Managing overall health risks will greatly impact healthy brain maintenance. The importance of physical exercise, diet, cognitive stimulation, social interaction, and sleep will be discussed. In addition, keeping blood pressure in the ideal range of 120/70 mm Hg, controlling cholesterol, maintaining BMI near 25, not smoking, limiting alcohol, and treating depression will benefit current and future brain health.
Cognitive Exercise
Cognition involves several different components of thinking including language, executive function (refers to complex critical thinking and problem solving), memory, and visuospatial skills (skills that are used for movement, depth and distance perception, and identifying where objects occur in space). Given that cognition involves multiple thinking skills, a variety of cognitive stimulation exercises are needed to challenge and maintain it.
A growing body of research supports the benefits of cognitive training/exercise. A large Finnish study found that adding a cognitive training program, nutritional counseling, a physical exercise program, and monitoring of cardiovascular risk factors to general health advice improved overall cognitive function, processing speed and executive function (critical thinking and problem solving). (1) In a Mayo Clinic Study of 2,000 people, cognitive exercises were shown to delay dementia. The greatest benefit was seen in novel activities that included social interaction and required speed. Consistent adherence was also key to obtaining the most benefit. (2) Examples of the cognitive activities documented were computer tasks, playing games, reading books, and social activities. Further, there was greater benefit from cognitive exercises that were stimulating, new, and challenging, but that was not so difficult that they created stress and frustration.
Brain imaging studies have identified positive brain changes in response to the stimulation of cognitive exercises. PET brain imaging studies have documented decreased Alzheimer’s plaques following consistent cognitive exercises. (3) There is also evidence that nerve cell growth and new nerve cell pathways occur through cognitive training rehabilitation following brain injury.
It is never too late or too soon to challenge your brain with positive cognitive activities that you enjoy. Enhancing language abilities through building vocabulary, learning a new language, or playing word puzzles are examples. Executive function skills can be enhanced by debating a subject from the opposite viewpoint from which you agree or determining the steps to build or organize a new project. Visuospatial skills are improved by working puzzles, performing sports, and participating in dance. A large randomized trial found moderate-intensity dance of 60 to 120 minutes weekly improved global cognition, cognitive flexibility, working memory, verbal fluency, and learning. (4) Music also engages multiple brain regions, activating not only the auditory brain regions but also the emotional, motor and creative areas of the brain. (5) Learning a musical instrument and singing in a chorus have each been shown to strengthen cognition. (6)
Computer-based cognitive training is popular and there are multiple choices available, including some offered free with paid upgrades. No program has been approved by the FDA, partly because the transfer of training benefit to improved daily function is difficult to prove. Brain HQ by Posit Science has been well studied with more than 60 peer-reviewed scientific papers published. Brain HQ has documented improved visual processing speed as a result of some of their computer games which were associated with fewer at-fault motor vehicle collisions in participants. (7) When considering a computer-based cognitive training program, choose a program that provides a positive challenge.
A healthy brain program should include cognitive exercises that are engaging and that you enjoy so that they will become a regular habit. Be creative and have fun, learning from mistakes while avoiding repeated frustrations that may counteract some of the benefits you are working to achieve.
- Lancet.2015;385:2255-63
- Neurology. 2019 Aug 6;93(6):e548-e558
- Arch Neurol.2012;69:623-629
- J Am Geriatr Soc. 2018 Dec 18
- Hum Brain Mapp. 2017 Jun;38(6):2955-2970
- J Appl Gerontol. 2019 Dec;38(12):1763-1783.
- J Am Geriatr Soc. 2014 Jan;62(1):16-24