiersin.org, July, 24, 2023

The Effects on Cognition in Parkinson's Disease: A systematic Review, Translational Neurodegeneration, Murray, et. al., 2014

Cognitive Exercises: American Parkinson's Disease Association

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Disclaimer: This podcast is for educational purposes only is not intended to treat or diagnose Parkinson's Disease. Please ensure that you are following the treatment plan developed by your doctor. Please ensure before starting anything new you get approval from your doctor. The information being provided is based on my own personal experiences and does not guarantee that it will benefit everyone.

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Transcript

Speaker 1: 0:11

Hello and welcome to Live Parkinson's Live an Exceptional Life. I'm your host, chris Custombatter, and I've been living an exceptional life with Parkinson's for the past 14 years. The mission of this podcast is to help as many people as possible living with Parkinson's to have a great quality of life. The topic of this podcast is boosting cognitive function through evidence-based practices. Now, why is this an important topic for people living with Parkinson's? Well, according to the Parkinson's Foundation, 50% of people with PD will experience some form of cognitive impairment during the course of their disease. Now are you feeling like your brain's getting a little fuzzy around the edges? Join us where we discuss evidence-based strategies to help you rev up your cognitive engine and sharpen your mental edge. Now forget fad brain games and infomercial products. We're diving deep into the science-backed strategies that really work. What we're going to cover is exercise, and we'll talk about unleashing your inner fitness guru and discover how movement can turbocharge your thinking. Talk about brain training Is it a fact or fiction? We separate the hype from the hope and explore effective training techniques to boost memory and focus. Then we'll talk about mindfulness De-stress and declutter your thoughts with the ancient practice of mindfulness and meditation. It's more than just sitting still, but that's part of it too. And then, finally, we'll talk about cognitive rehabilitation. These are tailored exercises to target specific cognitive challenges that people with PD experience, to help you build your brain and bounce back stronger, so you're ready to outsmart your getfulness and unlock your brain's full potential. Join us on today's episode and start your journey to strengthen your mind and cognition. Ps, we'll also be sharing some inspiring stories and expert tips to help you implement strategies into your daily life, so don't miss out. Let's start with exercise for the brain. Why do we keep stressing the need to exercise with Parkinson's? As mentioned earlier, according to the Parkinson's Foundation, up to 50% of people living with Parkinson's will experience some form of cognitive impairment. Now, that doesn't mean that they're going to progress into living with dementia or Alzheimer's. It just means that they're going to have some type of cognitive impairment, whether it's forgetfulness or having trouble with executive function or planning and organizing.

Speaker 1: 2:40

There is also a well-established link between exercise or physical activity and cognitive health, not only people with Parkinson's, but in the general population as well. The Centers for Disease Control and Prevention's Division of Nutrition, physical Activity and Obesity has published an article called Physical Activity Boost Brain Health from February 24th of 2023. And then in this article, they state that physical activity can help you think, learn, problem solve, as well as helping to improve your memory and reduce anxiety and depression. Now, when they talk about physical activity, that doesn't necessarily mean you have to go to the gym and sweat and be sore. It could be walking with your friends. That's the type of physical activity. Or if you're out gardening, that's another type of physical activity that you can do. They also note that physical activity can reduce your risk of cognitive decline, including dementia. And then, in another study in preventive medicine from 2015, they found was that cognitive decline is twice as common among adults who are inactive compared to those who are active. So that's another reason that we always stress the importance of exercise in your Parkinson's journey, because exercise is going to help you with your cognitive function and cognitive abilities.

Speaker 1: 4:05

So now that we can see the benefits of exercising for our brain, let's look at some of the different types of exercise that can help our cognition. In a study, the effects of exercise on cognition in Parkinson's disease, the researchers stated that clinical studies showed that various types of exercise, including aerobic resistance and dance, can improve cognitive function, especially executive function, in Parkinson's patients, and the study said that the best type, amount and duration of exercise for improving cognitive function aren't yet known. So there really hasn't been a lot of data or studies showing if one type of exercise is better than another. But they do say that the study suggests that the more intensive your aerobic exercise program, including strength and balance training, can promote greater cognitive gains. So the more you can get your heart rate up, sweat a little bit and then include strength training into your exercise program a couple times a week and balance training, which I try to do every day, that can help promote greater cognitive gains. They did say, however, that low intensity exercise for people that are a little bit scared about going to a gym said that low intensity exercise and balance-based exercises also show to benefit. So don't feel that scared or turned off from exercise because you feel like, oh, I've really I've got to go sweat and I'm intimidated at a gym. Even the low intensity exercises like walking, riding a bike if you can do that, they're also going to show benefits. So let's take a look at aerobic exercise and we talked about aerobic exercises, where you get your heart rate up and they're designed to help improve your heart and lung function.

