Sharp Brains: Brain Fitness and Cognitive Health News

Neuroplasticity, Brain Fitness and Cognitive Health News


Dr. Art Kramer on Why We Need Walking Book Clubs to Enhance Cognitive Fitness and Brain Health

Art KramerDr. Arthur Kramer is a Pro­fes­sor in the Uni­ver­si­ty of Illi­nois Depart­ment of Psy­chol­o­gy, the Cam­pus Neu­ro­science Pro­gram, the Beck­man Insti­tute, and the Direc­tor of the Bio­med­ical Imag­ing Cen­ter at the Uni­ver­si­ty of Illi­nois.

I am hon­ored to inter­view him today.

Dr. Kramer, thank you for your time. Let’ start by try­ing to clar­i­fy some exist­ing mis­con­cep­tions and con­tro­ver­sies. Based on what we know today, and your recent Nature piece (ref­er­enced below), what are the 2–3 key lifestyle habits would you sug­gest to a per­son who wants to delay Alzheimer’s symp­toms and improve over­all brain health?

First, Be Active. Do phys­i­cal exer­cise. Aer­o­bic exer­cise, 30 to 60 min­utes per day 3 days per week, has been shown to have an impact in a vari­ety of exper­i­ments. And you don’t need to do some­thing stren­u­ous: even walk­ing has shown that effect. There are many open ques­tions in terms of spe­cif­ic types of exer­cise, dura­tion, mag­ni­tude of effect but, as we wrote in our recent Nature Reviews Neu­ro­science arti­cle, there is lit­tle doubt that lead­ing a seden­tary life is bad for our cog­ni­tive health. Car­dio­vas­cu­lar exer­cise seems to have a pos­i­tive effect.

Sec­ond, Main­tain Life­long Intel­lec­tu­al Engage­ment. There is abun­dant prospec­tive obser­va­tion­al research show­ing that doing more men­tal­ly stim­u­lat­ing activ­i­ties reduces the risk of devel­op­ing Alzheimer’s symp­toms.

Let me add, giv­en all media hype, that no “brain game” in par­tic­u­lar has been shown to have a long-term impact on Alzheimer’s or the main­te­nance of cog­ni­tion across extend­ed peri­ods of time. It is too ear­ly for that-and con­sumers should be aware of that fact. It is true that some com­pa­nies are being more sci­ence-based than oth­ers but, in my view, the con­sumer-ori­ent­ed field is grow­ing faster than the research is.

Ide­al­ly, com­bine both phys­i­cal and men­tal stim­u­la­tion along with social inter­ac­tions. Why not take a good walk with friends to dis­cuss a book? We lead very busy lives, so the more inte­grat­ed and inter­est­ing activ­i­ties are, the more like­ly we will do them.

Great con­cept: a walk­ing book club! Now, part of the con­fu­sion we observe is due to the search of “mag­ic solu­tions” that work for every­one and every­thing. We pre­fer to talk about sev­er­al pil­lars of brain health, and dif­fer­ent pri­or­i­ties for dif­fer­ent indi­vid­u­als. Can you elab­o­rate on what inter­ven­tions seem to have a pos­i­tive effect on spe­cif­ic cog­ni­tive abil­i­ties and indi­vid­u­als?

Per­haps one day we will be able to rec­om­mend spe­cif­ic inter­ven­tions for indi­vid­u­als based on genet­ic test­ing, for exam­ple, but we don’t have a clue today. We are only begin­ning to under­stand how the envi­ron­ment inter­acts with our genome.

But I agree on the premise that there prob­a­bly won’t be a gen­er­al solu­tion that solves all cog­ni­tive prob­lems, but we need a mul­ti­tude of approach­es. And we can’t for­get, for exam­ple, the cog­ni­tive ben­e­fits from smok­ing ces­sa­tion, sleep, phar­ma­co­log­i­cal inter­ven­tions, nutri­tion, social engage­ment.

Phys­i­cal exer­cise tends to have rather broad effects on dif­fer­ent forms of per­cep­tion and cog­ni­tion, as seen in the Col­combe and Kramer, 2003, meta-analy­sis pub­lished in Psy­cho­log­i­cal Sci­ence (Note:  ref­er­enced below).

