Social Intelligence for Successful Relationships

Ever had the thought “What can I do when my friend is anxious?“…”What do I do or say when someone starts crying?“…

We offer a workshop for individuals who want to learn strategies and communication skills to manage concerns like these. Read more »

Social Intelligence for Successful Relationships

Course Date & Time: 23 April 2016, 1:30 – 5:30 pm

 

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Beyond stigma, there’s a role for mental health education

The 2012 Singapore Mental Health Study reported that 5.8% of the local adult population are affected by depression during their lifetime. The researchers of the study found that only a third of those with a mental illness in their lifetime had sought the help of mental health professionals (Today Online, 13 Oct 2015).

According to the same study, only 10% of the population did not subscribe to the belief that those with a mental illness “could get better if they wanted to” (The Straits Times, 6 Oct 2015). The other 90% would likely agree that “a person who has mental illness is seen as someone who is weak” (The Straits Times, “A healthy mind isn’t a given for anyone”, 10 Feb 2016) and that “depression is a failure of will” (The New York Times, “7 Thoughts From a Chronically Unhappy Person”, 21 April 2015).

But stigma is not the only reason why people who experience symptoms of depression, burnout, or anxiety do not seek professional help. Aside from prejudicial attitudes, the ability to recognise the warning signs of psychological distress remain a major barrier to mental health care. A 2015 study of 2219 Canadian employees revealed that of the participants objectively identified by the study authors to be experiencing depression, more than half “did not recognize a need to seek help” (ScienceDaily, 7 Oct 2015). But the fact of the matter is that poor mental health literacy is not unique to the community of that study. A 2014 study by IMH on local residents’ understanding of common mental disorders including depression revealed that just over half the respondents surveyed were able to accurately identify the signs and symptoms of depression (Channel News Asia, 6 Oct 2015).

Yes, we should support campaigns to reduce stigma. But, it would only be successful if it were to be accompanied by mental health education programmes which are not only about dementia (it is the only one of the top 3 mental health conditions of local concern) but which also reach the community including those in school and those in the workforce.

The early signs of dementia

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According to the 2013 Well-being of the Singapore Elderly (WiSE) study, 1 in 10 persons in Singapore aged 60 years and above has dementia, which according to the WHO definition, is a “syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities”.

To suggest that someone with dementia “may” have memory loss, is misleading. Dementia is a condition in which people with dementia encounter problems with memory. But it is of course worth noting that the “symptoms of dementia are not limited to forgetfulness and memory loss“, as the author of this 2015 Institute of Policy Studies (IPS) Commons article points out. The ability to plan and make decisions, as well as solve problems, are other cognitive difficulties faced by someone with dementia.

Recent research efforts offer relatively quicker ways for clinicians to diagnose dementia and identify individuals at risk for dementia. According to a recent study published in 2015, researchers have developed a brief questionnaire, known as the QDRS comprising 10 items, which can accurately identify if someone has very mild, mild, moderate, or severe dementia. And a 2014 study has found a time-efficient method for identifying those at risk for dementia — through their ability to track a moving target with a computer mouse which moves in the opposite direction to what they see on the screen. Those diagnosed with Mild Cognitive Impairment (MCI) (and who are at risk for dementia) made many more errors than the control group. A more recent study also points to the tendency for those with amyloid plaques associated with dementia to have walk at a slower pace compared to healthy peers.

But you’re concerned that you may be developing dementia. Or you’re concerned about someone you know being at risk for dementia…

So here are 3 questions to answer:

1. Have you noticed any of these early warning signs?

The local Health Promotion Board has a print-friendly fact sheet, while the local Alzheimer’s Disease Association offers a checklist and describes the stages of dementia. No? Move on to Question 2!

2. Are you aware that you have difficulties remembering things?

recent study which tracked over 2,000 individuals for 10 years reported that awareness of memory problems is a good clue as to whether they have dementia or not. In this study, those who were eventually diagnosed with dementia stopped being aware of their memory problems about 2.5 years before showing signs of dementia. So being aware that you have memory problems is actually a good thing. But read on…

3. How often do you have problems remembering things?

The US Alzheimer’s Association distinguishes behaviours which are characteristic of dementia from behaviours associated with healthy ageing in their list of early warning signs. Forgetting the names of things and/or the names of people is something that happens to most of us. Some of us experience the tip-of-the-tongue phenomenon quite often in fact. We can also be prone to forgetting appointments. But we’re usually able to retrieve these words and/or names later on, and we typically realise that we missed an appointment at a later time.