Speaker 1: 5:49

And so what are some good aerobic exercises for people that have Parkinson's? Well, I'm glad you asked, so let's lace up those sneakers and get started. The first one is walking. Now, the nice thing about walking it's a simple and accessible exercise that people with PD can do, regardless of your fitness level. You can pretty much do it anywhere, anytime, and if you're just starting out, it's no problem. Just start slow and gradually build the time in the distance that you go. Walking has been shown to improve cognitive function and memory. So slip on those tennis shoes, grab a friend and hit the payment, or hit the nature trail, because it's going to help you with your cognitive functioning.

Speaker 1: 6:31

Now, once you come back from there, if you're interested, you can slip on the bathing suit and go to the pool, because the next is swimming. Now, swimming is a low impact exercise that's easy on the joints that's one of the benefits and swimming is a good option for people with Parkinson's who have difficulty with their balance and their coordination. Low impact water classes are also a great option. So if you don't feel comfortable swimming laps or maybe treading water in the deep end with some flotation devices and other things, take one of the water classes. There's a lot of great options. I know where I go to the gym. There's a tone and fit which is a nice low impact water exercise for people, and it's great for people with Parkinson's. Now, swimming has been shown to improve your cognitive function, your mood and your quality of life.

Speaker 1: 7:22

Now that we've gotten out of the pool, it's time to grab our helmet and hit the open road, because the next aerobic exercise is cycling, and cycling is a good way to get cardiovascular exercise and improve your coordination. Now, if you are at a point where you cannot balance on traditional bike, not to worry, because stationary bikes can be a good option for people with Parkinson's as well, who have problems with their balancing on a traditional bike. And one of the reasons you want to consider cycling is it's been shown to improve cognitive function, motor skills and the quality of life for Parkinson's patients. We're done cycling, we go home, we decide we're going to dig out the dancing shoes and hit the dance floor. That's another great type of aerobic exercise, because dancing is a fun and engaging way to get exercise while improving your cognitive function. So when you're out in the dance floor, whether you're learning ballroom dancing or doing the tango, or whether you're doing a zumba class, any type of dancing. It's a fun way to get your exercise and sometimes you don't even think that you're exercising because you're having fun dancing, and dancing has been shown to improve your memory, tension and your executive function, meaning it helps you prioritize, organize things as well, and then, finally, as the day winds down, you want to calm your body and mind.

Speaker 1: 8:45

Try Tai Chi Now. For those of you that aren't familiar with Tai Chi, it's a general form of exercise that combines movement and breathing, and a lot of times we'll include meditative practices as well. Tai Chi has been shown to improve your balance, coordination and quality of life. Now I've done Tai Chi and it's really. It's a great exercise for balance. You do slow movements, gentle movements, so it works on your fluidity as well. So it's if you're looking for a way to calm down and relax but still enjoy a great type of exercise, I would highly recommend Tai Chi.

Speaker 1: 9:27

Now, the five that I just gave you they're not an all-inclusive list and the key is if you listen to some of my earlier podcasts is, if you're going to start an exercise program, number one is review it with your healthcare professional to make sure that it's appropriate for your current medical condition and once you get approval from your healthcare professional, remember to pick activities that you enjoy, because in order to just continue staying active in an exercise program, you have to do things that you like to do. So, for instance, if I don't like to swim, I'm not going to force myself to swim. I'm going to pick activities that I like to do. So make sure you pick things that you enjoy and then that'll help you make it part of your daily routine and then also start slowly and then gradually build into it. Now, besides aerobic exercises, be sure to include Strength training.

