When I was a high school student, my maternal grandmother was diagnosed with dementia. This became a reality after her husband died. My mom moved her into our home thinking we might be able to keep her safe and comfortable, but nursing home placement was inevitable. This event was devastating to me.
Globally, over 55 million people live with dementia, a figure expected to reach 139 million by 2050, with millions more experiencing mild cognitive impairment (MCI), a precursor to dementia, with estimates suggesting around 20% or more of older adults could be affected.
Many older adults experience forgetfulness and have lapses in their memories and therefore worry about these incidents. The fear of developing dementia is real and creates anxiety when memory is challenged.
With the numbers of dementia cases expected to continue to increase globally, there remains a strong interest in cognitive aging, including all phases such as prevention (enhancement), impairment (diagnosis), and/or disability (treatment).
Can Cognitive Function Be Maintained?
The Decade of the Brain (1990-1999) led to the discovery that the brain is adaptable and has plasticity throughout life and is able to produce new cells in adulthood, known as neurogenesis (Jones, et al., 1999). This federal initiative led to a major increase in the visibility of neuroscience research.
Brain plasticity (or neuroplasticity) is the brain’s remarkable ability to reorganize its structure, functions, and neural connections throughout life in response to experiences, learning, and even injury, allowing it to adapt by strengthening existing pathways or forming new ones.
A study of 120 older adults who exercised had a bigger hippocampus, and the people that have more tissue in the hippocampus have a better spatial memory (Erickson et al., 2011).
The AARP surveys (2022, 2023) reported the adults who engaged in healthy behaviors self-reported better brain health and higher mental well-being scores. Next, those adults who regularly engaged in healthy lifestyle behaviors were willing to engage in even more healthy behaviors. Finally, a positive relationship was found between engagement in healthy behaviors and self-reported brain health and mental well-being.
Cognitive losses experienced in middle age, previously considered to be caused by age, were found to be caused by factors outside of the aging process and external to the individuals, known as the Lifestyle-Cognition Hypothesis, and may have been preventable.
Mental Stimulation and Prevention of Cognitive Decline
The “Use It or Lose It” model adopted from education suggests that training our brain and engaging in learning will enhance brain plasticity and improve cognitive reserve. Cognitive or mental exercise is a core principle of neuroplasticity, meaning the brain adapts by strengthening frequently used neural pathways and weakening unused ones.
The brain seeks novelty. Rather than relying on passive tasks or external aids that can lead to skill decline, the emphasis is challenging your brain with activities like puzzles, learning new skills such as dancing, a new language, or reading helps build cognitive reserve.
Cognitive training may stimulate adult neurogenesis and generate neurons and synapses. Next, training builds psychological confidence for everyday activities.
Finally, training promotes mental discipline and enhances intellectual sharpness and develops cognitive vigor. Research on cognitive interventions demonstrated that individual differences in behavior are reflected in individual differences in neuroplasticity.
Memory Training Senior WISE (Wisdom Is Simply Exploration)
Senior WISE is a program designed to improve everyday memory, reduce stress, improve health, and build self-confidence. There are numerous other memory training programs, but these three variations of the program demonstrate how each version had different outcomes.
Original Study. In this study, 270 adults with an average of 75 years who were at risk for memory loss and without dementia were recruited from the community to participate in this clinical trial. The study was funded by the National Institute on Aging (NIA). Adults attended eight small group classes for a total of 12 hours of memory or health training. Over the 24 months, the memory training group made gains on cognition and had fewer memory complaints and maintained their performance on the other cognitive measures and instrumental activities. African Americans and Hispanic participants made greater gains than Whites did on some memory performance measures and instrumental activities. The intervention was able to forestall those participants with probable MCI over two years in both subjective and objective memory function (McDougall et al., 2010).
Short Memory Intervention. A six-hour condensed four-session version of the intervention was delivered to 27 older adults from a YMCA senior exercise class (Becker, et al., 2008). Compared to the eight-session version, there were changes in everyday memory scores that were significant only in the eight session groups. Both intervention groups increased their instrumental activities measures and their scores on the memory self-efficacy measure, but only the four-session group increase was significant. These findings demonstrated that the four-session model of Senior WISE was effective and cost efficient.
Senior WISE plus Yoga. Here, 12 hours of Senior WISE included a 30-minute yoga component before each training session. We recruited 133 older adults between the ages of 53-96, with an average of 81 years, from four retirement communities. Of those, 83 participants completed at least nine hours (75%) of the training and completed the post-test. We found significant gains in memory performance, performance-based instrumental activities, memory confidence, and a reduction in depressive symptoms. 13 individuals advanced from poor to normal memory performance and seven from impaired to poor memory performance; thus, a total of 20 individuals improved enough to advance to a higher functioning memory performance group (McDougall et al., 2015).
Summary of Evidence
The self-care movement has created a market for cures that are readily available. The interest in proactive health and natural solutions include cognitive and brain health. Years of memory training research found that cognitive function may be improved in multiple domains including attention, learning, memory, problem-solving, and thinking. Non-cognitive tasks also improved, such as everyday skills like memory self-confidence, finances, and medications. Memory training studies demonstrated that improvements varied by duration and complexity of the interventions.