Dementia Prevention: Brain Exercise

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Medical Author: William C. Shiel, Jr., FACP, FACR
Medical Editor: Leslie J. Schoenfield, M.D., Ph.D.

Dementia is significant loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning. Dementia is reported in as many as 1% of adults 60 years of age. Moreover, it has been estimated that the frequency of dementia doubles every five years after 60 years of age. So, dementia is clearly related to aging.

Alzheimer's disease is the most common form of dementia. Among other causes are medical conditions (thyroid disease, drug toxicity, thiamine deficiency with alcoholism, and others), brain injury, strokes, multiple sclerosis, infection of the brain (such as meningitis and syphilis), HIV infection, hydrocephalus, Pick's disease, and brain tumors.

Dr. Joe Verghese and others at the Albert Einstein College of Medicine in collaboration with Syracuse University studied 469 subjects older than 75 years of age who lived in the community setting. They recorded the frequency of participation in leisure activities for the subjects. They documented their thinking and physical abilities and recorded them in activity-days per week.

The results of the study were recently published in the New England Journal of Medicine (N Engl J Med 2003;348:2508-16). The researchers found that over an average period of 5.4 years, dementia developed in 124 subjects (Alzheimer's disease in 61 subjects, vascular dementia in 30, mixed dementia in 25, and other types of dementia in 8). They also found that among leisure activities, reading, playing board games, playing musical instruments, and dancing were associated with a reduced risk of dementia!

The authors of the study concluded that participation in leisure activities is associated with a reduced risk of dementia. They suggested that further studies be done to determine the power of the "protective" effect of leisure activities that involve thinking on the risk of dementia.

In an accompanying editorial, Dr. Joseph T. Coyle from Harvard Medical School noted that while more studies are needed to clarify the relative roles of genes vs. environmental factors, such as effortful mental activities, "seniors should be encouraged to read, play board games, and go ballroom dancing, because these activities, at the very least, enhance their quality of life, and they just might do more than that." This editor cannot agree more. So, to the elderly, "dance on!"

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J. Verghese, R. Lipton, M. Katz, C. Hall, C. Drby, G. Kuslansky, A. Ambrose, M. Sliwinski, H. Buschle. "Leisure Activities and the Risk of Dementia in the Elderly," New England Journal of Medicine; 2003;348:2508-16