First evidence of brain training reducing dementia risk

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A 10-year study presented at the Alzheimer’s Association International Conference in Canada found that a specific type of computerised brain training game can reduce the risk of dementia by half, by strengthening neural connections and boosting the speed of mental processing. ‘We believe this is the first time a cognitive training intervention has been shown to protect against cognitive impairment or dementia in a large, randomised, controlled trial,” said Jerri Edwards, first author of the study and an associate professor at the University of South Florida.

Most of us strive to sharpen our mental agility by doing Sudoku, exercising, and getting a good night’s rest. In addition, popular computer-based cognitive programs and brain games are inundated with claims of rejuvenating our memory and sharpening our focus – but do they really work?

Medical Daily reports that  researchers from the Wisconsin Alzheimer’s Disease Research Centre and Wisconsin Alzheimer’s Institute sought to compare the effects of three forms of brain training in a group of over 2,800 cognitively healthy seniors with an average age of 74 in a 10-year span for the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study.

The participants were sorted into four groups, including a control group, which received no brain training. One group got a classroom-based course aimed to boost memory; one group got a classroom-based course designed to sharpen their’ reasoning skills; and another group was given computerised training designed to boost the speed of mental processing. The three experiment groups received a total of 10 hours of training in the first five weeks, and around half of each experimental group got an additional training after 11 months and 35 months.

Over the 10-year follow-up period, those who got the commercially available brain training exercises had a 33% less risk of developing the neurodegenerative disease over 10 years than those who got no brain training at all. Among those who got a refresher class 11 and 35 months after the initial training, the risk went down even more. Those who went through more than 10 of the brain training sessions were 48% less likely over 10 years to experience dementia or cognitive decline.

Moreover, participants who took part in the other two training programs, which focused on memory retention and reasoning, were slightly less likely than the control group to suffer cognitive decline or dementia. This was especially true for those who got 10 sessions to improve reasoning strategies.

The computerised brain training exercise is commercially available as the “Double Decision” game, one of a suite of cognitive exercises marketed online by the San Francisco-based Posit Science Corporation, the report says. The game exercises an individual’s ability to detect, remember and respond to cues that appear and disappear quickly in varying locations on a computer screen. It uses colourful graphics and challenges players with escalating difficulty as their proficiency increases.

“We believe this is the first time a cognitive training intervention has been shown to protect against cognitive impairment or dementia in a large, randomized, controlled trial,” said Jerri Edwards, first author of the study and an associate professor at the University of South Florida.

The researchers emphasise these results are by no means a validation for brain training as a whole, but for just one specific task – boosting mental processing. Previous claims of brain training programs have included the ability to increase IQ, enhancing education, and improving daily functioning.

The report says it’s not clear why speed mental processing training works, or the exact changes it causes to the brain. However, scientists suspect continually using our brain in a certain way can actually enhance the communication between brain cells, providing a benefit in the long run. It’s a cognitive skill that declines with age, and one that some researchers say contributes to the increase in “noise” in electrical communications between cells and among regions in the brain.

Edwards’ study is the first to suggest computerised brain training could potentially help against dementia. This is a crucial finding since many scientists have been sceptical of the brain training industry. For example, the report says in a 2014 consensus statement, 70 scientists criticised brain training computerised games stating: “We object to the claim that brain games offer consumers a scientifically grounded avenue to reduce or reverse cognitive decline when there is no compelling scientific evidence to date that they do.

Abstract not available online

 

In another of the of several studies presented showing lifestyle has an effect on cognitive decline, research from the Wisconsin Registry for Alzheimer’s Prevention (WRAP) and the Wisconsin Alzheimer’s Disease Research Centre (ADRC) shows that people whose jobs involve complex interactions with other people fare the best as their brains age. These include jobs that involve mentoring, negotiating or teaching.

Elizabeth Boots, a member of Dr. Ozioma Okonkwo’s lab, presented research this week at the 2016 Alzheimer’s Association International Conference (AAIC) in Toronto showing that occupations that require complex thinking seem to protect older adults from the onset of Alzheimer’s disease symptoms.

“These new data add to a growing body of research that suggests more stimulating lifestyles, including more complex work environments with people, are associated with better cognitive outcomes in later life,” said Dr Maria Carrillo, Alzheimer’s Association chief science officer.

In the Wisconsin study, Boots and Okonkwo looked at brain scans of 284 people enrolled in the long-running WRAP study. The people had an average age of about 60 and were at higher risk for Alzheimer’s because of parental family history. Researchers also assessed the research participants for the complexity of their jobs, and whether they primarily worked with people, data, or things.

They found that those who had complex jobs working with people were cognitively healthy, even though their brains showed higher numbers of white matter lesions, which are markers of Alzheimer’s and cerebrovascular disease.

Okonkwo says the study is further proof of the theory of “cognitive reserve,” which describes the brain’s resilience and ability to maintain function despite injury. Childhood intelligence, educational attainment, and adult occupation all contribute to a person’s cognitive reserve.

“These findings suggest that a mentally engaging lifestyle can lessen the harmful effects that abnormal brain changes have on cognitive health,” Boots said. “We found that greater white matter injury was not detrimental to cognitive function in those with increased occupational complexity.

“Interestingly, this finding seemed to be driven by complexity of work with people – but not data or things – suggesting that social interaction in the workplace could play an important role in boosting cognitive reserve.”

Thus, people at risk may be able to delay the onset of Alzheimer’s symptoms by staying in school when young, and then working at a mentally challenging job involving other people.

The WRAP study began in 2000, when Dr Mark Sager of the Wisconsin Alzheimer’s Institute began enrolling middle-aged people at risk of developing Alzheimer’s. It currently has about 1,500 participants, who come for regular tests of cognitive skills, as well as brain scans, cerebral spinal fluid draws and other testing.

Abstract not available online

Full Medical Daily report
University of Wisconsin-Madison material


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