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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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6 Responses

  1. Mike Logan says:

    Darn, I was going to work out twice today.

  2. Alvaro says:

    Mike: please do 🙂

    Just make sure to intro­duce dif­fer­ent rou­tines in each work­out, and per­haps do some men­tal math at the same time 🙂

  3. Mike Logan says:

    What, no star­ing at real­i­ty TV? Men­tal Math? On a more seri­ous note, thanks for the webi­nar yes­ter­day. I have sev­er­al pages of notes to review, and will exer­cise some men­tal mus­cles whilst doing that.

  4. Thanks for the link back, Alvaro : ) It’s inter­est­ing, if a lit­tle con­cern­ing, that brain-fit­ness seems to be des­tined for some of the same mis­tak­en con­clu­sions found in the phys­i­cal-fit­ness realm (espe­cial­ly the search for the one true best sim­ple method) But maybe that’s the nat­ur­al result of using the phys­i­cal fit­ness anal­o­gy?

  5. Alvaro says:

    Hel­lo Mike: even bet­ter exer­cise-what do you remem­ber with­out con­sult­ing the notes?

    Tori: I don’t find it that con­cern­ing, it is the nature of every emerg­ing field, and the sim­plis­tic ten­den­cy to look for mag­ic pills.

    I think demand will grad­u­al­ly grow more sophis­ti­cat­ed, and we are doing our best to con­tribute to that end.

    The phys­i­cal fit­ness anal­o­gy is the best we have found so far to explain what is hap­pen­ing, but feel free to offer oth­ers!

  6. Gavin says:

    Study­ing peo­ple can lead to very broad assump­tions, just as study­ing indi­vid­u­als is nar­row.
    Regard­less of a high cog­ni­tive under­stand­ing, i believe that where peo­ple are liv­ing their lives to their val­ues and enjoy­ing it, they will be freed from over the top stress and left with that much more ener­gy and enjoy­ment of what­ev­er they do, which leads in itself to advanc­ing brain health.

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