Dr. Yaakov Stern is the Division Leader of the Cognitive
Neuroscience Division of the Sergievsky Center at the
College of Physicians and Surgeons of Columbia University,
New York. He is one of the leading proponents of the
Cognitive Reserve theory.
Alvaro Fernandez (AF): Dear Dr. Stern, it is a pleasure to
have you here. Let me first ask you this: the implications
of your research are pretty astounding, presenting major
implications across sectors and age groups. What has been
the most unexpected reaction so far?
Yaakov Stern (YS): well...I was pretty surprised when,
years ago, a reporter from Seventeen magazine requested an
interview. I was really curious to learn why she felt that
her readers would be interested in studies about dementia.
What she told me showed a deep understanding and insight:
she wanted to motivate children to stay in school. She
understood that early social interventions could be very
powerful for building reserve and preventing dementia.
AF: That's great...so let's now fast forward, say, 60 years
from our high-school years, and suppose that persons A and
B both technically have Alzheimer's (plaques and tangles
appear in the brain), but only A is showing the disease
symptoms. What may explain this discrepancy?
YS: Individuals who lead mentally stimulating lives,
through education, occupation and leisure activities, have
reduced risk of developing Alzheimer's. Studies suggest
that they have 35-40% less risk of manifesting the disease.
The pathology will still occur, but they are able to cope
with it better. Some won't ever be diagnosed with
Alzheimer's because they don't present any symptoms. In
studies that follow healthy elders over time and then get
autopsies, up to 20% of people who did not present any
significant problem in the daily lives have full blown
Alzheimer's pathology in their brains.
AF: What exactly may be going on in the brain that provides
that level of protection?
YS: There are two ideas that are complementary. One idea
postulates that some individuals have a greater number of
neurons and synapses, and that somehow those extra
structures provide a level of protection. The other theory
emphasizes the building of new capabilities, how people can
perform tasks better through practice, and how these skills
become so well learned that they are not too easy to
unlearn.
AF: OK, so our goal is to build that Reserve of neurons,
synapses, and skills. How can we do that?
YS: In summary, we could say engaging in activities. In our
research almost all activities are seen to contribute to
reserve. Some have challenging levels of cognitive
complexity, and some have interpersonal or physical
demands. In animal studies, exposure to an enriched
environment or increased physical activity result in
increased neurogenesis (the creation of new neurons). You
can get that stimulation through education and/ or your
occupation. There is clear research showing how those two
elements reduce the risk. Now, what is very exciting is
that, no matter one's age, education and occupation, our
level of participation in leisure activities has a
significant and cumulative effect. A key message here is
that different activities have independent, synergistic,
contributions, which means the more things you do and the
earlier you start, the better. But you are never stuck:
better late than never.
AF: Can you give us some examples of those leisure
activities that seem to have the most positive effects?
YS: For our 2001 study we evaluated the effect of 13
activities, combining intellectual, physical, and social
elements. Some of the activities with the most effect were
reading, visiting friends or relatives, going to movies or
restaurants, and walking for pleasure or going on an
excursion. As you can see, a variety. We saw that the group
with high level of leisure activities presented 38% less
risk (controlling for other factors) of developing
Alzheimer's symptoms. And that, for each additional type of
activity, the risk got reduced by 8%. Physical exercise, by
itself, also has a very beneficial impact. So, we need both
mental and physical exercise. The not-so-good news is that,
as of today, there no clear recipe for success. More
research is needed before we prepare a systematic set of
interventions that can help maximize our protection.
AF: What do you think of the relatively recent appearance
of so many computer-based cognitive training programs?
YS: At least from the point of view of Alzheimer's, we
don't know if learning a new language is more beneficial
than learning a new musical instrument or using a
computer-based program. It is too early to tell the
long-term effects. Right now, the most we can say is that
those who lead mentally stimulating lives, through
education, occupation and leisure activities seem to have
the least risk of developing Alzheimer's Disease.
----------------------------------------------------
Alvaro Fernandez is the CEO and Co-Founder of SharpBrains,
which provides the latest science-based information for
Brain Fitness and Brain Exercise, and has been recognized
by Scientific American Mind, CBS, Forbes, and more. Alvaro
holds MA in Education and MBA from Stanford University, and
teaches The Science of Brain Health at UC-Berkeley Lifelong
Learning Institute. Learn more at
http://www.sharpbrains.com/
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