jenifer croswell

Cognitive training identified as protective factor, with highest evidence, in recent NIH Alzheimer’s/ cognitive decline prevention report

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t-150x150(Edi­tor’s note: Sharp­Brains Sum­mit attendee Steve Zanon wrote a very insight­ful com­ment to our pre­vi­ous post regard­ing the NIH inde­pen­dent pan­el on Alzheimer’s/ cog­ni­tive decline pre­ven­tion. We repub­lish com­ment here for eas­i­er access.)

In the intro­duc­tions on day one of the NIH con­fer­ence Jenifer Croswell from OMAR out­lined three dif­fer­ent frames of ref­er­ence and deci­sion mak­ing in this con­text. She men­tioned (1) the indi­vid­ual and fam­i­ly based on per­son­al val­ues, (2) com­mu­ni­ty doc­tors affect­ing their patients, and (3) rec­om­men­da­tions for an entire pop­u­la­tion of peo­ple which should only con­tain strong evi­den­tiary based infor­ma­tion. She indi­cat­ed that this con­fer­ence would pro­duce a state­ment based on the third con­text and in that respect the pan­el has done a great job in high­light­ing the gaps that gov­ern­ment, indus­try & research need to focus on in order to most effec­tive­ly move forward.

How­ev­er some good news for indi­vid­u­als did come out of the con­fer­ence. Pages 7 & 8 of the “Sys­tem­at­ic Evi­dence Review” (link opens new win­dow where you can down­load report as PDF) pro­vides a great snap­shot of all the asso­ci­at­ed fac­tors con­sid­ered at the con­fer­ence and their cur­rent sta­tus in terms of lev­el of evi­dence. This doc­u­ment sum­maris­es the research from 25 sys­tem­at­ic reviews and 250 pri­ma­ry research stud­ies which were fil­tered from search­es that locat­ed 6907 cita­tions. The stud­ies were eval­u­at­ed for eli­gi­bil­i­ty and qual­i­ty, and data were abstract­ed on study design, demo­graph­ics, inter­ven­tion or pre­dic­tor fac­tor, and cog­ni­tive out­comes. The final report was peer reviewed. In terms of inde­pen­dence and weight of evi­dence this doc­u­ment is like­ly to pro­vide the strongest posi­tion on the sub­ject that we have today.

If we under­stand that all this evi­dence is still build­ing but clear­ly has strong direc­tion then I believe it is a good base­line (as of today) from which indi­vid­u­als may begin to make lifestyle choic­es. Of course as research pro­gress­es the base­line will change but for now I think it is a sol­id foun­da­tion from which to work. Per­son­al pref­er­ences would guide choic­es but where the direc­tion of asso­ci­a­tion is cat­e­gorised as …..

  • “no evi­dence” we should prob­a­bly con­sid­er ignoring
  • “inad­e­quate evi­dence” we should prob­a­bly con­sid­er treat­ing as suspicious
  • “increas­ing or decreas­ing risk” we should prob­a­bly con­sid­er to be strong­ly asso­ci­at­ed (but not defin­i­tive) and there­fore offer­ing promis­ing (but not cer­tain) lifestyle choices

So with any good risk man­age­ment strat­e­gy our best bet is to diver­si­fy risk across sev­er­al of the most like­ly fac­tors. The “Sys­tem­at­ic Evi­dence Review” clear­ly iden­ti­fies the most like­ly risk fac­tors. We don’t have cer­tain­ty but we do have direc­tion and I think that is an encour­ag­ing mes­sage for the public.

The good news for those inter­est­ed in brain train­ing is that in the find­ings for cog­ni­tive decline (page 8), cog­ni­tive train­ing has the high­est lev­el of evidence.

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Rec­om­mend­ed read­ing:  “Sys­tem­at­ic Evi­dence Review” of fac­tors that can decrease or increase risk of Alzheimer’s Dis­ease and cog­ni­tive decline, by NIH inde­pen­dent panel