INTERPRETERS’ BRAIN HEALTH: COACH’S CORNER

Jackie Gonzalez (née Emmart) MS, NIC-A, CF-L2, NBC-HWC

Formerly an ASL interpreter of Boston, MA, Jackie now lives in Hawai’i and hops out of bed each morning eager to support her health coaching clients in taking small, realistic, and attainable steps toward their optimal cognitive and overall well-being. She originally founded High Five Health in 2017 as a pop-up project to support Bostonarea Deaf and DeafBlind youth in improving their access to health care. In 2024, she rebranded the organization to High Five Health Coaching & Education, a bilingual resource for those who are ready to take charge of their health little-by-little, to benefit their short- and long-term well-being. You can check it out at www.highfivehealth. info and find Jackie on Instagram, where she posts about optimizing our brain health in ASL and English, at @ hi.coach.jackie.

ASL LINK: https://youtu.be/oWb42X_V_uw

In 2018, my mom was diagnosed with early onset Alzheimer’s Disease at just 61 years old. Several months ago, her neurologist informed us that she entered the final stages of the disease, and she now lives in a nursing home. With the help of a full-time aide and hospice care, she receives the love and companionship that she deserves and needs. Her spirit is actually still quite bubbly and though it is all word salad these days, she joyfully engages with those around her. Recently, when I called for my daily update, the nurse told me that my mom wore her sunglasses indoors all day and giggled when asked if she had been partying the night before.

Six years ago though, when the symptoms of her disease became apparent and she waved the white flag asking me for help, I did what we interpreters do every day: I looked for meaning. Why was she struggling with her memory? What were the contributing factors? Was this some predetermined genetic condition? What did this onset of symptoms mean for her then and how would it impact her future?

As I combed every book, article, and report I could get my hands on, what I found surprised me. It turned out that her disease was likely preventable. Had her lifestyle looked different over the years, her current situation might look much different. For example, if she regularly made other choices regarding sleep, stress management, cognitive stimulation, social connections, her eating and drinking habits, and how much and in what ways she moved her body, she might not be living in a nursing home right now. Instead of being followed by hospice, she might have been following her dream of stargazing at the Grand Canyon.

We will never know. What I do know, however, is that dementia is actually a disease not of our golden years, but of our midlife. The symptoms we see manifest in our 60s, 70s, and beyond are often the results of choices we regularly made starting 20+ years prior. I also know two crucial truths: first, regardless of your current health, there are steps you can take to drastically reduce your risk of dementia and enhance cognitive clarity. Second, you are worth the effort it will take to change your present for a brighter future.

We all know that interpreting is a challenging cognitive task, and I understand that is an understatement. Researchers out of Zürich humbly acknowledge that “...simultaneous translation [is] among the most demanding language task [sic] involving both linguistic and executive functions” (Klein, 2018, p.1). Some of us might feel like interpreting is even harder now, with all the technological demands as compared to “back in the day” when we went from job to job, all in the land of 3D. Still, I remember when I started twenty years ago, I got headaches after working all day. Then, in 2020 when almost all of my interpreting work moved to the 2D virtual space, I started getting those headaches again. I chalked it up to building screen stamina, especially with the Zoom, Microsoft Teams, Google Chat, WhatsApp, Whereby, Google Docs, Slack, FaceTime, and Whova fatigue setting in. Fortunately that seemed to be the case and each instance of screen fatigue faded with time and practice. And there is also over a decade of research from the University of Geneva Brain and Language Lab that gives credence to having felt that way.

