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Are young people smarter than older adults? My research shows cognitive differences between generations are diminishing

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/stephen-badham-1531316">Stephen Badham</a>, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a> We often assume young people are smarter, or at least quicker, than older people. For example, we’ve all heard that scientists, and even more so mathematicians, <a href="https://www.forbes.com/sites/nextavenue/2014/08/07/who-says-scientists-peak-by-age-50/">carry out their most important work</a> when they’re comparatively young. But my new research, <a href="https://www.sciencedirect.com/science/article/pii/S027322972400008X#:%7E:text=Highlights&text=Three%20review%20studies%20measure%20secular,%2C%20education%2C%20and%20overall%20health.">published in Developmental Review</a>, suggests that cognitive differences between the old and young are tapering off over time. This is hugely important as stereotypes about the intelligence of people in their sixties or older may be holding them back – in the workplace and beyond. Cognitive ageing is often measured by comparing young adults, aged 18-30, to older adults, aged 65 and over. There are a variety of tasks that older adults do not perform well on compared to young adults, such as memory, spatial ability and speed of processing, which often form the basis of <a href="https://theconversation.com/the-iq-test-wars-why-screening-for-intelligence-is-still-so-controversial-81428">IQ tests</a>. That said, there are a few tasks that older people do better at than younger people, such as reading comprehension and vocabulary. Declines in cognition are driven by a process called <a href="https://www.nature.com/collections/cbjacdabdf">cognitive ageing</a>, which happens to everyone. Surprisingly, age-related cognitive deficits start very early in adulthood, and declines in cognition have been measured as dropping in adults as young as just 25. Often, it is only when people reach older age that these effects add up to a noticeable amount. Common complaints consist of walking into a room and forgetting why you entered, as well as difficulty remembering names and struggling to drive in the dark. <h2>The trouble with comparison</h2> Sometimes, comparing young adults to older adults can be misleading though. The two generations were brought up in different times, with different levels of education, healthcare and nutrition. They also lead different daily lives, with some older people having lived though a world war while the youngest generation is growing up with the internet. Most of these factors favour the younger generation, and this can explain a proportion of their advantage in cognitive tasks. Indeed, much existing research shows that <a href="https://theconversation.com/iq-tests-are-humans-getting-smarter-158837">IQ has been improving</a> globally throughout the 20th century. This means that later-born generations are more cognitively able than those born earlier. This is even found when both generations are tested in the same way at the same age. Currently, there is growing evidence that <a href="https://www.pnas.org/doi/10.1073/pnas.1718793115">increases in IQ are levelling off,</a> such that, in the most recent couple of decades, young adults are no more cognitively able than young adults born shortly beforehand. Together, these factors may underlie the current result, namely that cognitive differences between young and older adults are diminishing over time. <h2>New results</h2> My research began when my team started getting strange results in our lab. We found that often the age differences we were getting between young and older adults was smaller or absent, compared to prior research from early 2000s. This prompted me to start looking at trends in age differences across the psychological literature in this area. I uncovered a variety of data that compared young and older adults from the 1960s up to the current day. I plotted this data against year of publication, and found that age deficits have been getting smaller over the last six decades. Next, I assessed if the average increases in cognitive ability over time seen across all individuals was a result that also applied to older adults specifically. Many large databases exist where groups of individuals are recruited every few years to take part in the same tests. I analysed studies using these data sets to look at older adults. I found that, just like younger people, older adults were indeed becoming more cognitively able with each cohort. But if differences are disappearing, does that mean younger people’s improvements in cognitive ability have slowed down or that older people’s have increased? I analysed data from my own laboratory that I had gathered over a seven-year period to find out. Here, I was able to dissociate the performance of the young from the performance of the older. I found that each cohort of young adults was performing to a similar extent across this seven-year period, but that older adults were showing improvements in both processing speed and vocabulary scores. <figure class="align-center "><img src="https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=333&fit=crop&dpr=1 600w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=333&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=333&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=418&fit=crop&dpr=1 754w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=418&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=418&fit=crop&dpr=3 2262w" alt="The figure shows data for a speed-based task where higher scores represent better performance." /><figcaption>The figure shows data for a speed-based task where higher scores represent better performance. <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></figcaption></figure> I believe the older adults of today are benefiting from many of the factors previously most applicable to young adults. For example, the number of children who went to school <a href="https://education-uk.org/history/chapter12.html">increased significantly</a> in the 1960s – with the system being more similar to what it is today than what it was at the start of the 20th century. This is being reflected in that cohort’s increased scores today, now they are older adults. At the same time, young adults have hit a ceiling and are no longer improving as much with each cohort. It is not entirely clear why the young generations have stopped improving so much. Some research has <a href="https://doi.org/10.1016/j.intell.2016.10.002">explored maternal age, mental health and even evolutionary trends</a>. I favour the opinion that there is just a natural ceiling – a limit to how much factors such as education, nutrition and health can improve cognitive performance. These data have important implications for research into dementia. For example, it is possible that a modern older adult in the early stages of dementia might pass a dementia test that was designed 20 or 30 years ago for the general population at that time. Therefore, as older adults are performing better in general than previous generations, it may be necessary to revise definitions of dementia that depend on an individuals’ expected level of ability. Ultimately, we need to rethink what it means to become older. And there’s finally some good news. Ultimately, we can expect to be more cognitively able than our grandparents were when we reach their age.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229132/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/stephen-badham-1531316">Stephen Badham</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-young-people-smarter-than-older-adults-my-research-shows-cognitive-differences-between-generations-are-diminishing-229132">original article</a>. </div>

