Memory, logic and reasoning puzzles, combined with advice on diet and exercise, can help reduce levels of age-related cognitive decline, according to a new study published in the journal Lancet Primary Care. Researchers said that people should not assume that age-related thinking and memory problems are “fixed”, adding: “There are quite a lot of simple things that you can do yourself, get up and do them.”
The study examined data on 11,563 people registered with GP surgeries in England, Scotland and Wales. People aged 60 to 85 with low cognitive scores suggestive of age-related cognitive decline were invited to take part and were split into three groups.
Three groups, three approaches
One group was given evidence-based advice for cognitive health, including advice on diet, exercise and brain stimulating activities. The second was pointed to a website called Active Brains, which promotes physical activity, a Mediterranean-style diet and provides cognitive exercises in the form of puzzles. The third group was directed to the same website and also given “brief support” comprising three email or telephone sessions with a nurse.
After 12 months, all groups showed improvement in their cognitive scores, and a significant proportion no longer met the criteria for age-related cognitive decline.
Key findings and improvements
Some 28.4% of people who were given simple lifestyle advice were no longer deemed to have age-related cognitive decline. This increased to 32.8% of those directed to the website and 31.6% of those directed to the website and given additional support. Cognitive scores were higher among the groups directed to use the website.
Researchers, led by academics at the University of Southampton, found an 8% reduction in mild cognitive impairment among those directed to the website, compared to those simply given advice. Among those directed to the website and given additional support, there was an 18% reduction in severe cognitive impairment compared to those who were just given advice.
Expert reaction and implications
Paul Little, professor of primary care research at the University of Southampton and study co-lead, said the support was not “highly technical”, adding: “If the NHS could provide some support, an 18% reduction in significant cognitive impairment is pretty important.”
Most of the people involved in the study already had good diets and exercised regularly, indicating that the benefits were largely from puzzles, the researchers said. Prof Little told the Press Association: “There are two positive messages: One, actually, there are quite a lot of simple things that you can do yourself. Get up and do them. The brain is plastic. Don’t assume it’s fixed. You can do something about it, and off you go. Do something about it.”
He added: “These are really exciting findings that people can easily take on board. Simple messages and simple things that people can do really make a difference – and the NHS does not need to spend a lot of money. It’s an important health message. The brain remains plastic and malleable – so it can learn new things – well into older age, so you can really make a difference and combat cognitive decline.”
Commenting on the study, Dr Honorine Lebraud, senior partnerships manager at Alzheimer’s Research UK, said: “This is an encouraging study, suggesting that lifestyle changes can support cognitive health, even after symptoms have emerged. The findings also show how digital tools could make it easier to provide personalised support to more people, helping them make positive changes to their lifestyle and brain health. However, suggesting that lifestyle changes can reverse cognitive impairment would be premature. For example, the improvement seen in verbal reasoning was modest. Longer-term research is needed to understand whether these benefits are sustained or translate to a lower dementia risk.”
Dr Richard Oakley, associate director of research and innovation at the Alzheimer’s Society, said: “People should not take this study to mean that doing puzzles can reverse dementia or improve symptoms for everyone living with memory problems. These findings are encouraging because the activities tested did not require lots of support from healthcare practitioners and could be relatively easy for health services to deliver at scale. However, the study involved people with early memory and thinking problems rather than a confirmed diagnosis of mild cognitive impairment or dementia, so it is unclear whether the same benefits would be seen in people living with these conditions or will last over time.”