But a 2014 study also found that those who reported a change (more difficulties) in their ability to remember things were much more likely to subsequently develop dementia. So if you’re concerned that you might have cognitive issues, you can take an online assessment — Self-Administered Gerocognitive Exam or the SAGE test. But it’s also important that you consult with a medical professional if memory and thinking problems are a concern for you. 

Autism: What have we learnt so far?

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Autism is a neurodevelopmental disorder in which individuals have difficulties with social interactions and communication and a reliance for routines and/or repetitive behaviours (Read this NIH fact sheet for more information). Individuals with autism also tend to display sensory seeking behaviour and according to more recent scientific endeavours, experience high rates of gastrointestinal issues.

It’s a disorder which receives much attention in both the press and in research. But research findings, despite advancing at the pace of greyhounds chasing a bunny on the race track, don’t always accompany news stories. The public’s understanding and awareness of this disorder is still work-in-progress, even though local resources for autism has vastly improved.

Research links the use of joint attention — the ability to use gaze and gestures to share attention — to autism, but a recent study points to a more accurate red flag for autism — a social smile during joint attention. This 2014 study observes that infants at 8 months tend to look at an object of interest and then smile at the person they are interacting with, before looking back at the object of interest, during joint attention. In contrast, infants at risk for autism tend not to direct the social smile at the other person in between looking at object and at the other person.

Other research has established that individuals with autism find faces aversive, and as a result have difficulties recognising the emotions of others (more about their difficulties with empathy here). In fact, a hot-off-the-press study finds that individuals with autism focus on areas of contrast and colour of real photographs and the centre of the image, whereas those who don’t have autism look almost exclusively at faces in the same photographs. And this tendency emerges at a young age: a 2014 study observes infants at 6 months to fixate on faces when someone is speaking. In contrast, infants diagnosed with autism later look away from the eyes and mouth when someone is speaking.

Recent research has also identified two other markers useful for screening autism among children aged 9 to 12 months. A 2014 study finds that babies with a head circumference that is at or higher than the 75th percentile at 9 months and infants who fail the tonic neck reflex (also known as the head tilt reflex) are at a higher risk for autism.

With slightly older children, nonverbal screening tools may be useful. A 2015 study proposes a novel way of screening for autism: It turns out that individuals with autism don’t reduce their sniffing of unpleasant smells (and conversely increase their sniffing of pleasant ones). In contrast, their peers who don’t have autism “stop” a wiffy smell in about 305 ms. Another 2015 study finds a higher proportion of children who are subsequently diagnosed with autism among families where parents voiced concerns about their child’s sensory and motor abilities from the age of 6 months, and their child’s language and social communication abilities from the age of 12 to 15 months. So although autism cannot be diagnosed till 2 years of age, there are clear indications and red flags which are proving to be effective for screening autism at a much younger age.

Screening for autism aside, there are still no clear answers to what contributes to autism. Recent research does however indicate differences in brain structure between individuals with autism and peers who don’t have autism. Apart from differences which have been observed in the brain structures which connect the two brain hemispheres to each other, a 2014 study observes a lack of neural pruning — the process by which neural connections which we don’t use are eliminated — among children with autism (for a more in-depth discussion, read this article). Genetic factors are acknowledged to contribute to autism, but environmental factors are also considered to play an important role. Increasing evidence that the composition of gut bacteria differs in individuals with autism from that of their peers who don’t have autism, has led some to suggest that gut bacteria to be a possible contributing factor to autism. While a 2015 study definitively excludes MMR vaccines as a contributing factor to autism (read more about the study here), another 2015 study speculates that other chemicals, such as solvents and pesticides, to which expectant mothers may have exposure, can adversely affect foetal development.

Despite the mixed findings about the cause of autism, more recent research does offer some promising news about effective interventions and strategies found to be useful for helping children and adolescents with autism. Just as children who don’t have autism can be trained to enhance their ability to identify emotional expressions and young preschoolers with autism can be taught social skills, recent research demonstrates that early intervention programmes play an important role in helping children with autism improve their social skills, as well as cognitive and language abilities.

