Channelling Your Inner EXECUTIVE Functions

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Recent evidence also suggests that executive functions can vary independently, allowing for strength in one area and weakness in another. A successful business exec can have papers spilling out of her briefcase…someone may strategize superbly, yet be dismayingly distracted by a sneeze down the hall. People thought to be lazy, tardy or messy may, in the clinical sense, be weak in a specific executive function, such as planning or organization.

Brain injury, stress or sickness, and even normal aging can also hamper the ability to function well. The good news is that scientists and clinicians at Baycrest are using what they have learned about executive functions to help people get the most out of their brains, and improve their quality of life.

On an even more positive note, everyone – young and old – can experience trouble channelling their “inner executives” from time to time without too much cause for concern. It turns out that executive functions are extremely vulnerable to everyday vexations, such as stress, poor diet, lack of sleep or no exercise. Dr. Winocur’s research lab has even found that insulin resistance, a commonly accepted precursor to diabetes, can insidiously alter cognition by lowering the brain’s supply of glucose. So, a healthy lifestyle can certainly go a long way in preserving mental function.

“The kinds of things your mother told you to do as a child, you should do them,” says Dr. Moscovitch. “You’ll think more clearly and perform better.”

Still, staying organized is less automatic as we age. Accomplishing even routine tasks, such as cooking a meal or packing for a trip, become more challenging. Dr. Winocur says that people change mentally the way they do physically, bit by bit. “They’re forgetting their eyeglasses more and occasionally forgetting where they parked the car. However, it’s important to keep in mind that, unless this happens all the time, it’s part of normal aging and nothing to be concerned about,” he says.

memory loss is reversible, at least in part And the really good news is that memory loss is reversible, at least in part. Healthy adults with an average age of 75, who had complained of memory loss, were able to increase their performance on a range of executive-function and memory tasks by some 30 to 40 per cent after comprehensive training at Baycrest. Better still, these gains lasted at least six months. And even more encouragingly, in some cases, participants continued to improve after the training ended.

The Baycrest program taught participants about how memory works, explaining that it’s hard to build raw memory power. Instead, participants learned strategies for setting goals, and for planning and monitoring their activities – abilities that younger adults perform quite spontaneously. As participants learned to break down tasks into simple, more do-able subtasks, as they tried new memory minders and mastered goals one step at a time, they grew more confident in their abilities.

To make the most of this new approach, says Dr. Winocur, you have to pay attention and recruit the cognitive processes appropriate to the task. “You have to be mindful. You have to work at it,” he says.

The same principle applies to people with serious brain injury. Dr. Deirdre Dawson, an occupational therapist and scientist at Baycrest’s Kunin-Lunenfeld Applied Research Unit, is investigating how cognitive intervention helps people after serious brain injury. She and her team have taught patients to follow the steps of “Goal, Plan, Do, Check.”

The program encourages patients to identify their own problems and devise their own solutions in everyday life – whether for something as simple as putting on pants or something as complex as planning an anniversary party. By cultivating their executive abilities, Dr. Dawson says, patients grow confident and use their new-found strategies to pursue additional goals.

“We suspect this approach could be useful as people age and that it will help them stay in their own homes longer,” says Dr. Dawson. And additional supports, such as step-by-step instructions, may help older people to more easily learn new tasks or to more flexibly tackle new activities.

Dr. Winocur says mental changes as people get older are as normal as needing eyeglasses or developing male-pattern baldness. And so he gives this advice: “Stay engaged and active. You don’t have to do things the same way at 70 as you did at 30. Do them in a way that serves your current needs.”

New knowledge of executive functions is making that more possible. Dr. Dawson counsels, “Identify the strategies that work for you, and apply them across everything you do.”

For more information on brain research at Baycrest, contact Florence Weinberger at 416-785-2500, ext. 2055 or e-mail fweinberger@baycrest.org

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