http://www.cnn.com/2003/HEALTH/conditions/06/19/avoiding.dementia.ap/index.html

Mind games may keep the brain sharp

Mental stimulation wards off dementia, says 21-year study

Thursday, June 19, 2003 Posted: 4:38 PM EDT (2038 GMT)

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BOSTON, Massachusetts (AP) -- An absorbing book or a challenging crossword puzzle may keep your mind more than busy. It may keep it healthy, too, according to a 21-year study of mental breakdown in old age.

The study adds to the evidence that stimulating the mind can ward off Alzheimer's disease and other dementia, much as physical exercise can keep the body fit.

The study was led by Albert Einstein College of Medicine in New York City and published in Thursday's New England Journal of Medicine. It was funded by the National Institute on Aging.

Researchers are eager to establish whether keeping mentally active can help guard against dementia. That would provide a simple, drug-free way of reducing the risk of the widespread, debilitating ailment. About 10 percent of people develop dementia between ages 60 and 70.

"I think the hypothesis is plausible enough that I spent several years of my life trying to figure out what the mechanism is, and I would advise our government to spend millions of dollars trying to figure it out," said Dr. David Bennett, a neurologist at Rush-Presbyterian-St. Luke's Hospital in Chicago. He has done similar research.

In the Einstein College study of 469 elderly people, those in the top third in mental activity had a 63 percent lower risk of dementia than the bottom third. Taking part in a single activity one day a week reduced the risk by 7 percent.

The use-it-or-lose-it notion is not a new idea. Other researchers have discovered evidence that mental activity may guard against dementia. But it is hard to prove, since early dementia without obvious symptoms may cause people to slack off their hobbies. If this is so, dementia affects hobbies -- and maybe not the reverse.

The researchers tried to minimize that possibility by considering only those who were dementia-free for seven years after joining the study. They also tried to eliminate the potential role of education and intelligence in guarding against dementia.

This study also took physical exercise into account. Nearly all physical activities, including stair climbing and group exercise, appeared to offer no protection against dementia. The only exception was frequent dancing, perhaps because dance music engages the dancer's mind, suggested lead researcher Joe Verghese, a neurologist at Einstein College.

It is not clear what physiological mechanism might confer the protection. But researchers say evidence is accumulating that the brain is much more easily molded than scientists once thought. Mentally engaging hobbies might lay down new neural pathways, one theory holds.

"The cerebral cortex and hippocampus, which are critical to these activities, are remarkably plastic, and they rewire themselves based upon their use," said Dr. Joseph Coyle, a Harvard Medical School psychiatrist who wrote an accompanying commentary.

Even if keeping the mind busy offers no protection against dementia, Verghese said doctors can hardly go wrong in recommending it: "If nothing else, it improves the quality of life."