Frank Magnarelli’s den is crammed with books, hundreds of them, on topics ranging from Einstein’s theory of relativity to the role of trade in shaping world history. Across from his desk hangs a photograph of a Saudi Arabian market, purchased when the retired biomedical engineer worked in the Middle East. A replica of Thomas Edison’s first lightbulb sits on a shelf near his electronic keyboard.

It is clearly the sanctum of a man who has read and traveled widely, and who values intellectual pursuits. So it stands to reason that as the 69-year-old faces his senior years and the challenges that often accompany aging, he is keenly aware of the need to maintain maximum cognitive function.

“Mental decline is a concern. Though when I saw a doctor about it, he looked at me like I was crazy,” Magnarelli says. “But I used to be able to mentally design entire systems, and I can’t do that anymore. My creativity is still there. I can do it on paper, but not in my head.”

Magnarelli exercises almost every day and audits UM courses through the University’s Osher Lifelong Learning Institute (OLLI) in Coral Gables, formerly the Institute for Retired Professionals. He also takes and teaches OLLI’s noncredit courses, attends lecture series available to its members, and is helping redesign the organization’s Web site.

Like many other retirees, Magnarelli’s decision to become involved with Osher stems as much from a hunger for cerebral stimulation as a desire to prevent age-related cognitive decline. Nonetheless, it is a prudent choice, one that may help him retain the mental and physical skills to live independently far into his golden years.

In 1935, when the U.S. Social Security Act was signed into law, not many Americans lived beyond age 65, notes Carl Eisdorfer, the director of UM’s Center on Aging and a professor in the Department of Psychiatry and Behavioral Sciences. Back then, mental decline accompanying old age was of relatively little concern because not enough people lived long enough for society to be plagued by it.

But today, with baby boomers expected to survive decades longer than their parents and 20 percent of the U.S. population likely to be older than 65 by 2030, it’s a key concern among all of the socioeconomic issues raised by the graying of America.

Researchers at the Miller School and throughout the University are exploring the cognitive aging process on several fronts. At the Center on Aging, the University-wide collaboration of faculty whose mission is to enhance the quality of life for the elderly and aging population, scientists are investigating which types of cognitive losses are normal and which result from disease. They’re asking what can be done to delay mental decline in healthy individuals as well as those with age-related dementia. Moreover, they are teasing out the roles specific genes play in successful aging and identifying environmental factors that may contribute to some individuals ending their days in mental confusion.

“It’s a bittersweet issue that every-one wants to live for a long time, but suddenly this becomes a dependent population,” notes Eisdorfer, who also directs the Center on Aging’s Memory Disorders Center and its recently established Brain Fitness Program.

In the past decade, research has shown—particularly from functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and other technologies that allow scientists to view the brain in action—that brains grow smaller and lose nerve cells with age. Neurotransmitters, the chemical messengers that carry information from one nerve cell to another, also appear to decline with age and perform less effectively.

This can affect everything from speech to comprehension to memory to everyday tasks such as driving, which requires us to absorb and react to a lot of information all at once. A common cognitive complaint related to memory involves the inability to keep two or three things in mind simultaneously—for example, leaving a room in which one is performing one task to handle a different task only to forget what the original task was. Another cognitive challenge that can come with aging involves increasing difficulty in conversing in a noisy environment, which requires the ability to take in a lot of information and sort out what’s important.

Although there’s no way to turn back the hands of time, studies show that, contrary to previous conventional wisdom, adults can create new nerve cells. Most of the connections between these cells are made early in childhood, but new links do form between neurons well into old age. Studies also reveal that even people with devastating neurodegenerative conditions such as Alzheimer’s disease can maintain function far longer than previously thought. The implications are tremendous: Although the losses accompanying age are unavoidable, they can be delayed.

Data has shown that physical exercise, for example, stimulates brain-derived neurotrophic factor (BDNF), a protein that, in turn, spurs the brain to create new connections.

At the Miami Veterans Affairs Health System, Hermes Florez, a Miller School associate professor of geriatrics, endocrinology, and epidemiology, has convinced 600 obese veterans to hit the gym three times a week, both for their health and to help scientists figure out how pumping iron and brisk walks improve cognitive function. These older individuals’ physical and cognitive abilities are tested before and after their year of supervised exercise. Florez and his colleagues are particularly anxious to confirm earlier Miller School work suggesting high levels of vitamin D help delay cognitive decline. The study, now encompassing Miami-Dade, Broward, and Monroe counties, will be extended to elderly people in Boca Raton this fall through the South Florida Quality of Aging Study headed by Bernard Roos, the professor of medicine who directs the Miller School’s Geriatric Institute. Exercise and nutrition, while vital, aren’t the only weapons in the battle against an aging mind. Brain fitness training—working specific areas of this complex organ to diminish naturally occurring losses in mental capacity—is another.

“I often refer to the brain as the muscle between your ears,” Eisdorfer says. “Some of the work I’m doing is trying to understand the impact of retirement. Very successful businesspeople don’t retire—the big wheel-turners find other wheels to turn.”

In other words, with the brain as with the body, you must use it or you’ll lose it.

Putting this theory into practice each week, a handful of people from their 50s to their 70s visit the Center on Aging’s Brain Fitness Program office to play a seemingly simple series of computer games such as determining whether brief sounds made by the computer are rising or falling in frequency, recalling where cars and road signs flashing on the screen appeared in a previous image, and matching up objects in a computerized round of Concentration. On the surface these activities, which are performed hourly for eight weeks at increasingly challenging speeds and levels, appear to have little meaning or connection to one another, but they actually constitute a carefully designed program for helping older people improve their mental agility and exercise a range of cognitive abilities.