Cog­ni­tive train­ing also works for a mul­ti­tude of per­cep­tu­al and cog­ni­tive domains  but has shown lit­tle trans­fer beyond trained tasks.

No sin­gle type of inter­ven­tion is suf­fi­cient. Today there is no clear research on how those dif­fer­ent lifestyle fac­tors may inter­act. The Nation­al Insti­tute on Aging is start­ing to spon­sor research to address pre­cise­ly that.

Ear­li­er you said that no brain soft­ware in par­tic­u­lar has been shown to main­tain cog­ni­tion across extend­ed peri­ods of time. Now, didn’t the ACTIVE tri­al (Note: ref­er­enced below) 5-year results show how cog­ni­tive train­ing (com­put­er­ized or not) can result in pret­ty durable results? For con­text, are there com­pa­ra­ble con­trolled stud­ies to ACTIVE where 10 or so hours of phys­i­cal exer­cise today can result in mea­sur­able (yet, incom­plete) cog­ni­tive ben­e­fits 5 years from now?

The ACTIVE study showed a good deal of 5-year reten­tion of the tasks that were trained for 10 hours each, but lim­it­ed trans­fer of train­ing was found for oth­er untrained tasks. It seems unlike­ly that sig­nif­i­cant trans­fer may ocur­ring with the rel­a­tive­ly lit­tle train­ing (e.g. 10 hours in the ACTIVE study) and focused tasks that have been pro­vid­ed in train­ing stud­ies thus far.

On whether there are con­trolled stud­ies sim­i­lar to ACTIVE that have mea­sured the long-term cog­ni­tive ben­e­fits of phys­i­cal exer­cise, not that I know of.

To wrap up this part of the con­ver­sa­tion, what’s in your mind the best way to explain the rel­a­tive ben­e­fits of phys­i­cal vs. cog­ni­tive exer­cise? From a fun­da­men­tal point of view, it seems clear that phys­i­cal exer­cise can help enhance neu­ro­ge­n­e­sis (Note: the cre­ation of new neu­rons), yet learning/ cog­ni­tive exer­cise con­tributes to the sur­vival of those neu­rons by strength­en­ing synaps­es, so I see more how those two “pil­lars” are com­pli­men­ta­ry than “one or the oth­er”.

I agree. Giv­en what we know today I would rec­om­mend both intel­lec­tu­al engage­ment and phys­i­cal exer­cise. How­ev­er, we do know, from a mul­ti­tude of ani­mal stud­ies, that phys­i­cal exer­cise has a mul­ti­tude of effects on brains beyond neu­ro­ge­n­e­sis, includ­ing increas­es in var­i­ous neu­ro­trans­mit­ters, nerve grown fac­tors, and angio­gen­e­sis (the for­ma­tion of new blood ves­sels).

Tell us more about your work with cog­ni­tive train­ing for old­er adults.

We have now a study in press where we eval­u­ate the effect of a com­mer­cial­ly avail­able strat­e­gy video game on old­er adults cog­ni­tion.

Let me first give some con­text. It seems clear that, as we age, our so-called crys­tal­lized abil­i­ties remain pret­ty sta­ble, where­as the so-called flu­id abil­i­ties decline. One par­tic­u­lar set of flu­id abil­i­ties are called exec­u­tive func­tions, which deal with exec­u­tive con­trol, plan­ning, deal­ing with ambi­gu­i­ty, pri­or­i­tiz­ing, mul­ti-task­ing. These skills are cru­cial to main­tain inde­pen­dent liv­ing.

In this study, we exam­ined whether play­ing strat­e­gy-based video game can train those exec­u­tive func­tions and improve them. We showed that play­ing a strat­e­gy-based video game (Rise of Nations Gold Edi­tion) can result in not only becom­ing a bet­ter video game play­er but it trans­ferred to untrained exec­u­tive func­tions. We saw a sig­nif­i­cant improve­ment in task switch­ing, work­ing mem­o­ry, visu­al short-term mem­o­ry, and men­tal rota­tion. And some, but more lim­it­ed, ben­e­fits in inhi­bi­tion and rea­son­ing.

I can share a few details on the study: the aver­age age was 69 years, and the exper­i­ment required around 23 hours of train­ing time. We only includ­ed indi­vid­u­als who had played video games 0 hours/ week for the last 2 years.