Speaker 1: 10:23

A lot of times we think, oh, strength training, I have to go to the gym and you see the commercials for one of the nationwide gyms. But I picked things up and put them down. So a lot of times people, especially with Parkinson's, might be intimidated to go to a gym or a fitness center because they think they have to try to compete with People that are in their lifting weights and doing strength training. Strength training doesn't always have to be using weights. You can use things like bands and they stretch and you can work your muscles a lot of times if you can't go to a gym and have a personal trainer help you devise a strength training program. There's a lot of common items around the house that you can use to help you build your strength. For instance, you can, for bicep curls, use a big can of beans or Tomato sauce can use those type of items as weights. Just keep in mind that strength training doesn't always mean I've got to go to the gym and work out if you're intimidated. Those are some of the roadblocks you can get around by using common household items.

Speaker 1: 11:33

But what strength training helps you do is it helps you improve your muscle strength and balance, which are going to help you in your daily activities. But again, just remember to pick things that you like and then ask a certified trainer or your healthcare professional For help in developing a strength training program that's going to meet your needs. They'll be more than happy to help you. And then I try to do strength training three times a week in addition to Aerobic exercise, so it's a great add-on and it's going to again help me with my muscle strength and my balance and then also Include into your exercise program balance exercises. Now, this is something that I do every day and I've got a series of five different exercises I go through. Ask a either a physical therapist or your healthcare professional or a certified trainer for some balance exercises, and they'll be more than happy to help you out. But what Balance exercises are going to do is help you improve your balance so that you stay upright and prevent falls, because falls are what people went to rehab facilities. The ultimate goal is to prevent falls, and balance Exercises are a great way to do that.

Speaker 1: 12:46

So, now that we've seen some of the exercise benefits, let's talk about brain training. Is it factor fiction? Can you really train your brain? Well, let's start by looking at brain training games and apps that are on the market to help you improve your cognition. Now, the nice thing about brain games is they're going to help us to maintain our cognitive abilities and they don't have to be expensive or require lots of time to set up and play. In Factors a lot of these games that are simple and are games that we often played while we were growing up. So let's take a look at some of the chart toppers for brain games and let's channel our inner child and Explore some of the games that are going to help us with our cognitive function, and this is all based on science.

Speaker 1: 13:33

I've looked at it, reviewed a number of different studies and read some articles from neurology practices, and these are games that they recommended either in the studies or in journal articles, and the first one is chess and checkers. Yep, that's right. Believe it or not, these two games hit the trifecta of benefits. They use your memory to remember and recall the rules, like which direction pieces can move, and both chess and checkers. Now, if you think of chess, the knights can move in an L shape, bishops move at a diagonal, ponds can only move Forward or diagonal if you're taking another piece. Rooks can move vertically and horizontally on the the board as well. So, and then the same thing with checkers. You have to remember which way the, the checkers go, and then you have to also Remember what King me or check or check mate mean, and they also involve strategy. So, especially while both chess and checkers, you have to have a strategy to Try to beat your opponent, and then you have to use your body physically to move the pieces. So that's where I'm getting that, the trifecta. So it's going to help you with your memory, your Strategy and strategic thinking, and it's going to help you move your body as well, all right.

Speaker 1: 14:55

The next one is memory and matching games. Now these can either be electronic versions or the old standby and card format, and these games require you to remember where similar cards are, to make either pairs or groups of three, and they help increase your attention span. Go to most retail Stores and, if you're the type that doesn't want to do it on the computer, and just pick up a pack of the memory game. It's fun and it's also going to help help with your cognition. And then the next is trivia games. Who hasn't played trivia games?

Speaker 1: 15:32

These are some of my favorites, and they can range from the old, reliable trivial pursuit. For those growing up, and I think it was the 80s, 90s and early 2000s, trivial pursuit was really a big game and where you tried to collect pieces to complete your pie, and they had topics ranging from science and nature, entertainment, history, geography, sports, and then once you wanted to be the first one to fill your pie with the little pieces based on answering questions. And then some of you may go to some of your favorite restaurant chains and see trivia games on the TV, or sometimes they even have a little kiosk at your table that you can use to test your musical or entertainment knowledge and question for you how many of you out there attend weekly trivia nights and you play with friends and maybe family members to win prizes? I know several people that they go on the trivia circuit. So each week they go to a different restaurant or bar and play the trivia games, because that helps them to improve their memory, recall and reasoning skills, and it helps us to narrow down our choices as well and come up with the correct answer. So a lot of times, though, in some of the trivia games that you'll see on the TVs, they'll start to eliminate answers to help you narrow it down, but the idea was you want to be able to try to narrow it down yourself. So trivia, whether it be history, science, nature, geography, or whether it's just music, trivia and entertainment knowledge, it's just a great way to strengthen your cognition and have a fun time at the same time.

