Can Brain Exercise Really Keep You Sharp?

Do brain games really work to ward off Alzheimer’s disease and dementia? Which ones work best and how do we know for sure that they help?

– July 10, 2017

It’s true. Using your mind as you get older definitely can help keep you mentally sharp. The latest study to demonstrate this comes from the Mayo Clinic, where researchers found a lower risk of mild cognitive impairment – the stage between being cognitively normal and dementia – even among people age 70 or older who regularly used computers, engaged in crafts, attended social activities and played games.

The team followed 1,929 cognitively normal seniors for an average of four years. After adjusting for sex, age and educational level, they saw a 30 percent decreased risk of new-onset mild cognitive impairment among those who used computers, a 28 percent lower risk among those who engaged in crafts, a 23 percent lower risk among those with social activities, and a 22 percent lower risk associated with playing games. These benefits were observed even among study participants who carried apolipoprotein E (APOE), a genetic mutation that is a risk factor for mild cognitive impairment and Alzheimer’s disease. However, only computer use and social activities were linked to decreased risk among this group.

An earlier study, from Rush University Medical Center in Chicago, showed that higher levels of cognitive activity throughout life were associated with a slower rate of age-related cognitive decline among 294 seniors whose average age was 80 and who reported reading, writing, visiting museums, playing bridge and other challenging card games, and doing puzzles. This study showed that the higher the level of cognitive activity performed early (and later) in life, the slower the rate of age-related cognitive decline.

Mental exercise can even help those already on the road to Alzheimer’s disease. The “cognitive reserve hypothesis” holds that individuals who have attained more ability to think, learn and remember can actually delay Alzheimer’s symptoms, even while beta-amyloid plaques are accumulating in the brain. This hypothesis was tested by researchers at Washington University School of Medicine in St. Louis in a study including 198 people, mean age 67, carried out between 2003 and 2008. The researchers compared 161 normally functioning men and women with 37 patients whose behavioral and medical history led to a diagnosis of Alzheimer’s. All the participants had imaging scans to determine the extent of plaque buildup in the brain. The greater this buildup, the more likely an individual is to be diagnosed with Alzheimer’s. Another test used was “animal naming” – you have one minute to name as many animals as you can; naming fewer than 15 may suggest Alzheimer’s. The researchers also looked at the number of years of education completed by all the participants. (Autopsies have shown that people who stay in school longer may be more resistant to Alzheimer’s symptoms even when degenerative changes are taking place in the brain.) The researchers found no symptoms of dementia in people who had no plaques in their brains, but when plaques were present, the severity of symptoms was inversely related to how much education the individual had completed. The study was published in November 2008, in the Archives of Neurology.

Andrew Weil, M.D.



Yonas E. Geda et al, “Association Between Mentally Stimulating Activities in Late Life and the Outcome of Incident Mild Cognitive Impairment, With an Analysis of the APOE ε4 Genotype.” JAMA Neurology, January 30, 2017, doi:10.1001/jamaneruol.2016.3822

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