Brain Exercise

Living Well in Myanmar

Why brain exercise may lead to a longer independent life

Declining brain strength is a normal, inevitable part of ageing – at least to some extent. Just as other organs such as the kidney and heart become weaker and go into “chronic failure”, so the brain is said to be failing permanently when irreversible cognitive decline sets in. 

For other organs we have several lifestyle and pharmaceutical preventative interventions intended to stave off failure. What can we do to defend ourselves against brain failure?

In this column previously I’ve discussed how diet and exercise may decrease the likelihood of developing Alzheimer’s disease (web link to: Preventing Dementia, October 13, 2013), in addition to all the other benefits of moving your body and eating right. As it turns out, exercising the brain – by making it think and learn – also defends against its decline.

Many of my older patients are attracted to the idea of including brain exercise in their daily routine with the hope of keeping the mind sharper for longer. It seems logical that challenging the brain regularly will make it healthier. The hope is that mental exercise will maintain powers of  awareness and interpersonal communication, as well as of responsible decision-making and independent living. However the Western medical evidence in support of this hypothesis is sparse.  

An interesting new study in the Journal of the American Geriatrics Society attempts to find out whether cognitive training in healthy adults can result in long-term reduction in cognitive decline and daily function. Nearly 3000 adults older than 65 were randomly placed into four study groups: reasoning training, speed-of-processing training, memory training and no training. Each group received 10 one-hour practise and instruction sessions over the course of one-and-a-half months in the late 1990s. 

Then, 10 years later, the participants were given written and verbal tests to assess their capacity in each area. They also filled out questionnaires on how well they were currently achieving activities of daily living such as meal preparation, housework, shopping, finances, hygiene, etc. 

In reasoning training, the study subjects learned techniques to help them solve problems by looking for a serial pattern in written exercises. For example, they examined the pattern in a bus schedule. As compared with the group that received no training, the reasoning group had improved cognitive ability immediately after the training and maintained a small improvement after 10 years. They also reported less difficulty with activities of daily living.

The speed-of-processing group looked at pictures and texts and was asked to mentally process pieces of information contained in each. The amount of time allotted was steadily decreased. After 10 years, this group maintained a moderate improvement in speed-of-processing over the no-training group, and they also reported less difficulty in daily living.

The memory training group focused on learning to better remember items and written text, for example, a shopping list.. Unlike the other two groups, the memory group was unable to maintain any memory benefit over the no-training group after 10 years. They did, however, show the same protection against daily living difficulties as the other two groups.

The general conclusions of the study are intriguing. This is the first research showing that certain types of brain training can help people be more independent as they age over the long-term. 

If this data is supported in future studies, it will change the way we counsel patients in their 50s and 60s. In addition to recommending diet, exercise and tests such as cholesterol and colonoscopy, we will prescribe brain-training exercise and activities – and presume that national health insurance will pay for it. For Myanmar and elsewhere, keeping people living independently has major potential to reduce public health costs. 

Exactly what the most effective brain activities are has yet to be determined. Possibilities include games, tests and educational courses. In any case, no harm has ever come from my patients stimulating their minds, so encouraging cognitive training is just good medical practise.  © Christoph Gelsdorf 2013