Mind

New studies suggest millions with mild cognitive impairment go undiagnosed, often until it’s too late

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> Mild cognitive impairment – an early stage of dementia – is widely underdiagnosed in people 65 and older. That is the key takeaway of two recent studies from our team. In the first study, we used Medicare data for about 40 million beneficiaries age 65 and older from 2015 to 2019 to estimate the prevalence of mild cognitive impairment in that population and to identify what proportion of them had actually been diagnosed. Our <a href="https://doi.org/10.1186/s13195-023-01272-z">finding was sobering</a>: A mere 8% of the number of cases with mild cognitive impairment that we expected based on a statistical model had actually been diagnosed. Scaled up to the general population 65 and older, this means that approximately 7.4 million cases across the country remain undiagnosed. In the second study, we analyzed data for 226,756 primary care clinicians and found that <a href="https://doi.org/10.14283/jpad.2023.131">over 99% of them underdiagnosed mild cognitive impairment</a> in this population. <h2>Why it matters</h2> Mild cognitive impairment is an early symptom of Alzheimer’s disease in <a href="https://doi.org/10.1001/jama.2019.2000">about half of cases</a> and progresses to dementia <a href="https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment">at a rate of 10% to 15% per year</a>. It includes symptoms such as losing the ability to remember recent events and appointments, make sound decisions and master complex tasks. Failure to detect it might deprive patients of an opportunity to get treated and to slow down disease progression. Mild cognitive impairment can sometimes be caused by easily addressable factors, such as medication side effects, thyroid dysfunction or <a href="https://theconversation.com/vitamin-b12-deficiency-is-a-common-health-problem-that-can-have-serious-consequences-but-doctors-often-overlook-it-192714">vitamin B12 deficiency</a>. Since mild cognitive impairment has <a href="https://doi.org/10.1016/j.amjopharm.2008.06.004">the same risk factors as cardiovascular disease</a>, such as high blood pressure and cholesterol, medication management of these risks combined with diet and exercise <a href="https://doi.org/10.1016/S0140-6736(15)60461-5">can reduce the risk of progression</a>. In 2023, the Food and Drug Administration <a href="https://www.fda.gov/news-events/press-announcements/fda-converts-novel-alzheimers-disease-treatment-traditional-approval">approved the drug lecanemab</a> as the <a href="https://theconversation.com/what-the-fdas-accelerated-approval-of-a-new-alzheimers-drug-could-mean-for-those-with-the-disease-5-questions-answered-about-lecanemab-197460">first disease-modifying treatment</a> <a href="https://www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/what-happens-brain-alzheimers-disease">for Alzheimer’s disease</a>, the most common cause of mild cognitive impairment. In contrast to previous drugs, which can temporarily improve symptoms of the disease, such as memory loss and agitation, this new treatment addresses the underlying cause of the disease. Lecanemab, a monoclonal antibody, <a href="https://www.news-medical.net/health/What-are-Amyloid-Plaques.aspx">reduces amyloid plaques</a> in the brain, which are toxic protein clumps that are believed to contribute to the progression of the disease. In a large clinical trial, lecanemab was able to <a href="https://doi.org/10.1056/NEJMoa2212948">reduce the progression</a> of early-stage Alzheimer’s disease. A similar drug, donanemab, also <a href="https://doi.org/10.1001/jama.2023.13239">succeeded in a clinical trial</a> and is expected to be <a href="https://www.medicalnewstoday.com/articles/fda-delays-approval-of-alzheimers-drug-donanemab-what-experts-think">approved sometime in 2024</a>. However, these drugs must be used in the early stages of Alzheimer’s disease, ideally when a patient has only mild cognitive impairment, as there is <a href="https://www.alz.org/alzheimers-dementia/treatments/lecanemab-leqembi">no evidence that they are effective in advanced stages</a>. <figure><iframe src="https://www.youtube.com/embed/w3IbAscNjsQ?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>An earlier diagnosis leads to early treatment and better outcomes.</figcaption></figure> <h2>What still isn’t known</h2> Many factors contribute to the <a href="https://doi.org/10.1002/alz.13051">lack of timely detection</a>. But researchers don’t have a good understanding of the relative importance of those individual factors or how to reduce the high rate of underdiagnosis. While distinct, symptoms are subtle and their slow progression means that they can be overlooked or misinterpreted as normal aging. A neurologist in China told our research team that diagnosis rates spike in China after the New Year’s holiday, when children who haven’t seen their parents for a year notice changes that are harder to pick up when interacting with someone daily. Doctors also commonly discount memory concerns as normal aging and doubt that much can be done about it. While cognitive tests to distinguish mild cognitive impairment from pathologic decline do exist, they take about 15 minutes, which can be hard to come by during the limited time of a doctor’s visit and may require a follow-up appointment. <h2>What’s next</h2> People, particularly those in their 60s and beyond, as well as their families and friends need to be vigilant about cognitive decline, bring it up during doctor’s appointments and insist on a formal assessment. The <a href="https://www.medicare.gov/coverage/yearly-wellness-visits">Medicare yearly “wellness” visit</a> is an opportunity to explore such concerns, but only about half of beneficiaries <a href="https://doi.org/10.1377/hlthaff.2019.01795">take advantage of it</a>. Just as physicians ask patients about unexplained weight loss and take those concerns seriously, we believe questions that explore a patient’s cognitive state need to become the norm. The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take on interesting academic work.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/216892/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/soeren-mattke-1484707">Soeren Mattke</a>, Director of the USC Dornsife Brain Health Observatory, <a href="https://theconversation.com/institutions/university-of-southern-california-1265">University of Southern California</a> and <a href="https://theconversation.com/profiles/ying-liu-1221170">Ying Liu</a>, Research Scientist, Center for Economic and Social Research, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/new-studies-suggest-millions-with-mild-cognitive-impairment-go-undiagnosed-often-until-its-too-late-216892">original article</a>. </div>

