Lisa Jarvis: Tired of spending billions on dementia care? Try a brain workout

If ever you needed a nudge to give your brain a workout, new research underscoring the benefits of “brain training” should offer fresh motivation.

The two long-term studies add to a growing body of evidence that people can boost their brain health by doing mentally stimulating activities, such as learning a language, visiting a museum or playing chess.

They also show that consciously working to build cognitive resiliency can delay the onset of dementia for years. That’s an important message as the U.S. grapples with the growing challenge of Alzheimer’s disease, which affects some 7 million Americans and counting.

Both studies were part of a wave of trials started in the U.S. in the late 1990s with the goal of better understanding how lifestyle, genetics, the environment and other factors affect people’s chances of developing dementia. Decades later, they are yielding real insights.

For the first study, researchers mined decades of Medicare data from roughly 2,000 people who had been recruited in the late 1990s to participate in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial. That study had tested whether certain types of brain games might boost brain health. People were sorted into groups, each assigned one of three computer games that tested either speed, memory or reasoning.

Participants spent an hour playing the game twice a week for six weeks, and then did the same thing again after one and three years. That made it more than a fun little challenge, like your daily crossword or sudoku.

It was hard work. The payoff, though, was substantial: Twenty years later, about 25% fewer people in the speed training group developed dementia compared with the people who weren’t offered the intervention.

Interestingly, the memory and reasoning games did not have the same effect. Researchers suspect the difference is related to the type of exercise the speed game required of the brain. It tested people’s ability to juggle several tasks at once — and unlike with the memory and reasoning tests, players weren’t told how to improve their results. And the better they performed on the test, the more difficult it got.

Study co-author Marilyn Albert, who directs the Johns Hopkins Alzheimer’s Disease Research Center, hypothesizes that implicit form of learning improved brain connectivity, or the ability of the different parts of the brain to work together. The booster sessions years on strengthened those links, she says.

Ideally, future research would explain the underlying biology of how such a game reduces dementia risk. That doesn’t require running another multi-decade trial. When the ACTIVE study began, scientists had yet to invent the brain imaging techniques that allow researchers to observe changes and signs of disease in real time.

Now, though, it would be possible to conduct short-term studies that pair the games with imaging and perhaps blood markers, offering deeper insight into what’s happening in people’s brains when they play these games, says Albert. New research could also potentially lead to even more effective brain games.

Meanwhile, a separate study showed that building a resilient brain is a lifelong endeavor — and that pursuing mentally stimulating activities early in life can make a difference decades down the road. Rush University Medical Center’s Memory and Aging Project followed nearly 2,000 people to understand how their genetics and environment affect their chances of getting Alzheimer’s.

Participants were asked detailed questions about the types of experiences they had across all stages of life — things like whether they were read to as a child, visited a library or played chess.

Researchers found that the people who were most engaged in enriching activities throughout their lives had much lower odds of developing Alzheimer’s. And among those who did develop the disease, people who spent a lot of time on intellectually enriching activities were healthier for five more years, on average, than those who didn’t spend as much time at the mental gym.

About half of the participants in the Rush study donated their brains to science, which offered another fascinating insight. Researchers found that even people whose brains were coated with the telltale plaques associated with Alzheimer’s benefited from a lifetime of mental workouts.

In other words, two people might have the same pathology in their brain, but one “could handle more wear and tear before symptoms appear,” explains Andrea Zammit, a study co-author and neuropsychologist at the Rush Alzheimer’s Disease Center in Chicago.

One of the more encouraging findings out of the Rush study is that although the benefits were greater when someone seeks out intellectual stimulation throughout their life, people still were helped by enrichment in old age. As Zammit puts it, “It’s never too late to start.”

Of course, getting started can be challenging. The Rush study suggests the U.S. should be doing more to ensure everyone has access to enriching environments, whether that’s libraries and museums, or through programs targeting early childhood or older adults.

Meanwhile, as studies like Albert’s point to short-term interventions that can stave off dementia, doctors and policymakers should be considering how to integrate those into a health care system often more focused on treatment than prevention.

After all, if these efforts ultimately allow more older adults to live independently for longer, they could chip away at the nearly $800 billion the U.S. spends on dementia care each year, while improving countless lives.

The public is hopefully getting the message that we do have some control over our brain health. Proactive individuals might decide to pursue more structured activities — older adults wanting a workout for their brain can try a version of the speed game that participants played in the ACTIVE trial — while others might simply be more intentional about regularly opening up a book or challenging a friend to a game of Scrabble.

In our digital age, the growing research on brain health is also a good reminder that while scrolling and posting might offer a quick dopamine hit, real engagement — that is, focused, purposeful activities — offers a much bigger reward.

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This column reflects the personal views of the author and does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.

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