A researcher's perspective on brain health programs
Which brain health programs and initiatives are you offering the older adults in your community, and how effective are they? Recent research may help you determine whether or not to reconsider your offerings.
A number of brain health options are currently available to organizations that serve older adults. Many of these are advertised as “evidence based,” meaning that the program's exercises or suggestions for improving brain health are based on the best available research. However, in many cases, the success of specific brain fitness programs and initiatives themselves has not been formally evaluated. This is beginning to change, with an increasing number of program evaluation studies appearing in the academic literature. Here, I'll review some recently published research on programs aimed at increasing the brain health of older adults.
Multidimensional Brain Fitness Programs
In an earlier blog post, my colleague Catherine O'Brien, Ph.D., discussed the benefits of programs that provide a multidimensional approach to brain fitness, targeting a number of lifestyle factors that have been shown to impact cognitive decline and risk of dementia. In an article that has been accepted for the 2015 Senior Housing and Care Journal, O'Brien and I have been able to provide initial findings from our evaluation of the multidimensional brain fitness program Boost Your Brain and Memory developed by Mather LifeWays Institute on Aging.
This study was conducted with 186 participants at 12 senior living locations. The course itself lasted six weeks, and taught about lifestyle areas such as physical, intellectual, and social activity in addition to teaching memory strategies. Some of the encouraging findings from that evaluation are that 92% of participants reported making brain healthy lifestyle changes during the course, and 97% reported that they planned to make even more lifestyle changes in coming months in order to further decrease their risk of dementia. Moreover, 93% of participants reported understanding how lifestyle affects risk of dementia to a moderate or great extent, and 90% reported understanding how the adult brain changes to a moderate or great extent. After the course, 87% of the participants reported feeling optimistic about maintaining their memory as they aged, compared to only 38% of the control group. In other studies, such optimism about memory has been associated with a number of positive cognitive outcomes. Participants also rated the relevance and usefulness of this course's content highly.
Early findings have also recently been reported in Educational Gerontology for another educational program that targets adults between 40 and 65. This two-hour workshop, Keep Your Brain Fit!, featured modules on lifestyle, memory, and working effectively. In the feasibility study for this program, the researchers found that 69.2% of participants reported being less worried about their cognitive abilities, and 49% reported feeling better able to cope with cognitive challenges.
One of the most exciting recent studies covers a multidimensional brain fitness program that goes beyond just educating program participants. This study, the FINGER study, evaluated the impact of a two-year program that incorporated diet, exercise, cognitive training, and vascular risk monitoring on 1,260 older adults who were identified as being at risk for cognitive decline. When the researchers compared participants in this intensive program to a control group, they found that the brain fitness group scored 25% higher on the cognitive evaluations administered, with an 83% higher score in executive functioning and 150% higher score on processing speed. The group in the multidimensional program also showed better measurements of body mass index, dietary habits, and physical activity. These researchers will continue to evaluate the long-term impact of this program over the next seven years.
Programs Focusing on Intellectual Activity
In addition to these studies of multidimensional programs, two important studies look at the cognitive impact of interventions involving intellectual skills and training.
The first, which was published in Psychological Science, looked at the cognitive impact of learning a challenging new skill late in life. This study's participants spent 15 hours a week for two months learning new skills: photography and computerized photo editing, quilting, or both. Looking at the groups as a whole, those participants who learned photography or both photography and quilting showed significant improvements in episodic memory (our memory of past events) compared to other older adults. The researchers suggest that the significant effect of the photography and dual conditions could be due to the photography tasks being “considerably more demanding of episodic memory” than the quilting tasks. The researchers looked at what proportion of the participants in each condition showed what they considered notable improvement over the 14 weeks of the study. When looked at in this way, 76% of those in the photography condition, 57% of those in the dual group, and 60% of the quilting group showed notable improvement. Thus, while the impact of the quilting training wasn't strong enough to demonstrate significant change for the group as a whole, this activity still proved to be cognitively beneficial to a sizable proportion of those participants.
Lastly, in light of all the attention received by computerized cognitive training, I wanted to mention a recent meta-analysis of 51 studies in PLoS Medicine that sheds some light on what seems to work and what doesn't. Overall, this examination concluded that computerized cognitive training programs can be “effective at enhancing cognitive function in healthy older adults, but small effect sizes are to be expected.” Interestingly, these researchers found that group-based classes were much more effective than at-home training, that training sessions lasting greater than 30 minutes had a greater impact, and that that those training programs that met more than three times per week did not show statistically significant results.
As we can see, not only are researchers making considerable progress in identifying risk factors for dementia and cognitive decline, but we are seeing more and more positive results from the evaluations of some of the programs that incorporate research connecting lifestyle factors and activities to improved cognition. If this trend continues, we will be seeing more rigorously tested and more effective brain health programs offered throughout senior living (and beyond)—ideally guiding residents in living more brain-healthy lifestyles.
Roscoe Nicholson is a senior research associate at Mather LifeWays Institute on Aging.