Mind

Can a daily multivitamin improve your memory?

<a href="https://theconversation.com/profiles/jacques-raubenheimer-1144463">Jacques Raubenheimer</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> <a href="https://theconversation.com/au/topics/research-check-25155">Research Checks</a> interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate. <hr /> Don’t we all want to do what we can to reduce the impact of age-related decline on our memory? A new study suggests a daily multivitamin and mineral supplement is a simple and inexpensive way to help older adults slow the decline in some aspects of memory function. The <a href="https://ajcn.nutrition.org/article/S0002-9165(23)48904-6/fulltext">new study</a>, which comes from a <a href="https://www.clinicaltrials.gov/ct2/show/NCT02422745?term=NCT02422745&draw=2&rank=1">long-running clinical trial</a>, shows there may be a small benefit of taking a daily multivitamin and mineral supplement for one type of cognitive task (immediate word recall) among well-functioning elderly white people. At least in the short term. But that doesn’t mean we should all rush out and buy multivitamins. The results of the study don’t apply to the whole population, or to all types of memory function. Nor does the study show long-term benefits. <h2>How was the study conducted?</h2> The overarching COSMOS study is a well-designed double-blind randomised control trial. This means participants were randomly allocated to receive the intervention (a daily multivitamin and mineral supplement) or a placebo (dummy tablet), but neither the participants nor the researchers knew which one they were taking. This type of study is considered the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654877/">gold standard</a> and allows researchers to compare various outcomes. Participants (3,562) were older than 64 for women, and 59 for men, with no history of heart attack, invasive cancer, stroke or serious illness. They couldn’t use multivitamins or minerals (or <a href="https://www.pnas.org/doi/10.1073/pnas.2216932120">cocoa extract</a> which they also tested) during the trial. Participants completed a <a href="https://www.clinicaltrials.gov/ct2/show/NCT04582617?term=NCT04582617&draw=2&rank=1">battery of online cognitive tests</a> at the start of the study (known as baseline), then yearly for three years, of which only three were reported in this paper: <ul> <li> ModRey, measuring immediate recall. Participants were shown “a list of 20 words, one at a time, for three seconds each,” and then had to type the list from memory </li> <li> ModBent, measuring object recognition. Participants were given 20 prompts with a shape and then had to select the correct match from a pair of similar prompts. After this, they were prompted with 40 shapes in turn, and had to indicate whether each was included in the original 20 or not </li> <li> Flanker, measuring “executive control”. Participants had to select a coloured block that corresponded to an arrow in a matrix of arrows, which could have the same (or different) colour to the surrounding arrows, and the same (or different) direction as the prompt block. </li> </ul> <h2>What did the researchers find?</h2> Of all the tests the researchers performed, only immediate recall (ModRey) at one year showed a significant effect, meaning the result is unlikely to just be a result of chance. At two and three years, the effect was no longer significant (meaning it could be down to chance). However they added an “overall estimate” by averaging the results from all three years to arrive at another significant effect. All the effect sizes reported are very small. The largest effect is for the participants’ immediate recall at one year, which was 0.07 – a value that is <a href="https://academic.oup.com/jpepsy/article/34/9/917/939415">generally considered very small without justification</a>. Also of note is that both the multivitamin and placebo groups had higher immediate word recall scores at one year (compared to baseline), although the multivitamin group’s increase was significantly larger. <a href="https://www.pnas.org/doi/epdf/10.1073/pnas.2216932120">In the researchers’ prior study</a>, the increase in word recall scores was described as a “typical learning (practice) effect”. This means they attributed the higher scores at one year to familiarisation with the test. For some reason, this “learning effect” was not discussed in the current paper, where the treatment group showed a significantly larger increase compared to those who were given the placebo. <h2>What are the limitations of the study?