Can brain training prevent dementia? New studies could provide answers.

This specter prompted Tardif to volunteer for a unique American trial, known as POINTER study, which examines whether computer-based brain exercises similar to video games, combined with healthy eating, physical exercise and social interaction, can prevent dementia in people considered most at risk.

Butler Hospital and Miriam Hospital, both in Providence, jointly operate one of five POINTER study sites nationwide and are recruit volunteers of 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 could help someone else is great.

A an estimated 5.8 million Americans live with Alzheimer’s disease – a number that is expected to rise sharply as baby boomers age. But with hopes of an imminent and effective drug for Alzheimer’s disease dwindling, studies testing the protective power of computerized brain exercises, as well as lifestyle interventions, have taken on a new urgency.

“We’re not going to get a successful treatment that will come along and beat Alzheimer’s disease anytime soon,” said Dr. Stephen Salloway, professor of neurology and psychiatry at Brown University’s Warren Alpert Medical School and co. -responsible for the Rhode Island test site. .

The POINTER trial 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, exercise typically less than three times a week, and have mild high blood pressure, cholesterol or blood sugar levels, or a family history of memory problems.

The participants are divided into two groups: a structured group which receives instructions and regular coaching to adopt a Mediterranean style diet with more fruits and vegetables, and to increase social interactions, approaches that may be helpful in warding off 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 exercises.

The other group receives more general information about exercise, good nutrition, and the benefits of engaging in socially and mentally stimulating activities, such as learning a new skill or hobby.

The researchers will assess both groups of volunteers every six months for two years, measuring changes in cognition and physical health.

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

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

“It’s possible that by exercising our brains…maybe it changes some of the biology, but we just don’t have the evidence to be able to make any firm statements about that,” Dr. Dana Plude, deputy director of the National Institute of Aging’s Division of Behavioral and Social Research, which oversees many of the institute’s studies of dementia. “So we need this kind of research to answer these kinds of questions.”

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

But the results of a landmark study, known as the ACTIVE trial, found that healthy older people who received specific brain training, called processing speed, had a 29% lower risk of dementia after 10 years than an untreated control group.

(The speed of processing requires participants to spot a target in the middle of the screen while simultaneously noticing a target at the periphery – even when very briefly blinking on the screen.)

Various brain exercises can help you with daily activities, such as driving, remembering people’s names, and finding your car keys.

Plude of the Institute of Aging said his agency funds trials that take different approaches to find out which activities might be most effective.

“Some people who want to do these kinds of things may prefer to do them individually, and they would be uncomfortable in a group, and other people will only do it if they are in a group,” he said.

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

Working on this theory, Plude’s division also recently funded a small, year-long study in California that tests whether brain exercises incorporated into an already popular community fitness program are effective at consistently getting people to participate.

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

“The goal of this grant is to take the known science of dementia risk reduction and create a program that can be run in any YMCA, or in church basements, or in the network of all community health centers across the country,” said Henry Mahncke, CEO of Posit Science.

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

Overall, the National Institute on Aging supports 423 active clinical trials for Alzheimer’s disease and related dementias, with nearly twice as many non-pharmaceutical interventions, such as those at the YMCA and Rhode Island, compared to those involving medication.

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

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

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

His favorite part of the trial, he said, is the group conversations with the other volunteers, who offer advice on healthy recipes, such as adding spinach to fruit smoothies, as well as encouragement to stick to the schedule when tempted to skip certain activities.

“I’m trying to heal to avoid Alzheimer’s disease, and having these people will help me on that journey,” he said. “Hope this helps my brain.”

Kay Lazar can be reached at [email protected] Follow her on Twitter @GlobeKayLazar.

Source link

Richard V. Johnson