One 2012 study has reported that an intensive programme comprising 20-hours-a-week one-to-one training with interpersonal exchanges over a period of 2 years, yields improved brain responses to faces among infants with autism aged 12 to 30 months. Use of this therapeutic intervention by parents has been shown to be effective on even young infants with autism. In this 2014 study, at-risk 6-month-olds, who showed signs of autism at the start of intervention (e.g., a lack of interest in social interactions and communication), had better cognitive and language skills 12 to 30 months later. In a follow-up study of these infants, further improvements were observed after 2 years of intervention. Infants’ cognitive, communication, and adaptive skills (skills for everyday living) were observed to undergo greater improvement compared to peers with autism who attended a preschool programme and who were given speech therapy.

Other groups of researchers have also shown that parent training is also an effective way to improve the quality of social interactions between parents and infants with autism. A 2014 study has shown that teaching parents to support their children’s learning during everyday activities results in better language and social communication among toddlers with autism. In another recent study, one-year-olds with autism whose parents received coaching on how to attract their infant’s attention and interest their infant in social interaction games produced better outcomes than peers receiving community-based early intervention and monitoring. A separate 2015 study has also shown that the benefits of parent training over a period of 24 weeks to include a reduction in disruptive and aggressive behaviours among children with autism aged 3 to 7 years (Supernanny also some useful tips…). It’s evident that there are various effective therapeutic options available to families of children with autism.

Interventions which reduce the severity of children’s autistic behaviours are important. But support for families are as, if not more, important. This is particularly true for caregivers and parents of children with autism, who experience a high level of caregiving stress on a daily basis and can be at risk for caregiver burn out. Journal writing has been found to help mothers manage their stress levels, while mothers are less likely to experience depression if their partners share the burden of caregiving. But it’s often easier said than done. Respite care — which provides parents and caregivers with time off to take of themselves — can play an important role for helping parents and caregivers manage their stress. And more public awareness won’t do anybody any harm either.

World Autism Awareness Day is a few months away but there’s no time like the present to support a greater public awareness of autism.

Manage your stress for a sweeter life

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So, here are the answers to yesterday’s quiz:

1. False. Those with Type 1 diabetes have a pancreas that doesn’t produce insulin. In contrast, the pancreas of those with Type 2 diabetes does produce insulin, but their body is unable to respond to the insulin. Here are the facts.

2. False. Most people have Type 2 diabetes. Those who have Type 1 diabetes usually have the condition before the age of 35 years. And in fact, experts project as many as 1 in 2 locals having diabetes by 2050.

3. True. Regular exercise and an appropriate diet both work to improve insulin sensitivity of people with Type 2 diabetes. Find out more about how exercise helps here. According to research, the total amount of carbohydrates that we consume is important for managing blood sugar levels. Read more to understand why here. You can also find out what it means to “eat right” here.

4. False. The risk of developing heart disease for those with diabetes is 2 to 4 times higher than people who don’t have this condition, and smoking doubles this risk if you have diabetes. Read more here. A 2015 study also found that those with mild cognitive impairment were more likely to progress to dementia (which is linked to heart disease) if they also had diabetes.

5. False. People with diabetes are at a higher risk of developing kidney disease because excessive blood sugar damages the kidneys over time. In fact, studies report that about 10 to 40% of people with Type 2 diabetes will need dialysis due to kidney failure. But research also shows early screening and early treatment to be highly effective for maintaining kidney function.

6. True. In addition to excessive sweating, weight loss, and other symptoms, people with undiagnosed diabetes may notice changes and problems with their vision. Read more about these eye problems here.

7. Experts recommend a balanced diet, regular exercise, and blood sugar monitoring for keeping blood sugar levels stable, not just oral medications and/or insulin injections.

And it’s not just common sense. Research shows that exercise does reduce the risk of diabetes. A 2014 study found that people who lived “walkable neighbourhoods” — neighbourhoods where the shops and amenities were within walking distance — were less likely to develop diabetes.

Here are some practical tips for monitoring blood sugar levels.

As this ADA help sheet suggests, it’s also important to tell yourself that tracking blood sugar levels helps you evaluate how well you’re looking after yourself. Instead of berating yourself for not doing better, try these techniques for managing your emotions.

8. True. Nerve damage and/or poor circulation from excessive blood sugar are the reasons why people with diabetes may experience slower healing from cuts and sores. So it’s particularly important to take care of our feet. Read more about that here.

Did you get all 8 questions correct? Good job!

But recent research shows that a balanced diet and regular exercise aren’t the only lifestyle changes to make in order to get a better handle on one’s diabetes.  In fact, a 2015 study found that chronic stress to be a factor for developing diabetes, while another 2015 study found that people who stay awake later at night have a higher chance of developing diabetes than people who sleep earlier, even when both groups have the same amount of sleep.

