WASHINGTON ― Elderly patients with mild cognitive impairment (MCI) who completed a 12-week multidisciplinary brain fitness program saw marked improvement in cognitive performance and enlargement in hippocampal size.
"To my knowledge, it is the first and only program that has been shown to enhance cognitive function and grow the volume of hippocampus," Majid Fotuhi, MD, PhD, chairman, NeuroGrow Brain Fitness Center, McLean, Virginia, and Johns Hopkins Medicine, Baltimore, Maryland, told Medscape Medical News.
"One of the key interventions in this program, above and beyond treatment of a patients' medical conditions, providing neurofeedback and meditation training and emphasizing the role of diet, exercise, and omega-3 fatty acids, is an emphasis on purpose in life," Dr Fotuhi told Medscape Medical News.
"This program can be replicated in any clinical setting with access to integrated medical practice where a group of neurologists, psychologists, sleep specialists, dieticians, and exercise physiologists can work together as a unified team," he added.
The study was presented here at the Alzheimer's Association International Conference (AAIC) 2015.
Brain Changes
Cognitive decline and brain atrophy in late life can be due to a variety of different pathologies secondary to varying loads of Alzheimer's disease, cerebrovascular disease, sleep disturbances, sedentary lifestyle, and lack of cognitive stimulation, Dr Fotuhi explained.
"Alzheimer's is not the only cause of cognitive decline. Multiple medical conditions can erode the size of the hippocampus and cause cognitive decline. Many patients have five or six different etiologies for a decline in their memory, and we should treat all those medical conditions aggressively," he said.
Dr Fotuhi and his team tested the effectiveness of an intensive multidisciplinary brain fitness program in 127 adults with MCI (average age, 70.7 years).
The program focuses on evaluation and personalized treatment of non-Alzheimer's etiologies. Patients received a full medical and neurologic evaluation to determine all potential contributing factors to their cognitive decline and then started a 12-week program that includes 5 hours a week of one-on-one interventions.
Each week, they received 2 hours of cognitive stimulation, 2 hours of neurofeedback, and 1 hour of counseling/brain coaching. The program includes cognitive skills training, mindfulness meditation, advice on exercise, and the Mediterranean diet, including supplementation with omega-3 fatty acids.
Participants underwent quantitative electroencephalography (Q-EEG) and MRI and a battery of neurocognitive tests at baseline and after completion of the program.
Results showed that 84% of patients who completed the Brain Fitness Program experienced statistically significant improvements in at least three of the 10 components of the neurocognitive test battery (P < .05), such as attention, concentration, executive function, problem solving, or speed of cognitive processing.
On the postprogram Q-EEG, 58% of patients had improvements toward normalization of their brain wave activity. On average, there was a 41.4% regression toward the norm.
MRI conducted in 17 patients after the program found that 65% experienced a reversal of hippocampal atrophy or growth above baseline volume.
"Two patients who underwent MRI a year after the program, and the improvement in the hippocampus is on average 3% to 4%," said Dr Fotuhi. Overall, younger age and higher baseline Mini–Mental State Examination score correlated with the most improvements.
"Astounding" Results
Commenting on the results for Medscape Medical News, Cyrus Raji, MD, PhD, from the University of California, Los Angeles, said, "Dr Fotuhi is applying lifestyle modifications in patients with memory loss and dementia to stop their cognitive decline. What I find particularly notable about this work is his demonstration of improvement of hippocampal volumes on quantitative MRI."
"In my work, I have studied the effects of lifestyle on the brain and demonstrated the benefits of such interventions in large epidemiological samples," Dr Raji added.
"What Dr Fotuhi has done that is astounding is he is actually applying this approach to 'real world' patients in the community and showing benefits. This provides patients the ability to one day go to a growing number of neurologists like him for programs to reduce risk for dementia and cognitive decline. This work is of considerable value," Dr Raji said.
The study had no funding. Dr Fotuhi has disclosed no relevant financial relationships.
Alzheimer's Association International Conference (AAIC) 2015. Abstract 4331. Presented July 19, 2015.
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Cite this: Unique Brain Fitness Program Boosts Cognition, Brain Size - Medscape - Jul 21, 2015.
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