Disconcerting Dementia News

by Carole Jackson, Bottom Line Health

I’m still deeply involved in the time-intensive job of raising my family, so I admit to harboring some wistful dreams of the days and years ahead when I’ll be able to indulge myself with brainy pursuits such as doing crossword puzzles, playing Sudoku and taking classes at the local college just because I want to — all the more so since it’s been thought that these activities help us stay sharp and stave off dementia.
That’s been the conventional wisdom, at least… but new research I’ve just read adds a bizarre twist — it appears that using your brain is protective only to a point. Then it may make matters worse. A new study from Rush University Medical Center in Chicago shows that once dementia symptoms set in and affected people who had been mentally active, the deterioration seemed to occur faster and to be more destructive. Can this really be true?
You can bet I picked up the phone right away to learn all I could about this study from its author, senior neuropsychologist Robert. S. Wilson, PhD. He told me that he and his research team evaluated 1,157 healthy people age 65 and older who did not have any signs of dementia. At the start of the 12-year study, each participant was assigned points (from one to five) based on the quantity and quality of mental activities he/she engaged in regularly. When these folks were checked again about six years later, about half (614) had no cognitive impairment… and, over the next six years, each point that they had earned on their mental activity scale correlated to a reduced rate of cognitive decline by an impressive 52% per year.

But there was a bit of bad news, too: Mentally active participants who did develop symptoms of Alzheimer’s disease had an average 42% increase (compared with those who weren’t as intellectually active) in their annual rate of decline for each point that they had originally scored on the mental activity scale.
In other words, said Dr. Wilson, exercising mental skills did help people retain their cognitive abilities if — and it’s a big if — they did not develop Alzheimer’s. For people who did, once symptoms were apparent, the decline appeared to be much faster than if they had been living a less stimulating life.

What Does This Mean?
How to make sense of these results? Dr. Wilson believes that the protective effect of increased mental stimulation actually masks the early signs of cognitive decline. When the symptoms finally do become evident, the disease is already far along — more so than among people who showed signs earlier because they had less mental stimulation.
Dr. Wilson told me that his research team is still following the same subjects — those who are still mentally sharp as well as those who now are officially diagnosed with Alzheimer’s — in order to learn more about how long a “cognitive lifestyle” is protective. Since other research has now established that Alzheimer’s starts decades before symptoms actually start to show up, it’s important to learn whether keeping the brain active is a way to delay the onset of disease symptoms even as the disease pathology moves forward, which may be a way to keep people living in a vital, independent state for a longer time.

Robert S. Wilson, PhD, senior neuropsychologist, professor of neurological sciences and psychology, director of the section of cognitive neuroscience, Rush University Medical Center, Chicago.