Speaker 1: 17:16

The next are reflex games. You're probably thinking to yourself what's he talking about? What are reflex games? Well, how many of you played the game Simon? Now, for those that haven't, simon's an electronic game and it comes with four color pads. It's red, yellow, blue and green, and it's an electronic game. So when you turn the game on, the color pads are going to light up in a particular pattern and they start off slow, so it'll go through the first pattern and then you have to, as the player, push the pads in the order that they lit up and then, if you get the pattern correct, then it gives you another pattern and then the more patterns you get correct, it continues to get faster and the patterns become more complex and then finally Simon beats you if you miss one of the patterns and then you have to start again. But it's a great way, if you haven't played, to give it a try.

Speaker 1: 18:21

And it's a game that a lot of us played growing up and it's a good example of a reflex game. And another one is a good example of a reflex game we played this as kids is Simon Says. And if you've never played Simon Says, you have a leader and the leader is going to say to do some type of activity or movement. So they may say cut your nose and tap your belly, but you only do that if they say Simon Says. So if they say scratch your head and you do it without them saying Simon Says, then you lose. So these are some examples of reflex games, and they're great because you need to use both your mind and your body together and that can help you maintain your coordination. And then another is charades or a picture. So whether it's acting out an answer or drawing an answer, these two games both require you to think on the spot and they can help strengthen your vocabulary retention, and they're great games for maintaining social connections with friends and family.

Speaker 1: 19:32

Now, I know my sister-in-law will probably kill me for this, but I'm gonna use it as an example anyway. Years ago probably about 25 years ago, when I first got married, we were over at my in-laws and we were playing Pictionary. My sister-in-law was on my team and it was her turn to draw, and so the rest of us in our group could guess what it was. And she said I can't draw it. And I said sure, you can just do your best and we'll try to guess. And she said I can't. And I said, yes, you can just do the best you can. And finally she said I can't, I don't know what the word is and I don't know how to draw it. And I said okay, well, let me see it. And she showed me the word and I said, well, what's the word? And she said shiver. And I said shiver. And then I looked at the word it was shiver. So we all got a good laugh out of that and we still laugh at that today. But that was an example where we were playing Pictionary and having a good time.

Speaker 1: 20:28

So Pictionary and Shirae are gonna be another great option for you as well. And then, for those of you that like vocabulary and like words, scrabble is another great way to help formulate words quickly and remember how to spell them. It's the old, classic board game, and it's a great way to strengthen both your written and your oral vocabulary. At the same time, you're having a good time with friends and family. So, again, it's gonna give you a lot of benefits too. So helps you with your written and oral vocabulary, and it's together with that social interaction, which is a key to helping us maintain a great quality of life.

Speaker 1: 21:11

Now for those of you that love technology, let's look at some of the chart toppers for brain training apps. The first one is Cognifit, and it's an interactive mental tool that uses software and a proprietary scientific technology to show you games that test your memory, your executive function and concentration. Now this app also includes mental tests and activities that are designed to test your reasoning and intellect. So if download Cognifit, it'll give you a little test up front just to see what your baseline is and then it'll show you different activities based on baseline. Now I have a friend in the Momentum Parkinson's class that I participate in and she said that she uses the Cognifit app every day to help her stave off dementia because her mother had dementia and she said dementia runs in her family. So she's constantly doing brain games and she said the games can be challenging but she enjoys the app and it's available on Google Play and the App Store and I believe it's free to download, but there is a charge if you wanna access some of the more advanced features. Now the next one is Luminosity, and this is a brain training app and it's used by over 70 million people globally and the app has over 50 games designed to give your brain weekly mental workouts. So as you play, the games are adjusted to your individual characteristics and modified to burn that varied mental game, so you're continually challenging your brain. And again, that's available on the App Store and in Google Play and I believe that's a free download as well. And then another one would be Word Search Colorful, and that's free and provides you users with a variety of riddles and, as the name indicates, you do Word Search and it has hundreds of puzzles to challenge you, some of which are time-based. And, if you wanna do the additional challenge, some of them are time-based to help you increase your focusing on your cognitive function. And then the next one is Brain HQ, and Brain HQ has multiple exercises that test users' cognitive skills in the areas of memory, attention, orientation and speed, and it was developed by a group of international neuroscientists.

