Men’s Health: A Work in Progress

URMC is sponsoring a “Journey to Healthy Living” on Thursday, June 13, at the 9^th Men’s Health Day at Mario’s Italian Steakhouse. Scripts sat down recently with event organizer Dr. Jean Joseph for an interview about the state of men’s health. We regret that tickets to the event have recently sold out (as of June 4), but still thought it important to share his perspectives with you.

 Scripts:  Why an event focused solely on men’s health?

Joseph:  More than 10 years ago, we recognized that it’s not enough just to treat illness; we wanted to help men avoid it in the first place. So we came up with the idea of Men’s Health Day. Those of us in the medical profession see far too many patients who have waited until the last minute before seeking medical care – many of whom are suffering from an illness that could have been entirely avoided in the first place. Most of these patients are men. Heart disease, stroke and cancer take an alarming toll every year on men in our country. There is a reason why women in nursing homes significantly outnumber men: because men are dying five years earlier, leaving their friends and families to cope without them.

Scripts: What is it that men aren’t doing – and women are – that makes the difference?

Joseph:  If you discount genetics or environmental factors, there are many things men can do to live longer that they’re not doing now. What many are doing is indulging in a variety of self-destructive behaviors like smoking, unsafe sex, not wearing a seat belt, excessive drinking, and generally not getting regular checkups and ignoring their health until it’s too late. We’re not blaming guys. Some of the reasons for these are cultural; men are conditioned from an early age to understand that being reckless is “typical boy” behavior and that excessive partying and ignoring their health is manly. Women, on the other hand, have an advantage. Most have had regular checkups with a gynecologist since puberty and view being proactive about their health a positive thing.

Scripts: Are there simple steps that man can take to make a difference?

Joseph:  Education and self-awareness are the first steps to reversing the statistics. Getting regular checkups and adopting a healthier lifestyle are the next. With rising health costs and competition for services, it’s more important than ever for men to stay healthy and vigorous in order to live satisfying and active lives for as long as possible. And today, as long as possible could mean 90 to 100 years of age – or even more.

By presenting Men’s Health Day, we are aiming to provide an informal forum where men will receive solid information and feel free to ask questions. If you are a man age 45 or older, I encourage you to attend. And if you are a woman who cares about an older man, please pass this information on and urge him to attend.

Again, here are the details:

Men’s Health Day, open to men ages 45 and up

Thursday, June 13, 2013, 11 a.m. to 3:30 p.m.

Mario’s Italian Steakhouse, 2740 Monroe Avenue, Rochester, New York

Attendees will learn more about:

• Back pain
• Heart health
• Low testosterone
• Memory and nutrition
• Health care reform and how it will impact our community

Admission is free but space is limited and reservations are required. Call (585) 275-8762.

Jean Joseph, M.D., M.B.A., is a professor in the department of Urology and the Wilmot Cancer Center at the University of Rochester Medical Center. He is the head of the section of urologic laparoscopy and robotic surgery. Joseph is also the medical director of Patient- and Family-Centered Care at URMC.

DIY Heroes: Set Down the Scraper, Get Lead Smart

Is your home looking, well, homely? Big box improvement stores have thrown down the gauntlet, holding paint sales that practically beg you to spruce things up.

But don’t reach for that scraper just yet. If you’re living in a home built before 1978 (if you live in Rochester, the chances are good, considering a whopping 87 percent of the city’s housing was constructed prior to 1950), there are real, often under-appreciated health risks associated with stirring up dust from old, lead-based paints. Risks are especially concerning for children’s developing brains and nervous systems. What’s more, symptoms of lead poisoning might not be obvious until effects surface later in life in the form of learning disabilities, difficulty concentrating, reproductive troubles, and more.

Wondering why lead was added to paint to begin with? Or how you can protect yourself and loved ones from exposure risks during your next renovation project? This spring, we’re re-sharing a clip from a couple years back, featuring environmental health expert Dr. Katrina Korfmacher. In it, she discusses some history, risks and safety considerations related to lead paints. (You also can learn more about URMC’s efforts to eliminate lead poisoning in the Rochester area, here.)