So there you have it. The key to having a sweeter life (and lower levels of un-metabolised sugar in your bloodstream): Get to bed earlier and manage your stress!

Did you know?

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A recent study found that there are more younger people with Type 2 diabetes mellitus in Singapore than other countries in Asia. According to the same study, as many as 3 in 10 people have diabetes before the age of 40 years.

Even though diabetes is a condition that’s been known to us since the days when the Egyptians wrote about a “thirsty disease” on papyrus, it’s not always a well-understood condition. What do you know about diabetes? Try this quiz!

True or False?

1. If you have Type 2 diabetes, your body is unable to produce insulin.

2. Type 2 diabetes is more common than Type 1 diabetes.

3. Exercise helps insulin work better for those who have Type 2 diabetes.

4. The risk of developing heart disease for people with diabetes is the same as for those who don’t have diabetes.

5. About 1 in 10 people with diabetes will eventually develop kidney disease.

6. Blurred vision can be a sign of diabetes.

7. The only way for people with diabetes to control blood sugar levels is to take oral medications and/or have insulin injections.

8. Healing from cuts and sores can take longer for those with diabetes.

Find out the answers tomorrow for a healthy World Diabetes Day!

Source: https://www.singhealth.com.sg/…/…/Diabetes-Mellitus.aspx

Are you addicted to your smart device?

I can’t concentrate on work because I’m on my smartphone.
I’d rather be on my smartphone than do other things that I’m supposed to.
I feel anxious when I don’t have my smartphone with me.
I can’t imagine not having a smartphone (even for a day).
I have repetitive strain injury because of overuse of my smartphone.
I often use my smartphone for much longer periods than I had planned to.

…are the kind of things that someone with a smartphone addiction might admit to. So say the experts. And also the kind of questions which Korean teenagers were asked in a 2013 PLOS One study about smartphone addiction.

It’s not clear whether we’re a nation addicted to smartphones. Candy crush, maybe… TV drama and youtube videos which we can watch anywhere anytime now thanks to our mega data plans and wifi hotspots, yes… Preoccupied with trying to create social envy on facebook, ok maybe.

Clearly some people think so. That’s why a bunch of Republic Poly students have come up with their own app to increase face time (thus avoiding the situation where everyone at the dinner table is busy on their own and not in a conversation).

But smartphone addictions aren’t a new type of addiction. In fact, “technology addictions actually share the same underlying mechanisms as other addictions” (Asia’s smartphone addictionBBC, 7 Sept 2015).

But if you are trying to kick the habit, you can use technology to solve your problem! Consider installing two desktop applications — Self-control and Freedom. They block your ability to surf the net for the number of hours which you’ve set aside for work. Manage your smartphone addiction with Focus Lock and Pause — two apps which lock specific apps for a customized amount of time. You can also install an app— Anti-Social — to prevent you from checking Facebook while you work. Even better, you can install Offtime which is an Android app which allows calls get through and essential apps to function while you get on with the important stuff.

And no, Facebook and Instagram aren’t essential apps.

And don’t forget to take that phone off the dinner table!

 

6 Easy Ways to Prevent Cognitive Decline

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According to a recent study, 1 in 10 people above the age of 60 years in Singapore has dementia, which is a “syndrome in which there is deterioration in memory, thinking, behaviour and the ability to perform everyday activities” (WHO).

If someone were to ask you how you can prevent dementia, you might be tempted to say that an active brain is the answer. Challenging your brain to do something difficult like learn a new language, dance, sport, or musical instrument does delay the symptoms of dementia by several years, but it may not lower your risk of dementia. A 2015 study found that those who had cognitively demanding jobs were less likely to show signs of dementia at the age of 75 years and above, and another recent study found that bilinguals were less likely to show signs of dementia compared to monolinguals, while earlier studies have already shown that learning to master something that you’re not already expert at, such as mahjong or tai chi, improves your cognitive skills if you have mild dementia.

So what causes dementia?

That’s not an easy question to answer. But research in the last decade has identified what makes it more likely for us to develop dementia.

Having diabetes increases our risk. A 12-year-long 2015 study conducted in Taiwan has found that individuals with diabetes have a higher risk of dementia, and that risk increases further with diabetes complications such as blindness and kidney failure.

But it’s not just diabetes. In fact, research shows that the factors which put us at risk for cardiovascular disease leading to heart attacks and strokes — alcohol consumption, smoking, and obesity — are also risk factors for dementia. Research shows that as many as 50% of people have dementia because of known risk factors such as physical inactivity, depression, smoking, mid-life hypertension, mid-life obesity, and diabetes.