</h2> The team used a suitable statistical analysis. However, it did not adjust for demographic characteristics such as age, gender, race, and level of education. The authors detail their study’s major limitation well: it is not very generalisable, as it used “mostly white participants” who had to be very computer literate, and, one could argue, would be quite well-functioning cognitively. <figure class="align-center "><figcaption></figcaption>Another unmentioned limitation is the advanced age of their sample, meaning long-term results for younger people can’t be assessed.</figure> Additionally, the baseline diet score for their sample was abysmal. The researchers say participants’ diet scores “were consistent with <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1899558">averages from the US population</a>” but the cited study noted “the overall dietary quality… [was] poor.” And they didn’t measure changes in diet over the three years, which could impact the results. <h2>How should we interpret the results?</h2> The poor dietary quality of the sample raises the question: can a better diet be the simple fix, rather than multivitamin and mineral supplements? Even for the effect they observed, which micronutrient from the supplement was the contributing factor? The researchers speculate about vitamins B12 and D. But you can find research on cognitive function for any arbitrarily chosen <a href="https://www.centrum.com/content/dam/cf-consumer-healthcare/bp-wellness-centrum/en_US/pdf/lbl-00000775-web-ready-centrum-silver-adults-tablets-(versio.pdf">ingredient</a>, including <a href="https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=selenium+cognitive+function">selenium</a>, which can be <a href="https://www.sciencedirect.com/science/article/pii/S0048969720378608">toxic at high levels</a>. <h2>So should I take a multivitamin?</h2> <a href="https://newsinhealth.nih.gov/2013/08/should-you-take-dietary-supplements">Health authorities advise</a> daily multivitamin use isn’t necessary, as you can get all the nutrients you need by eating a wide variety of healthy foods. However, supplementation may be appropriate to meet any specific nutrient gaps an individual has. Using a good quality multivitamin at the recommended dose shouldn’t do any harm, but at best, this study shows well-functioning elderly white people might show some additional benefit in one type of cognitive task from using a multivitamin supplement. The case for most of the rest of the population, and the long-term benefit for younger people, can’t be made. <hr /> <h2>Blind peer review</h2> Clare Collins writes: I agree with the reviewer’s assessment, which is a comprehensive critique of the study. The key result was a small effect size from taking a daily multivitamin and mineral (or “multinutrient”) supplement on memory recall at one year (but not later time points) and is equivalent to a training effect where you get better at taking a test the more times you do it. It’s also worth noting the study authors received support and funding from commercial companies to undertake the study. While the study authors state they don’t believe background diet quality impacted the results, they didn’t comprehensively assess this. They used a brief <a href="https://pubmed.ncbi.nlm.nih.gov/22513989/">diet quality assessment score</a> only at baseline. Participants may have changed their eating habits during the study, which could then impact the results. Given all participants reported low diet quality scores, an important question is whether giving participants the knowledge, skills and resources to eat more healthily would have a bigger impact on cognition than taking supplements. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208114/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Image credit: Shutterstock <a href="https://theconversation.com/profiles/jacques-raubenheimer-1144463">Jacques Raubenheimer</a>, Senior Research Fellow, Biostatistics, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-a-daily-multivitamin-improve-your-memory-208114">original article</a>.

Body

What is cognitive functional therapy? How can it reduce low back pain and get you moving?