Remember: Lead poisoning is preventable, but its effects are irreversible. Practice prudence when you paint, sand or scrape.

For additional national and local resources, check out:

• http://www.epa.gov/lead/
• http://www.letsmakeleadhistory.org/
• http://www.cityofrochester.gov/lead/ (Alternately, you can call 585-428-LEAD with concerns.)
• http://www.monroecounty.gov/eh-leadpoisoning.php (Dial 585-753-5087 to learn more.)

Of interest, Korfmacher—director of the Community Outreach and Engagement Core of the University of Rochester Medical Center Environmental Health Sciences Center—co-authored a new study that published this month in the Journal of Health Politics, Policy, and Law. The paper highlights community-based efforts to develop strategies and policies that—by targeting high-risk housing—might hold the key to reducing lead hazards in children’s homes. To learn more about how local lead laws (like Rochester’s new lead abatement ordinance, which requires regular inspections for lead paint hazards as a part of the city’s certificate of occupancy process for rental properties) are making a healthy difference, click here.

Life Beyond Stroke: Inspiration from a Three-time Survivor

According to the Centers for Disease Control, the Rochester region has one of the highest stroke rates in New York, affecting 14 people per 1,000. No doubt, strokes can be devastating—but there’s hope on the other side.

To prove it, we’re changing things up this week and showing off this quick video clip from Christina Goodermote, a local mother and three-time stroke survivor whose perseverance has allowed her to work, maintain her busy household, and be courageous enough to take karate and surfing lessons.

Grab a cup of coffee, take a moment, and be inspired.

Stroke: A Crash Course

Stroke occurs when blood flow to the brain is disrupted by either a blood clot or when a blood vessel in the brain bursts, spilling blood into surrounding tissues. Failure to recognize the symptoms often results in a delay in getting emergency care, which can reduce a person’s chances of survival and diminish quality of life.

You can remember the signs of a stroke with a simple acronym, FAST:

·         Face – Ask the person to smile. Does one side of the face droop?

·         Arm –  Ask the person to raise both arms. Does one arm drift downward?

·         Speech  – Ask the person to repeat a simple phrase. Is their speech slurred or strange?

·         Time – Seconds starved of oxygen cost you brain cells. If you observe any of these signs, call 911 immediately.

Anyone can have a stroke no matter their age, race or gender. And the chances increase if you have the following risk factors: high blood pressure, high cholesterol, diabetes, atrial fibrillation (abnormal heart rhythm), atherosclerosis (hardening of the arteries), alcohol use, smoking and tobacco use, obesity, family history, circulation disorders, age, and a history of strokes.

The good news is that as many as 80 percent of strokes can be prevented, and the best way to protect yourself and loved ones is to understand personal risk and how to manage it.

URMC’s Stroke Treatment Alliance

The Stroke Treatment Alliance of Rochester, or STAR, is a collaborative effort by University of Rochester Medical Center’s Strong and Highland hospitals, Unity Hospital and Rochester General Hospital to improve and unify stroke care and raise awareness of the warning signs for this potentially devastating health emergency.

To learn more about the Stroke Treatment Association of Rochester, click here.

Worth the Worry? Research Links Dental X-Rays, Brain Cancer Risk

If you “say cheese!” for annual dental X-rays, you might have found new research published in last month’s American Cancer Society journal, Cancer, to be a bit unsettling.

The study, out of Yale University School of Medicine at New Haven, suggested ties between yearly radiographs and an upped risk for the most common brain tumor in Americans: meningioma.

But don’t swear off scans completely, says Eastman Institute for Oral Health dentist Yan-Fang Ren. A deeper look into the matter – and study design – is warranted. He says visual examination alone often falls short, and X-rays remain an invaluable tool for helping dentists detect oral health issues before they devolve into bigger, harder-to-treat problems.

We spoke to Dr. Ren to learn more.

Scripts: According to the study comparing 1,400 meningioma patients to similar adults without tumors, cancer patients were much more likely to recall having frequent “bitewing” and “panoramic” x-rays, especially as kids. Can you describe what these procedures are – and if they’re still commonly used today?

