In the earlier years of this millennium, a surge of studies had seemed to suggest that playing brain-stimulating games – like crossword puzzles, Sudoku, chess and even Angry Birds – would improve our memory, and delay or prevent the onset of Alzheimer’s. This research included the studies by Japanese neuro-scientist Ryuta Kawashima that got half the world playing daily Sudoku to stave off brain rot.
In fact, it’s not just games, this earlier research had seemed to suggest – any mental activity that requires concentration, such as reading the newspaper, writing, or learning a new language, particularly if done over a lifetime, would rein in the brain changes indicative of Alzheimer’s and other age-related dementias.
Alas, the promise held out by those earlier studies has not panned out. More recent, rigorous review of that research has found that it failed to add up to any strong findings that brain drain could be stemmed by catapulting that angry red bird at that dastardly green pig, and doing it till you became a zombie-eyed addict to an animated game series. In fact, put under the microscope of strict scientific scrutiny, these studies have actually been found to show little more than that brain games make people better at playing the particular game(s) that they play. So, if you solve a lot of crossword puzzles, then you get better and better at solving crossword puzzles. That’s it.
This finding knocked the stuffing out of the popular theory behind many brain games, that is, that if you improve working memory by playing a brain game, this would then translate to better mental functioning on other tasks. In two words, it won’t. The effects do not spill over to other untrained areas and do not elevate critical frontal lobe brain functions such as decision-making, planning and judgment — functions that allow us to carry out our daily lives.
At crisis point
So, where do we stand today as far as a hope for prevention or cure of Alzheimer’s goes? Pretty much neck-high in a sea of failed drug research and failed treatment trials – but also a glimmer of hope, coming in from prevention strategies that are inexpensive, do not require any medical intervention, and simply add up to a few Old Faithfuls.
But let’s get the bad news out of the way, first:
There is, at present, no miracle cure for Alzheimer’s or any other type of dementia. Nor is there any drug that can stop its progression. The few drugs available, such as donepezil and memantine, work only to reduce symptoms and only over the short term; and they do not work for all Alzheimer sufferers.
Scientists have some hints that drugs can reduce the brain-clogging plaques that are a hallmark of Alzheimer’s, but the research so far has not shown that reducing these brain plaques can, in turn, reduce the symptoms of Alzheimer’s or prevent the disease. Such drugs are also years away from getting to the market.
But – and it’s the only ‘but’ we have – there is strong evidence that three lifestyle changes might reduce the risk or at least delay the onset of Alzheimer’s. A mega-analysis by a committee of experts in the U.S this year rigorously reviewed the totality of research literature in this field over the last six years. The committee, at the highly-respected National Academy of Sciences (NAS), concluded that the three lifestyle approaches shown to correlate strongly with preventing memory loss and what is known as “cognitive impairment” (that is, the loss of the ability to think clearly and to make decisions) were:
Controlling high blood pressure
Regular physical exercise
Specific brain training exercises
Fighting dementia without drugs
Here is the nitty-gritty on how these three interventions appear to help stave off brain aging:
Controlling blood pressure is something people should do anyway, to prevent heart disease. But good evidence shows it can reduce the risk of memory loss and dementia, probably because high blood pressure damages delicate blood vessels in the brain.
And several studies have shown that physical exercise can help to optimize brain function. The good news for couch spuds is that you don’t have to start lifting monster dumbbells in order to do your brain a favour. Modest aerobic exercise is all it takes, according to this review. That includes brisk walking. As long as you sweat a bit and your heart rate goes up, that’s what your brain needs. By bolstering your cardiovascular fitness and blood circulation, exercise nourishes your brain with the nutrients and oxygen it needs to perform optimally. Some brain regions and functions seem to benefit more than others from physical activity – specifically, the frontal lobe, responsible for high-level mental skills.
How much exercise? Maybe 150 minutes a week — 30 minutes five times, or 50 minutes three times — can have an effect on reducing cognitive impairment later in life, the experts found.
The study leader’s recommendation: “Try to avoid the tendency to sit down, watch television for endless hours at night. Get out there, do something.”
“Is it going to prevent Alzheimer's disease? I can't say that. But I think it may have an effect on reducing cognitive impairment.”
For more on how exercise can help prevent brain aging, see Faster, Higher, Stronger... Smarter?