That last cri­te­ria is inter­est­ing. We typ­i­cal­ly say that good “brain exer­cise” requires nov­el­ty, vari­ety and chal­lenge. So, if you take adults who are 69-years-old and haven’t played a videogame in 2 years, how do you know if the ben­e­fit comes from the par­tic­u­lar videogame they played vs. just the val­ue of deal­ing with a new and com­plex task?

That’s a great ques­tion. The real­i­ty is that we don’t know, since we had a “wait­ing list con­trol group. In the future per­haps we should com­pare dif­fer­ent videogames or oth­er men­tal­ly stim­u­lat­ing activ­i­ties against each oth­er and see what method is the most effi­cient. Per­haps the Nation­al Insti­tutes on Health may be inter­est­ed in fund­ing such research.

In any case, your study rein­forces an impor­tant point: old­er brains can, and do, learn new skills.

Yes. The rate of learn­ing by old­er adults may be slow­er, and they may ben­e­fit from more explic­it instruc­tion and tech­nol­o­gy train­ing, but, as a soci­ety, it is a mas­sive waste of tal­ent not to ensure old­er adults remain active and pro­duc­tive.

Anoth­er recent study we con­duct­ed, this one still under review, is titled Expe­ri­ence-Based Mit­i­ga­tion of Age-Relat­ed Per­for­mance Declines: Evi­dence from Air Traf­fic Con­trol. It deals with the ques­tion: “Can Age Itself Be an Obsta­cle for some­one to per­form as an Air Con­troller? And the Answer is: age itself, with­in the age range that we stud­ied, is not an obsta­cle. Our results sug­gest that, giv­en sub­stan­tial accu­mu­lat­ed expe­ri­ence, old­er adults can be quite capa­ble of per­form­ing at high lev­els of pro­fi­cien­cy on fast-paced demand­ing real-world tasks.

Now, the field of com­put­er­ized cog­ni­tive train­ing has poten­tial in a vari­ety of appli­ca­tions beyond “healthy aging”. You are obvi­ous­ly famil­iar with Daniel Gopher’s work train­ing mil­i­tary pilots using Space Fortress. Is your lab doing some­thing in that cog­ni­tive enhance­ment direc­tion?

Yes, I have been involved in that area of work since the late 70s, when I helped design the pro­to­cols for Space Fortress. Which pro­vides indeed a very inter­est­ing exam­ple of real-life trans­fer: pilots do seem to fly bet­ter as mea­sured by real-life instru­ments.

Our lab is now embark­ing on a 5-year study for the Navy to explore ways to cap­i­tal­ize emerg­ing research on brain plas­tic­i­ty to enhance train­ing and per­for­mance. MIT and my lab will ana­lyze the best train­ing pro­ce­dures to increase the effi­cien­cy and effi­ca­cy of train­ing of indi­vid­ual and team per­for­mance skills, par­tic­u­lar­ly those skills requir­ing high lev­els of flex­i­bil­i­ty. The results from this study will be in the pub­lic domain, so I hope they con­tribute to the matu­ri­ty of the field at large.

That’s an impor­tant point. What does the field of cog­ni­tive fit­ness at large need to mature and become more main­stream?

We need more research. But not any kind of research. What we need is a kind of inde­pen­dent “Seal of Approval” based on inde­pen­dent clin­i­cal tri­als. Most pub­lished research of cog­ni­tive train­ing inter­ven­tions is spon­sored and/ or con­duct­ed by the com­pa­nies them­selves. We need inde­pen­dent, objec­tive and clear stan­dards of excel­lence.

The Depart­ment of Edu­ca­tion main­tains a What Works Clear­ing­house to review exist­ing evi­dence behind pro­grams that make edu­ca­tion-relat­ed claims. Per­haps we need a sim­i­lar approach for pro­grams mak­ing cog­ni­tive claims with adults. We also see a need for more sol­id and wide­ly-avail­able cog­ni­tive assess­ments, to have bet­ter base­lines and inde­pen­dent mea­sures of cog­ni­tive abil­i­ties.

Good news there: the NIH is prepar­ing an “NIH Tool­box” to pro­vide valid, reli­able instru­ments to researchers and clin­i­cians, to solve the prob­lem that exists today, name­ly, the lack of uni­for­mi­ty among many mea­sures used. The ini­tia­tive was launched in 2006, and it is a 5-year effort, so we’ll need to wait to see results.