Ren: First, it’s really important to note that some of the subjects in this latest study received dental X-rays decades (even fifty years) ago – a time when radiation doses were far greater due to less sophisticated technologies, like slower speed films. Because of this, the study results can only be considered suggestive of a possible association – more rigorous research would be needed to prove an actual cause and effect relationship. As other experts have carefully pointed out, the amount of radiation in modern dental x-rays is pretty small – more than 100 times less than what a woman’s mammogram delivers to a single breast.

That said, yes – bitewing and panoramic X-rays are still used today. Bitewings provide a picture of the upper and lower back teeth, showing decay between the teeth, as well as how the upper and lower teeth line up. They can also reveal bone loss due to severe gum disease or a dental infection.

Panoramic X-rays, as their name suggests, show a broader view of the teeth, sinuses, nasal area, and temporomandibular (jaw) joints. While they can’t image cavities, panoramics are still useful for detecting other problems, like impacted teeth, bone abnormalities, cysts, solid growths (tumors), infections, and fractures.

Scripts: Many critics of this latest research point out the study’s weak design: Using “recall” surveys, which can be hazy. Still, the findings have left many patients worried that X-rays carry some risk, even if that risk is small. How do you weigh the benefits of regular X-ray exams against (even minute) radiation risk?

Ren: Each patient’s situation differs; some might have more complex oral health needs, and require X-rays more frequently than others. Again, infections of the teeth and gums can be quite grave, at times even pave the path for other serious medical conditions. And, not to downplay the danger of meningiomas by any stretch, but it’s worth noting that most of these tumors are benign and slow-growing.

Personally, at Eastman Dental, our priority is practicing minimally invasive dentistry – which means we aim to make diagnoses at the earliest stage of disease, ideally reducing discomfort and preserving the most tooth structure, and a patient’s whole body health. Again, radiation doses are significantly lower now that they were decades ago, in part thanks to modern precautions we now take to reduce exposure – such as using high-speed films, digital radiographs (which can cut radiations exposure by up to 90 percent), and machines with attached collimators (telescope-shaped devices that prevent radiation scattering, limiting the size and shape of the X-ray beam and ultimately delivering a smaller dose to tissue).

Scripts: But, for a generally healthy patient, is an annual X-ray overkill? Would every two to three years suffice (and does the recommendation differ for kids versus adults)?

Ren: The American Dental Association’s formal guidelines for healthy persons suggest that kids receive one X-ray every one to two years, adolescents receive one every one-and-a-half to three years, and adults receive X-rays every two to three years.

Still, this isn’t a one-size-fits-all recommendation, because it also depends on the patient’s risk level and any signs and symptoms of existing oral disease. You should talk with your dentist to decide how often you need radiographs as part of your ongoing care plan.

Since 1915, Eastman Dental has been working to provide quality care, from simple cleanings to repair, replacement, or cosmetic work. Visit their website for more about the services offered, their emergency dental care, and special clinic locations that offer sliding fee scale discounts. To make an appointment, call (585) 275-5051.

Progressive Memory Loss: Shoring up Support for Alzheimer’s Patients, Families

It often starts out modestly, almost imperceptibly – a few glitches in recall, trouble remembering a name, maybe – and then can progress to a truly debilitating disease. Sometimes one that requires intense, round-the-clock care that stretches family members and loved ones thin.

As the demand for Alzheimer’s and other memory care services continues to grow (an estimated 25,000 people in the Finger Lakes region suffer from the disease – the most common form of dementia – and that number will likely triple by 2050, as the population ages), URMC recently announced a novel program that pulls together support from all angles. Known as the Memory Care Program, a cross-specialty team of neurologists, psychiatrists, geriatricians, neuropsychologists, social workers, nurses, and marriage and family therapists staff the clinic.

“Truly effective treatment requires a coordinated approach, gathering a team of clinicians that can help address the many facets of these diseases,” says URMC neurologist Dr. Fred Marshall, who directs the new program.

