Improving Your Brain

Contributed by: Dennis Fortier, President, Medical Care Corporation
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A great post today in the Productivity501 blog, describes 7 Ways to Upgrade Your Brain.  Given all of the commercial activity hyping computerized brain games, I thought the suggestions in this well written article were refreshingly natural.

I encourage you to click through and read the article as each of the suggestions is thoughtfully supported with excellent examples.  At the top level, the "7 Ways" are:

1. Read
2. Get a degree
3. Seek out new experiences
4. Think
5. Practice
6. Write
7. Do things that are hard

One fantastic activity for exercising the brain that is not mentioned here, but is validated with a growing body of scientific evidence, is socialization.  Particularly, socialization in and among groups, where new relationships will be formed and cultivated.

Apparently, the social accounting required to assess a person's trustworthiness and value as a friend, demands a high level of thought, memory, and alternative scenario imagination.  All of these activities engage the brain across many regions and realms of cognition.  Had the author of the "7 Ways" post covered this topic, his examples might have included joining groups, clubs, or volunteer organizations where the activities require teamwork and communication with the other members.

What is the Best Brain Exercise?

Contributed by: Dennis Fortier, President, Medical Care Corporation
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What is the best brain exercise?

This is a question that remains unanswered by current science.  However, one could easily be confused by the competing claims in the growing market of "brain training" programs and exercises.  Importantly, as we describe in this blog from time to time, conversing and socializing both constitute excellent work-outs for the brain involving multiple realms of cognition.

The online version of the Daily Mail ran a story today that referred to an un-cited research study making this same point.  According to the story, researchers in Zurich had performed a review of the published literature on the benefits of brain training and intellectual activities specifically designed to improve cognitive function.  They found that, in many studies, subjects who performed the activity under review performed no better than subjects who were instructed to have a conversation.

I remain optimistic that we will identify brief, pleasurable activities that exercise the brain and improve its function.  However, to date, the best advice is probably to stay socially and intellectually engaged across a wide range of circumstances and topics.

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How Much do Brain Games Help your Brain?

Contributed by: Dennis Fortier, President, Medical Care Corporation
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Following a recent study sponsored by the BBC and published in Nature Magazine, this topic has been in the news a great deal. I will share my opinion about the answer to the question posed in my headline but would like to first comment on how this story is being reported.

As I described in this post yesterday, we must all be careful in how we interpret scientific commentary. This is because scientists speak in a language of precision that should be regarded as such, and very precise comments should not be generalized. A common example is when scientists comment that a particular hypothesis or phenomenon "has not been proven" and the comment is erroneously generalized to mean that the hypothesis is false. That is not how a scientist would interpret the comment; they would understand that the hypothesis may well be true but more study is required to prove or disprove it.

And so it may be with brain games.

I know that many game manufacturers have cast outlandish claims into the commercial marketplace in an effort to sell "health" to the worried well. As such, I think that the scientists involved in the BBC study have correctly suggested some claims have probably been too aggressive given the current level of evidence of a benefit from brain exercises.

However, please note that their study was not particularly well designed as they were looking for an improvement in cognition based on very little brain exercise, over a short period of time, compared to a group of control subjects who also used their brains in similar exercises. These limitations are described here by Berard Croisile of HAPPYneuron and here by Alvaro Fernandez of SharpBrains, both affiliated with the brain exercise industry and both well versed in the state of the science in this field.

Keep in mind that the scientific process encompasses more than a single study, even when the study is well-designed. The full process involves hypothesis generation, iterative testing of hypotheses, and reproduced results through various study designs. Scientific facts are rarely plucked from a single study but rather shaped and codified through a series of controlled experiments and analysis. In terms of understanding the health benefits of playing brain games, the scientific process is still in its infancy.

On the whole, the hypothesis that using your brain in challenging ways will exercise neural circuits and keep them healthy is both plausible and supported by a growing body of scientific evidence. We all agree that questions about how much exercise, which types of exercises, and how much benefit one can accrue are topics requiring more study.

However, we must not generalize the conclusions from the BBC study into the false belief that the scientific jury has reached a verdict on this matter. The preponderance of evidence suggests that exercising your brain is most likely good for your cognitive health.

NIH Says "Alzheimer's not Preventable"

Contributed by: Dennis Fortier, President, Medical Care Corporation
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Based on current evidence, the recent conclusion reached by a National Institute of Health panel of experts, is pretty sound. They concluded that we do not yet have proof that the progression of Alzheimer's disease pathology can be slowed by actively reducing known risk factors and by adopting certain lifestyle changes such as smoking cessation, intellectual stimulation, and physical exercise.

Careful Interpretation Required
As we often write in this blog, scientists speak in a language of precision that serves them well amongst themselves but often leads to unintended conclusions in the public realm. This is a case where I think it is worthwhile to translate the panel's conclusion for public consumption.

