Buzz
Memory loss is a common concern as we age, and it can be terrifying. Many people worry about losing their mental sharpness as they grow older, and those fears are often exploited for profit. Corporations sell brain-training products with lofty promises—like Lumosity, which claims to help users ‘improve memory, increase focus, and find calm.’ Similarly, the 2013 Apple App of the Year, Elevate, asserts that its brain training program can enhance various skills, including memory and focus. While these products are big business, they rarely deliver on their bold promises.
The fear of cognitive decline in aging has long been used to market products. Brain-boosting apps and games like Lumosity and Elevate capitalize on these anxieties by making grand claims—like improving memory, focus, and other cognitive abilities. But in reality, these products often fail to live up to their promises.
Dementia remains a mystery in many ways, but one thing is clear: it arises from a complex mix of factors. A single, simple solution—such as playing a phone game for a few minutes each day—won’t likely have a significant impact. However, a multifaceted approach may offer a better chance. While many risk factors are outside our control, there are some that we can influence, and understanding which is which is the key to protecting yourself.
What exactly is dementia, and what causes it?
Memory loss can manifest in three main forms: age-related cognitive decline, mild cognitive impairment (MCI), and dementia. While these conditions share some overlapping symptoms, they are distinct from one another, so it’s crucial to understand the differences.
Age-related cognitive decline refers to the typical, mild memory loss that accompanies getting older.
Age-related cognitive decline occurs as part of the natural aging process. Just as our hair, skin, and muscles age, so do our brain cells, leading to some impairment in their function and communication. Losing a few neurons is a normal part of aging, and mild memory lapses can often be attributed to this process.
Mild cognitive impairment (MCI) refers to a condition that sits between normal aging and dementia in terms of severity.
MCI presents as more significant memory problems than what is typical for someone’s age group, but people with MCI are still able to function independently. Determining what is considered 'normal' in terms of memory loss can vary and should be assessed by a qualified healthcare provider. While MCI can make daily tasks, such as remembering appointments and medications, more challenging, it generally does not cause behavioral changes like dementia does.
Dementia refers to a decline in cognitive abilities, including memory, reasoning, and thinking, which affects a person’s daily life and activities.
According to the National Institute on Aging, dementia is defined as 'the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.' People with dementia often forget things like appointments and medications, but may also struggle with visual and language skills, spatial reasoning, and decision-making. They might wander, get lost, or experience mood changes such as irritability, paranoia, and aggression. In some cases, dementia can lead to more severe behavioral issues, including hallucinations and physical violence.
Alzheimer’s disease is the most common cause of dementia. It can develop as either early-onset or late-onset. In the more common late-onset form, dementia symptoms appear during or after the mid-to-late 60s. Early-onset Alzheimer’s is much rarer, accounting for about 10 percent of all cases, and can begin anytime between the ages of 30 and 60.
While scientists do not yet fully grasp the exact cause of dementia, it is generally understood that cognitive issues emerge when neurons cease to communicate with other brain cells and eventually perish. In Alzheimer’s disease, specifically, amyloid proteins and tau fibers gather in irregular clumps, disrupting neuron connections and destroying healthy tissue. These clusters, known as amyloid plaques and tau tangles, are thought to play a significant role in the cognitive and behavioral changes observed in Alzheimer’s patients. Memory-related brain areas are often the first to be affected, leading to forgetfulness and widespread memory loss. As the disease spreads to other parts of the brain, individuals begin to lose their ability to reason, speak, and behave appropriately. In the later stages, the damage extends to basic physical functions, such as breathing and swallowing.
The precise causes of dementia remain largely unknown, which makes early detection almost impossible.
Who is at risk?
The underlying physiological causes of dementia are still not fully understood, making early diagnosis very challenging. If any precursor can be identified through routine blood tests or imaging, it has not yet been discovered. For most people, dementia symptoms are their first and only indication, so understanding your risk is crucial.
The primary risk factor for dementia is age. Whether caused by Alzheimer’s or another condition, dementia is far more prevalent in the elderly; the NIH estimates that half of individuals over 85 have some form of dementia. A family history also plays a role. While some individuals without a family history may still develop dementia, the more family members who have experienced it, the higher the likelihood. Additionally, mental health conditions, especially depression, have been linked to an increased risk of developing dementia.
Both early- and late-onset Alzheimer’s have a genetic component, though this doesn’t mean you should rely on a DNA test to assess your risk. Researchers have identified specific chromosomes and genetic mutations linked to the development of Alzheimer’s, but your genetic makeup is only one piece of a much larger, complex process that spans decades. Many individuals with Alzheimer’s don't have any of these mutations. It is important to note, however, that most people with Down syndrome will develop Alzheimer’s, potentially because the gene that produces amyloid proteins resides on chromosome 21, which people with Down syndrome have an extra copy of.
What can we do about it?
Unfortunately, there is no way to prevent dementia right now, nor is there a method to stop, reverse, or slow its progression. While finding a cure remains a major goal, the ultimate aim of dementia research is to prevent it altogether, ideally through lifestyle changes that are easy to adopt. Scientists have tested several interventions that might delay the onset of cognitive decline, but only a few show real promise.
Exercise might help, but the evidence is unclear.
Among all the potential interventions, none has been studied as extensively as exercise. The results are mostly inconclusive. While some studies suggest that increased physical activity could delay normal age-related cognitive decline, there’s no solid proof that it works for mild cognitive impairment (MCI) or dementia. Nevertheless, staying physically active is beneficial for overall health, so it’s worth engaging in—but it won’t be the single solution to prevent dementia.
Brain training games don't necessarily boost your brainpower in real life.
