No lazy fix for cognitive decline

 Exercise is great for brain health too

Exercise is great for brain health too

Is there a single brain exercise program you can use in older age that can act as a quick fix for a decline in general mental function?   On balance, science would tell you no - unless you also believe in fairies. 

That seems like a strange thing to say on a site that focuses on RehaCom - brain training software for cognitive rehabilitation.  

There is a difference between RehaCom and most brain training software though.  There is also a big difference in a brain training approach that might work in the healthy older person versus someone recovering from a brain injury.

RehaCom was designed to be used in rehabilitation where a person would use the software after a brain injury AND with guidance from a therapist.  In this type of scenario, RehaCom is a piece of the whole puzzle rather than a complete solution in itself.

RehaCom could indeed be used in older age with healthy persons but it is not optimised for that purpose.  It might be effective and it might be safe and fun - but if you are healthy invest in a gym membership!

Now if you are a healthy person… what’s the score?

So what happens if we practice with a “brain training system”.  What we know for sure is that practice can improve performance in the software tasks and the improvement can even last for years. Most scientists doubt that just using any software would allow transfer of beneficial effect into everyday life benefits. It’s difficult to be sure and it’s hard to research this type of thing.  The activities performed certainly should be broad in order to benefit general mental fitness.

For those people whose work is not too stimulating, having hobbies like learning a new language can provide a means to help maintain cognitive performance that could be as effective or more effective than brain training.

When it comes to benefit there is no doubt that exercise helps.  Physical exercise has been shown to maintain and improve brain health and especially “executive function”; the set of abilities that allows you to select behaviour that’s appropriate to the situation, inhibit inappropriate behaviour and focus on the job at hand in spite of many distractions. 

Executive function includes basic functions like processing speed, response speed or alertness and working memory - the type used to remember where you put the car keys. (The keys are always on the “side”)

Executive function is expected to decline when people reach their 70s, but elderly people who have been athletic all their lives have much better executive function than sedentary people of the same age. This could be because people who are healthier tend to be more active, but that’s not the whole story. 

When inactive people get more exercise, even starting in their 70s, their executive function improves. An effective training program involves just 30 to 60 minutes of fast walking several times a week.

Exercise is also strongly associated with a reduced risk of dementia late in life. People who exercise regularly in middle age are one-third as likely to get Alzheimer's in their 70s as those who did not exercise. Even people who begin exercising in their 60s have their risk reduced by half.

Fitness training helps the brain by slowing the age-related shrinkage of the frontal cortex, which is important for executive function. We know that In rodents, exercise is suspected to improve blood flow in the brain, and therefore the availability of energy, to vital cell structures. 

Exercise may also help the brain by improving cardiovascular health, preventing heart attacks and strokes that can cause brain damage.  Let this slip and you definitely need RehaCom and a good therapist.

Exercise causes the release of growth factors, proteins that increase the number of connections between neurons, and the birth of neurons in the hippocampus, a brain region important for memory.  Any of these effects might improve cognitive performance, though we don't yet know which ones are most important.

Now if you have had a brain injury…what’s the score?

If you are recovering from a stroke, traumatic brain injury or a condition like multiple sclerosis you can certainly benefit from using RehaCom software.  

 RehaCom designed for use in brain injury recovery

RehaCom designed for use in brain injury recovery

Ideally you will have had an assessment from a neuropsychologist or trained professional who will aim to identify the specific cognitive deficits.  Every individual is different and so generalising is not useful.  Screening module are available as part of RehaCom to help identify deficits and suggest which of the RehaCom training modules to use.

RehaCom training procedures are very specific and align very well with the specific cognitive deficits identified in an assessment.  A therapist will almost certainly aim to recover abilities with training (using RehaCom) and will provide guidance on compensating when recovery is less certain. The therapist’s key role is to orchestrate all the strategies to deliver an improvement in performance.  We have written about the overall approach in other articles.  RehaCom automatically adapts to the user’s performance and provides valuable feedback to the user and the therapist on improvement. Consistent and fairly intense work is often needed.

Up to now we have suggested that if you are ageing but are healthy then the best investment you can make is in fitness training and in activities that stimulate the brain in diverse ways.

If you have unfortunately had a brain injury then RehaCom could be a valuable part of your rehabilitation strategy. It was designed for that purpose and developed over decades - not to entertain but to help you get your life back on track.  Of course, for all of us fitness training will bring benefits without a doubt.