And it’s precisely because of this deep and diverse team that the same clinic, all under one roof, can deliver a comprehensive evaluation of each new patient,  provide guidance on medications and coping strategies,  educate patients and families about a broad variety of resources and support available in the community, and more. To appreciate the full breadth of the new program’s services,  tune into the video below.

The new Memory Care  Program – made possible by a $1 million anonymous gift to the Medical Center (as part of the University of Rochester’s $650 million “Meliora Challenge”) – anticipates following up to 3,000 patients, and plans to recruit new faculty and expand capacity as demand grows.

Know someone with Alzheimer’s? You can find even more information about URMC’s program at www.memorycare.urmc.edu, or by calling 585-273-5454.

Go Fish! Do Omega-3 Supplements Deserve a Spot in Your Medicine Cabinet?

A new report making waves this month says the jury’s still out on whether those big, fish-oil soft gels offer much benefit for persons already living with heart disease.

The latest analysis, which reviewed just over a dozen smaller studies, found that taking the supplements – or not – made little difference in whether 20,000 chronic heart disease patients suffered heart attacks or strokes.

But don’t toss your fish pills just yet, says URMC cardiologist Dr. Robert Block. There’s more to consider. Below, he helps make sense of the latest science – and its short-comings.

Scripts: Historically, have cardiologists advised cardiac patients (say, those with high cholesterol) to take fish-oil capsules – and if so, based on what research?

Block: It’s important to note that a fair number of older studies – many of which were conducted before the mainstream adoption of today’s aggressive medicines, like statins and beta-blockers – were quite conclusive. They suggested fish oil supplements indeed played an important role of protecting patients with heart failure.

Take the GISSI (Gruppo Italiano per lo Studio dells Sopravvivenza nell’Infarto Miocardico) trial, for instance, which found that these pills lowered the risk of fatal cardiovascular events by 10 percent for cardiac patients. So, conceivably, it could be that more recent trials (in which the bulk of patients were already taking powerful medications) might not accurately appreciate the role that fish oil actually plays – especially for people never diagnosed with heart disease to begin with.

To that end, many cardiologists do recommend fish oil supplements – or better yet, eating more real fish – since the known side-effects (other than the occasional potential for a fishy burp!) are negligible. What’s more, fish oil does not interact with other medications – a big problem we see with many prescription drugs.

Scripts: Some people assume that “supplements,” in general, are just as good of a substitute for consuming the real food. But does this study possibly suggest that the part of the benefit of fish oil, in its most natural form (that is, in actual fish!), comes because fish are eaten in place of other less-healthy meats?

Block: Certainly, fish are a wonderful dietary staple. The health benefits are well-documented, and the most current, 2010 Dietary Guidelines for Americans advise all of us (even pregnant women) to eat more servings of fish. And, even while the data supporting fish oil supplements is less cut -and-dried, the American Heart Association nevertheless maintains an official recommendation that patients with the metabolic syndrome (pre-diabetes) should eat more fish – or take fish-oil supplements.

But certainly, you raise a fair point – consuming nutrient-rich foods in their natural form is important, because theoretically, because it represents a smart trade-off: Chances are good that your fish-based meals are replacing other less-good-for-you protein sources, like pork or red meats.

Scripts: Many of the studies wrapped into this latest analysis didn’t follow patients for the long-term. Isn’t it possible that, especially for patients who have not developed heart disease, there still is some longitudinal benefit from supplements?

Block: Absolutely! This is a major limitation of the study, and a point that’s getting a good deal of press attention. When it comes to preventive cardiology, we’re keenly focused on long-term health risks – looking ahead 30 to 50 years, rather than shorter periods like these trials are studying.

What’s more, sample size really matters – and is often overlooked by the public. Frankly, many of the studies wrapped into this most recent meta-analysis (a “study of studies”) were probably too small to detect the modest but important risk-reduction role supplements likely play.

Scripts: So bigger, longer-term studies are warranted – that makes sense. But, are all fish-oil supplements created equal?

Block: Supplements definitely vary in quality – and of course, cost. Take Lovaza, for instance; it’s an FDA-approved prescription drug composed of about 85 percent EPA and DHA, the most important fatty acids in fish, and is commonly prescribed for diabetics and obese folks with high triglycerides (a major cause of pancreatitis—a very serious health issue).