Speaker 1: 23:40

Now, while web-based training games and apps are convenient and a good way to boost your cognitive function, there are some limitations that I wanted to share with you. The first is personalization. A lot of the web-based apps usually offer standardized training which might not address your specific cognitive needs, and not all of them are targeted towards people living with Parkinson's as well. Secondly, limited skill development. Some of the games and apps may be fun and engaging, but only focus on specific skills like memory or attention and don't address other skills like executive function or reasoning. Another issue or limitation with some of the apps and games is staying motivated, and, since most of these games are played alone on either a computer or a tablet, and it's hard to stay motivated to keep playing when you're playing by yourself. And if the game's become too challenging, then a lot of times people will quit because it just gets to be too stressful for them. And then number four is technical and dexterity issues. A lot of people have dexterity issues with or limited access to technology, but one of the big ones is dexterity issues, where they have trouble either pushing the buttons or moving their fingers to reach some of the keys and buttons that they need to push. And then, finally, cost is some of the apps come with a subscription and or fees, whether it be a monthly or yearly subscription, or you have to pay a fee upfront to get access to a lot of the components of the app. And then the last one is the learning curve. Some apps may take too long to learn and are too complex, and they're going to cause us to get frustrated and not wanna do cognitive games. So keep those limitations in mind if you wanna get into using web-based games or apps.

Speaker 1: 25:45

Okay, now that we know what games to play and to help each other with our cognitive abilities, let's turn our attention to the third piece and help us improve our brain power. So, if we're thinking of trivia pursuit, we're trying to get our third pie piece here, and that is meditation and mindfulness. Now, you probably heard both of these terms, but I'm really sure what they mean. Are they the same or are they different? Well, that's a good question. So let's look at the two terms and then we'll start with meditation.

Speaker 1: 26:18

Now, meditation is a formal practice where you train your attention to focus on either a specific object, a thought or a sensation and when I say sensation, it may be focus on your breath or focus on your toes or that would be a sensation, and it could be a mantra that you repeat as well or even a physical sensation like feeling your feet on the ground. Now, the goal of meditation is to foster staying in the present moment and being aware and just making nonjudgmental observations of your thoughts and your emotions and then letting them pass. So when you're meditating, you may have thoughts that come into your head. You would just acknowledge the thought and then let it pass away without judging it, and what it's designed to do is help to reduce stress, encourage calm and help you focus your thoughts and attention on present moment. Now there are different meditation techniques that you can use and there are different classes that are offered, and, again, most of them are designed to achieve calmness, things like mindfulness meditation, there's mantra meditation, there's transcendental meditation. So there's a lot of different types of meditation out there. You just have to select the one that is right for you. Now, how's that different from mindfulness?

Speaker 1: 27:45

Now let's take a look at mindfulness and how it differs from meditation. Mindfulness is a mental state of paying attention to the present moment without judging, and it's not a formal practice like meditation. You don't sit down and say I'm gonna practice mindfulness for 15 minutes. It's something that you do on a daily basis as you look at things, as you move around through your daily life. Now, the goal of mindfulness is to be fully aware of your thoughts and feelings, and then even your body sensations, without getting caught up in them, and the reason you do this. It helps you reduce your stress, improves focus and allows you to make more conscious choices in your life.

Speaker 1: 28:28

How can you apply mindfulness? Mindfulness can be practiced anywhere, at any time you can. For instance, you can be mindful while you're eating, while you're walking, talking and, yes, even working. While meditation and mindfulness are similar. They are slightly different. The best analogy I could give you is meditation is practice, so you're practicing focusing on your breath or focusing on a different sensation. And then mindfulness is taking what you've learned in meditation and applying it into your daily life. So you're using that focus in your daily life to help stay in the moment and reduce stress and anxiety. So that's the difference between the two.

