Helping aging brains slow down normal deterioration of mental ability

Evelyn and Coleman Bernstein are an active couple in their mid 70s. They volunteer, go to the theatre, play computer games, take later life learning courses offered through colleges, and keep busy with family and friends. If there is a secret to aging well, they know it.

Even though they’ll admit to slowing down a bit and having the occasional memory slip – such as misplacing the cordless phone – they embrace their active lifestyle and rely on monthly calendars to organize their schedules and remember all the to-do’s. They also keep to simple routines like putting the car keys in the same place in their home so they won’t lose them.

Now scientists with the Baycrest Research Centre for Aging and the Brain have developed an approach to cognitive rehabilitation that could one day help older adults like Evelyn and Coleman slow down the changes in cognitive function that naturally occur with normal aging.

Most people experience a certain amount of memory loss and cognitive decline as they get older. The changes are so gradual that they might not be noticed until a person reaches their 50s and 60s. The daily tasks that require attention, the ability to remember to do things, organize, problem-solve and plan ahead can become a little harder to do. These are known as strategic abilities, or executive functions, associated with the frontal lobes. Executive functions are often the first to deteriorate with age.

Baycrest is excited by the results of a clinical-experimental study conducted on 49 healthy older adults with normal cognitive decline. The participants underwent a 12-week cognitive rehabilitation program and showed significant improvement in memory, practical task planning and psychosocial function.

“Participants experienced a 15 to 40 per cent improvement in their cognitive functions after taking the program,” reported study co-coordinator Dr. Gordon Winocur.

“When we tested them six months later, they showed an even higher increase in improvement, which suggests the more they practiced using the strategies, the better they got at it.”

While other studies have tested cognitive rehab strategies on larger groups of older adults, they’ve tended to focus more narrowly on improving a few cognitive functions. The benefits documented in lab have had limited practical application in the real-life home setting and there hasn’t been long term follow-up to see if the training sticks.

The Baycrest study is the first to develop a comprehensive approach to rehabilitating a wide range of cognitive functions that older adults typically use every day. “Our primary emphasis was on improving the use of general strategic abilities because they are particularly vulnerable to the aging process,” said study co-coordinator Dr. Donald Stuss.

The participants, who ranged in age from 71 to 87, underwent training in three modules – memory, goal management and psychosocial function. In the memory skills training, participants were shown how to use internal and external strategies for learning, retaining and recovering information. Goal management training emphasized the enhancement of attentional control to reduce everyday memory slips, monitor goal attainment and simplify cognitively demanding real-life tasks. Psychosocial training was designed to enhance psychological wellbeing and build participants’ confidence in their cognitive abilities.

While the results are very promising, the authors caution that their cognitive rehab program is still a “prototype”. It will be at least four to five years before such a program would be available to older adults through community clinics.

The study produced five papers which are published in a specially-created section of the January 2007 issue of the Journal of the International Neuropsychological Society.