On the other hand, cheaper, over-the-counter options generally pack only 30 to 60 percent EPA and DHA. Many people at high-risk for cardiovascular disease take them (including me) because they feel better doing so, and are banking on their potential for longer-term health benefits.

Of course, it’s important to note that improving heart health isn’t the only thing omega-3 fatty acids have been lauded for.  Other studies have found fish-oil supplements to reduce joint pain and stiffness, boost the effects of anti-depressants, and play an important, brain-building role in the womb (aiding babies’ neurological and visual development). So, it’s important that we take new studies in stride, looking closely at their design and asking how each fits into the bigger picture of all the science that’s gone before – as well as the science that’s currently underway.

Dr. Block specializes in the care of patients with high blood cholesterol levels. If you’ve been diagnosed with unhealthy cholesterol levels, and are you looking for help getting them under control, call URMC’s Lipid Clinic at URMC at (585) 341-7700.

Is ‘The Change’ Really to Blame for Memory Woes?

No, you’re not imagining it. New research out of the University of Rochester Medical Center and the University of Illinois published in the journal Menopause this month, offering some concrete evidence proof that the “brain fog” striking some women in their late 40s and 50s is indeed real.

While the findings come as no surprise to the millions of women who’ve had bouts of forgetfulness as hormone levels wane, the science provides a fascinating glimpse into which aspects of memory might actually be affected – and begs big questions as to why. To learn more, we spoke with URMC study leader and neuropsychologist Dr. Miriam Weber.

Scripts: When it comes to memory troubles and menopause, we often automatically think of trouble with recall – say, making a “mental note” to pick up a gallon of milk on the way home from work. But this study suggests that this particular type of memory isn’t at issue, and the problem might actually lie with “working memory” (e.g., our ability to manipulate new information, like calculating a “30 percent off” sale price), or with our ability to keep focus amid challenging tasks. Do we have any idea why this might be – or what tricks women can use to compensate, staying sharp?

Weber: That’s a great question. We don’t know precisely why so many menopausal women seem to having difficulty in these areas; we’ve long assumed that it’s related to hormonal fluctuations, but data from this particular study doesn’t provide clear answers.

To compensate, though, most women would do well to minimize multi-tasking. By really homing in and focusing their attention on one thing at a time, they might be more successful in helping their brains encode the new information. Since our data suggests that women’s complaints aren’t associated with a true retention problem (e.g., remembering that gallon of milk), if they can successfully encode it, they should be able to hold onto it. So, tricks might be to pay careful attention, get rid of distractions, and practice repeating the new information a few times. Of course, day planners and sticky notes can’t hurt, either!

Scripts: Did any women in the study seem to escape the “memory fog?” Did the degree of memory troubles vary much among participants?

Weber: Yes. About a third of the women in our study sample didn’t have significant memory complaints, and their having fewer complaints played out in our tests – they performed better on working memory and attention tasks.

Those who did have memory complaints, however, also tended to have more symptoms of depression, anxiety and sleep difficulties – but not worse hot flashes. What’s more, their cognitive performance troubles remained even after controlling for these other symptoms – meaning the cognitive troubles can’t simply be attributed to these other symptoms. It’s not “just” depression; something more is at play.

Scripts: Was it surprising that changing hormone levels seemed unlinked to actual memory troubles?

Weber: To be honest, we weren’t completely surprised. Other studies also have failed to show a relationship in this population.

That said, we think this might be due to how we are measuring the hormone. For instance, researchers typically measure at one point in time, rather than capturing cumulative exposure – which might be important. There is some suggestion that hormonal fluctuations, rather than the absolute level at any one time, are tied to depressive symptoms in women in the menopausal transition. So, vacillating levels might have implications for cognitive problems. It certainly would be of interest for future studies!

Scripts: We know your paper doesn’t address this issue specifically, but is there thought that, after menopause, women’s cognitive abilities stabilize and/or return to pre-menopause levels?

