Can brain training prevent dementia? New studies may point to some answers.


That specter prompted Tardif to volunteer for a first U.S. trial known as the POINTER study, which examines whether computer-based brain exercises similar to video games, combined with a healthy diet, exercise and social interaction can ward off dementia for those who have it. most at risk.

Butler Hospital and The Miriam Hospital, both in Providence, jointly run one of five POINTER study sites nationally and recruit volunteers from Greater Boston and Rhode Island.

“Maybe I can do something to lower my chances of getting it,” Tardif said. “Or if [researchers] getting something from me that can help someone else, that’s great.”

An estimated 5.8 million Americans are living with Alzheimer’s disease — a number that is expected to rise sharply with the aging baby boomers. But with dwindling hopes of an imminent, effective drug for Alzheimer’s disease, studies testing the protective power of computer-based brain exercises, as well as lifestyle interventions, have taken on a new urgency.

“We’re not getting a blockbuster treatment that will quickly overcome Alzheimer’s disease,” says Dr. Stephen Salloway, a professor of neurology and psychiatry at Brown University’s Warren Alpert Medical School and co-leader of the Rhode Island trial site. †

The POINTER study aims to enroll 2,000 people across the country, including about 400 in New England. Volunteers must be between the ages of 60 and 79, generally exercise less than three times a week, and have mildly high blood pressure, cholesterol, or blood sugar, or have a family history of memory problems.

The participants will be divided into one of two groups: a structured group that receives instruction and regular coaching for adopting a Mediterranean diet with more fruits and vegetables, and for increasing social interactions, approaches that can be helpful in fighting off obesity. cognitive decline.

“If we can control the risk factors for heart disease and stroke, we’ll keep your brain healthier,” Salloway said.

They are also expected to adhere to specific computerized brain training exercises and prescribed aerobics, strength training and stretching.

The other group is given more general information about exercise, proper nutrition, and the benefits of socially and mentally stimulating activities, such as learning a new skill or hobby.

Researchers will evaluate both groups of volunteers every six months for two years and measure changes in cognition and physical health.

The brain exercises involve a computer software program known as BrainHQ, which is designed to be challenging in very specific ways. Using a video game-like approach, it tests and enhances participants’ attention, brain processing speed, memory, spatial navigation and human skills.

The POINTER study, with $35 million from the Alzheimer’s Association to recruit and run the trial sites, is expected to receive up to $47 million more from the National Institute on Aging to conduct brain scans of participants. the scans, hopefully it will provide important clues as to why the interventions are or are not effective.

“It’s possible that by exercising our brains … that might change some part of the biology, but we just don’t have the evidence to make any firm statements about that,” said Dr. Dana Plude, deputy director in the Department of Behavioral and Social Research at the National Institute on Aging, who oversees many of the institute’s dementia-related research. “So we need this kind of research to answer those kinds of questions.”

Over the years, the evidence has been mixed as to whether certain forms of cognitive training may be more effective than others at preventing cognitive decline. For example, some studies have suggested that doing crosswords or other problem-solving puzzles may help, while others have found little effect.

But results from a groundbreaking study known as the ACTIVE study showed that healthy older adults who were given specific brain training, called speed of processing, had a 29 percent lower risk of dementia after 10 years than an untreated control group.

(The processing speed requires participants to see a target in the center of the screen and notice a target in the periphery at the same time — even when they blink the screen very briefly.)

Several brain exercises can help with everyday activities, such as driving a car, calling people’s names, and finding car keys.

Plude, of the Institute for Aging, said his agency is funding trials that take different approaches to discover which activities are most effective.

“Some people who want to do these kinds of things may prefer to do them individually, and they would feel uncomfortable in a group, and other people won’t do it unless they’re in a group,” he said.

“Let’s try to do these types of training activities in different ways and see which ones have traction,” Plude said. “And it probably won’t be one-size-fits-all.”

Plude’s division worked on that theory, and also recently funded a small, one-year study in California that tests whether brain exercises embedded in an already popular community-based physical fitness program are effective at consistently attracting people to participate. .

It awarded $465,000 to Posit Science, the company that founded BrainHQ, to partner with the YMCA of San Francisco to develop a brain-strengthening program that also includes training in better nutrition, physical fitness, stress reduction, and improvements in sleep and social interactions.

“The purpose of this grant is, let’s take the well-known science of reducing dementia risk and build a curriculum that can be implemented in any YMCA, or in church basements, or a network of health-based community centers in the nationwide,” said Henry Mahncke, the director of Posit Science.

Another new trial funded by the aging institute is called PACT, underway in Florida. The $44 million, five-year trial will enroll 7,600 people and investigate whether automated brain training exercises can reduce the risk of mild cognitive impairment and dementias, including Alzheimer’s disease.

All told, the National Institute on Aging is supporting 423 active clinical trials of Alzheimer’s disease and related dementias, nearly twice as many with non-pharmaceutical interventions, such as those at the YMCA and in Rhode Island, compared to those with medicines.

Heather Snyder, vice president of medical and scientific relations at the Alzheimer’s Association, said both approaches may prove effective.

“Anyone who has lived with someone in their family with Alzheimer’s disease, you understand the challenges facing a family, to improve the quality of life, but also to get ahead of it so that people have more time to do things with their family and to have the best quality of life they can,” she said.

That sentiment resonates with Tardif, North Attleborough’s grandfather who lost his mother to Alzheimer’s disease and is participating in the Rhode Island POINTER study.

His favorite part of the trial, he said, are group conversations with the other volunteers, who offer healthy recipe tips, such as adding spinach to fruit smoothies, and encouragement to follow the program when he’s tempted to skip some activities.

“I’m trying to get better at avoiding Alzheimer’s disease, and having these people will help me on that journey,” he said. “I hope it will help my brain.”


Kay Lazar can be reached at kay.lazar@globe.com Follow her on Twitter @GlobeKayLazar

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