Stimulating Brain Activities Delay Onset of Memory Decline

August  4, 2009 — (BRONX, NY) —  For the second time in six years, researchers at Albert Einstein College of Medicine of Yeshiva University have shown that people who engage in brain-stimulating activities in later years can reduce their risk of developing Alzheimer's and other types of dementia or delay its onset. The latest study, published in Neurology, found that cognitive activities as diverse as doing crossword puzzles and playing music can delay the occurrence of dementia.

The study involved 488 initially healthy people, average age 79, who enrolled in the Bronx Aging Study between 1980 and 1983. The Aging Study is a prospective investigation of very elderly volunteers (ranging from 75-85 years) designed to assess risk factors for dementia and coronary and cerebrovascular (stroke) diseases. Their cognitive abilities were tested at the beginning of the study and then every 12 to 18 months for an average of five years. Subsequently, 101 of these people developed dementia, and the researchers looked at whether cognitively stimulating leisure activities influenced dementia's onset.

At the start of the study, all participants were asked how many cognitive activities (reading, writing, crossword puzzles, board or card games, group discussions, or playing music) they participated in and for how many days a week.

The researchers found that for every "activity day" (participation in one activity for one day a week) the subjects engaged in, they delayed for about two months the onset of rapid memory loss associated with dementia.

Study participants who engaged in the highest level of activity, defined as 11 "activity days" per week delayed accelerated onset of dementia by 15.5 months versus those with the lowest level of activity, defined as four activity days per week. The positive effect of brain-stimulating activities in this study appeared to be independent of a person's level of education.

"The study shows that it is important for older people to engage in cognitively stimulating activities, and to do them frequently," said study senior author Joe Verghese, M.B.B.S., associate professor of neurology and director of the division of cognitive & motor aging at Einstein. "We found that the more activities you do and the more often you do them, the better off you are."

Joe Verghese, M.B.B.S.Conversely, when study participants who engaged in more brain-stimulating activity began losing their memory to dementia, they lost it faster than people who exercised their brains less. Fortunately, this greater rate of decline was not precipitous.  "Even when the memory decline accelerated, it was gradual over a long period of time," said lead researcher Charles B. Hall, Ph.D., professor of epidemiology & population health and of neurology at Einstein.

Drs. Hall and Verghese noted that these results on the benefits of cognitive activity closely resemble previous Einstein research. In a 2003 study published in The New England Journal of Medicine and led by Dr. Verghese, study participants who regularly played board or card games, did crossword puzzles, or read books and newspapers reduced their risk of developing dementia.  In a 2007 Neurology study, Dr. Hall and his colleagues found that, among people who developed dementia, those with more years of education had experienced memory loss later in life compared with less-educated people. That study also showed that when dementia did develop, people with more education lost their memory faster than those with less education — a finding consistent with this 2009 study.

Dr. Hall speculates that people who are more highly educated and/or who engage in more brain-stimulating activities have a greater cognitive reserve — the brain's ability to maintain function in spite of damage. Such people may be building a buffer against dementia, enabling them to ward it off even after incurring damage to the brain. But eventually, after some brain-damage threshold is reached, this buffer is no longer effective.

Dr. Hall and colleagues are now studying which particular cognitive activities are most effective in delaying memory loss in patients who develop dementia. "We now need to find out whether the activities themselves actually prevent memory decline or whether those people who choose to do these activities are simply the kind of people who have memories that last longer," he said.

The paper, "Cognitive activities delay onset of memory decline in persons who develop dementia," was published in the August 2009 issue of Neurology. In addition to Drs. Hall and Verghese,other Einstein researchers involved in the study were R. B. Lipton, M.D., M. Sliwinski, Ph.D., M. J. Katz, M.P.H., and C. A. Derby, Ph.D.