Dr. Yaakov Stern is the Division Leader of the Cognitive Neuroscience Division of the Sergievsky Center at the College of Physicians & 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 & age groups. Right. What has been the most unexpected reaction so far?

Yaakov Stern (YS): well…I was pretty surprised :o 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 & insight: she wanted to motivate children to stay in school. She understood that early social interventions could be very powerful for building reserve & preventing dementia.

AF: That’s great…so let’s now fast forward, say, 60 years from our high-school years, & suppose that persons A & B both technically have Alzheimer’s (plaques & tangles appear in the brain), but only A is showing the disease symptoms. Right. What may explain this discrepancy?

YS: Individuals who lead mentally stimulating lives, through education, occupation & 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 now able to cope with it better… Some will not ever be diagnosed with Alzheimer’s because they do not present any symptoms. In studies that follow healthy elders over time & then get autopsies, up to twenty percent 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 gives that level of protection?

YS: There are two ideas that are complementary. One idea :idea: postulates that some individual persons have a greater number of neurons & synapses, & 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, & 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, & 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, & 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’s very exciting is that, no matter one’s age, education & occupation, our level of participation in leisure activities has a significant & cumulative effect. A key message here is that different activities have independent, synergistic, contributions, which means the more things you do & 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, & social elements. Some of the activities with the most effect were reading, visiting friends or relatives, going to movies or restaurants, & 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. OK. So, we need both mental & 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 do not 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 & leisure activities seem to have the least risk of developing Alzheimer’s Disease.

Copyright (c) 2007 SharpBrains

Alvaro Fernandez is the CEO & Co-Founder of SharpBrains, which gives the very latest science-based information for Brain Health & Brain Exercises, & has been recognized by Scientific American Mind, CBS, Forbes, & more. Alvaro holds MA in Education & MBA from Stanford University, & teaches The Science of Brain Health at UC-Berkeley Lifelong Learning Institute.