DOES MENTAL AND PHYSICAL ACTIVITY PROMOTE COGNITIVE VITALITY IN LATE LIFE?

About 40% of adults age 65 and older have age-associated memory impairment, roughly 10% have mild cognitive impairment, and an additional 5% have dementia. That’s a lot of older adults. And the numbers get higher with age, as those of us involved in long-term care know only too well.

Given the toll that mental decline takes on older adults’ quality of life, and the high cost of caring for those with cognitive deficits, finding ways to preserve cognitive vitality is critical. To that end, leading researchers in the field met in Philadelphia this March at a conference, “Does Mental and Physical Activity Promote Cognitive Vitality in Late Life?” organized by the AGS and made possible by a grant from the National Institute on Aging. The short, and encouraging, answer to the question that constituted the conference title was: “Probably.”

“Older persons are very concerned about declining mental abilities,” said Howard Fillit, MD, executive director of the New York City–based Institute for the Study of Aging, and the Chair of the three-day conference. “But during the past decade, research has shown that lifestyle factors, such as getting physical exercise and ongoing mental stimulation from social or occupational involvement, may prevent mental decline.”

He and other conferees took a close look at epidemiological studies and intervention trials, and current knowledge regarding possible mechanisms underlying the effects of physical and mental activity on cognitive vitality.

Many studies have been plagued by potential confounders and other problems, and have reached conflicting conclusions, noted Lenore J. Launer, PhD, Chief of the NIA’s Neuroepidemiology Section. Overall, however, intervention trials and research examining the influence of regular physical exercise on brain structure and function are encouraging, reported Arthur Kramer, PhD, of the University of Illinois. Regular exercise appears to help preserve cognitive function via several mechanisms: by spurring the creation of new neurons, new blood vessels in the brain, and new connections among neurons.

Research also suggests that cognitive activity can help prolong cognitive vitality. Consider the results of the ACTIVE Study, a randomized, controlled trial of cognitive training interventions involving nearly 3000 women, age 65-94. More than two years after the interventions ended, women in the intervention groups had better cognitive skills than controls, ACTIVE researcher Sherry L. Willis, PhD, reported. Social activity—which usually has a cognitive component—also seems to have a protective effect. Several studies have found that older people who engage often in social and intellectual activities are at decreased risk of Alzheimer’s disease.

Relatively little is known about the mechanisms underlying the effects of intellectual activity on cognitive vitality, Dr. Kramer noted. But both physical exercise and intellectual activity appear to prompt the production of hormones and neurochemicals, including brain-derived neurotrophic factor (BDNF), which plays a key role in learning and memory.

These findings hold great promise for older adults. However, there is still a tremendous amount of research to be done. We need to know more about how duration, intensity, and type of activity affect outcomes. And we need to find new ways to bring programs that extend cognitive longevity into the community.

There are some promising models already. Take Experience Corps, a Johns Hopkins initiative that matches older volunteer tutors and mentors with schoolchildren in troubled urban schools. Given the nature of their work with the children, these volunteers get additional physical, social, and intellectual stimulation. In a randomized, controlled study, the volunteers—who spent at least 15 hours a week in the classroom—showed improved executive function, and enhanced physical function.

That’s something to think about, especially as it applies to the older adults in our care.