OH sorry, your incompetent? doctor didn't supply you with cognitive speed training exercises?
cognitive speed training (22 posts to March 2014)
Or music therapy?
- music (94 posts back to March 2011)
- music therapy (85 posts back to October 2014)
- musical training (13 posts back to June 2014)
- singing (12 posts to July 2013)
- music playing (2 posts to April 2023)
Or other games?
sudoku (6 posts to May 2019)
The new science of brain workouts, beyond Sudoku and crosswords
There was a time when bookstores devoted entire shelves to brain fitness even though no one really called it that. Crossword collections. Sudoku. Memory games. Later came adult coloring books. Each promised, in one way or another, to keep the mind sharp.
At the time, the evidence for these activities’ practical benefits was thin. But recently, neuroscience has identified a growing list of ones that appear to help the brain: learning a language, playing music, walking, mastering a new skill.
Which invites a broader question: If these experiences strengthen the brain, could they be combined into something more deliberate — a workout designed for the mind?
“Right now we only focus on the brain when something goes wrong. But we are finding that there may be things we can do for prevention,” said Sandra Bond Chapman, a professor of behavioral and brain sciences at the University of Texas at Dallas.
Earlier studies of brain-training programs suggested they were largely a bust, finding that participants predominantly improved only at the specific task they practiced or something similar, such as remembering six-digit authentication codes on their mobile phones or completing similar memory exercises.
That picture has begun to change.
A number of studies published over the past year have approached the question from different angles, which all point in the same direction: Cognitive training may produce broader, measurable changes in the brain.
In October, researchers at McGill University reported that older adults who completed 30 minutes of brain training a day for 10 weeks showed improvements in the brain’s cholinergic system, critical for learning and memory. The following month, another team released an analysis of MRI scans of 190 healthy adults between the ages of 20 and 70 showing that cognitive training can physically reorganize the adult brain. Then, in February, investigators published the 20-year follow-up of a landmark clinical trial, finding that adults 65 and older who completed a specific speed-of-processing training program had a 25 percent lower risk of developing dementia than participants in the control group.
And the field buzzed with excitement at the Alzheimer’s Association International Conference last month, where researchers presented new findings from the largest clinical trial investigating whether computerized brain-training exercises can reduce the risk of cognitive decline with age.
The trial, funded by more than $50 million from the National Institutes of Health, reflects growing interest in an intervention that is inexpensive, scalable and accessible to almost anyone with a computer or tablet.
The July findings, from a collaboration among researchers at Clemson University, the Medical University of South Carolina, and Penn State, involved just 53 participants. But the study used the gold standard of clinical research — a randomized controlled trial — that points researchers toward new questions.
The emerging evidence suggests that only certain types of training produce meaningful benefits, which differ between men and women. While the reasons remain unclear, the findings are fueling a new push toward personalized brain training — matching specific exercises to the people most likely to benefit from them.
The challenge now is separating science from marketing. Aaron Seitz, a professor of psychology, game design and physical therapy at Northeastern University, cautions that some companies continue to oversell the early science. And while there’s no broad scientific consensus that the training games work, he said, there is little doubt among researchers that the evidence merits further investigation.
“Everyone in this space has seen examples of people who have gotten significant benefits from the training,” Seitz said.
In the study presented at the Alzheimer’s Association meeting, participants were randomly assigned to one of three groups and spent two to three hours a week on computerized exercises for about three months.
One set of games targeted what the researchers called top-down thinking — the higher order mental skills that allow us to plan, reason and shift our attention from one task to another.
“It’s a bird’s-eye view of how you organize things,” said Hye Won Chai, the study’s lead author and a research assistant professor at Clemson University.
Participants are challenged with deliberate decisions that require focus and resist distractions such as doing quick math.
A second set of games — described as bottom-up training — emphasizes more automatic reactions to sensory input, emotions and habits.
The focus is in this study was on speed and visual attention, requiring participants to rapidly detect, identify and localize stimuli under increasing time pressure. In one exercise, participants had to keep track of two pieces of information at once: a vehicle that briefly flashed in the center of the screen and a Route 66 sign that appeared elsewhere. They were then asked to identify the vehicle and remember where the sign had appeared.
The third group served as an active control, spending the same amount of time playing familiar computer games such as a variant of Connect Four, Solitaire and word searches.
Before the training began — and again after it ended — the researchers drew blood to measure two forms of amyloid beta, a protein closely associated with Alzheimer’s disease. One form, known as amyloid beta 42, is especially prone to clumping into the plaques that accumulate in the brains of people with the disease.