If I asked you which region(s) of the brain were involved in interpreting, I imagine you might say Broca’s area, because of its role in language production and working memory. You would be right, though it does not stop there. Broca’s area is also connected to other regions that support language comprehension and production, and when we actively interpret, there is significant interaction between Broca’s area and those nearby regions (Watts, 2014). In fact, many brain regions are involved in interpretation, and their connections create a complex network that requires rapid and impeccable communication. To geek out for a minute, the caudate nucleus and more so the putamen–known for their roles in complex tasks like learning and movement, decision making and trust–are also key to the coordination of the brain regions involved in simultaneous interpreting. However, the caudate is less active as our interpreting skills improve (Watts, 2014). But, wait, there is more. One study found that when spoken language interpreters went from their L1 to their L2 (which they rarely did), they engaged two extra brain areas: “the left inferior temporal lobe, which is related to word-finding and semantic processing, and the cerebellum” (Hervais-Adelman, 2020, p.1) which is involved in storing and refining actions. It is not just about myriad areas coming online to perform the task, as measurable changes have been observed in the brain’s structure.

Interpreting actually shapes our brains! A 2017 study of cortical thickness from international collaborators noted, across both hemispheres, changes in several brain regions of their interpreter participants. Increases were seen in the left perisylvian areas linked to speech processing, which are known to be involved in spoken language interpretation. Of note, however, were the changes in the right hemisphere, observed in areas not even specifically associated with interpretation. This suggests that an even wider network is engaged in developing skills in simultaneous interpretation (Hervais-Adelman, 2017). And lest we think that interpretation only has an impact when we are actively working, research from the University of Zürich showed that there is an increase in neural communication in an interpreter’s brain even when they are at rest (Klein, 2018). All this is to say: we really do need to care for our entire brain if we are to succeed in this profession, and in life, for that matter.

Reflecting on my 20-year interpreting career and modifiable risk factors impacting brain health, I recognize the irony: my brain’s current state was influenced by my habits–good and bad–that also started two decades ago. Just as its state 20 years from now will be shaped by the sum of daily choices I make until then. This twenty-year window in brain health means that by the time we see symptoms of dementia in our loved ones or ourselves, we are way downstream from the onset of chronic stressors. The brain is resilient so it fights hard to restore its balance and also, just like every other organ in our body, when it is not given what it needs and it is attacked for a period of time (e.g., decades), it tires of the fight and it, too, waves a white flag.

As of 2024, that white flag for an estimated 6.9 million Americans age 65 and older, who are now living with the disease, came in the form of Alzheimer’s dementia (Alzheimer’s Association, 2024). Alzheimer’s is the brain’s response to prolonged exposure to harmful factors, and is much like what we see with the pancreas when it is overworked for a period of time, which readers may be more familiar with considering its prevalence. When we chronically abuse our pancreas, we see an onset of insulin resistance that can lead to pre-diabetes, as is the case for over 46% of adults in the United States (Martin, 2024). Without any lifestyle modifications, pre-diabetes can become full blown Type 2 diabetes. By the time Type 2 diabetes develops, we have already been asking too much of our pancreas for too long, and understandably, it is worn out from the constant peaks and valleys of blood sugar and insulin dysregulation.

Chronic attacks on the brain are mostly modifiable. Some of the more common examples fall within the following patterns: inconsistent and insufficient sleep, insufficient daily movement, lack of purpose and community, suboptimal intake of nutrients, and an imbalance of eustress and distress in favor of the latter. Additional attacks include hormone dysregulation, carrying excess weight, toxic exposures, eating to excess, maintaining harmful relationships, metabolic syndrome, insufficient oxygenation of the brain, untreated pathogens and infections, lack of varied and challenging cognitive stimulation, and social isolation (Gupta & Loberg, 2021). When you read this list, if any of these factors resonate with you, you can start your path toward optimizing your brain health by addressing that chronic attack first.

It all comes down to cognitive reserve, which is a measure of your brain’s resilience. This is your brain’s ability to respond to threat and harmful exposures as it ages, and to re-establish optimal function when there are setbacks. Brain health is akin to those teachers who give you an A to start the semester and then you decide what grade you end up with, based on the choices you make through the term. Most of us start our lives with an A+ brain. The “grade” we get in adulthood is determined by our daily habits throughout life. This does not mean we cannot turn in some homework late and maybe even flunk a quiz or two. It does, however, mean that we must consistently control the controllables and do everything in our power (which is quite a lot) to rebuild and nurture our A+ brains.

