WOW: I’m delighted to be talking to Dr. Paul Nussbaum, a noted clinical neuropsychologist, and the national leader in brain health. Dr. Nussbaum is cited frequently in the media and in the national press, including The New York Times, Wall Street Journal, USA Today. He is also a recent winner of the 2007 American Society on Aging’s Gloria Cavanaugh Award for Excellence in Training and Education in the field of aging. Dr. Nussbaum, I don’t know who Gloria Cavanaugh is.

PAUL: Oh, she’s a great lady and remains a great lady and is a leader in the field of aging.

WOW: I see. I see. Well, congratulations for that. We’ve been gifted to have Fit Brains on the wOw site for a couple of months now. It’s a very popular part of the site, and I thought I’d take the opportunity to ask you the science behind the games, the exercises. Our demographic is mostly women over 40, and all of them are beautiful and intelligent and savvy and accomplished. Yet, I would say we all share the same fear of losing it.

PAUL: Yes.

WOW: I wonder if you could just enlighten us a little bit about how we know – there must be a clinical answer – to knowing the difference between any kind of loss of memory that is natural and normal, and that which is serious and could be an Alzheimer’s alert.

PAUL: The first part of your question is that recently we’ve learned that this greatest system ever designed – the human brain – is able to be shaped and can develop, and it has what’s called "plasticity," which is a fancy way of saying that your brain is dynamic, it’s constantly reorganizing and it’s malleable. Across the lifespan, your brain doesn’t care how old you are, it just wants to be stimulated. And we’ve learned, actually in 1998, that the human brain can generate new brain cells. Interestingly we knew that for rats back in the ’50s, but we just discovered it for the humans, go figure, in 1998. So the question becomes: What do we as humans do? What can we do to promote brain health? How can we increase the number of brain cells in our brain and create, really, Joni, what’s called "brain reserve." Brain reserve is the foundation; it’s the altar for brain health. And the way that I describe brain reserve is, very simply, this: If you’re flying in an airplane, you’re 500 feet above the ground and you’re looking down at a jungle … we all have that image in our head. You can’t even see the land because the trees are so dense. Compare that image to flying at 500 feet and looking down and seeing a Caribbean island, if you will, with one palm tree. We all want our brains to look like the jungle because – if you stay with me – Alzheimer’s disease is a type of weed whacker. It comes in, it doesn’t take out the weeds – it takes out brain cells. And what we know is if you have a jungle – if your brain looks like a jungle – you have tremendous brain reserve. Such that, that weed whacker, even though it may be in your brain, is going to take a long time to show its face. In fact, research today indicates that some brains at autopsy are diagnosed with Alzheimer’s, that the classic neuropathologic markers are there, yet the person never manifested the disease in life. So the key is, how do we build brain reserve? And that’s where I have been talking about and publishing a brain health lifestyle. It’s one of the proactive things/ways that we can build up brain reserve across our lifespan, and it includes five major domains.