Tuesday, May 4, 2010

Brain training gets a cramp

Exercise the body and it will get fitter; exercise the brain and it will get smarter. While this commonly held belief may make intuitive sense, a careful look at the evidence on mental calisthenics is suggesting otherwise. Our ability to think, remember and problem-solve are among our most precious assets, so it's not surprising that brain training, especially through handheld computers and online games, has given rise to a multimillion-dollar industry; but does it work? This week's HealthWatch asks if the investment in these activities offers any return beyond entertainment value.
What is cognitive function? Cognitive function, or cognition, refers to the mental skills that allow us to process thoughts, recognize our environment and organize information into logical concepts. Some examples of these are learning, understanding, solving puzzles, memory, reasoning and planning.
Tell me about brain training: Brain training involves mental exercises designed to improve cognitive function, based on the theory that the right type of brain workout will improve your grey matter's performance and agility. Sudoku and crossword puzzles are popular low-tech ways to sharpen your brain's logic and problem-solving skills, but online game-playing has now become all the rage. Proponents tout such benefits as slowing and even reversing the cognitive decline associated with aging, and staving off Alzheimer's by improving information processing, verbal fluency, thinking and reaction times, and visual memory, or the ability to recall patterns. While unproven, the suggestion is that the more synapses, or connections, you can develop between brain cells, the greater your chance of maintaining brain function.
Are there proven ways to stimulate the brain? If you don't subscribe to the "train the brain" theory, physical exercise - endurance exercise, in particular - such as brisk walking has been shown to be an effective way to improve mental function. In one study, seniors who walked regularly showed significant improvement in memory, learning ability and concentration compared to their sedentary counterparts. Social interaction is also an important way of staying sharp, be it bridge clubs or other venues that foster discussion.
Is my memory loss normal? As we get older, many of us worry about whether our forgetfulness is "normal" or if it is an early warning sign of dementia. Age-related forgetfulness is known as benign senescent forgetfulness. Diagnosing dementia is a complex process, but one of the most important criteria for the difference between this and dementia such as Alzheimer's disease is that the latter is usually accompanied by other signs of cognitive impairment besides memory loss. These include the loss of normal speech, changes in the ability to concentrate and the inability to recognize objects.
Can improved gaming skills transfer to other aspects of life? One of the supposed benefits of brain training is that improved gaming skills can better performance in related real-life tasks. A co-author of the study in question described it this way: "People who practise a certain mental task - for instance, remembering a series of numbers in
sequence, a popular brain-teaser used by many video games - improve dramatically on that task, but the improvement does not carry over to cognitive function in general."
What do we know about the benefits of cognitive training? Not surprisingly, much of the scientific interest in brain training has been in the healthy elderly or those with early Alzheimer's disease. Unfortunately, the overall results of research in these areas have been either disappointing or limited in terms of being able to draw any solid conclusions.
With more than 10 studies of anti-brain-aging exercises in the healthy elderly conducted so far, only a miniscule improvement in cognitive functioning is believed to result from this kind of effort.
In patients with early Alzheimer's, the results are a bit more promising, but the quality of the research done so far is more problematic and thus unreliable. There is, however, a suggestion that when training focuses on what is lost in early Alzheimer's, the ability to remember recent events, for instance, shows at least some short-term recovery.
The study: Owen AM, Hampshire A, Grahn JA et al. Putting brain training to the test. Nature 2010 Apr 20.
What was this study about? Noting that our understanding of whether or not brain training improves intelligence in healthy adults is actually quite limited, investigators in Britain performed a large-scale study to determine if they could demonstrate a benefit. Participants were recruited from the viewing audience of a popular BBC science program. The study was conducted online and involved 11,430 participants, aged 18 to 60, who were asked to train at least 10 minutes a day, three times a week, for a minimum of six weeks.
They were randomly assigned to one of three groups, where the emphasis in the first was to perform cognitive tasks that could improve memory, planning and reasoning, while the other experimental arm focused on concentration as well as visual and spatial skills. A control group was assigned to answer obscure questions by surfing the Internet. All subjects were tested with IQ-type tests before and after the study period.
What were the findings? The study results were actually quite disappointing. Despite a fair amount of effort, all this training resulted in only the most miniscule improvement in cognitive skills. Using memory as an example, the authors point out that brain training improved subjects' ability to remember a string of numbers to the tune of three one- hundredths, or three per cent of a single number; and it would take four years of this level of training to score a significant improvement.
What's the take home message? If you're interested in sharpening your mind and potentially staving off the ravages of Alzheimer's disease, trade in that hour in front of a computer playing brain games for a brisk walk, bike ride or swim. Your brain will thank you for it.
This material is designed for general educational purposes only and does not pertain to individual cases. It should not replace necessary medical consultations.

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