Choosing what to measure has become one of the central challenges in brain health research. Blood pressure and cholesterol indicate heart health. Lung function can be measured with a simple breathing test. But there is no equivalent yardstick for the brain, no widely accepted way to determine whether it is aging well or growing more resilient.
Consequently, researchers have evaluated a wide array of measures, such as blood biomarkers, neuroimaging findings and assessments of memory, everyday functioning, quality of life and, ultimately, the onset of dementia.
Chapman, founder and chief director of the Center for BrainHealth at the University of Texas at Dallas, is helping lead an effort to create a more comprehensive metric. Her team’s BrainHealth Index combines measures of executive function, emotional well-being and social connectedness into a single score designed to track how an individual’s brain changes over time.
Chapman likens the effort to the Framingham Heart Study, which transformed cardiovascular medicine by identifying the risk factors that predict heart disease. For now, however, the science remains in its early stages.
All three groups in Chai’s study spent roughly the same amount of time exercising their brains. Some played word games and puzzles. Others completed exercises designed to improve reasoning. A third group trained processing speed — the brain’s ability to rapidly take in, interpret and respond to visual information.
The surprise came when the blood tests were analyzed. Only the speed-training group showed favorable changes in Alzheimer’s-related biomarkers.
The finding led researchers to a part of the brain that rarely enters public conversation: the cholinergic system, a network of cells that supports attention, learning and memory. The system naturally declines with age — about 2.5 percent per decade — but deteriorates much more rapidly in Alzheimer’s disease.
“Our theory is that speed-processing exercises stimulate the cholinergic system in a way that influences biological pathways involving tau and amyloid,” Chai said.
The idea is consistent with findings from the McGill University study published in the peer-reviewed journal JMIR Serious Games that also showed training benefited the cholinergic system.
Etienne de Villers-Sidani, an associate professor of neurology and neurosurgery who led the McGill research, thinks the two studies tell a similar story. As people age, many forms of knowledge — including vocabulary and the meaning of words — remain stable or even improve. Processing speed, by contrast, begins to slow much earlier.
That may help explain why games built around words may be less effective than exercises that challenge the brain to process information more quickly.
That doesn’t mean crosswords or Sudoku are a waste of time, said de Villers-Sidani, who collaborated with Posit Science, which provided access to BrainHQ for some of the games. They remain mentally engaging and enjoyable.
“I’m not saying it’s bad to do that,” he said. “But it’s not where you need to focus to reverse some of the effects of aging. It’s not moving the needle that much.”
The science of cognitive aging has long been marked by an intriguing puzzle: Men and women show different patterns of cognitive decline, with women accounting for nearly two-thirds of Americans living with Alzheimer’s disease and related dementias.
Chai’s study hints that the differences may extend to how people respond to cognitive training. In the small trial, speed-processing exercises altered Alzheimer’s-related amyloid biomarkers in men but not in women.
Such structural changes do not necessarily translate into meaningful improvements in daily functioning. But Robyn Honea, a neuroimaging expert who worked on the study while at the University of Kansas Medical Center and now leads a precision medicine company, was hopeful.
“That’s a good thing,” Honea said. “Those measures usually decrease with aging and Alzheimer’s, so seeing them increase suggests healthier brain function.”
Improvements in women’s brain health, by contrast, were associated with changes in the depth of cortical folds in regions involved in memory and attention.
Still, Honea said, we don’t understand what that means and “we don’t fully understand why.”
The evidence suggests that brain training is not equally effective for everyone. Seitz said the biggest gains tend to occur in people who have the most room for improvement. College students, for example, often show only modest benefits because they are already functioning at a high level and are immersed in cognitively stimulating environments. Older adults with relatively sedentary lifestyles, on the other hand, can experience much larger improvements from a wide range of mentally engaging activities.
“The people who gain the least are the people with the highest functioning,” Seitz said. “The farther they are from when in the life they performed their best, those are the best candidates.”
For people with Alzheimer’s disease, the picture is more complicated. Damage to the brain may make it harder for some individuals to benefit from training, while others may still respond to targeted interventions.
Even where cognitive training shows benefits, researchers emphasize it should not be viewed as a stand-alone solution. A review of research in British medical journal the Lancet last year found that greatest cognitive benefits were observed when it was combined with other lifestyle interventions — particularly physical exercise — rather than used in isolation.
The bottom line is that the evidence resists easy conclusions.
“It’s kind of messy,” Seitz said.
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