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Evaluating those ‘Brain Fitness’ Programs

Seniors and their families may be considering a ‘brain fitness’ book, DVD or Wii as the perfect gift this Christmas.

Playing piano is a great way to keep your brain fit

Sales pitches for these systems vary from social possibilities -  ‘improve intelligence, play games online, meet a million-member community of players’ – to deadly serious claims that play to everyone’s terror of developing dementia.

The gist of brain fitness programs is the phenomenon of ‘brain plasticity’, which is a relatively new discovery that the brain, rather than being a static organ, actually changes throughout one’s life. It has been proven that changes in neural pathways and synapses, caused by  changes in behavior, environment and neural processes, can  continue well into adulthood. Positive cellular changes due to learning, as well as traumatic, large-scale changes such as the brain’s response to injury, cause cortical remapping of the brain so that it develop new responses.

For those concerned about the prospect of dementia, the potential neuroplasticity is particularly relevant to the brain’s ‘executive functions’, the cognitive abilities that control and regulate other abilities and behaviors.

Executive functions include the ability to initiate and stop actions, to monitor and change behavior as needed, and to plan future behavior when faced with novel tasks and situations. Executive functions allow us to anticipate outcomes, to plan and to adapt to changing situations, form concepts and think abstractly.

Dementia patients typically demonstrate deterioration in  episodic memory  -  memory of autobiographical events such as times, places and their associated emotions; and recognition memory -  the ability to recognize previously encountered events, objects, or people and match them to stored memory. They also have challenges with semantic memory – remembering and finding appropriate words – and verbal fluency.

Will improving these executive functions prevent dementia? There is no scientific answer to that question – but keeping your executive functions in good shape is just common sense.

Are structured brain fitness programs essential to maintaining executive functions and preventing dementia? Let’s see what the research has proven.

One study headlines with Healthy Older People Shouldn't Bother Spending Money on Computer Games and Websites Promising to Ward Off Mental Decline: "These marketed products don't confer any additional benefit over and above being socially and intellectually active in one's normal daily life," Dr. Peter J. Snyder of Lifespan Affiliated Hospitals in Providence, Rhode Island, told Reuters Health. "There are some things that we could be doing that have much more rigorous data to support their application."

Types of "brain training" are known to help people with memory problems function better, but their benefits for those who don't have measurable cognitive impairment isn't clear. The study analyzed 10 randomized controlled trials of a variety of approaches, ranging from a popular computer-based cognitive training program to individualized piano lessons.

While there was some evidence that the cognitive training helped people's immediate performance on the specific tasks related to the training, there was no evidence that the effects could be generalized to other areas of mental function.

Their conclusion is that while brain fitness training isn't helpful for people who have memory problems, the findings don’t rule out that brain exercise can help sharpen the wits of healthy people.

In contrast, other studies have shown that older adults perform better on cognitive tests after repeatedly practicing those tests, linking a commercially available software program to improvement on unaffiliated standard measures of memory and to better performance on everyday tasks. The Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) study was funded by the Posit Science Corporation, which owns the rights to the Brain Fitness Program, tested in the study.

Of the 487 healthy adults over the age of 65 who participated in a randomized controlled trial, half used the Brain Fitness Program for 40 hours over the course of eight weeks. The Brain Fitness Program consists of six audio exercises done on a computer, intended to retrain the brain to discriminate fine distinctions in sound. The other half of participants spent an equal amount of time learning from educational DVDs followed by quizzes.

Those who trained on the Brain Fitness Program were twice as fast in processing information, while the non-user control group did not show statistically significant gains. The Brain Fitness users scored well on memory and attention tests for which they did not train; they also reported significant improvements in everyday cognitive activities such as remembering names or understanding conversations in noisy restaurants.

But do we need to purchase a fancy brain fitness system to achieve the same effects? Since we know that cog­ni­tion is made of sev­eral dif­fer­ent abil­i­ties, including work­ing mem­ory, atten­tion and exec­u­tive func­tions, are there more accessible and inexpensive ways to maximize these functions?

Social and intellectual engagement in day-to-day life, from reading to grandchildren, to doing crossword puzzles, is probably just as effective than any formal brain exercise programs, and they’re free. There is also strong scientific evidence that being physically active every day preserves cognitive function; exercising and taking other steps to maintain heart health and a healthy weight will help keep the brain healthy, too.

Seek activities that offer the most important element - engagement with others. Playing cards, playing and singing music, dancing – all require partners or colleagues, have rules, require attention and more than one ‘executive function’. Think of a bridge game – lots of planning, episodic memory, recognition and verbal fluency required there! Think of a volunteer project – again, planning, communicating, inspiring and working with other volunteers and recipients. Imagine a choral concert – attention to the music, recognition of rehearsal learning, focus on the conductor, the text, the pitch and the harmony of the other voices.

So, where does that leave your idea for a ‘brain fitness’ stocking stuffer?

Go ahead and buy it, as part of your arsenal of wellness practices for a healthy lifestyle. We’ve learned from these studies that simply enhanc­ing cog­ni­tive functions won’t delay the onset of cog­ni­tive deficits such as dementia. Be realistic in your expectations and enjoy the benefits.

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How do you keep your brain healthy and fit? Share your tips in the Comments section below.
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