Weber: It’s certainly possible. Back in 2009, a study published in the journal Neurology found that, in a sample of nearly 2,000 women, some very mild cognitive declines in the late transition stage did indeed rebound to early levels post-menopause. So, that particular study seems to suggest that women might stabilize and/or see their capabilities return to pre-menopause levels. Our study will follow participants for five years, so we eventually hope is to be able to shine light on this, too.

Scripts: So, what’s the big takeaway message for women?

Weber: The most important thing to realize is that there really are some cognitive changes that occur during this phase in a woman’s life. If a woman approaching menopause feels she is having memory problems, no one should brush it off or attribute it to a jam-packed schedule.

That said, it’s really important to note that any difficulties experienced are not incapacitating! She should be able to function just fine, though she might be working a little harder at it than she has in the past. Women should take comfort in knowing that their concerns are common, and that the currently available data suggests that these difficulties might actually be short-lived.

To learn more about the study, click here.

Still Struggling with the Time Switch? Here’s the Skinny on Your ‘Body Clock’

While the lilting songs of the robins and those first dancing daffodils are certainly welcome signs of spring, shifting your body’s clock forward an hour is no walk in the park.

In fact, for some people, their body bristles at the ringing alarm clock for days after the weekend time change. If you’re among this groggy group still reeling from that lost hour, keep reading – sleep medicine expert Dr. Wilfred Pigeon has insights into what’s going on inside you, and how you can cope.

Scripts: In casual conversation, we talk a lot about our “internal clock” – especially this time of year. But, what exactly is it – and how does it work?

Pigeon: Nestled deep in our brain is a bundle of neurons (nerve cells) forming the suprachiasmatic nucleus, or “SCN.” This grouping of nerves steers a whole host of natural “biological rhythms” – including the timing of sleep and wakefulness.

It’s not surprising that light plays so heavily into our feeling either tired or rested, because the nerves composing our SCN are, put simply, “wired” to the retinas in our eye. Nature’s 24-hour light-dark cycle supplies the SCN the critical information it needs to keep our daily rhythms on pace – which the SCN does, in part, by triggering the nearby pineal gland to increase the production and release of melatonin, a sleep-inducing hormone, at precisely the right time for us to make use of it.

To see how delicate the timing of sleep and wake cycles can be, you need only fly across a few time zones and observe what happens. Jet lag (and the poor sleep that ensues for a couple of nights) is essentially the product of a confused SCN.  It’s almost like a band keeping pace with an inexperienced drummer; the jet-lagged brain and body really struggle to get back on course.

Scripts: Why is it so much more difficult to “spring ahead” than to “fall back”?

Pigeon: It’s probably because so many of us are chronically sleep-deprived – making it that much more painful to lose an hour, as opposed to gaining one.

Scripts: So, how can you help yourself adjust to the earlier hour more smoothly?

Pigeon: The best advice, really, is to have been proactive and prepared prior to 2 a.m. Sunday morning.  I usually recommend setting your clock ahead on the Saturday morning before, instead of waiting until bedtime, as this gives yourself more time to ease into the change.

But now that the clocks have already moved, one of your best bets is getting plenty of nice exercise this week — it just might help wear you out for your earlier bedtime. And as you continue to ease in, it can’t hurt to sip a strong cup of coffee in the mornings, or open the blinds and let sunlight spill into your bedroom as soon as you get up.

Scripts:  And of course, on the bedtime end of the equation, it can be difficult to coach ourselves to turn in at this earlier hour. What do you recommend in the evenings?

Pigeon: First, if you are sleepy enough, embrace it! Call it a night. But if you’re not tired, don’t even bother – you’ll just spend that extra hour lying awake in bed frustrated. Give it time – your body will acclimate naturally.

That said, a few tips for better nighttime sleep can never hurt. The cardinal rule, of course, is the maintain a regular bedtime as much as possible, and to avoid naps – which might feel good at the time, but can sometimes make it tricky to sleep later on. As much as possible, avoid stimulating activities immediately before bed – that includes channel and web surfing, exhausting mental feats (like calculating taxes!), and of course, physical exercise. Finally, as much as you can, keep the bedroom reserved for just sleep and sex – not lounging or watching TV.