Here is a quote from one of the panel experts; this was one of the direct comments that generated the hopeless headlines in countless news outlets over the past week:

"There is not a high level of evidence that any of these factors (supplements, mental exercise, medications) can prevent Alzheimer's or age-related cognitive decline."

Now let me state it in another way that would be equally acceptable to the independent and precision minded scientists on the panel:

"There is not a high level of evidence that any of these factors (supplements, mental exercise, medications) do not prevent Alzheimer's or age-related cognitive decline."

It is a simple switch in perspective but might have dramatically changed the message that most lay-readers take away.

I understand that many commercially driven entities are selling solutions with exaggerated claims about efficacy. We all appreciate the consumer advocacy the expert panel has provided in helping us understand how well certain supplements or brain games have been (or have not been) validated with solid science. However, it is important to stay balanced and to understand that certain approaches, although not proven, have growing evidence of benefits. When those approaches have no harmful side-effects and are supported by rock-solid common sense, it might be best to present them with some degree of optimism.

Managing Risks for Dementia

Contributed by: Dennis Fortier, President, Medical Care Corporation
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One of my favorite types of scientific research is the "review paper" when authors collect and review the literature in a certain field and report on the depth and breadth of findings in the targeted area of study. As such, I was happy to see a recent report by the BBC that the Alzheimer's Society had chaired a panel of experts and reviewed more than 70 research papers on reducing the risk of dementia.

The report contained some elements that may be as surprising as they are important. Notably, they suggested that age 35 is probably the right time to start managing known risks in an effort to ward off dementia later in life.

I strongly suggest you click to read the BBC's synopsis of the report but the highlights are noted here:

Strong Evidence in support of:
- Get Physical Exercise
- Don't Be Obese
- Bring Down High Blood Pressure
- Reduce High Cholesterol
- Don't Smoke

Some Evidence in support of:
- Drink Modest Amounts of Alcohol
- Eat a Mediterranean Diet
- Remain or Become Socially Active

The Jury is out on:
- Brain Training
- Vitamin Supplements

The importance of this review, and other similarly scientific reviews, can not be overstated in this era of aggressive commercialization of unregulated health care solutions. There is a lot of hype in the press that has not yet been scientifically validated. Some of it might ultimately prove to be worthwhile but this review let's you know the current state of the science.

Does Web Surfing Ward Off Dementia?

Contributed by: Dennis Fortier, President, Medical Care Corporation
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If you read many of the recent headlines you might think so. A closer look at the study producing those headlines suggests that some of them are probably worded a bit more strongly than the research can support.

The good news is that this study provides further confirmation that ongoing intellectual stimulation is usually correlated with lower prevalence of dementia. We have seen this in many studies and there can be little doubt that using your brain creatively, to solve problems, to socialize, and to learn new information or skills is generally beneficial to cognitive health.

An important message that is sometimes lost amid the rush to identify those games and activities that provide the most effective work-out for the brain, is that many simpler and more natural human activities also provide a healthy cognitive challenge. One activity that requires a broad range of cognitive skills is making and maintaining personal relationships.

The key take away is this: Don't underestimate the importance of social activity as you seek new ways to exercise your brain. Perhaps joining a club or volunteering could bring you a natural and rewarding approach to the sought after cognitive benefits.

Brain Games and Cogitive Health

Contributed by: Dennis Fortier, President, Medical Care Corporation
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Slowly, researchers are gathering enough scientific evidence to clarify the impact of various brain games on cognitive health. This is an important topic because marketers of such offerings have been hyping benefits for some time while academic skeptics have been sounding cautionary alarms. Until now, both sides have been operating in the dark or, at best, in dim light.

According to a study recently published in the Journal of the American Geriatrics Society, a group of 65+ year old subjects who engaged in daily computer-based exercises from Posit Science were able to outperform another group who spent the same amount of time watching educational DVD's and being tested on the content. This is one of the first studies that showed a correlation between computer based brain exercise and improved performance in other areas of cognition. That is, playing the games seemed to have improved mental performance in exercises other than the game.

The authors of the study speculated that Lumosity, a web-based brain exercise, might also yield improvements in cognition but were much less optimistic about the benefit of the Nintendo "Brain Age" series of games.

For me, it is encouraging that sound research has begun to identify the specific types of cognitive exercises that support genreal brain health. I look forward to more answers in this area.

More Perspective on Brain Exercises and Supplements

Contributed by: Dennis Fortier, President, Medical Care Corporation
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The Stanford Center on Longevity released a statement today describing their perspective on the utility of consumer products for brain health.

Given the proliferation of supplements and software for brain exercises, this center felt it appropriate to issue a cautionary message about the relatively modest evidence so far amassed about the benefits of these various approaches.

We are all hopeful that many approaches to brain health will prove viable but, in the meantime, it is best to be clear and objective while setting realistic expectations about the impact of these consumer products.