Speaker 1: 29:15

Now, both mindfulness and meditation have both been growing in popularity and helping people with their overall general well-being and quality of life for some time now. But there is some promise that it showing that it supports cognitive function and people with Parkinson's as well. So let's look at how the two can help you with your cognitive function. Both meditation and mindfulness can reduce stress and anxiety, and these are both major contributors to cognitive decline. They can also improve your attention and focus. By training your focus and attention, it can help you lead to better cognitive performance in your daily tasks. So when you practice meditation, you're practicing focus, and it could be on an object. And then in mindfulness, you're taking that focus and putting it into practice when you're doing your daily tasks around the house, and that's going to help you with your cognitive performance as well. And then the third piece is enhanced neuroplasticity, and that's your brain's ability to adapt and create new neural connections, and this can potentially help you counteract the neurodegenerative process of Parkinson's, because we all know it's a neurodegenerative disease, and so if you can help build these new neural pathways, that's going to benefit you in terms of your Parkinson's.

Speaker 1: 30:42

Now the types of practices to help with cognitive function can include mindfulness meditation, where you're focusing on your breath or body sensations. Some people will even do the surrounding sounds maybe they listen to ocean sounds or rain sounds and what it does. It helps them stay in the present moment and helps them reduce stress and anxiety, because they're not worried about all the things that are going on in their daily life and the stress at work and the stress at home, so they can just focus on their breath or the sounds and help to reduce their stress and anxiety. And then there's movement meditation, and that's combining movement with mindful meditation such as Tai Chi and yoga. They can be particularly beneficial for people with Parkinson's. They work on both your cognition and your motor symptoms. So if you haven't had a chance to try Tai Chi, it's a great experience. They use slow, gentle movements and you focus on your breathing as you're doing the movements. So it really does help to reduce stress and anxiety and it's great for your balance as well, and same for yoga. Yoga is, if you haven't done yoga the different yoga poses you're working on your balance, but you're also working on your cognition because you're focusing on certain aspects of the different yoga poses and moves. And then they also have guided meditations. So there's some apps out there believe calm is one of them and they record specific relaxation sessions or sleep sessions or meditation sessions that you can use to help work on your focus and then reduce your stress, and they're going to help you manage your Parkinson's symptoms and help you build your cognitive skills as well.

Speaker 1: 32:43

Now, since there's been an explosion in the number of people doing meditation and mindfulness practices, there's been a lot of research, and, while it's still ongoing, studies do suggest some positive effects of both mindfulness and meditation on cognitive function and people with Parkinson's and some of the benefits and effects that seem to be shining through our improved memory and attention, enhanced executive function, reduced cognitive decline and an increased quality of life. Now it's important to note, though, that individual results are going to vary and consistency is the key for long term benefits. So if you just meditate once and then don't do it again for three or four weeks, you're probably not going to see the long term benefits of meditation and mindfulness. So you want to have consistency and it's going to vary from individual to individual depending on how well you're able to calm your mind and focus your mind on whether it be a breath, a sound or sensation. And then meditation and mindfulness should not replace conventional medical treatment. So make sure that you're still seeing your doctor on a regular basis and you're sharing your symptoms and asking them for help to address both your motor and non motor symptoms, and then consult a healthcare professional before you start any new practice, especially if you have other healthcare issues besides Parkinson's. So that's important to note as well. All right, now that we've looked at the exercise, we've looked at brain training and games meditation for helping us boost our brain power.

Speaker 1: 34:30

Now let's look at the final piece of the puzzle, and that's called cognitive rehabilitation. Probably asking yourself cognitive rehabilitation? Yes, cognitive rehabilitation exercises are tailored to address specific cognitive impairments that people living with Parkinson's may experience. So what I want to do is share some of the common types and how we can use these rehabilitation exercises to target specific skills to help you with your cognition. So I like to be open and honest and in many of these that I'm going to be discussing, I personally experience myself most, if not all, I would say. So I'll be, I'll be discussing these and the exercises to help address them and talk a little bit about how they benefited me and hopefully they can benefit you as well.