Scripts: In general, how much sleep do we need on an average night? And if we get too little, how does this affect us physically and emotionally? 

Pigeon: Though we’re quick to spout off “eight hours” as the magic number for adequate sleep, the truth is that the numbers are actually a bit fuzzy. Much depends on how sleep quantity (or sleep duration) is measured – and actually, several large surveys have found the overall average sleep duration to consistently come in at just about seven hours per night. What’s more, it may be that we “catch up” on weekends, so not all nights are created equal.

Sleep, of course, is crucial to health – and life! Chronic deprivation can diminish the production of growth hormone, and even disturb our ability to learn and recall information. In fact, over a relatively short time – just a  week – the effects of nightly partial sleep deprivation can lead to performance reductions on cognitive and motor tasks that are right on par with the kind of decreases we observe in persons with blood alcohol contents of 0.10 percent! (That’s above the legal driving limit in all U.S. states!)

At the extreme, prolonged total sleep deprivation in laboratory rats has been shown to weaken their ability to fight infection and regulate body temperature – and in extreme cases, has led to death in a matter of weeks. Although this may seem dramatic, it goes to show just how vital sleep is to life.

Dr. Pigeon is the author of Sleep Manual: Training Your Mind & Body to Achieve the Perfect Night’s Sleep, and directs the Sleep & Neurophysiology Research Lab at the University of Rochester Medical Center. To learn more about the facility, click here, or call (585) 275-2900.

Growing Brainy Babies: Are IQ Destinies Cast in the Womb?

Could babies be fated to become geniuses before they’re even born? And if so, can we predict their intellectual potential early on? It’s an interesting question.

Pushing back the frontiers of research into babies’ budding brains, a recent study in the journal Neurology points out that, at least for pre-term infants born before 30 weeks gestation, the rate of brain growth –rather than the brain’s sheer size – may be predictive of their future intelligence.

Of course, understanding the delicate underpinnings of the human intellect is no easy feat. To shed some light on the topic – and the recent preemie study – we spoke to URMC psychologist Heather Adams.

Scripts: What does this new research with preemies teach us about the last two months in the womb?

Adams: It underscores the dramatic brain changes already underway. Babies’ brains go through a big, important growth spurt in the last trimester.

S: What can pregnant women do to encourage their children’s brain growth while in-utero?

Adams: Well, I’m not a physician – so I can’t give recommendations to pregnant women – but prior research suggests that there are things that can happen to a fetus to either promote or interfere with its optimal brain growth. For instance, a study of Inuit mothers and babies showed that their diets, which are traditionally rich in poly-unsaturated fatty acids, had beneficial effects on the length of gestation (bringing a baby full term). Also, their DHA (fish oil) intake was related to their babies’ cognitive and motor development. (See another blog post on this “fishy” topic, here.) Other studies similarly have confirmed that the mother’s diet and overall health has bearings on fetal brain development. 

Of course, risky habits like smoking, drinking alcohol, and using cocaine have been shown to negatively affect in-utero brain growth.

S: What can new parents do to promote their babies’ brain growth/intelligence after they’ve been born? (Are any of those “baby genius” products founded on real science?)

Adams: Researchers at the University of California, Riverside, have been studying the relationship between this “baby media” (including but not limited to videos such as Baby Einstein, Baby Mozart, etc.) and child development. Their work is still is process. One study published in 2010 in the Archives of Pediatrics & Adolescent Medicine found that there was no indication that watching these kinds of videos promoted language development – so we’ll have to see. What’s more, there have been many other studies suggesting that infant learning takes place through babies’ interactions with their parents/caregivers – being read to, playing games, having positive social relationships/attachments, etc. So, that might be more important.

S: Does this latest research imply that part of our brains – and our future intellectual destinies – are hardwired (in part, at least) before we’re even born?

Adams: Yes!  We know that there are genetic influences on a child’s intelligence, on his or her ability to learn, and on educational outcome. One recent study even concluded that genetic differences among children attribute for about 50 percent to their school achievement.

