PITTSBURGH, Pa. — Barry Leonard, 81, with longtime concerns about memory lapses, spent part of a recent Monday morning joining other seniors playing the marimba, the mallets in his hands tapping out the notes and measures drummed into his brain by months of repetition.
The music was a breeze for Sally Newman, 87, a former professional pianist who got a bigger mental challenge afterward from computer games testing her ability to recall objects flashing on the screen.
The octogenarians are among the first 15 participants enrolled in the University of Pittsburgh’s Brain Exercise and Training Wellness Program, or BRiTE, designed to assist people who have mild cognitive impairment. It’s a condition associated with memory problems in older adults, which can be a preliminary sign of Alzheimer’s disease or other forms of dementia. The program is based on research and theories suggesting people can be helped at such a stage by well-rounded mental, physical and social stimulation.
Using a grant of more than $1 million from a Spanish pharmaceutical firm, Grifols International, Pitt formally launched the program Oct. 1 last year. Initial participants were among those who had been evaluated at Pitt’s Alzheimer Disease Research Center and diagnosed with problems less severe than dementia, but the program is open now to others with memory concerns who would like to apply.
“We are focusing on people with mild cognitive problems who are still active, trying to help them remain as active in society as they can,” said Dr. Oscar Lopez, a neurologist and Pitt professor who is director of both its Alzheimer’s center and the BRiTE program.
Lopez said that while housing and services for people with dementia have become more common over the years — although there remains no cure or prevention for Alzheimer’s — he’s aware of no other center in the United States focused on helping people with mild cognitive impairment. It is modeled after a program in Barcelona, Spain, that provides wide-ranging activities to stimulate people socially, mentally and physically.
According to studies, Lopez said, about 23 percent of the population age 65 and older could be classified with mild cognitive impairment, and one out of 10 of them in a given year progresses into dementia. Why it happens in some people and not others, and at varying rates of progression, is unknown.
People with dementia typically lack decision-making abilities and competence to handle their own affairs. Those with mild cognitive impairment “have isolated memory problems, and all of the other parts of the brain are working perfectly well,” Lopez said.
Lopez said research suggests people with modest memory problems can postpone more serious issues — even improve in functioning, at least temporarily — by engaging in a stimulating lifestyle. Hence, the new center’s half-day curriculum: brain challenges by computer, music and art lessons, and strength and balance training accompanied by yoga techniques.
For three to four hours on Mondays, Wednesdays and Fridays — although days and hours are to be expanded as more people enroll — the participants move between stints in two rooms that contain musical instruments, computers, weights, yoga mats, drawing supplies and more.
On the marimba, a stand-up instrument played by striking keys with mallets, some modest physical exertion is accompanied by training on sequential notes. To help participants play music, instructor Jennie Dorris puts the notes on a board at the start of class, then erases them after some practice so the players are on their own other than hearing her call out “C-D-E-G” or other sequences.
“It really tests your memory, going measure by measure,” Dorris says.
It took some getting used to for Leonard, a retired business owner with no musical experience, although the mallets he held followed along well in striking the right keys recently.
He said his memory’s “not good, not great, but it’s livable. Sometimes I’ll be saying a sentence, and there’s a word I normally know but I can’t come up with it. They say that isn’t a real problem, that most people my age have that problem — it’s when you don’t know where you are that you’re really screwed up.”
“We all have memory loss to some degree,” said Newman, a former Pitt professor of intergenerational studies who lives close enough to walk to the program, although others are capable enough to drive themselves.
She said she’s been told not to worry about lack of recall of something she only recently learned, “but if something I’ve known all my life is suddenly disappearing, that’s frightening.”
One significant difference from most people with dementia is that those with mild cognitive impairment tend to be aware of their difficulties and are able to articulate what struggles they have compared to their younger selves. They also understand that the more BRiTE-style activities in which they’re engaged — people with dementia tend to increasingly isolate themselves — the better off they’re likely to be.
“They’re not a magic intervention,” Lopez noted. “They cannot stop the biological progression of Alzheimer’s or another neurodegenerative problem, but we can help people to be connected to society for a longer period of time.”