One intervention that has gained traction is 'cognitive training,' which involves playing progressively harder games designed to challenge various parts of your brain. The appeal is clear: solve enough puzzles and games, and you might improve your cognitive abilities. However, the scientific evidence doesn't fully support this. Some games show more potential than others, but overall, brain training mainly helps improve your skill at the game itself.
For cognitive training to be effective, any improvements from playing games should transfer to related tasks in a phenomenon known as the 'transfer effect.' Proving this is more difficult than expected: scientists disagree on which areas of cognition are affected by brain training games and how to measure progress meaningfully. As a result, very few studies have confirmed transfer effects. That hasn't stopped companies like Lumosity from making claims otherwise, even though there is no evidence that these games can prevent cognitive decline. (Lumosity was fined $2 million by the FTC in 2016 for 'deceptive advertising charges.')
Managing high blood pressure could be beneficial.
A potentially more effective strategy is rigorous hypertension management, which involves lowering your blood pressure to normal levels—120/80 mmHg or lower. A recent randomized clinical trial involving over 9000 adults with hypertension revealed a link between intensive blood pressure control and reduced risk of mild cognitive impairment (MCI) and probable dementia: participants who achieved a systolic blood pressure of 120 mmHg or lower had a significantly lower rate of MCI compared to those whose systolic pressure remained under 140 mmHg (14.6 vs 18.3 cases per 1000 person-years). Intensive blood pressure management also notably decreased the combined risk of MCI and dementia. Although researchers observed a decrease in probable dementia—7.2 vs 8.6 cases per 1000 person-years for the 120 mmHg and 140 mmHg groups, respectively—it wasn't statistically significant.
This study isn’t flawed; in fact, it's groundbreaking. It’s the first large-scale randomized clinical trial to find a statistically significant connection between a common, treatable physical condition and the risk of MCI. Moreover, the study was so effective at lowering cardiovascular events and reducing overall mortality that the blood pressure management program was concluded after just 3.3 years—more than a year and a half ahead of schedule. MCI and dementia assessments continued for the full five years. Given the participants’ relatively young age (around 68 years on average), the short observation period, and the fact that MCI generally occurs before dementia, it's logical that major results were only found concerning MCI. The fact that any results related to dementia were found is an exciting bonus. While future research could alter these conclusions, for now, it seems wise to keep your blood pressure in check.
Social interaction remains our most promising strategy to date.
There is growing evidence that social isolation is a key risk factor for cognitive decline and dementia. A 2017 Lancet Commission report estimates that social isolation accounts for up to 2 percent of lifetime dementia risk—comparable to the risk from hypertension. While this is still a relatively new field, numerous studies are exploring how increased socialization may help reduce the risk. To learn more, I spoke with Dr. Hiroko Dodge, the principal investigator behind Oregon Health & Science University’s I-CONECT project.
In a June 2015 paper published in Alzheimer’s & Dementia, Dr. Dodge and her team conducted a clinical trial to examine the effects of 'naturalistic human contact' on cognitive function in elderly adults (with an average age of 80). About half of the participants participated in 30-minute daily video chats with trained interviewers for six weeks, while the rest did not. When compared to baseline scores and the control group, the video chatters showed improvements in semantic fluency (the ability to generate words in specific categories) and psychomotor speed (reaction time). Statistically significant results were only found in participants with normal cognition—those without impairment or dementia—but even those with MCI showed improvements compared to the control group. The study was considered successful, and a larger follow-up trial is currently in progress.
Dr. Dodge emphasizes that the human aspect of video chat plays a crucial role in the positive outcomes they've observed. During the sessions, interviewers were trained to focus on maintaining eye contact and fostering dynamic conversation—two vital elements of in-person interaction that socially isolated individuals often lack. Moreover, video chat is easily accessible for those who can benefit most from it: adults who are physically and socially isolated. When I asked Dr. Dodge if regularly FaceTiming or video chatting with elderly relatives who are isolated was beneficial, she affirmed, explaining that consistent face-to-face interactions can enhance cognitive compensation mechanisms—essentially, the brain’s ability to adapt to cognitive challenges.
While a cure or preventive measure for dementia remains distant, the NIH considers clinical trials the ‘gold standard’ for medical proof. However, as Dr. Dodge pointed out, deriving statistically meaningful results from these trials is exceptionally challenging. The primary reason is the high variability inherent in dementia research, particularly when human subjects are involved.
As Dr. Dodge described, even with the same individual, test results can fluctuate significantly: 'If you ask [subjects] to do tests in the morning and again in the afternoon, the variation is substantial. When they feel good, or after a good night's sleep, they perform much better. On the other hand, poor sleep or a minor illness can drastically alter the results.'
Dr. Dodge also pointed out that cognitive compensation adds another layer of complexity. Even people with similar levels of cognitive impairment may perform differently on tests, depending on how well they have learned to manage their condition.
Though research into social isolation shows promise, it is still in its early stages. Until studies include a more diverse range of participants across ages, ethnicities, nationalities, genders, and socioeconomic backgrounds, we cannot definitively determine how much impact it can have.
The existing research on dementia intervention strongly supports the idea that maintaining both social and physical activity is our best strategy for long, healthy lives. Yet, as Dr. Dodge pointed out, it's important to remember that you can do everything 'right' and still develop dementia. We need to stop blaming individuals for not preventing a disease that, in many cases, cannot be prevented. 'If somebody gets dementia, others may say, 'Oh, she didn’t do social interaction, or she didn’t do cognitive stimulation' ... unfortunately, some people will get the disease, and it’s not their fault.'
