A new study from Lifespan evaluated the research to date on the impact of cognitive training on the healthy elderly population. Their review of all relevant randomized, controlled trials shows no evidence that structured cognitive interventions or "brain exercise" programs delay or slow progression of cognitive changes in healthy elderly. Such programs are now an $80 million per year industry. The study appeared in Alzheimer's & Dementia.
There is much research on the benefits of cognitive rehabilitation strategies among elderly who already experience mild cognitive impairment (MCI) or Alzheimer's disease, as well as on the positive impact of physical exercise. The researchers, however, wanted to evaluate current research that would focus on the impact of cognitive interventions in the healthy elderly population. With this in mind, they established three objectives for their study: to systematically review the available literature on cognitive training and the healthy elderly, to assess and compare the efficacy of different cognitive interventions and to provide recommendations for future research.
According to senior author Peter J. Snyder, PhD, vice president of research for Lifespan, and a professor of clinical neurosciences (neurology) at the Warren Alpert Medical School of Brown University, the researchers determined that the last meta-analysis performed on studies of healthy elderly and memory training was published in 1992. Since then, the definition of cognitive training has expanded and media attention has sparked an increase in public awareness with more and more Americans trying to curtail the effects of aging. As a result, Americans are now expected to spend $80 million this year on brain exercise products, compared to $2 million in 2005.
Through a systematic review of literature using established techniques to analyze randomized controlled trials of cognitive interventions in the healthy elderly, the researchers found a very small number of studies that met their criteria. What studies did meet their criteria they found to be limited in their methodologies or were often lacking in follow-up. Based on this quantitative literature review, called a meta-analysis, they concluded that there was no evidence indicating that structured cognitive intervention programs had an impact on the progression of dementia in the healthy elderly population.
Snyder says, "The brain aging products sold today can be a financial drain, decrease participation in more proven effective lifestyle interventions, like exercise, and potentially undermine cognitive health by frustrating the "worried well" if poorly designed." The researchers note that some products have actually been marketed as weapons in the fight against Alzheimer's disease.
Snyder and the researchers conclude, "Evidence-based information regarding cognitive intervention in healthy elderly needs to be gathered and presented clearly to both the scientific community and our vulnerable elderly population. More random clinical trials in cognitive training need to be conducted with sufficient follow-up time that can actually measure changes in daily functioning. Only in that way will we know if such exercises are effective in slowing the progress of MCI."
He also notes, "We believe it is vital for clinical researchers to communicate the state and progress of research in a clear and unbiased manner to keep the public informed and assist in their decision making about preventive lifestyle interventions."
Other researchers involved in the project include one of Snyder's doctoral students, Ms. Kathryn Papp, of the department of psychology, and Dr. Stephen Walsh of the center for biostatistics, both at the University of Connecticut.
Lifespan, a not-for-profit organization, is Rhode Island's largest health care system. Formed in 1994, it includes Rhode Island Hospital and its Hasbro Children's Hospital; The Miriam Hospital; Bradley Hospital and Newport Hospital. Lifespan (www.lifespan.org) is the state's largest private employer, with more than 11,000 employees, and is affiliated with The Warren Alpert Medical School of Brown University. Lifespan hospitals are among the top recipients of research funding from the National Institutes of Health, receiving more than $66 million combined in fiscal 2007. All Lifespan-affiliated hospitals are charitable organizations that depend on support from the community to provide programs and services.
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