By life, I mean things like normal activities, intellectual pursuits, games or events with friends (or by yourself, for that matter), and the like. A Cochrane review (of 24 trials over 37 years that had 2,229 subjects), found that there was “surprisingly little evidence” supporting the use of cognitive training programs for memory improvement compared to other activities for people age 60 or older, with or without mild cognitive impairment (MCI).

And while the interventions were as good as other stimulating activities, the review only found two types of trainings that were proven effective. This means that we can’t assume that any given commercial or non-commercial program being promoted is necessarily effective. But you knew that.

This is why I chose the title for this post. I’m asking,

Would you prefer to do or learn something that is truly meaningful to you (for example, learn a language) or engage in a training program designed without that consideration (as most are, especially the commercial ones)?

If you learn the language, your brain will work better (nonspecific training effects are shown in research) AND you’ll gain the language skills. If you join a discussion group, your brain will work better, and you’ll enhance your social skills, build and maintain friendships and support, and expand your awareness of whatever you’re discussing. But if you take the program, you only get the better brain function.

Providers of training programs take heed: there is no reason for your programs to be insulated from the desire to learn information and skills that your customers find meaningful. And there is no reason that your programs have to insulate people from each other; they can be social. And we haven’t even gotten into the matter of longevity being improved in those with social engagement and support.

Look on the Bright Side

The good news is that stimulating your brain for cognitive improvement really does make a difference, whether you use a professional (training) program or natural activities that stimulate the brain. A good deal of research has looked at the question of natural activities that improve or maintain cognitive abilities in older persons, and the results encourage us to be engaged in life, especially social activities. Research on involvement in religion suggests that it is primarily the social aspect that improves longevity. This is probably true for cognition and memory as well.

And science is not standing still, cognitive and memory programs are being enhanced with new knowledge for new experiments. Medscape interviewed expert Gary Small, MD, who pointed out that the review did not sufficiently emphasize the fact that the programs were shown to be helpful. Point taken. They were helpful. He also wondered if the programs might not be more effective if some improvements were made. Dr. Small pointed out that programs can target specific mental functions. He is developing programming with improvements like this in mind. Likewise, Dr. Martin, an author of the Cochrane review, is developing programming targeting common age-related complaints.

Extra Details

From the review:

[B]ut none of the effects observed could be attributable specifically to cognitive training, as the improvements observed did not exceed the improvement in active control conditions. This does not mean that longer, more intense or different interventions might not be effective, but that those which have been reported thus far have only limited effect.

The authors defined cognitive training as “an intervention providing structured practice on tasks relevant to aspects of cognitive functioning, such as memory, attention, language, or executive function.” The settings can be group or individual. The interventions were categorized into cognitive domains such as memory, executive function, attention, and processing speed.

The control group that had the stimulating activities (called the “active controls”) received “non-cognitive activities” or “unspecific cognitive stimulation, such as art discussion.”

Medscape quoted one of the authors, Dr. Martin, as saying,

The conclusion is based on the fact that we have looked at 37 years of memory training research and shown that only 2 types of training are effective. We consider this ‘little’ evidence.

Outcome measures for persons with MCI included, “rates of conversion to dementia, and rates of institutionalization. Incidence and severity of adverse effects were also considered.” For those without MCI, outcomes included “immediate and delayed recall of face-name associations; visuospatial memory; short-term memory; paired associates; and immediate and delayed recall of words, paragraphs, and stories.” Immediate and delayed verbal recall significantly improved in persons without MCI.

Of the various training targets, only the memory training had enough comparable data to be pooled.

Be cautious in interpreting the results for persons with MCI, because only three studies addressed that population and the data were “scarce.”

References

Johnson, K. (2011). Cognitive training to improve memory just as effective as other intellectual activities. Medscape Medical News, January 25.

Martin M, Clare L, Altgassen AM, Cameron MH, & Zehnder F (2011). Cognition-based interventions for healthy older people and people with mild cognitive impairment. Cochrane database of systematic reviews (Online), 1 PMID: 21249675

Continuing Medical Education

You can take a CME course from Medscape.