The most recent comprehensive research analysis from hundreds of studies finds three practices may reduce cognitive decline.
Strong evidence that anything prevents Alzheimer’s disease is lacking, but a few changes can likely delay memory loss, according to a 2017 review by the National Academies of Sciences, Engineering and Medicine.
Specific memory training, consistent exercise and controlling high blood pressure offer the best hope, the committee concluded. Members examined the best research on ways to limit or prevent cognitive impairment, the loss of ability to think clearly and make decisions, that often afflicts older adults.
The number of Americans with Alzheimer’s is more than 5 million, and growing as the overall population ages. Treatments such as Aricept (donezepil) and Namenda boost working brain cells with unaffected neurons, but there is no cure.
Commercial Products Are Not Effective
There is no evidence that the profusion of online and commercial products, from supplements to memory games, slow or prevent the decline, according to experts.
Can Lumosity Prevent or Slow Mental Decline?Many people play computer brain games such as Lumosity, hoping to avoid cognitive decline. A recent study analysis (see main article) indicates brain games may slow the advance of Alzheimer’s and dementia. “We’re very concerned about the brain game industry taking this and running with it, and saying the National Academy of Science has shown that cognitive training is going to forestall cognitive decline, and we have our brain game here,” said Dr. Ronald Petersen, an Alzheimer’s expert at the Mayo Clinic and member of the review committee. Lumosity was fined several million dollars last year for claiming that their "games can help users perform better at work and in school, and reduce or delay cognitive impairment associated with age and other serious health conditions." According to the Federal Trade Commission, Lumosity didn’t have data to support its ads. "Lumosity preyed on consumers' fears about age-related cognitive decline, suggesting their games could stave off memory loss, dementia and even Alzheimer's disease,” said Director of the FTC’s Bureau of Consumer Protection Jessica Rich. A new study published by the Journal of Neuroscience has more bad news for the company. It found “no effect of commercial cognitive training on neural activity during decision-making.” What subjects did get better at, whether using Lumosity or standard online video games, was the specific game they were playing. The study found no evidence that this task-specific improvement would transfer to other cognitive tasks. |
“At present, there are no pharmacologic or lifestyle interventions that will prevent mild cognitive impairment or Alzheimer's disease,” said Dr. Ronald Petersen, an Alzheimer’s expert at the Mayo Clinic, who was on the committee.
“All this is not new, but this review is the strongest evidence base we have,” Petersen added.
“We have all been exposed to a study here, a study there. One suggests this intervention is beneficial, the other finds it’s not. This review looked at the totality of literature over the last six years and put it to the most rigorous test you can imagine.”
Cognitive Training, Exercise and Blood Pressure Control
“Even though clinical trials have not conclusively supported the three interventions discussed in our report, the evidence is strong enough to suggest the public should at least have access to these results to help inform their decisions about how they can invest their time and resources to maintain brain health with aging,” said Dr. Alan Leshner, chair of the committee and CEO emeritus of the American Association for the Advancement of Science.
“The strongest evidence was in the area of cognitive training,” Petersen said.
Do crossword puzzles or Sudoku qualify? They won’t hurt, but studies show gains from specialized training called mnemonic strategies.
Mnemonic memory programs include face-name recognition and name-face learning, number mnemonics, story mnemonics, and the method of loci, where key details are kept along a familiar route or place you recall.
Additionally, training programs often entail instruction on how to take advantage of environmental supports, called external memory aids.
“Can you, in fact, find a new way to try to remember a list of grocery items?” Peterson asked. Also, try figuring out restaurant tips in your head, he advised, instead of using a calculator or your smartphone.
Commercial products have not proven they help, Petersen cautioned. See sidebar for information about common commercial brain games.
Exercise Helps Your Aging Brain
Several studies indicate that exercise is important.
“Here we're talking about modest aerobic exercise,” Petersen said. Brisk walking and cycling are good choices.
“How much? Maybe 150 minutes a week—30 minutes five times, 50 minutes three times—can have an effect on reducing cognitive impairment later in life,” Petersen said.
A preponderance of documentation demonstrates the health benefits of physical activity. Some of these benefits, such as stroke prevention, are causally related to brain health.
“Is it going to prevent Alzheimer's disease?” asked Peterson. “I can't say that. But I think it may have an effect on reducing cognitive impairment.”
Control Blood Pressure to Help Brain Function
Managing hypertension by controlling blood pressure seems to delay vascular dementia, according to the committee. High blood pressure damages delicate blood vessels in the brain.
Controlling blood pressure is particularly important during midlife, from ages 35 to 65. There is also strong evidence that using antihypertensive medications and making lifestyle changes to manage blood pressure can help prevent stroke and cardiovascular disease.
Conclusions
None of the evidence is strong enough to justify a public education campaign, the committee of experts found. But it did point to the need for more and larger randomized, controlled research.
“We’re all urgently seeking ways to prevent dementia and cognitive decline with age,” said Dr. Richard Hodes, director of the National Institute on Aging.
Sources
“Interventions to prevent cognitive decline, dementia,” ScienceDaily.
“More Bad News For Brain-Training Games,” NPR.
“No Effect of Commercial Cognitive Training on Neural Activity During Decision-Making,” Journal of Neuroscience.
“What Can Prevent Alzheimer’s? Here’s What the Evidence Shows,” NBC News.
“Memory training interventions for older adults: A meta-analysis,” National Center for Biotechnology Information.
“Lifestyle Program May Slow Cognitive Decline,” American Academy of Neurology.
“A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial,” The Lancet Journals.
Blog posting provided by Society of Certified Senior Advisors
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