Early Mental Stimulation May Thwart Cognitive Decline

Megan Brooks

April 26, 2017

Stimulating the brain in early life and midlife through higher education and complex jobs can help people stay mentally fit later in life, according to new research that supports the "cognitive reserve" theory.

"While it's well established that a healthy lifestyle reduces the risk of impaired memory and thinking in later life, our study shows that people can develop a form of mental resilience earlier in life through education and mentally challenging occupations, which adds to the effect of lifestyle," lead researcher Bob Woods, PhD, from Bangor University, United Kingdom, told Medscape Medical News.

"This resilience, which is described as 'cognitive reserve,' can continue to develop later in life through mentally stimulating activities," said Dr Woods.

The study was published online March 21 in PLOS Medicine.

Mental Buffer

The researchers explored the mediating effect of cognitive reserve on the association between healthy lifestyle factors and cognitive function in later life. They analyzed data collected from 2011 to 2013 from 2315 cognitively healthy adults aged 65 years and older from the Cognitive Function and Ageing Study Wales (CFAS-Wales) cohort.

After controlling for age, sex, and chronic conditions, it was found that cognitive and social activity, physical activity, healthy diet, and light to moderate alcohol consumption were positively associated with cognitive function. Together, these factors accounted for 20% (95% confidence interval [CI], 17% - 23%) of variance in cognitive test scores.

Cognitive reserve, indexed by education and occupational complexity, was an important mediator of this association. Indirect effects of cognitive reserve contributed 21% (95% CI, 15% - 27%) of the overall effect on cognition, the researchers report.

"We found that people with a healthier lifestyle had better scores on tests of mental ability, and this was partly accounted for by their level of cognitive reserve," said Dr Woods.

"Cognitive reserve can be thought of as a mental buffer which protects us against age-related pathology," coinvestigator Julia Teale, PhD, from the University of Exeter, United Kingdom, told Medscape Medical News. "We can build up our cognitive reserve during early life through education and [during] midlife through our occupation by challenging ourselves mentally."

The researchers note that the study's limitations include its cross-sectional nature, the fact that data were collected at only one time point, and the challenges of accurately measuring the latent construct of cognitive reserve, which in this study was represented by education and occupational complexity.

Despite these limitations, Dr Woods said the results support prior evidence that "adopting a healthy lifestyle – exercise, healthy diet, engaging in social and mentally stimulating activities – is good for the heart and for the brain. There are no magic bullets that will guarantee we won't develop dementia, but we can give ourselves the best odds by following this advice."

"Love Your Brain"

Maria Carrillo, PhD, chief science officer of the Alzheimer's Association, told Medscape Medical News the authors' conclusions "primarily confirm previous findings and reinforce an important public health message."

Dr Carrillo and colleagues at the Alzheimer's Association recently completed a comprehensive summary of the evidence on modifiable risk factors for cognitive decline and dementia.

In their report, they conclude that there is "sufficiently strong evidence" to suggest that regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension) reduce the risk for cognitive decline and may reduce the risk for dementia. There is also sufficiently strong evidence to conclude that a healthy diet and lifelong learning/cognitive training may also reduce the risk for cognitive decline, they said.

On the basis of the findings in the report, the Alzheimer's Association released "10 Ways To Love Your Brain," which includes a list of factors that can reduce cognitive decline and may reduce dementia.

The CFAS-Wales study is supported by grants from the Economic and Social Research Council and the Medical Research Council. Two authors serve on the editorial board of PLOS Medicine.

PLoS Med. Published online March 21, 2017. Full text

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