<a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> If you haven’t had lower back pain, it’s likely you know someone who has. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/22231424/">around 40% of adults</a> in any year, ranging from adolescents to those in later life. While most people recover, <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">around 20%</a> go on to develop chronic low back pain (lasting more than three months). There is a <a href="https://bjsm.bmj.com/content/54/12/698">common view</a> that chronic low back pain is caused by permanent tissue damage including “wear and tear”, disc degeneration, disc bulges and arthritis of the spine. This “damage” is often described as resulting from injury and loading of the spine (such as bending and lifting), ageing, poor posture and weak “core” muscles. We’re often told to “protect” our back by sitting tall, bracing the core, keeping a straight back when bending and lifting, and avoiding movement and activities that are painful. Health practitioners often <a href="https://theconversation.com/having-good-posture-doesnt-prevent-back-pain-and-bad-posture-doesnt-cause-it-183732">promote and reinforce these messages</a>. But this is <a href="https://bjsm.bmj.com/content/54/12/698">not based on evidence</a>. An emerging treatment known as <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">cognitive functional therapy</a> aims to help patients undo some of these unhelpful and restrictive practices, and learn to trust and move their body again. <h2>People are often given the wrong advice</h2> People with chronic back pain are often referred for imaging scans to detect things like disc degeneration, disc bulges and arthritis. But these findings are very common in people without low back pain and research shows they <a href="https://pubmed.ncbi.nlm.nih.gov/24276945/">don’t accurately predict</a> a person’s current or future experience of pain. Once serious causes of back pain have been ruled out (such as cancer, infection, fracture and nerve compression), there is <a href="https://pubmed.ncbi.nlm.nih.gov/27745712/">little evidence</a> scan findings help guide or improve the care for people with chronic low back pain. In fact, scanning people and telling them they have arthritis and disc degeneration can <a href="https://pubmed.ncbi.nlm.nih.gov/33748882/">frighten them</a>, resulting in them avoiding activity, worsening their pain and distress. It can also lead to potentially harmful treatments such as <a href="https://pubmed.ncbi.nlm.nih.gov/27213267/">opioid</a> pain medications, and invasive treatments such as spine <a href="https://pubmed.ncbi.nlm.nih.gov/19127161/">injections</a>, spine <a href="https://pubmed.ncbi.nlm.nih.gov/12709856/">surgery</a> and battery-powered electrical stimulation of spinal nerves. <h2>So how should low back pain be treated?</h2> A complex range of factors <a href="https://pubmed.ncbi.nlm.nih.gov/29112007/">typically contribute</a> to a person developing chronic low back pain. This includes over-protecting the back by avoiding movement and activity, the belief that pain is related to damage, and negative emotions such as pain-related fear and anxiety. Addressing these factors in an individualised way is <a href="https://pubmed.ncbi.nlm.nih.gov/29573871/">now considered</a> best practice. <a href="https://pubmed.ncbi.nlm.nih.gov/15936976/">Best practice care</a> also needs to be person-centred. People suffering from chronic low back pain want to be heard and validated. They <a href="https://pubmed.ncbi.nlm.nih.gov/35384928/">want</a> to understand why they have pain in simple language. They want care that considers their preferences and gives a safe and affordable pathway to pain relief, restoring function and getting back to their usual physical, social and work-related activities. An example of this type of care is cognitive functional therapy. <h2>What is cognitive functional therapy?</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/29669082/">Cognitive functional therapy</a> is about putting the person in the drivers’ seat of their back care, while the clinician takes the time to guide them to develop the skills needed to do this. It’s led by physiotherapists and can be used once serious causes of back pain have been ruled out. The therapy helps the person understand the unique contributing factors related to their condition, and that pain is usually not an accurate sign of damage. It guides patients to relearn how to move and build confidence in their back, without over-protecting it. It also addresses other factors such as sleep, relaxation, work restrictions and engaging in physical activity based on the <a href="https://www.restorebackpain.com/patient-journey">person’s preferences</a>. Cognitive functional therapy usually involves longer physiotherapy sessions than usual (60 minutes initially and 30-45 minute follow-ups) with up to seven to eight sessions over three months and booster sessions when required. <h2>What’s the evidence for this type of therapy?</h2> Our recent clinical trial of cognitive functional therapy, published in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/fulltext">The Lancet</a>, included 492 people with chronic low back pain. The participants had pain for an average of four years and had tried many other treatments. We first trained 18 physiotherapists to competently deliver cognitive functional therapy across Perth and Sydney over six months. We compared the therapy to the patient’s “usual care”. We found large and sustained improvements in function and reductions in pain intensity levels for people who underwent the therapy, compared with those receiving usual care. The effects remained at 12 months, which is unusual in low back pain trials. The effects of most recommended interventions such as exercise or psychological therapies are <a href="https://pubmed.ncbi.nlm.nih.gov/34580864/">modest in size</a> and tend to be of <a href="https://pubmed.ncbi.nlm.nih.gov/32794606/">short duration</a>. People who underwent cognitive functional therapy were also more confident, less fearful and had a more positive mindset about their back pain at 12 months. They also liked it, with 80% of participants satisfied or highly satisfied with the treatment, compared with 19% in the usual care group. The treatment was as safe as usual care and was also cost-effective. It saved more than A$5,000 per person over a year, largely due to increased participation at work. <h2>What does this mean for you?</h2> This trial shows there are safe, relatively cheap and effective treatments options for people living with chronic pain, even if you’ve tried other treatments without success. <a href="https://www.restorebackpain.com/cft-clinicians">Access to clinicians</a> trained in cognitive functional therapy is currently limited but will expand as training is scaled up. The costs depend on how many sessions you have. Our studies show some people improve a lot within two to three sessions, but most people had seven to eight sessions, which would cost around A$1,000 (aside from any Medicare or private health insurance rebates). <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207009/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-osullivan-48973">Peter O'Sullivan</a>, Professor of Musculoskeletal Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/jp-caneiro-1463060">JP Caneiro</a>, Research Fellow in physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a>; <a href="https://theconversation.com/profiles/mark-hancock-1463059">Mark Hancock</a>, Professor of Physiotherapy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a>, and <a href="https://theconversation.com/profiles/peter-kent-1433302">Peter Kent</a>, Adjunct Associate Professor of Physiotherapy, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-cognitive-functional-therapy-how-can-it-reduce-low-back-pain-and-get-you-moving-207009">original article</a>.

