Beyond Brain Games for Preventing Dementia

It has been all over the news that the Goliath of the brain games industry, Lumosity has to pay a 2 Million USD settlement to the Federal Trade Commission for charges that they deceived consumers.

“Lumosity preyed on consumers’ fears about age-related cognitive decline, suggesting their games could stave off memory loss, dementia, and even Alzheimer’s disease,” -Jessica Rich, Director of the FTC’s Bureau of Consumer Protection.

Lumosity.com had a subscription based service, where you would be paying between $14.95 – $299.95 for a different membership levels on the site. The website was structured around short  games, which you were supposed to play 10-15 minutes, 3-4 times per week to achieve maximal benefit. To further reel you in, your performance was tracked and you could watch your progress on the website.  What the website didn’t say, was that even though you were performing better at these games, you wouldn’t be experiencing gains in real world cognitive abilities.

The evidence for brain training is overwhelmingly positive, until you give it a good poke and realize the foundation of these studies is flawed. Most of the studies relied on a design where participants complete brain training exercises on games that were very similar to the tests used to evaluate performance. Here, people who were participating in a study would perform the same game over and over again. Then, they would be tested on a version of that task at the end of the study. Unsurprisingly, they got better. Most of us understand that practicing one task, will eventually make you better at that one task. The problem is when you try and take these skills and apply them to a similar, but different task, a concept called generalizability. What happen to these newly learned skills?

Let’s use the example of learning how to play an instrument, let’s say a flute (assuming you know how to read sheet music already).  At first, you learn a simple song like Hot Cross Buns, and you learn it well enough to want to move to a more challenging song. The skills you learned like finger positions for notes, and how to properly blow air through the flute will transfer — these are generalizable skills.  However, knowing the sequence of notes and finger movements in Hot Cross Buns is not generalizable to being able to play Mary had a Little Lamb without additional practice.

Now how does this match to what Lumosity was trying to do? Lumosity was showing that when you practiced one game, your performance got better. Just like if you were playing Hot Cross Buns over & over again. But, when you tried to take those new gains into a different task, the real world, what happens? Not a whole lot. Your increasing abilities in the brain games does not help you to remember your grocery list or have a quicker response in your car when the light changes to red. Unfortunately preventing age-related cognitive decline or dementia is not as simple as playing computer games for less than an hour a week! However, this does not mean you are left without any ways of decreasing your risk of cognitive decline or dementia.

 

Facts & Figures4What is the actual risk of Dementia?

Currently the number of individuals reaching the age of 65 is increasing across Canada and the world.  The increase in the number of older adults in the population has also caused an increase in the number of individuals living with age related diseases.  In a large survey of adults over 65, individuals were most scared of developing dementia (35%) compared to other age-related diseases like cancer (23%) or stroke (15%).

Dementia is a broad category of diseases of the brain, which are characterized by deterioration of normal thinking abilities and memory.  The most common form of dementia is Alzheimer’s disease. Thinking abilities, like memory and attention normally decrease as you age.  Although risk for dementia increases with age, it is not a part of normal brain aging.

 

What Can I Do?

Scientists and health policy advisors have been working together to find ways to delay or stop the onset of dementia. There have been great advances recently, and there are two main categories of preventable risk factors: Lifestyle Risk Factors and Metabolic Risk Factors.

Many of these risk factors overlap with risk of cardiovascular and cerebrovascular disease. Lifestyle Risk Factors include: 1) Alcohol misuse, 2) Unhealthy diet, and 3) Smoking. Metabolic Risk Factors include: 1) High blood pressure, 2)High cholesterol, 3) Obesity, and 4) Diabetes.

To combat these risk factors, research has seven evidence based suggestions to prevent cognitive decline or dementia:

  1. Engage in regular aerobic exercise
  2. Keep your mind active (e.g., read, learn a new language, try a new hobby)
  3. Be socially engaged
  4. Eat a heart healthy diet
  5. Avoid head injuries (helmets, use of mobile devices)
  6. Treatment for depression and sleep apnea
  7. Talk to your doctor about how to manage risk factors or stroke or heart attack that you might have: (e.g., high blood pressure, diabetes, smoking, High cholesterol, midlife obesity)

Exercise

Research has shown that decreasing sedentary behavior and increasing physical activity can decrease these risk factors for dementia.  One study found that simply walking three or more times per week significantly decreased the risk of developing dementia.  Keeping mentally and socially active can also decrease your risk for dementia.  Reading is one of the best ways to keep active; as your vocabulary is a mental ability that can increase as you age!

World Health Organization Exercise Suggestions for adults over 65 years of age:

  • Aerobic activity sessions should be at least 10 minutes long.
  • Aerobic Physical Activity Minimum Recommendation per Week:
    • 150+ mins. of moderate-intensity aerobic activity –OR
    • 75+ mins. of vigorous intensity aerobic activity –OR–
    • an equivalent combination
  • For additional health benefits, older adults should engage in additional aerobic physical activity per week
    • 300+ mins. per week of moderate intensity aerobic activity  –OR–
    • 150+ mins. of vigorous-intensity aerobic activity –OR-
    • an equivalent combination
  • Older adults, with poor mobility, should perform physical activity to enhance balance 3 + days/wk to prevent falls.
  • Muscle-strengthening activities, involving major muscle groups, should be done 2+ days/wk. 
  • When older adults cannot do the recommended amounts of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow.

 For more information visit World Health Organization Website

Diet

A recent study out of Chicago has suggested following the MIND diet can decrease risk of developing dementia by 35%.  The best news is that older adults, who only moderately followed this diet, still had some reduction in their dementia risk. For more information visit Rush University Website

The MIND Diet from Rush University

  • Eat from these 10 food groups:
    • Green leafy vegetables: 6+ servings/wk
    • Other vegetables: At least one a day
    • Nuts: 5 servings/wk
    • Berries: 2+ servings/wk
    • Beans: At least 3 servings/wk
    • Whole grains: 3+ servings/day
    • Fish: Once a week
    • Poultry: 2 servings/wk
    • Olive oil: Use it as your main cooking oil
    • Wine: One glass a day
  • Avoid these food groups
    • Red meat: Less than 4 servings/wk
    • Butter and margarine: Less than a tablespoon daily
    • Cheese: Less than 1 servings/wk
    • Pastries and sweets: Less than 5 servings/wk
    • Fried or fast food: Less than 1 servings/wk

It is never to late to reduce your risk!

Leading a healthy lifestyle is the best way we currently know how to prevent cognitive decline and dementia. These guidelines work best if you start in early adulthood; however, if you start a healthy lifestyle at any point across your lifespan, even in you 80s, you will reduce your risk of dementia. One of the easiest ways to get started is to reach out to a friend and try to meet these goals together!

Risk for dementia increases with age, even those who have lead a healthy and active lifestyle. If you are truly concerned about your memory performance, visit your family doctor and they can assess if you are performing lower than what is expected for you age.

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