There are countless ways to give your brain an optimal environment in which to thrive. On a personal level, the return on this investment will look different for everyone. Professionally, taking care of our brains means that we will be able to more meaningfully prepare for our assignments. It means we can effectively collaborate with our teams and bring our best selves to each job. When at our best, we can properly represent the individuals with whom we work and give them the quality services they so deserve. There is no “one thing” to improve and no magic supplement to take, much like there is no one region dedicated to interpreting. Optimizing brain health involves five interconnected pillars of regular and modifiable behaviors. These are fostering meaningful social connections, increasing eustress and decreasing distress (both in the body and in the mind), anaerobic and aerobic movement, ensuring quality and sufficient sleep, and maintaining a nutritious diet. Every day, every hour, and every minute are opportunities to demonstrate whether you want to increase or decrease your risks for developing dementia. While you may be unaware of the harm caused by your daily choices in the short-term, in 20+ years, the truth will be apparent. Given the countless steps you can take to dramatically reduce the risk of cognitive decline, why leave to chance what you have the power to change? Start now, and little-by-little you will strengthen your vitality and your satisfaction in both personal and professional realms. For the love of your brain! #highfivehealth #fortheloveofyourbrain

Brain Health Resources

High Five Health Coaching & Education

A bilingual (ASL & English) resource for people who are ready to take charge of their health and improve their cognitive and overall well-being for the long run. You will find an introductory course on optimizing your brain health, many health-related resources to explore, and personalized health coaching available for you one-on-one, in small groups, and for organizations who hire Deaf and ASL-fluent employees. Mention this VIEWS article for 10% off a threemonth one-on-one health coaching package.

Preserving the Etchings of the Mind: Aging, Dementia, and Hearing Loss

By Dr. Jaime A.B. Wilson

Dr. Wilson, a Deaf neuropsychologist, provides a unique perspective on dementia prevention, highlighting how deafness and hearing loss may increase dementia risk. His relatable writing, filled with metaphors and stories, clarifies these topics. This book is essential for anyone interested in dementia, and may be especially valuable for the Deaf community and those experiencing midlife hearing loss.

Keep Sharp

By Dr. Sanjay Gupta

If you are just starting out on your journey toward optimal long-term brain health, Dr. Gupta is your guy. His writing is not overly technical, making this essential information accessible to a wider audience and an excellent intro to all things brain health.

References

Alzheimer’s Association. (2024). Alzheimer’s Disease Facts and Figures. Alzheimers Dement 2024. https://www.alz.org/media/ Documents/alzheimers-facts-and-figures.pdf

Gupta, S., & Loberg, K. (2021). Keep sharp: build a better brain at any age. First Simon & Schuster hardcover edition. New York, NY, Simon & Schuster.

Hervais-Adelman, A., Moser-Mercer, B., Golestani, N. (2020, January 8). The neuro science of simultaneous interpretation. Inter national Association of Conference Interpreters. https://www.academia.edu/19573817/ The_Neuroscience_of_Simultaneous_Inter pretation

Hervais-Adelman, A., Moser-Mercer, B., Murray, M.M., Golestani, N. (2017). Cortical thickness increases after simultaneous interpretation training. Neuropsychologia, 98, 212-219. https://doi.org/10.1016/j.neuropsy chologia.2017.01.008.

Klein, C., Metz, S. I., Elmer, S., & Jäncke, L. (2018). The interpreter’s brain during restHyperconnectivity in the frontal lobe. PloS one, 13(8), e0202600. https://doi.org/10.1371/journal.pone.0202600

Martin, S.S., et. al. (2024). 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation, 149(8). https://doi.org/10.1161CIR.0000000000001209

Watts, G. (2014, November 17). The amazing brains of the real-time interpreters. BBC. https://www.bbc.com/future/arti-cle/20141117the-ultimate-multi-taskers