Body

How the brain stops us learning from our mistakes – and what to do about it

You learn from your mistakes. At least, most of us have been told so. But science shows that we often fail to learn from past errors. Instead, we are likely to keep repeating the same mistakes. What do I mean by mistakes here? I think we would all agree that we quickly learn that if we put our hand on a hot stove, for instance, we get burned, and so are unlikely to repeat this mistake again. That’s because our brains create a threat-response to the physically painful stimuli based on past experiences. But when it comes to thinking, behavioural patterns and decision making, we often repeat mistakes – such as being late for appointments, leaving tasks until the last moment or judging people based on first impressions. The reason can be found in the way our brain processes information and creates templates that we refer to again and again. These templates are essentially shortcuts, which help us make decisions in the real world. But these shortcuts, known as heuristics, can also make us repeat our errors. As I discuss in my book <a href="https://www.drpragyaagarwal.co.uk/sway-press">Sway: Unravelling Unconscious Bias</a>, humans are not naturally rational, even though we would like to believe that we are. Information overload is exhausting and confusing, so we filter out the noise. We only see parts of the world. We tend to notice things that are repeating, whether there are any patterns or not, and we tend to preserve memory by generalising and resorting to type. We also draw conclusions from sparse data and use cognitive shortcuts to create a version of reality that we implicitly want to believe in. This creates a reduced stream of incoming information, which helps us connect dots and fill in gaps with stuff we already know. Ultimately, our brains are lazy and it takes a lot of cognitive effort to change the script and these shortcuts that we have already built up. And so we are more likely to fall back on the same patterns of behaviours and actions, even when we are conscious of repeating our mistakes. This is called confirmation bias – our tendency to confirm what we already believe in, rather than shift our mindset to incorporate new information and ideas. We also often deploy “<a href="https://theconversation.com/is-it-rational-to-trust-your-gut-feelings-a-neuroscientist-explains-95086">gut instinct</a>” - an automatic, subconscious type of thinking that draws on our accumulation of past experiences while making judgements and decisions in new situations. Sometimes we stick with certain behaviour patterns, and repeat our mistakes because of an “<a href="https://www.sciencedirect.com/science/article/pii/S0014292121002786">ego effect</a>” that compels us to stick with our existing beliefs. We are likely to selectively choose the information structures and feedback that help us protect our egos. One experiment found that when people were reminded of their successes of the past, they were more likely to <a href="https://www.sciencedirect.com/science/article/abs/pii/S1057740815000728">repeat those successful behaviours</a>. But when they were conscious of or actively made aware of their failures from the past, they were less likely to overturn the pattern of behaviour that led to failure. So people were in fact still likely to repeat that behaviour. That’s because, when we think of our past failures, we are likely to feel down. And in those moments, we are more likely to indulge in behaviour that makes us feel comfortable and familiar. Even when we think carefully and slowly, our brains have a bias towards the information and templates we had used in the past, regardless of whether these resulted in errors. This is called the <a href="https://www.psychologytoday.com/gb/blog/mind-my-money/200807/familiarity-bias-part-i-what-is-it">familiarity bias</a>. We can learn from mistakes though. In one experiment, monkeys and humans had to watch noisy, moving dots on a screen and judge their net direction of movement. The researchers found that both slowed down after an error. The larger the error, the longer the post-error slowing, showing more information was being accumulated. However, the quality of this information <a href="https://www.eurekalert.org/news-releases/809286">was low</a>. Our cognitive shortcuts can force us to override any new information that could help prevent repeating mistakes. In fact, if we make mistakes while performing a certain task, “frequency bias” makes us likely to repeat them whenever we do the task again. Simplistically speaking, our brains start assuming that the errors we’ve previously made are the correct way to perform a task – creating a habitual <a href="https://link.springer.com/article/10.3758/pbr.15.1.156">“mistake pathway”</a>. So the more we repeat the same tasks, the more likely we are to traverse the mistake pathway, until it becomes so deeply embedded that it becomes a set of permanent cognitive shortcuts in our brains. Cognitive control It sounds bleak, so what can be done? We do have a mental ability that can override heuristic shortcuts, known as “cognitive control”. And there are some <a href="https://www.cell.com/neuron/fulltext/S0896-6273(21)00075-1">recent studies in neuroscience with mice</a> that are giving us a better idea of what parts of our brains are involved in that. Researchers have also <a href="https://www.cell.com/neuron/fulltext/S0896-6273(18)31007-9">identified two brain regions</a> with “self-error monitoring neurons” – brain cells which monitor errors. These areas are in the frontal cortex and appear to be part of a sequence of processing steps – from refocusing to learning from our mistakes. Researchers are exploring whether a better understanding of this could help with development of better treatments and support for Alzheimer’s, for example, as preserved cognitive control is crucial for <a href="https://www.frontiersin.org/articles/10.3389/fnagi.2020.00198/full">wellbeing in later life</a>. But even if we don’t have a perfect understanding of the brain processes involved in cognitive control and self-correction, there are simpler things we can do. One is to become more comfortable with making mistakes. We might think that this is the wrong attitude towards failures, but it is in fact a more positive way forward. Our society denigrates failures and mistakes, and consequently we are likely to feel shame for our mistakes, and try and hide them. The more guilty and ashamed we feel, and the more we try and hide our mistakes from others, the more likely we are to repeat them. When we not feeling so down about ourselves, we are more likely to be better at taking on new information that can help us correct our mistakes. It can also be a good idea to take a break from performing a task that we want to learn how to do better. Acknowledging our failures and pausing to consider them can help us reduce frequency bias, which will make us less likely to repeat our mistakes and reinforce the mistake pathways. Image credit: Shutterstock This article originally appeared on <a href="https://theconversation.com/how-the-brain-stops-us-learning-from-our-mistakes-and-what-to-do-about-it-203436" target="_blank" rel="noopener">The Conversation</a>.