Staff at the Memory Disorders Center are testing patients for types of dementia, recommending treatments, and designing studies to determine how individual factors—including stress management, mood, sleep, exercise, cognitive training, and nutrition—affect mental ability as we age.

The goal, Eisdorfer explains, is to be able to identify an individual’s complex set of specific cognitive weaknesses and prescribe the precise stimulatory activities that will address those weaknesses, much the way a physical therapist will use different techniques to rehabilitate a skier who has had knee surgery than a swimmer who has torn a shoulder ligament.

While the Memory Disorders Center explores how to help those with normal or mildly impaired cognition, David Loewenstein, a professor of psychiatry and behavioral sciences, is developing tests with his colleagues to detect the earliest signs of dementia, when medications and other interventions can offer the greatest chance of delaying decline. Before a person is diagnosed with dementia, whether from Alzheimer’s or other diseases, a battery of neuropsychological tests is done to pinpoint any deficits in memory, language, spatial skill, and reasoning. In most cases these tests identify dementia after it is severe enough to interfere with social and cognitive functions, but Loewenstein and fellow researchers have developed a semantic interference test that predicts which patients with mild cognitive loss will develop dementia two to three years down the road.

“The National Institute on Aging is funding this because, as better biological agents become available and cognitive rehabilitation becomes more effective, the earlier we catch cognitive loss, the better the outcome,” Loewenstein explains. “In the next few years, as we develop more effective treatments, this test will have clinical utility in terms of who should receive which treatment.” The test, he adds, also provides guidance as to whether or not minor, normal memory lapses signal impending dementia.

At present, the only treatment for Alzheimer’s disease is a class of drugs called cholinesterase inhibitors, which at best delay the progression of dementia symptoms. They do not reverse brain damage that already has occurred. Loewenstein and Amarilis Acevedo, a voluntary professor of psychiatry and behavioral sciences, are developing rehabilitative brain exercises to help Alzheimer’s patients compensate by relying on areas of the brain that remain healthy. “By teaching around their deficits,” Loewenstein says, “we found that people with Alzheimer’s disease could learn and maintain their learning for longer periods of time.” Such patients can live independently for longer and with a better quality of life than those whose cognitive losses go untreated, he adds.

Adaptation is also the name of the game for Sara Czaja, a professor with joint appointments in the Miller School’s Department of Psychiatry and Behavioral Sciences and the College of Engineering. The director of CREATE (the Center for Research on Aging and Technology Enhancement), a National Institutes of Health-funded multisite center, Czaja focuses on making health care technology more beneficial and user-friendly to older people. She notes that new technologies such as Internet, e-mail, and telephone menu systems can be particularly valuable to this population, which is more likely to have mobility restrictions and physical limitations. Finding ways to help them adapt to and thereby benefit from these new technologies can increase their access to services as well as enable them to stay in touch with family and friends, book doctors’ appointments, and keep doing some of their own essential errands.

However, Czaja reported last year in the Journal of the American Medical Association that a sample of 112 elderly people who used Medicare’s Web site in a controlled laboratory setting found it “confusing and overly complex.” She hopes to convince Medicare to make the site easier for older individuals to use. “A unique aspect of our research is our focus on everyday tasks and technologies that people use on a daily basis such as the Medicare Web site or interactive telephone menu systems that are ubiquitous for activities like banking, shopping, or checking on schedules or reservations,” Czaja explains. She and other UM researchers then develop interventions and educational programs that can help seniors use these technologies.

And in the Department of Industrial Engineering, research professor Joseph Sharit is looking into how government and corporate policies as well as workplace technologies affecting older employees can be adapted to better address their changing cognitive capacities.

n the heredity front, William Scott, a professor of human genetics and member of the Miami Institute for Human Genomics, has discovered a subgroup of elderly Amish who live into their 90s with few signs of cognitive or physical impairment and is studying them to identify genetic markers that may be common among those who age successfully.

Further, a $5 million gift from the McKnight Brain Research Foundation will help the Department of Neurology’s Evelyn F. McKnight Center for Age-Related Memory Loss examine both cause and prevention of cognitive decline. “For many years it was thought senility was par for the course if you lived long enough,” explains Clinton Wright, the McKnight Center’s recently named scientific director and an associate professor of neurology. “Only recently, in the past few decades, has it been appreciated that’s not the case. People who develop dementia have some kind of pathological process, but everyone loses some cognitive abilities with age. Our focus at McKnight is to try to identify the signatures of normal cognitive aging because they aren’t completely understood on many levels.”

Wright, widely recognized for his work at Columbia University on the impact of vascular disease on cognition, is developing collaborative research projects with the Center on Aging. McKnight Center funding also will support his work with Ralph Sacco, professor and chair of the Department of Neurology, and Margaret Pericak-Vance, director of the Miami Institute for Human Genomics, on a genome-wide association study of cognition and subclinical MRI brain findings using data collected as part of the Northern Manhattan Study and brought to Miami by Sacco.

Meanwhile, as all of these experts continue trying to answer the age-old questions about old age, people like Frank Magnarelli seem to have time on their side. Magnarelli says he hails from “Italian peasant stock” who lived healthily into their 90s. In addition to strong genes, his current good health, commitment to fitness, and cognitive reserve from being an avid reader, student, and teacher suggest he’ll follow his family’s lead. Still, when it comes to brain power, he’s not taking any chances. “It helps me keep sharp and stay in touch with a whole new world that seniors tend to become alienated from,” he says of attending the Osher Institute. Plus, he adds, “It’s been a great deal of fun.”

JOAN LIPINSKY COCHRAN is a freelance writer aging gracefully in Boca Raton, Florida.