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Brain Health: Physical or Mental Exercise?

Our fel­low blog­ger Jeremy over at Psy­Blog has writ­ten a thought­ful post com­par­ing the value of a num­ber of cog­ni­tive enhanc­ing tools. His over­all verdict?

The evi­dence for exer­cise boost­ing cog­ni­tive func­tion is head-and-shoulders above that for brain train­ing, drugs, nutri­tional sup­ple­ments and med­i­ta­tion. Sci­en­tif­i­cally, on the cur­rent evi­dence, exer­cise is the best way to enhance your cog­ni­tive func­tion. And as for its side-effects: yes there is the chance of an injury but exer­cise can also reduce weight, lower the chance of demen­tia, improve mood and lead to a longer life-span. Damn those side-effects!”

Arti­cle: Which Cog­ni­tive Enhancers Really Work: Brain Train­ing, Drugs, Vit­a­mins, Med­i­ta­tion or Exercise?

Jeremy, I started writ­ing this as a com­ment to your post in your blog, but then it got too long. Let me write my reac­tion to your post here.

While I appre­ci­ate your analy­sis and share most of your points, I think the “rank­ing” effort (this type of inter­ven­tion is bet­ter than that one) is ulti­mately mis­lead­ing.  It is Rubik's Cube brain exercisebased on a faulty search for a gen­eral solution/ magic pill for every­one and everything.

If only things were so sim­ple. Per­haps one day there will be research to sup­port that view, but cer­tainly not today. A num­ber of inter­ven­tions have shown their value. In dif­fer­ent pop­u­la­tions, and con­texts. For “exer­cise is the best way to enhance your cog­ni­tive func­tion” to be true, one needs to have a pretty spe­cific under­stand­ing of “best”, “your” and “cog­ni­tive function”.

First of all, the main moti­va­tor for many peo­ple inter­ested in cog­ni­tive enhance­ment inter­ven­tions is to reduce the prob­a­bil­ity of devel­op­ing Alzheimer’s symp­toms. For that, lead­ing a men­tally stim­u­lat­ing life, or true Life­long Learn­ing, through Edu­ca­tion, Occu­pa­tion and Leisure activ­i­ties has been shown (ok, per­haps strongly cor­re­lated) to be the strongest vari­able in a vari­ety of stud­ies, via the so-called Cog­ni­tive Reserve. In other words, research-based advice would prob­a­bly be, for a teenager: Don’t Drop Out of School. For a mid­dle age per­son: Make Sure you Have a Stim­u­lat­ing Job. For a retired per­son: Find and Try to Mas­ter  New Hobby Every Few Years.

Sec­ond, the case for phys­i­cal exer­cise is mostly based on mov­ing peo­ple from being Seden­tary to Doing a Bit (2–3 times/ a week, 20 min­utes “sweat­ing”). Now, there are mil­lions of peo­ple already doing that. Is there noth­ing else they can do to improve their cog­ni­tive fitness?

You may also have seen this Inter­view with Prof. Daniel Gopher on cog­ni­tive sim­u­la­tions for high-performing indi­vid­u­als. Do mil­i­tary pilots and bas­ket­ball ath­letes really need to hear “Please do aer­o­bic activ­i­ties at least twice a week…”.

What about traders, bankers or con­sul­tants who already fre­quent the gym often, but need help with stress management/ emo­tional self-regulation in order to remain “cool” when they need to? Would you tell them “Please stop trading/ that Board meet­ing when things get dif­fi­cult, leave your desk/ room for 30–40 min­utes to take a quick run, and every­thing will be fine when you come back”. Or would they bet­ter learn the cog­ni­tive skills needed to man­age stress real-time via biofeed­back or med­i­ta­tion, for example.

Third, as you point out, there are stud­ies on spe­cific groups of peo­ple (add/ adhd, dyslexia, stroke/ TBI) where well-directed cog­ni­tive exer­cise has shown an effect in well-designed tri­als, whereas phys­i­cal exer­cise, to my knowl­edge, hasn’t to the same degree. We are talk­ing about over 25 mil­lion indi­vid­u­als in the US in those 3 cat­e­gories alone. What do you tell them?

Fourth, the ACTIVE trial. Yes, that study is not per­fect. But the results of the 3 dif­fer­ent types of cog­ni­tive exer­cise (one com­put­er­ized, two not) are pretty spec­tac­u­lar, in my view. Can you show me one sim­i­larly con­trolled clin­i­cal trial where 10 hours of phys­i­cal exer­cise today pro­duces cog­ni­tive gains not only now but also 5 years from now?

Fifth, while phys­i­cal exer­cise has shown clear value in improv­ing some cog­ni­tive abil­i­ties, such as some exec­u­tive func­tions, it hasn’t show com­pa­ra­ble value in oth­ers, such as infor­ma­tion pro­cess­ing or mem­ory. Which is one cru­cial rea­son why, in my view, look­ing for cure-alls will prob­a­bly prove elusive.

In sum­mary, you have writ­ten a very wor­thy arti­cle, with good analy­sis but draw­ing, in my opin­ion, the wrong con­clu­sion and impli­ca­tions. I have to dis­agree with the approach, arti­fi­cial in my view, to “rank” dif­fer­ent inter­ven­tions as if they were mutu­ally exclu­sive. And as if every­one had the same needs and goals.

There is no research today to back or imply a claim ask­ing peo­ple to just do X (phys­i­cal exer­cise) and for­get for the time being Y (men­tal exer­cise). Or the other way. Both play their role.

In our work we try to inte­grate all these con­cepts by say­ing that the 4 main “pil­lars” for cog­ni­tive health are: good nutri­tion, phys­i­cal exer­cise, stress man­age­ment and men­tal exer­cise. In the absence of per­fect research, we encour­age con­sumers and the pro­fes­sion­als help­ing them to iden­tify, by them­selves, the area to work on next. Based on avail­able research and tools, their spe­cific con­text, needs and goals.

This con­ver­sa­tion exem­pli­fies why we believe that bet­ter and more widely avail­able cog­ni­tive assess­ments are needed, and fast, to help set up valid base­lines and help users of those “cog­ni­tive enhancers” mea­sure their own progress in inde­pen­dent, reli­able ways.

Thank you for open­ing a good conversation…and help­ing me exer­cise my brain by com­pos­ing this answer.

For more information:

- It is Not Only Cars That Deserve Good Main­te­nance: Brain Care 101

- Neu­ro­science Inter­view Series: over 15 con­ver­sa­tions with lead­ing neu­ro­sci­en­tists and psy­chol­o­gists on cog­ni­tive fit­ness and the brain

Update: the con­ver­sa­tion con­tin­ues at Look­ing for the Best Brain Fit­ness Method? Think Balance.

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