Mind

3 ways your brain changes with ageing

Your entire body changes when you age, including your brain, which is responsible for everything. Regardless of your physical or neurological health, there is such a thing as “cognitive ageing.” It happens to the best of us! So, what are these changes? 1. Processing speed This refers to how quickly the brain can process information and provide a response. Processing speed affects almost every function in the brain, and it’s measured by how quickly you can manage a mental task. How it changes with ageing: <ul> <li dir="ltr" aria-level="1"> It decreases over time. </li> <li dir="ltr" aria-level="1"> The decrease starts in early adulthood, so by the time you reach your 70s and 80s, your processing speed is significantly down compared to the speed you once had in your 20s. </li> </ul> 2. Memory Memory is complex, and there’s different kinds of memory, but these are the functions that you’ll notice changes in as you age: <ul> <li dir="ltr" aria-level="1"> Working memory, the ability to hold information and manipulate it mentally, declines </li> <li dir="ltr" aria-level="1"> Episodic memory, the ability to remember personally experienced events at a certain plane or time, declines </li> <li dir="ltr" aria-level="1"> Prospective memory, the ability to remember to do things in the future, declines </li> </ul> 3. Attention The ability to concentrate and focus on something specific so that information can be mentally processed changes. <ul> <li dir="ltr" aria-level="1"> Selective attention, the ability to focus on something specific despite distractions or irrelevant stimuli, declines </li> <li dir="ltr" aria-level="1"> Divided attention, also known as “multi-tasking”, declines </li> <li dir="ltr" aria-level="1"> Sustained attention, the ability to remain concentrated on one task for an extended period of time, declines </li> </ul> Can anything be done? Unfortunately, there is no way to combat cognitive ageing, but there are things you can do to keep your brain healthy, which in turn will help keep you sharp. <ul> <li dir="ltr" aria-level="1"> Adequate sleep </li> <li dir="ltr" aria-level="1"> Proper nutrition </li> <li dir="ltr" aria-level="1"> Stimulate your brain with crosswords, sudoku or brain training apps </li> <li dir="ltr" aria-level="1"> Speak to people every day </li> <li dir="ltr" aria-level="1"> Read more </li> </ul> The longer you wait to help keep your brain healthy, the harder it becomes for your brain to remember things. Image credit: Shutterstock

Mind

Long COVID: How lost connections between nerve cells in the brain may explain cognitive symptoms