Speaker 1: 35:22

All right, let's start with the first rehabilitation exercise, and that's attention and working memory. So what exactly do these terms mean? Well, attention is your ability to focus your mental resources on a specific object, thought or activity that you're doing, and it allows you to take and process the information and filter out all the distractions. So when you go to a concert, for instance, and you're focused on watching the guitar's play, you don't see the drummer or anything else, because your attention is focused on that particular player in the band. That would be a good example.

Speaker 1: 36:02

And there are three different types of attention. There's selective attention and my wife will probably say that I have selective attention and selective attention is when you're focusing on one thing while ignoring others. So, for example, you go to a concert and or you're in a big group and you're listening to your friend speak in a noisy crowd. But you can unfocus the crowd noise and just focus on what your friend's saying. That would be selective attention and that's why I think my wife would say I have selective attention, because when she's asking me to do things sometimes I lose my focus or attention, if you will.

Speaker 1: 36:40

The second type is sustained attention and that's when you focus on a task for an extended period of time. So for instance, you go to a speech or a lecture and you're listening to somebody talk for 45 minutes. That would be an example of sustained attention and I would have trouble doing that myself because usually after about three to five minutes my mind starts to wander and I'm thinking about other things. So I would have difficulty with sustained attention. And then the third type is divided attention. Then that's when you can attend to multiple things at one time. So you're driving and listening to music would be an example, and so maybe you're writing a story and you're listening to music at the same time. That would be divided attention.

Speaker 1: 37:27

Then working memory is the temporary storage and manipulation of information. So you can think of working memory as the RAM on your computer. So meaning. If you're not familiar with that, what RAM does? It only lets you do and process so much information at a time. If you have a certain low RAM in your computer and you're trying to run too many different programs, your computer usually freezes up. So that's what the difference is. So working memory is like the RAM on your computer it's only going to allow you to process so much information at a time.

Speaker 1: 38:07

And working memory plays a key role in how we learn and comprehend. It helps us hold on to instructions and learn new things. It's also involved in reasoning and problem solving. So when you're sitting down and you have a riddle or you have a problem that you need to solve, you're going to have to rely on your working memory for that. And then language processing. Working memory is going to help us understand both spoken language and written language, so they're important pieces of the pie.

Speaker 1: 38:45

So some of the tasks for helping with attention and working memory are dual task training, and that's where you do two tasks or two exercises at one time. I just recently posted a YouTube video on dual exercises for cognitive function and in the video I talk about combining different cognitive activities with like counting backwards, saying the months of the year, backwards, counting forward, spelling forward and backward while you're doing exercise. So you're doing two different things at one time and then so, if you get a chance, check it out at Liv Parkinson's on YouTube and you'll be able to see what I'm talking about, with dual task training and then memorizing sequences and visual spatial tasks, and those are where you're tracking different objects on the screen. So attention and memory working memory are going to help you memorize sequences. So when you're doing we talked a little bit earlier about the memory game you can say, ah, I remember what the sequence is, or I remember where this is. And these are exercises are going to help you target the following skills they're going to give you sustained and divided attention, it's going to help you with your information processing speed and it's going to help you with your working memory capacity as well. So dual task training or working on different sequences. So, for instance, if they give you a list of 10 different objects and there's three different categories, they might, you might be able to sequence those in your head to help you remember and say, oh, that's right, there's three pieces of furniture, there's three modes of transportation and there is four colors. So that's a way to help you sequence and remember.

Speaker 1: 40:38

Another type of rehabilitative exercise is executive function and that's the ability to plan and organize your tasks. And again, I have problems with this. I used to be fairly good at it, but now I have to walk myself step by step through things in order to to work through them and remember them. But these are tasks to help improve and maintain. Executive function include things like brain teaser games, like riddles or logic puzzles. So, for instance, if you go out and you get a book, or you go online and and just search under riddles and do those, and then there's also logic puzzles where you have to solve, using your logic to come up with the answer Sudoku, where you're using salt, using numbers, to solve the puzzle. That's using your logic and reasoning. And then there's what they call end back exercises and they involve memorizing sequences of letters and numbers and then and then also trying to identify patterns within those letters and numbers. I know a lot of times when you go to take a memory test, when you go to see your healthcare professional, they'll have where you have to connect the dots and it'll go one a to be. Those would be sequencing and executive function skills, target book planning and organizational skills, and they also help you with your time management. And then the next rehabilitative exercise is memory. And that's where you you have.

