Memory pill market loaded with snake oil

With people worldwide living longer, marketers are seizing on every opportunity to sell remedies and devices that they claim can enhance memory and other cognitive functions, and perhaps stave off dementia.

Among them are "all-natural" herbal supplements like Luminene, with ingredients that include the antioxidant alpha lipoic acid, the purported brain stimulant Ginkgo biloba, and huperzine A, said to increase levels of the neurotransmitter acetylcholine; brain-training games on computers and smartphones; and all manner of puzzles, including crosswords, sudoku and jigsaw, that give the brain a workout, albeit a sedentary one.

Unfortunately, few such potions and gizmos have been proved to have a long-term benefit beyond lining the pockets of their sellers.

In April, a wide-ranging report on cognitive aging by the Institute of Medicine -- the health arm of the National Academy of Sciences -- recommended that aging people be wary of supplements and vitamins that claim to decrease risk of dementia (the report is available at http://bit.ly/1LQkaoK.) The report found "no evidence" that any of them improve cognitive functioning despite many claims to the contrary, said Dan Blazer, an emeritus professor of psychiatry at Duke University Medical Center and chairman of the panel.

Even the widely acclaimed value of doing crossword puzzles has been called into question, beyond its unmistakable benefit to one's font of miscellaneous knowledge. Although there is some evidence that doing crosswords can help to delay memory decline, Molly Wagster, a neuroscientist at the National Institute on Aging, said they are best done for personal pleasure, not brain health.

"People who have done puzzles all their lives have no particular cognitive advantage over anyone else," she said.

The institute on aging is one of several scientific organizations sponsoring rigorous trials of ways to cash in on the brain's lifelong ability to generate new cells and connections. One such trial, Advanced Cognitive Training for Independent and Vital Elderly, or ACTIVE, was a 10-year follow-up study of 2,832 cognitively healthy community-dwelling adults 65 and older.

Participants were divided into four groups and randomly assigned to one of three 10-session training programs -- for memory, reasoning and speed of processing -- or to a no-treatment control group, with an additional four booster training sessions 11 and 35 months later.

A decade later, at an average age of 82, 60 percent of those in the training programs, compared with 50 percent of the controls, had maintained or improved their ability to perform activities of daily living. All also had improved their respective trained functions. Those in the reasoning and speed-of-processing groups retained those benefits 10 years later, but the effects of memory training were ultimately lost.

While these results are hardly dramatic, given the aging population, even small benefits from training programs can greatly increase the number of older people who remain able to live on their own and enjoy life. Wagster suggested that such programs could be conducted at senior centers, YMCAs, churches, temples and other venues that house community events.

EMBRACING TECHNOLOGY

There is also research-based evidence that certain computer games can improve cognitive skills in older people. Dr. Adam Gazzaley, a neuroscientist at the University of California, San Francisco, and his colleagues demonstrated that a computer game called NeuroRacer enhanced the ability to multitask, a function that typically declines with age. NeuroRacer requires players to steer a car on a winding, hilly road with the left thumb while watching for signs that randomly pop up and have to be shot down with a right-hand finger.

Participants ages 60 to 85 who trained on the game for four weeks improved their ability to focus well enough to outscore untrained 20-year-olds, and they maintained the benefit for at least six months. Effects of the training transferred to other cognitive skills known to decline with age: sustained attention, divided attention and working memory, the researchers reported in the journal Nature.

In addition, physical evidence of the benefit was demonstrated with electroencephalograph measurements of brain activity that indicate cognitive control.

Nonetheless, Gazzaley cautioned against assuming that video games are "a guaranteed panacea" for cognitive decline.

In a systematic review of studies involving cognitive training of older adults using computerized programs, including many who had no experience with video games or computers, researchers at Johns Hopkins University Bloomberg School of Public Health reported that cognitively healthy people 55 and older did not have to be "technologically savvy in order to successfully complete or benefit from training."

COMPUTER FRIENDLY

Although it is commonly thought that older adults do not enjoy learning to use new technology, the researchers noted that the older adults who completed the computerized training programs "were positive" about the experience.

Lenny Bernstein of The Washington Post contributed some information to this report.

ActiveStyle on 07/13/2015

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