So what lowers our risk?

The answer is exerciseOne study estimates that physical inactivity is the reason for over 20% of the population to have dementia in US, UK, and Europe, while a 2013 study found that the risk of dementia at age 85 to 94 was 60% lower for men who maintained 4 out of 5 healthy lifestyle habits (regular exercise, not smoking, a low body weight, a healthy diet, and low alcohol intake) than those without these habits (with exercise being the main cause for lowering the risk of dementia).

But what if we’re already doing all those things. We exercise the recommended number of hours a week, if not more, and we don’t smoke…our BMI is within the healthy range and our lifelong goal is pursuing a wonderful diet of fruits and vegetables.

What else can we do to prevent cognitive decline? Here are few things we can do…

1. Spend less time sitting down because a 2015 study found that the more we sat down, the higher our chance of heart disease, obesity, and diabetes (…and dementia).

2. Get a creative hobby because a recent study which followed older adults for 4 years found that those active in arts and craft were less likely to experience cognitive decline.

3. Spice up your food because a recent study found that a once-a-week intake of chilli lowered the rate of cancers, respiratory diseases, and ischemic heart disease. The authors didn’t report its effects on dementia though. Instead, spice in the form of tumeric (curcumin) has been found to be useful for repairing brain cells affected by dementia.

4. Eat leafy green vegetables because a 2015 study found that cognitive decline was slower among those who regularly ate spinach, kale, collards, and mustard greens. And go easy on the meat and cheese (Why? Read this article on the Blue Zones to learn more).

5. Increase your intake of walnuts because a new study suggests that they delay the progression of Alzheimers.

6. Incorporate eggs, bananas, dark chocolate, avocado, blueberries, and omega-3-rich foods into your diet because a collection of studies show that omega-3 fatty acids, choline, magnesium, and cocoa flavanols are among the nutrients which support brain functioning.

There are 6 easy steps to support brain functioning and delay cognitive decline, but preventing dementia requires regular exercise, a diet of vegetables, fruits, and no tobacco, good control of blood sugars, and good mental well-being. No one said it’d be easy…

Trying to help someone lose weight? Here’s what not to say

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Ever wanted to talk to your child, partner, or close friend about their weight and size?

Even if our heart is in the right place, it’s exactly what the experts say we should not do. Research has shown that overweight teens whose parents said that they should try “healthy eating” were more likely to engage in unhealthy weight-control methods (e.g., throwing up) than if parents talked about their teen’s size or weight. But other research has also found that girls who were told that they were fat at 10 years of age were more likely to have a BMI above 30 at age 19.

A 2015 study suggested that teenagers may not be aware of their own BMI and as a result not perceive a need to adopt healthy eating habits. But another 2015 study also showed that having accurate self-perceptions (about being overweight) does not necessarily equate to making healthy eating choices. In fact, labelling teenagers as overweight may in fact be counterproductive.

So what can we do instead? Apart from helping your child, partner, and/or close friend make healthy food choices by eating fruits and vegetables with them and cooking healthy meals with them, experts also advise against using food as a reward for good behaviour.

We suggest 8 useful tips which could help your loved one on the path to healthy eating:

1. Get more sleep. Studies show that lack of sleep is a major determining factor of later risk of being overweight. A 2014 study found that young children who slept less than the recommended duration for their age (e.g., less than 12 hours at 2 years or younger; less than 10 hours at 3 or 4 years of age; less than 9 hours at 5 to 7 years of age) were more likely to be overweight and to have more body fat at age 7 years. A separate 2014 study also found that infants who slept less than 10 hours a day at 16 months of age needed more feeds than their peers who slept 13 hours or more. And it’s doesn’t affect just children. Numerous studies link lack of sleep among adults to increased eating and weight gain, making good sleeping habits a priority.

2. Setting boundaries, warmth and affection matter. A 2014 study showed that children whose parents who set rules without engaging their children in dialogue about their rules and who don’t affirm their children with warmth and affection were at a higher risk of having a BMI above 30: Their risk of obesity was found as early as 2 years of age. A separate 2014 study in Australia found that overprotective maternal parenting during the earlier years (e.g., when children were 6 to 9 years of age) was linked to children having a higher BMI when they were 10 to 11 years of age. That’s why it’s important that your loved one should know that you care for them regardless of their shape and size. And these guidelines for what to say and what not to say apply not just to parents, but partners and friends.