Dr. Kramer, many thanks for your time and work. My apolo­gies for hav­ing you stay by your desk dur­ing this inter­view. Next time I am in Illi­nois, I will invite you to a walk­ing inter­view.

Excel­lent idea! The plea­sure has been mine. Let me thank you as well, for the very impor­tant work you are doing.


To Learn More:

Solv­ing the Brain Fit­ness Puz­zle Is the Key to Self-Empow­ered Aging



  • Willis SL, Tennst­edt SL, Mar­siske M, et al. Long-term effects of cog­ni­tive train­ing on every­day func­tion­al out­comes in old­er adults. JAMA. 2006;296:2805–14.
  • Stan­ley Col­combe, Arthur F. Kramer (2003). Fit­ness effects on the cog­ni­tive func­tion of old­er adults: A Meta-Ana­lyt­ic study. Psy­cho­log­i­cal Sci­ence 14 (2) , 125 130.
  • Charles H. Hill­man, Kirk I. Erick­son & Arthur F. Kramer Be smart, exer­cise your heart: exer­cise effects on brain and cog­ni­tion. Nature Reviews Neu­ro­science 9, 58–65.

Leave a Reply...

Loading Facebook Comments ...

7 Responses

  1. Ward says:

    Great post !

    very infor­ma­tive and down to earth. I real­ly liked the idea of a walk­ing book club.

  2. Mark Waldman says:

    A won­der­ful inter­view with Dr. Kramer. There is so much hype sur­round­ing “brain enhance­ment” pro­grams, and its great to hear a wise and cau­tion­ary sum­ma­ry con­cern­ing the long-term ben­e­fits across the spec­trum of cog­ni­tive abil­i­ties. For exam­ple, Dr. Andrew New­berg at the Uni­ver­si­ty of Penn­syl­va­nia just fin­ished a study on the effects of a 12 minute med­i­ta­tion exer­cise with cog­ni­tive­ly impaired adults. He found 10–20% improve­ment after eight weeks of train­ing (you guys should inter­view him ). In his next book, How God Changes Your Brain, he too states that exer­cise is the best brain sharp­en­er in the world-even 10 min­utes a day will make huge improve­ments-and like Kramer, he sug­gests that you com­bine exer­cise with intense social stim­u­la­tion. And the more com­pli­cat­ed you make the exer­cise (sequen­tial­ly touch your fin­ger­tips as you spell out per­son­al­ly mean­ing­ful words (like peace, com­pas­sion, hap­pi­ness, etc.), the greater the cog­ni­tive ben­e­fits. Also, cre­at­ing your own per­son­al­ized brain/body exer­cise pro­gram increas­es the ben­e­fi­cial results. Stud­ies also show that a strong sense of opti­mism is need­ed to make any of these brain enhance­ment strate­gies work.
    Mark Wald­man
    Asso­ciate Fel­low
    Cen­ter for Spir­i­tu­al­i­ty and the Mind
    Uni­ver­si­ty of Penn­syl­va­nia

  3. Kenneth Heinrich says:

    Hel­lo again, Alvaro.

    Is there a link to the full arti­cle pub­lished in Nature, for those of us who do not sub­scribe to that jour­nal?


  4. Alvaro says:

    Ward: glad you enjoyed it!

    Mark, thank you for those com­ments, and the lead to Dr. Newberg’s study. We will track it down. And per­haps he already has some good pub­lished study we can dis­cuss in detail.

    Ken­neth: usu­al­ly sci­en­tists offer some of their puubli­ca­tions in their Lab web­sites. For Dr. Kramer’s, you can request reprints at

  5. Kenneth Heinrich says:

    Many thanks, Alvaro,
    I just received the arti­cle

Leave a Reply

Categories: Cognitive Neuroscience, Health & Wellness, Neuroscience Interview Series, Peak Performance, Professional Development, Technology

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

All Slidedecks & Recordings Available — click image below

Search for anything brain-related in our article archives

About SharpBrains

As seen in The New York Times, The Wall Street Journal, BBC News, CNN, Reuters, and more, SharpBrains is an independent market research firm and think tank tracking health and performance applications of brain science.