Scientists continue to ask how the environment in turn interplays with these genetics to allow intelligence and aptitude to develop over time. What we do know is that, in studies where identical twins are separated at birth (not for the purpose of the research, of course!) and raised separately, their intelligence test (IQ) scores are still more similar to each other’s than to those of their adoptive siblings.

S: What do we know about pace of brain development and growth throughout childhood?

Adams: A newborn baby’s brain is about one-fourth of its final adult size; in terms of weight, it more than doubles in the first year of life. By the time a child reaches 3 years old, his brain is about 80 percent of its adult size; by 5 years of age, it reaches 90 percent. That’s a lot of important growth in a very short time.

In addition to physical changes in size and weight, the brain is undergoing critical organizational developments. Neuronal (brain cell) pathways become more efficient over time. We researchers refer to this in terms of two important processes: Myelination and pruning.

Myelination is the development of a fatty coating that covers “axons” – the long branches between nerve cells, reaching out and allowing them to communicate with one another. This coating, which improves axon “talking,” begins to grow around birth and develops rapidly in the first few years of life – perhaps even continuing through young adulthood. “Pruning,” on the other hand, is a way that the brain “trims itself back” to become more efficient. The overall number of neurons and the connections between them actually decreases from birth to adulthood – but this process strengthens the brain, and makes remaining connections much speedier.

Researchers are still busy working to develop a “brain atlas” to better understand and map the developing brain, but ultimately, development is believed to continue through the early to mid-twenties, generally maturing in a back-to-front pattern. The front of the brain — which serves skills such as impulse control, planning, abstract thinking, reasoning abilities, and self-monitoring — develops in a rudimentary fashion throughout childhood, but it’s not until the teen years and beyond that these functions really start to hum.

S: Can a parent’s actions really help a child become smarter? And can IQs change significantly over a lifetime?

Adams: Ah, this is a tough one! It’s certainly not as simple as saying “If a parent does X, a child will become smarter by Y additional points on a standard IQ test.” There is a rich and complex interplay between what you’re born with (your biological makeup – which includes, but is not limited to, the intelligence level of your parents), your environmental exposures are before and after birth, and your educational experiences.

In 2007, the National Institutes of Health’s MRI study group published a paper reporting that, on a battery of neuropsychological tests, the largest intellectual growth occurred by the time kids turned 10, and then leveled off after. So, even though the brain continues to develop anatomically during the teen and early adult years, and new learning continues to occur and skills are refined, the major developments in cognition probably occur before the teen years.

For more posts on our amazing brains, click here and here.

Has Your Brain Already Crystallized?

If grandpa grouses while fumbling with his new cell phone, or grandma bristles at the thought of sending an e-mail over the dark and scary abyss that is the World Wide Web, be patient with them. There’s much more at play than just stubborn resistance to today’s technological wonders – their brains were hardwired in an era that demanded much less toggling between screens and fewer “bursts” of intense multitasking.

As it turns out, keeping pace in ever-more-electronic world is no small feat for the aging brain. That’s because our mental circuitry – the most frequently used neuron pathways, like well-traveled roads – tends to “crystallize” into a series of expressways over time. But that doesn’t mean paving new paths (by, say, learning in middle age) is a lost cause – it just demands special learning techniques and a little more patience.

That’s heartening news for adults who are headed back to school, shifting careers in later life, or simply want to be lifelong learners, says neuropsychologist Dr. Mark Mapstone. In the clip below, he sheds more light on our amazing (and aging) brains.

Dr. Mapstone co-directs URMC’s memory care clinic, which features a team of neurologists, psychiatrists, a geriatrician, a neuropsychologist, a psychometrician (expert in measuring psychological function), a social worker and a nurse practitioner.

The team serves patients at URMC’s Neurology Clinics at Clinton Crossings and Strong Memorial Hospital, as well as the Psychiatry Department at Monroe Community Hospital. Together, its providers help patients and their families deal with the many dimensions of memory disorders, beginning with an early and accurate diagnosis. The team meets regularly, provides diagnostic and longitudinal follow-up and supportive care, and offers patients access to clinical trials, as appropriate. To learn more, click here.