Speaker 1: 42:14

You take encoding and retrieval exercises like memorizing word lists or recalling personal details from the story. Memory flashcards defined in remember paired objects. So, for instance, I might read you a three sentence or four sentence little story and then ask you to recall a couple of the pieces from the story. Or I may give you a list of words and then ask you to repeat the words and then go do a couple other exercises and then come back and ask you what the words were again. So those all work to help improve your memory. And then these target both your short and your long-term memory. So working on those games, practicing memorizing word lists and recalling personal details from a story, and then flashcards if you do flashcards on a regular basis it's gonna help both your short and long-term memory and your encoding and retrieval processes and it's also gonna help you with your memory strategies. I know one of the big issues that I have is remembering people's names. I'm great with faces, but when it comes time to names I forget very easily and it takes me three or four or five times, before I remember.

Speaker 1: 43:32

And then language is another one, and you can include word find games, naming objects, doing semantic tasks where you're required to categorize items, and sequence generation. So, for instance, you might have a group of for sequence tasks, you might have a group of 10 words, and again three of them might be related to transportation, three to flowers and then four to maybe outdoor type items, and then what you're responsible for doing is trying to put them in order in a sequence of how they fit together and divide them up that way. So, and then these type of games whether it be the word find games and I talked about the word find app or naming objects, where someone will show you a picture and ask you what the object is those all help you with your vocabulary, your fluency, and they also help you with your comprehension and communication skills. Now, this is not an exhaustive list, these four rehabilitative exercises that I just talked about, but specific exercises are gonna be chosen by your healthcare professional based on your individual needs and your cognitive profile. So if you're working with either an occupational therapist or a speech therapist, they can help you identify the most suitable exercises rehabilitation exercises to help you optimize your cognitive function. Well, that's a wrap on helping us build our mental fitness and using evidence-based approaches to sharpen our cognition. Now, we covered a lot today, from the science behind exercise and mindfulness to the potential brain training and rehabilitation exercises.

Speaker 1: 45:27

Now, remember, there's no one size fits all answer when it comes to boosting your brain power and working on your cognitive functioning the keys to find a combination of strategies that work for you and fit into your lifestyle. So if the easier you make things for instance, you might say I'm gonna spend 10 minutes or 15 minutes every day doing Sudoku puzzles, or on the weekends, I'm going to do I'm gonna play Scrabble with friends so try to pick activities as well that you like, that fit into your lifestyle and also not only provide benefits for your cognitive function but also your social interaction as well. And then, don't be afraid to experiment and have fun. So try new, different games that you've never done before and I think that you'll find that there's a bunch of different games out there that are very interesting. And then, most importantly, be patient and consistent with your efforts. It's gonna take time If you feel like you're losing some of your memory or you're getting fuzzy. These exercises take time to work. It's not gonna happen overnight.

Speaker 1: 46:37

And then let's take a look at some key takeaways. To remember Number one you wanna prioritize physical activity, move your body. That's right. Regular exercise is the cornerstone of cognitive health, believe it or not? Let me say that again regular exercise is the cornerstone of cognitive health. And then explore mindfulness and meditation. See if you can find some techniques that resonate with you to help you reduce your stress and sharpen your focus. And then consider brain training. Choose evidence-based apps, like some of the ones we discussed, and games, and try to remember their tools are not magic solutions, so use them to help you, but don't lean on them as a crutch. And then talk to your healthcare professional, discuss what some of your cognitive goals are, explain some of the issues that you're having and ask for help from them to provide exercises and games that you can do to help strengthen whatever specific issues that you're having.

Speaker 1: 47:37

And then stay curious and engaged, challenge your mind, learn new things and actively participate in life. Remember your brain's incredibly adaptable. Even making small changes can make a big difference. Don't forget to share your experiences and questions with our online community. If you go to fanlistcom Live Parkinson's Life. There's a online community there. If you wanna leave comments or start a chat going, we can all jump in and provide some feedback and help with your questions, comments, and please subscribe to the podcast and visit my new YouTube channel, live Parkinson's Live an Exceptional Life, for more information on living a great quality life with Parkinson's. And again I thank you for listening to this podcast and I look forward to having you on future podcasts. Thanks again, thank you.