Use It or Lose It

In this series, we discussed lifestyle changes that can have indirect and sustained effects on our ability to stave off age-related cognitive decline. In our final post of this series, we will focus on how consistently engaging in cognitively stimulating activities can improve performance and contribute to preserved cognition.

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As we age, we experience neural changes in the form of brain atrophy and, in many cases, Alzheimer’s disease pathology. However, not everyone responds to these changes in the same way. Some people tolerate larger amounts of pathology better than others. It is suggested that people who are more resistant to these brain changes have a greater cognitive reserve or back-up resources that allow them to maintain relatively preserved cognitive function (Stern, 2012). Cognitive reserve is built up over a person’s lifetime. Individuals with greater educational or occupational attainment often have greater cognitive reserve. However, research also shows that people who regularly engage in cognitively demanding leisure activities may have greater cognitive reserve.

The idea that playing word games or doing math problems can help to delay dementia is incredibly enticing, but researchers are still trying to understand the limits by which these “cognitive training” or “brain training” programs lead to measurable benefits (Lenze & Bowie, 2018). For example, training on a particular activity (i.e., word games) may only be beneficial if it is done for a certain number of minutes a day, is supported by a therapist, or is initiated before any significant cognitive decline is present. Researchers also warn that the changes associated with certain cognitive training programs may not be as widespread or relevant to daily life as advertised. They emphasize that other health-related activities, such as exercise, may be a more beneficial use of our time.

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In a recent review, researchers found that interventions that use cognitive activities or games to enhance cognition can reliably improve the trained activity. In other words, repeatedly practicing a particular task leads to improved performance on that same task. However, this same review did not find convincing evidence that this specified training can lead to increased cognitive performance more globally, a phenomenon known as transfer (Simons et al., 2016). The concept of transfer is important when evaluating the benefits of cognitive training, as it describes the extent to which playing a particular cognitive game will help us in our day-to-day lives. Although we always want to improve our score on a game, it is often far more important that we are able to learn how to operate a new phone application or remember the name of the person we just met.

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Further, there is little evidence that these cognitive training programs are more beneficial to long-term cognitive reserve than “real-world” cognitively stimulating activities, such as learning a new language or hobby. Experts emphasize the importance of keeping our minds active but also recommend that we select cognitively demanding activities that we enjoy. Many colleges and universities have opportunities for members of the community to enroll in enriching courses that can provide this ongoing stimulation, and, in some cases, older adults can take these courses at little or no cost. Some colleges even provide computer coding ‘Boot Camps’ specifically targeted to older adults in the community.

Over the past several months, we have explored ways in which we can slow down and, in some cases, reverse age-related cognitive decline. While there is no “magic bullet” that can prevent these changes entirely, research suggests that all individuals can benefit from a combination of moderate exercise, adequate sleep, meaningful social engagement, and consistent cognitive stimulation. In the same way a runner can improve their pace with a combination of running, cross-training, eating well, and getting enough sleep, successful brain conditioning relies on a multidimensional approach.