By Sharon Naismith
Sudoku, crosswords and computer memory games are being prescribed as part of a preventative training regime for 150 people showing memory loss or the first signs of Alzheimer’s disease. Together with education about diet, exercise and a healthier lifestyle, the games could help keep the disease at bay and allow affected people to stay in their homes longer.
The games are a key component of a seven-week Healthy Brain Ageing Cognitive Training Program which is being offered by the Brain and Mind Research Institute of the University.
“We want to identify people in the early stages of Alzheimer’s disease and to implement any interventions we can to keep them functioning cognitively, which might delay the onset or slow the progression of the disease,” explains Associate Professor Sharon Naismith, Director of the Clinical Research Unit at the institute and founder of the program.
“There is a fine line between people who develop memory problems as they get older and Alzheimer’s.”
Naismith, a clinical neuropsychologist, admits the trial program will not prevent or cure Alzheimer’s disease, but it could promote new brain growth, or neurogenesis. In turn, the trial has the potential to help a generation of people continue to live and function at a much higher level than they otherwise would have, providing a lifestyle and economic dividend to the wider Australian society.
Patients showing signs of “mild cognitive impairment” or early Alzheimer’s are referred to the program by their neurologist, psychiatrists or geriatrician. “It is a shock to them. We know that not everyone will progress to Alzheimer’s, so it’s a very delicate area. There is a fine line between people who develop memory problems as they get older and Alzheimer’s.”
Each patient is given an MRI scan and reviewed by a doctor and a psychiatrist. The patient’s memory and thinking functions are tested before a program is worked out for the individual. It begins with education about the risk factors including poor diet and lack of exercise.
“We target what we call modifiable risks factors. Some of them are vascular, like changes in the blood vessels of your brain, high blood pressure, high cholesterol, heart disease, obesity or smoking. If you have those risk factors you are more likely to get Alzheimer’s,” Naismith says.
Exercising heart and mind
She says all the things that the Heart Foundation promotes, like exercise, are also important for brain health and preventing dementia. “Just as we look after our hearts, we have to look after our minds.” Physical exercise is really important, as it promotes protective chemicals, known as neurotrophins, in the brain.
Another risk for dementia is having depression for the first time later in life. “Depression releases glucocorticoids, stress chemicals that are toxic to the main memory structure of the brain, the hippocampus.”
The cognitive training program tests whether getting people to use their brains more can protect them against the effects of Alzheimer’s. “The more we use our minds and the more educated we are, the more resilience our brains may have against Alzheimer’s”, she adds.
The participants attend two-hour long classes twice a week. Half their time is spent playing games that have been prescribed to challenge their brains and address particular strengths and weaknesses. So someone with language problems might do crosswords or play Scrabble, while a person with memory problems might memorise a shopping list. “Our previous trial showed it does improve memory.”
The program should improve neuroplasticity, the ability of the brain to adapt to changing circumstances, and it could even help restore brain function. For example, other parts of the brain might take over the functions of damaged areas. Naismith says: “We need to stop the disease while people are still functional, not when they are already in a nursing home. We need to keep them at home with their families so that they can maintain a quality of life.”