Specialized brain training exercises. The evidence is strongest for this intervention. But it does not mean crossword puzzles or Sudoku, the meta-analysis found. Instead, the best evidence for anti-brain decline came from research that looked at specific ways of training the brain to enhance its functioning through, for example, memory improvement techniques, or “mnemonics" as they are called.
People will have to work at it, the study leader said. “Can you, in fact, find a new way to try to remember a list of grocery items?” he asked. Instead of using a smart phone calculator to figure out a tip, do it in your head, he advised.
Mnemonics is not a very familiar word, but it really refers to some very simple strategies and techniques used by people who are credited with having a photographic memory. One of the most popular of these is linking words with pictures to give you the mental imagery which will help you remember those words. The late Shakuntala Devi, a.k.a. “the human computer”, popularized these techniques in her memory-improvement books. Here’s an example:
Let’s say you want to remember a list of unrelated words like these:
Shakuntala Devi suggested you can memorise this list by creating some unforgettable mind-pictures – and the more absurd those images, she said, the better. So: picture the pen writing on the cat’s back. Or, better yet, “see” several pens writing on several cats’ backs. Hold that picture in your mind for some time. Fix it firmly in your imagination. Then, move on and conjure up the next picture...
The cat is chasing the bottle. Just picture that feline, deadly intent on her game, her tail rigidly up, running in hot pursuit of the bottle...
Now you see the bottle sloshing out several tiny spectacles from its mouth. thousands and thousands of miniscule spectacles spilling from its mouth...
The spectacles now leap on to the bus – straight on to its headlights, then off again. On and off. On and off. No wonder that bus looks so bewildered. ..
Finally, the bus is picked up by a helicopter. And together they fly in the sky, the helicopter grinning as it dangles the bus in its “claws”!
There... that was a painless exercise, wasn’t it? And see how easily you’ll remember the list of items in the right order because of the absurd associations and the strong action pictures you’ve used:
The pen scribbling on the cat...
The cat chasing the bottle...
The bottle spouting spectacles...
The spectacles jumping on and off the bus...
The bus flying with the helicopter...
And you can stop right there and pat yourself on the back. Because you’ve done it: Taken a list of items. Linked the first to the second, the second to the third, and so on, in a chain of crazy mind pictures. And in doing so, you’ve memorised the list of items in their correct order. That is the power of mnemonics.
The Longevity Center at UCLA (the University of California in Los Angeles) has been studying Alzheimer’s for over two decades. UCLA researchers have found that using specific memory techniques can strengthen neural circuits in the brain’s front lobe, a critically important memory-processing centre. The Center’s director, psychiatrist Gary Small, says the building blocks of a sharp memory are what he calls Look- Snap-Connect. Look stands for focusing attention. The biggest reason people don’t remember things is that they’re simply not paying attention. You’re introduced to someone and one minute later you can’t remember her name because you weren’t paying attention to it. Snap is a reminder to create a mental snapshot of the information (e.g., the name) you want to recall later. Many of us find it easier to remember visual information – i.e. pictures – than other types of information. And then, the third step, Connect, is just a way of linking up the mental snapshot with the new information. So, an example would be if you’re introduced to someone called Payal, focus on the name (Look), then make a snapshot of her name (an anklet, payal) and then picture her wearing that payal. Once that image is fixed in your mind, it will surface when you next meet up with her, and you’ll instantly remember her name.
Using simple techniques like these, the UCLA researchers have found, can bring “significant improvement” in memory performance over a short period of time.
And, where Alzheimer’s is concerned, of course, timing is important. The UCLA research indicates that the physical evidence of Alzheimer’s disease — brain plaques and tangles — starts accumulating decades before people develop symptoms of the disease (like memory loss). “We think that a better strategy than trying to repair a damaged brain is to protect it before the disease disrupts neuronal function,” Small says. Being pro-active is key.
How strong is the evidence for the three interventions? Strong enough, the NAS review concluded, to suggest that the public should at least have access to these findings to enable them to make health decisions. This does not, however, translate into a public education programme, the committee said: that needs to wait upon evidence from clinical trials that conclusively support these three interventions. We don’t yet have this kind of clinching evidence. All the same, these interventions are the brightest rays of hope we have at present to keep the human brain real-world strong.
(The author is a former editor of 'Health & Nutrition' magazine, and now works as a counseling therapist)