'Use It or Lose It' Strategy Can Prevent Cognitive Decline

CHICAGO – Older adults with normal cognition who engaged in a mental fitness program for 1 hour a day, 5 days a week for 8 weeks demonstrated significant improvements in memory and nonmemory tasks, according to data presented at the annual meeting of the American Academy of Neurology.

Gains were documented in standard neuropsychological tests that measured auditory memory, digit processing, letter-number sequencing, learning, delayed recall, and list memory, according to Dr. Kristine Yaffe, professor of psychiatry, neurology, and epidemiology and biostatistics at the University of California, San Francisco.

The randomized, double-blind trial, known as IMPACT, included 437 adults with a mean age of 75 years and Mini-Mental State Examination scores of 26 or higher. Of the total number of participants, 215 were assigned to the Brain Fitness Program, a cognitive training program designed to augment brain plasticity (Posit Science Corp., San Francisco), and 222 were assigned to an active control group that engaged in a more standard computer-based educational program. Each group underwent about 40 hours of training.

In the primary outcome measure–the Repeatable Battery for the Assessment of Neuropsychological Status [RBANS] GlobalAuditory Memory score–those in the experimental group demonstrated an average improvement of 3.66 points, compared with 1.30 points for those in the control group (P = .01). The training did not improve scores on the visual memory component of the RBANS.

In addition to the performance demonstrated on the objective test, the mental fitness buffs reported that their cognition had improved on a self-report questionnaire.

“'Use it or lose it' makes a lot of sense, but there [are] not a lot of data,” said Dr. Yaffe, who is also chief of geriatric psychiatry and director of the memory disorders clinic at the San Francisco VA Medical Center.

She categorized the risk factors for dementia and cognitive decline according to whether or not they can be modified. Although age and family history are unchangeable, for example, cardiovascular disease, obesity, metabolic dysregulation, depression, and physical and intellectual inactivity are risk factors that are amenable to intervention and modification, she noted.

With these risk factors in mind, Dr. Yaffe suggested the following strategies to prevent cognitive decline and dementia:

▸ Screen for depression and institute effective treatment promptly.

▸ Reduce cardiovascular risk factors, such as hypertension, metabolic syndrome, hypercholesterolemia, diabetes, and obesity, especially during midlife.

▸ Prevent head trauma.

▸ Promote mental activity, including lifelong education.

▸ Encourage physical activity.

Dr. Yaffe has served as a consultant to Posit Science Corporation. Her coauthors received personal compensation for activities with Posit Science as consultants.

CHICAGO – Older adults with normal cognition who engaged in a mental fitness program for 1 hour a day, 5 days a week for 8 weeks demonstrated significant improvements in memory and nonmemory tasks, according to data presented at the annual meeting of the American Academy of Neurology.

Gains were documented in standard neuropsychological tests that measured auditory memory, digit processing, letter-number sequencing, learning, delayed recall, and list memory, according to Dr. Kristine Yaffe, professor of psychiatry, neurology, and epidemiology and biostatistics at the University of California, San Francisco.

The randomized, double-blind trial, known as IMPACT, included 437 adults with a mean age of 75 years and Mini-Mental State Examination scores of 26 or higher. Of the total number of participants, 215 were assigned to the Brain Fitness Program, a cognitive training program designed to augment brain plasticity (Posit Science Corp., San Francisco), and 222 were assigned to an active control group that engaged in a more standard computer-based educational program. Each group underwent about 40 hours of training.

In the primary outcome measure–the Repeatable Battery for the Assessment of Neuropsychological Status [RBANS] GlobalAuditory Memory score–those in the experimental group demonstrated an average improvement of 3.66 points, compared with 1.30 points for those in the control group (P = .01). The training did not improve scores on the visual memory component of the RBANS.

In addition to the performance demonstrated on the objective test, the mental fitness buffs reported that their cognition had improved on a self-report questionnaire.

“'Use it or lose it' makes a lot of sense, but there [are] not a lot of data,” said Dr. Yaffe, who is also chief of geriatric psychiatry and director of the memory disorders clinic at the San Francisco VA Medical Center.

She categorized the risk factors for dementia and cognitive decline according to whether or not they can be modified. Although age and family history are unchangeable, for example, cardiovascular disease, obesity, metabolic dysregulation, depression, and physical and intellectual inactivity are risk factors that are amenable to intervention and modification, she noted.

With these risk factors in mind, Dr. Yaffe suggested the following strategies to prevent cognitive decline and dementia:

▸ Screen for depression and institute effective treatment promptly.

▸ Reduce cardiovascular risk factors, such as hypertension, metabolic syndrome, hypercholesterolemia, diabetes, and obesity, especially during midlife.

▸ Prevent head trauma.

▸ Promote mental activity, including lifelong education.

▸ Encourage physical activity.

Dr. Yaffe has served as a consultant to Posit Science Corporation. Her coauthors received personal compensation for activities with Posit Science as consultants.

CHICAGO – Older adults with normal cognition who engaged in a mental fitness program for 1 hour a day, 5 days a week for 8 weeks demonstrated significant improvements in memory and nonmemory tasks, according to data presented at the annual meeting of the American Academy of Neurology.

Gains were documented in standard neuropsychological tests that measured auditory memory, digit processing, letter-number sequencing, learning, delayed recall, and list memory, according to Dr. Kristine Yaffe, professor of psychiatry, neurology, and epidemiology and biostatistics at the University of California, San Francisco.

The randomized, double-blind trial, known as IMPACT, included 437 adults with a mean age of 75 years and Mini-Mental State Examination scores of 26 or higher. Of the total number of participants, 215 were assigned to the Brain Fitness Program, a cognitive training program designed to augment brain plasticity (Posit Science Corp., San Francisco), and 222 were assigned to an active control group that engaged in a more standard computer-based educational program. Each group underwent about 40 hours of training.

In the primary outcome measure–the Repeatable Battery for the Assessment of Neuropsychological Status [RBANS] GlobalAuditory Memory score–those in the experimental group demonstrated an average improvement of 3.66 points, compared with 1.30 points for those in the control group (P = .01). The training did not improve scores on the visual memory component of the RBANS.

In addition to the performance demonstrated on the objective test, the mental fitness buffs reported that their cognition had improved on a self-report questionnaire.

“'Use it or lose it' makes a lot of sense, but there [are] not a lot of data,” said Dr. Yaffe, who is also chief of geriatric psychiatry and director of the memory disorders clinic at the San Francisco VA Medical Center.

She categorized the risk factors for dementia and cognitive decline according to whether or not they can be modified. Although age and family history are unchangeable, for example, cardiovascular disease, obesity, metabolic dysregulation, depression, and physical and intellectual inactivity are risk factors that are amenable to intervention and modification, she noted.

With these risk factors in mind, Dr. Yaffe suggested the following strategies to prevent cognitive decline and dementia:

▸ Screen for depression and institute effective treatment promptly.

▸ Reduce cardiovascular risk factors, such as hypertension, metabolic syndrome, hypercholesterolemia, diabetes, and obesity, especially during midlife.

▸ Prevent head trauma.

▸ Promote mental activity, including lifelong education.

▸ Encourage physical activity.

Dr. Yaffe has served as a consultant to Posit Science Corporation. Her coauthors received personal compensation for activities with Posit Science as consultants.