Mental Stimulation Postpones, Then Speeds Dementia
Kurdish men in Turkey play chess. - Keeping an active mind by doing things like playing chess helps stave off the development of dementia. (Bulent Kilic / AFP via Getty Images)
When it comes to staving off dementia, new evidence suggests that the "use it or lose it" dictum holds true -- at least for a while. But it also appears that mentally stimulating lifestyles may speed up dementia once it hits in old age.
"We do think that a cognitively active lifestyle is protective up to some point," says Robert Wilson, a professor of neurological sciences at Rush University Medical Center in Chicago.
But the protection doesn't hold up indefinitely.
New Evidence
Wilson and his colleagues recruited 1,157 people age 65 and older from the Chicago area. When the study began, none of the seniors had dementia. During face-to-face interviews, each was asked how often he or she participated in stimulating activities. "Things such as reading a newspaper, listening to the radio, going to a museum, or playing a board game such as chess or checkers," Wilson says. Then they gave each person a score on a cognitive activity scale. The more frequently people engaged in stimulating activities, the higher their score.
More than a decade later, researchers followed up with cognitive evaluations and diagnostics. They found that among the seniors who didn't have dementia, the rate of cognitive decline was reduced by 52 percent for each point on the cognitive activity scale. But the results were much different for those who developed Alzheimer's disease -- their rate of decline increased. The average rate of decline per year increased by 42 percent for each point on the cognitive activity scale.
Findings Fit With Theory Of 'Cognitive Reserve'
"Someone who's brilliant and engages in a lot of activities might reduce their risk of Alzheimer's disease for a while," says Yaakov Stern, professor of clinical neuropsychology at Columbia University.
His theory is that mentally engaged people build up a "cognitive reserve" that may help them compensate when the initial brain changes associated with dementia and Alzheimer's begin to develop.
"One simple idea is that perhaps they have more flexibility in how they approach tasks," Stern says. So, if the disease begins to disrupt or damage one network in the brain, they may be able to engage alternative networks in the brain to solve problems or do tasks.
Delay Followed By Speedy Decline
So for those who are mentally engaged, it may take many more years for the symptoms of the disease to appear. But once they do, the course of the disease seems to speed up. Researchers say there's a bit of a silver lining here: knowing that the disease will likely progress more quickly.
"We think this is very good news," Wilson says. "It suggests that cognitive activity extends your period of cognitive independence as long as it possibly can."
And it will likely shorten the battle at the end of life. This means Alzheimer's patients may be less of a burden to caregivers and loved ones.
9(MDAyNzUwMDI2MDEyNTA3MTU5NzcyNTQyNA004))
SCOTT SIMON, host:
Researchers who study Alzheimer's disease released a new study of seniors in Chicago this week. It confirms what we've been hearing for a while: keeping an active mind does help protect against the onset of dementia. But it turns out that the use it or lose it strategy only works for so long. As NPR's Allison Aubrey reports, once mental decline sets in, it's the folks who've been most cognitively engaged who decline the fastest.
ALLISON AUBREY: Researchers recruited a whole neighborhood of folks age 65 and older from one area of Chicago, about 1,100 in all. And when the study began 12 years ago, they were all free of dementia.
Robert Wilson, a professor of neurological sciences at Rush University, led the study. He says at the outset they asked each senior how often they participated in stimulating activities such as...
Dr. ROBERT WILSON (Rush University): Reading a newspaper, listening to the radio, going to a museum, playing board games like chess or checkers.
AUBREY: And lots of other activities. Then they gave each person a score. The more frequently people engaged in stimulating activities, the higher the score.
More than a decade later, they followed up with cognitive evaluations and diagnostic exams. What they found is that the people who had developed Alzheimer's and had also started out with high scores for their mentally stimulating lifestyles were the very individuals who were declining fastest.
Dr. YAAKOV STERN (Columbia University): Even someone who's brilliant and engages in a lot of activities, they might reduce their risk of developing Alzheimer's disease for a while, but the disease really does win in the end.
AUBREY: Yaakov Stern is professor of clinical neuropsychology at Columbia University.�He says these findings fit with what researchers have theorized for a while now - mentally engaged people build up what he calls a cognitive reserve that may help them compensate when the initial damage of Alzheimer's -including a buildup of plaques and tangles in the brain - start to develop. But he says it's not exactly clear how this works.
Dr. STERN: One simple idea is that perhaps they have more flexibility in how they approach tasks. So they can - if the pathology begins to affect one aspect of the networks in the brain, they might be able to use alternate networks to solve the problem or do the task.
AUBREY: So for those who are mentally engaged, it may take many more years for the symptoms of the disease to appear. But once they do, the course of the disease seems to speed up. Robert Wilson says there's a bit of a silver lining knowing that the disease will likely progress more quickly.
Dr. WILSON: So we think this is really good news. It suggests that cognitive activity extends your period of independence as long as it possibly can.
AUBREY: While at the same time, Wilson says, shortening the battle at the end of life and making patients less of a burden to caregivers and their loved ones.
Allison Aubrey, NPR News. Transcript provided by NPR, Copyright National Public Radio.