3. Don’t talk about making changes. Instead, it’s more effective to get your loved ones involved in cooking healthy meals and visiting a local attraction or festival.

4. Don’t impose a diet on your child or partner or tell them what they cannot eat. Your good intentions will produce better outcomes if you participate in fun and enjoyable physical activities with them.

5. Don’t say “it’s good for you”. Studies with preschoolers show that a more effective way of getting young children to eat vegetables is to say nothing or to tell them that they’re “yummy”. (It helps of course if they really are yummy!)

6. Say “try this”. Telling your loved one what to eat is more effective than telling them what not to eat. Research finds that positive messages which start with “do” are better received than negative messages which are start with “don’t”.

7. Try and try again. A 2015 study found that children were more likely to eat fruits and vegetables if they were introduced to them on repeated occasions and if their parents also ate them with their children.

8. Start a gardening project. There is consistent evidence that children who participate in gardening projects are more likely to eat fruits and vegetables.

 

3 simple ways to keep mentally fit

Sleep is essential in order for our brains to function well as we age. A 2014 study found that those with poor sleep tend to have more memory and problem solving concerns. A local study also found that the less we sleep the faster our brains age.

Exercise is another key ingredient for healthy aging. The authors of a 2014 study report that those who didn’t exercise regularly were more likely to have problems with their memory. Moreover, older adults with have better lung and heart health, which is enhanced through regular physical activity, also tend to have better memory and problem solving abilities, according to another 2014 study.

Being socially active is another cornerstone for optimal aging. And these days social connections includes those through social media: According to a 2014 study, training older adults to use social media helped to improve their mental well-being. It’s clearly never too late to learn!

Our outlook on life can also contribute to our ability to age well. A 2014 study finds that those who are cynical — that is, those who tend to believe that others are “mainly motivated by selfish concerns” — are more likely to have dementia. Researchers observed that depression rates were lower among older adults who used the internet, according to a 2014 study.

It’s of course also important to eat right. A 2014 study finds that one gramme (1g) of tumeric a day improves the memory of those in the early stages of diabetes (and who therefore have a higher risk of dementia). Other research shows that eating baked or broiled fish once a week is associated with better brain functioning among older adults. According to this 2014 study, it doesn’t matter whether the fish that you’re eating has a lot of omega-3 fatty acids or not. That means that including ikan kurau could be just as beneficial for your brain health as salmon is. Fish curry, anyone?

Pursuing mentally challenging activities also plays an important role in determining how we age. A 2014 study shows that having a mentally challenging job is associated with better cognitive functioning later in life, while another 2014 study finds that those who engage in intellectual activities are less likely to experience cognitive decline later in life.

But it’s not actually about playing more majong or playing video games. Rather, it’s important for us to learn new skills. As they say, either you use it or you lose it. And recent research does show that learning a demanding skill pays dividends.

So here are 3 simple ways to challenge yourself.

1. Shop at a different supermarket
Instead of going to your usual supermarket, challenge your brain by going to a supermarket that’s not familiar to you. By going to the a different NTUC, Giant, or Sheng Siong, you’ll be able to find the brands you want, but your brain will have to work harder to locate them. Plus it could save you time, especially if you did your grocery shopping together with your other errands at the same location.

2. Explore a new route
Instead of doing your errands by the usual route that you know, try a different route. It could be using a different MRT line or bus route. It could be finding a different way to walk from the bus stop or MRT station to your office or home. Challenge your brain to add more information to the mental map that you already have for that neighbourhood or area.

3. Learn a new routine
You may already have a hobby that involves learning a pattern or routine. If you already read music, learning to play a genre that’s new to you (e.g., jazz) or learning a new instrument (e.g., the ukelele) will definitely help you make new neural connections.

If your hobby involves movement, try learning a new form. For dancers, this could mean trying something new like ballet for adults, tango, or tap. For those who practise tai chi, it could mean learning another style or form. Instead of cycling, learn to roller-blade or ice-skate. Or try a cycling trail in a nature reserve instead of using the park connectors.

If you like learning languages, it may be time to switch to a new language. If you play chess, challenge yourself with a new strategy game like weiqi (圍棋) or bridge.

If you’re already very practised at solving sudoku and optimizing your Freecell score, you may be surprised to find out that doing more of the same (even if you’re attempting the really difficult stuff) isn’t likely to be helping you delay dementia.

Because if you’re not outside your comfort zone, your brain’s probably not busy making new neural connections and you’re not building up your cognitive reserve.