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Can Brain Training Reduce Dementia Risk and Boost Cognitive Health?

April 29, 2024 From Medscape

The idea that engaging in mental activities can preserve or enhance cognitive health is often summarized by the phrase “use it or lose it.” This concept is backed by research suggesting that a cognitively active lifestyle might protect against cognitive decline. But what exactly constitutes a “cognitively active lifestyle”? Does it include puzzles, crosswords, or perhaps specialized brain training?

What is Brain Training?

“Brain training typically refers to tasks or drills designed to strengthen specific aspects of cognitive function,” says Yuko Hara, PhD, director of Aging and Alzheimer’s Prevention at the Alzheimer’s Drug Discovery Foundation. Manuel Montero-Odasso, MD, PhD, elaborates that it involves performing tasks to improve focus, concentration, and memory by increasing attentional demands.

Dr. Michael Merzenich, professor emeritus at UCSF, highlights the importance of brain training in preventing or delaying Alzheimer’s disease by growing cognitive reserve and managing brain health in a commentary on Medscape. He emphasizes the role of brain training and physical exercise in maintaining cognitive function.

Mechanism of Action

Cognitive training stimulates neuroplasticity by creating new synapses in the brain, particularly in the frontal lobe and prefrontal cortex, enhancing brain health and cognitive abilities. “When we try to activate networks mainly in the frontal lobe, we generate new synapses, enhancing brain health and cognitive abilities,” Montero-Odasso explains.

Neuroimaging has corroborated these neuroplastic changes, showing increased activation in the prefrontal cortex post-training. Henry Mahncke, PhD, CEO of Posit Science/BrainHQ, states, “The brain can rewire itself at any age, improving cognitive abilities like memory, speed, and attention.”

Unsubstantiated Claims and Controversy

Despite promising mechanisms, brain training is controversial. Some manufacturers have been criticized for unsubstantiated claims. A 2016 review found brain training improves performance on specific tasks but has little evidence supporting improvements in everyday cognitive performance. Similarly, a 2018 review found evidence regarding the prevention of cognitive decline through brain games insufficient.

“The general consensus is that people may get better at specific tasks through practice, but these improvements don’t necessarily translate to other cognitive domains or prevent dementia,” Hara notes.

Supporting Evidence

Some studies support brain training’s benefits. The IMPACT study and ACTIVE study, involving large sample sizes and long follow-up periods, found significant improvements in cognitive functions among participants undergoing brain training. For example, The ACTIVE study found a 29% lower risk for dementia in participants who received speed-of-processing training.

Montero-Odasso’s SYNERGIC study showed that combined aerobic-resistance exercise and cognitive training significantly improved cognition in older adults with mild cognitive impairment.

Beyond Formal Brain Training

Engaging in mentally stimulating activities beyond formal brain training, such as puzzles, board games, and new challenges, can also enhance cognitive reserve. Observational studies suggest that such activities are associated with improved cognitive performance and lower dementia risk. However, Montero-Odasso emphasizes that “newness” is crucial for effectiveness, suggesting that trying entirely new activities is more beneficial.


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