Alzheimer’s & Cognitive Challenge
Alzheimer’s disease manifests as impaired cognition and other body functions. It has been shown that Alzheimer’s risk can be reduced within an enriching environment that provides positive psychological and experiential factors (1). Cognitive reserve is resilience to neuro-pathological damage within the brain, and can be enhanced by a physically and mentally stimulating lifestyle (2). Stimulation of cognitive functions through learning and daily activities may delay cognitive decline.
As mentioned in Part One of this series, Alzheimer’s symptoms occur once the brain is no longer able to compensate for the underlying pathology, which progresses for decades before cognitive decline. Cognitive reserve enables such compensation. In fact, significant accumulation of Alzheimer’s pathology (amyloid plaques and tau tangles) has been seen in asymptomatic cognitively thriving people who have high cognitive reserve (1). Here we will outline some evidence of how cognitive reserve can be bolstered and Alzheimer’s risk reduced.
Musical Instruments
Playing a musical instrument is cognitively unique, as it requires a wide variety of brain regions and functions simultaneously throughout both hemispheres of the brain (3). Task complexity is key for brain health and fostering cognitive reserve, and playing an instrument is highly complex, and requires considerable focus.
A twin study investigated whether twins who played a musical instrument had protection against dementia compared to their non-musical co-twin (3). This enabled confounders like genetics and environmental exposures to be ruled out. Sex, education and physical activity were also adjusted for. So what did they find? Those playing an instrument in older adulthood were 64% less likely to develop dementia or cognitive impairment. It’s never too late to try something new! So try an instrument and start practising some songs to develop those neural connections! From first-hand experience, I can tell you it is extremely satisfying to piece together a simple guitar riff!
Learning Languages
Learning a new language is another cognitively complex activity that can help delay cognitive decline (2). Bilingualism has been investigated as a protective characteristic against dementia. It requires constant shifting between languages, with different sounds, concepts, rules and vocabulary, requiring substantial cognitive load such as attention, flexibility and inhibition. Such processes contribute to higher cognitive reserve.
But you don’t need to be bilingual to benefit - second language learning also requires significant cognitive capacity of language processing and executive control and also enhances cognitive reserve. There are many language apps you can use to learn a new language! I like duo-lingo and have been working on my Spanish!
Community
Taking part in community groups and cultural engagement like visiting museums are associated with slower cognitive decline and lower dementia risk in adults (4). This may be due to mental, physical and social components such as cognitive stimulation, cultivating skills and interests, aiding emotional and dopamine (an important neurotransmitter) regulation and reducing stress, depression and sedentary behaviour. These factors are all associated with reduced dementia risk.
There is increased risk of cognitive impairment in socially isolated older adults. Community engagement, especially cultural engagement, is associated with lower Alzheimer’s risk independent of social factors. While you may assume that community and cultural engagement to support the brain are only important as we age, this is not the case! Cultural engagement from the age of thirty was associated with a lower risk of developing dementia later in life! Just to show (yet again!) that it’s never too early to start making brain healthy changes in your life.
Purpose in Life
The psychological tendency to derive meaning from life’s experiences has long been believed to exert positive health outcomes (1). It involves having a sense of intentionality and goal orientation that underscores behaviour, attitude and psychology in the day-to-day. In a study of almost 250 people in the Rush Memory and Aging Project, those who reported having a higher purpose in life had better cognitive function. Greater life purpose was found to create neural reserve or resilience by protecting against Alzheimer’s pathology, even after controlling for confounding factors like depression and education.
The process of finding meaning and purpose in life is quite complex and requires several cognitive processes that enhance cognitive reserve and assist mitigating Alzheimer’s symptoms. In order to accomplish this, people need to be able to self-reflect, manufacture a self-narrative, create self-awareness within a broader within-world context, and establish goals, priorities and focus (1). Purpose in life is also associated with happiness, satisfaction, personal growth, and even better sleep! (Which we know from the previous blog in this series is also important for Alzheimer’s prevention).
Living a life that is in line with your passions, and values, and that serves an end beyond your own immediate needs is key to finding meaning and purpose. This doesn’t mean we all need to become the next Greta Thunberg or Ghandi. As long as you have something that excites you and where you feel you are contributing to something of importance in your community - no matter how local or global.
This will look different for everyone. For me, I want to help people live healthier and happier lives. I am constantly learning about health, and advocating to individuals, to groups, and to the online/social media ether. Others might be involved in sports, volunteering, gardening, being a parent or grandparent, travelling - literally anything that engages you completely, that fills your cup and that makes you feel like a valuable member in society.
So how can you challenge you brain? How can you enhance your cognitive reserve? How can you integrate complex activities into your life? What can you learn that is new and that you can build upon? While this may not be easy (and it shouldn’t be - challenge is challenging!) it should get easier over time.
So, here’s a little inspiration. It took me days to learn the riff for Nirvana’s Come and You Are. I didn't think I’d be able to do it and it first didn’t sound like music at all, but rather just (quite unpleasant) noise. But I persisted. And I got it. Within the next day I learned three new guitar riffs. Something I didn’t think I would ever get suddenly became easier, more efficient, and enjoyable!
Each week, set a goal. A goal to pursue something new to learn, or something new to do. Sign up to a community group, or volunteer for a local charity. Not only will your brain be better for it, but so will you as a whole person.
By Jessica Zabow
Clinical Nutritionist (BHSc)
& Yoga Teacher (RYT500)
References:
Boyle, P.A., Buchman, A.S., Wilson, R.S., Yu, L., Schneider, J.A., & Bennett, D.A. (2012). Effect of purpose in life on the relation between Alzheimer disease pathologic changes on cognitive function in advanced age. Archives in General Psychiatry, 69(5), 499-505. https://doi.org/10.1001/archgenpsychiatry.2011.1487
Klimova, B., Valis, M., & Kuca, K. (2017). Bilingualism as a strategy to delay the onset of Alzheimer’s disease. Clinical Intervention in Aging, 12(1), 1731-1737. https://doi.org/10.2147/CIA.S145397
Balbag, M.A., Pedersen, N.L., & Gatz, M. (2014). Playing a musical instrument as a protective factor against dementia and cognitive impairment: A population-based twin study. International Journal of Alzheimer’s Disease, 2014(836748), 1-6. https://doi.org/10.1155/2014/836748
Fancourt, D., Steptoe, A., & Cadar, D. (2020). Community engagement and dementia risk: Time-to-event analyses from a national cohort study. Journal of Epidemiology and Community Health, 74(1), 71-77. https://doi.org/10.1136/jech-2019-213029