For a portion of people who get COVID, symptoms continue for <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/6october2022" target="_blank" rel="noopener">months or even years</a> after the initial infection. This is commonly referred to as “long COVID”. Some people with long COVID complain of “<a href="https://theconversation.com/what-is-and-what-isnt-brain-fog-190537" target="_blank" rel="noopener">brain fog</a>”, which includes a wide variety of cognitive symptoms affecting memory, concentration, sleep and speech. There’s also growing concern about findings that people who have had COVID are at <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00260-7/fulltext" target="_blank" rel="noopener">increased risk</a> of developing brain disorders, such as dementia. Scientists are working to understand how exactly a COVID infection affects the human brain. But this is difficult to study, because we can’t experiment on living people’s brains. One way around this is to create <a href="https://www.nature.com/articles/s41578-021-00279-y" target="_blank" rel="noopener">organoids</a>, which are miniature organs grown from stem cells. In a <a href="https://www.nature.com/articles/s41380-022-01786-2.pdf" target="_blank" rel="noopener">recent study</a>, we created brain organoids a little bigger than a pinhead and infected them with SARS-CoV-2, the virus that causes COVID-19. In these organoids, we found that an excessive number of synapses (the connections between brain cells) were eliminated – more than you would expect to see in a normal brain. Synapses are important because they allow neurons to communicate with each other. Still, the elimination of a certain amount of inactive synapses is part of normal brain function. The brain essentially gets rid of old connections when they’re no longer needed, and makes way for new connections, allowing for more efficient functioning. One of the crucial functions of the brain’s immune cells, or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768411/" target="_blank" rel="noopener">microglia</a>, is to prune these inactive synapses. The exaggerated elimination of synapses we saw in the COVID-infected models could explain why some people have cognitive symptoms as part of long COVID. Parallels with neurodegenerative disorders Interestingly, this pruning process is believed to go awry in several disorders affecting the brain. In particular, excessive elimination of synapses has recently been linked to <a href="https://www.nature.com/articles/s41593-018-0334-7" target="_blank" rel="noopener">neurodevelopmental disorders</a> such as <a href="https://www.nature.com/articles/s41593-018-0334-7" target="_blank" rel="noopener">schizophrenia</a>, as well as <a href="https://www.frontiersin.org/articles/10.3389/fncel.2019.00063/full" target="_blank" rel="noopener">neurodegenerative disorders</a> such as Alzheimer’s and Parkinson’s disease. By sequencing the RNA of single cells, we could study how different cell types in the organoid responded to the virus. We found that the pattern of genes turned on and off by the microglia in our COVID-infected organoids mimicked changes seen in neurodegenerative disorders. This may go some way in explaining the link between COVID and the risk of developing certain neurological disorders. <figure class="align-center "><img src="https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=425&fit=crop&dpr=1 754w, https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=425&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=425&fit=crop&dpr=3 2262w" alt="" /><figcaption>A brain organoid used in our study. You can see the microglial cells in red. Sellgren lab, Author provided</figcaption></figure> A possible target for treatment One limitation of our research is that our organoid models closely resemble the foetal or early brain, rather than the adult brain. So we can’t say for sure whether the changes we noted in our study will necessarily be reflected in the adult brain. However, some <a href="https://pubmed.ncbi.nlm.nih.gov/33248159/" target="_blank" rel="noopener">post-mortem</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/35255491/" target="_blank" rel="noopener">imaging studies</a> report neuronal death and reduction in grey matter thickness in COVID patients, which hints at similar instances of synapse loss caused by an infection in adults. If this proves to be a fruitful line of enquiry, we believe our findings could point to a mechanism contributing to persisting cognitive symptoms after COVID and other viral infections that affect the brain. SARS-CoV-2 is an RNA virus and similar <a href="https://pubmed.ncbi.nlm.nih.gov/27337340/" target="_blank" rel="noopener">processes</a> have been seen in mice infected with other RNA viruses that can also cause residual cognitive symptoms, such as the <a href="https://pubmed.ncbi.nlm.nih.gov/31235930/" target="_blank" rel="noopener">West Nile virus</a>. From here we want to study how different drugs could inhibit the changes we saw in the infected models, hopefully paving the way towards effective treatments. In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410571/">other research</a>, we’ve observed that an antibiotic called minocycline can reduce the degree to which microglia prune synapses in a dish. So we want to see if this drug can help in our brain organoid models following SARS-CoV-2 infection.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/192702/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Writen by Samudyata and Carl Sellgren. Republished with permission from <a href="https://theconversation.com/long-covid-how-lost-connections-between-nerve-cells-in-the-brain-may-explain-cognitive-symptoms-192702" target="_blank" rel="noopener">The Conversation</a>. Image: Getty Images

Mind

High score: Video game play linked to better cognitive performance

Children playing video games for more than three hours a day score better on cognitive performance compared to non-gamers. A study involving more than 1,800 children aged nine and ten by researchers at the University of Vermont in the United States, is believed to be the largest investigation looking at the association between <a href="https://cosmosmagazine.com/people/good-games/" target="_blank" rel="noreferrer noopener">video games</a>, cognition and brain function. The researchers found children who played more than 21 hours of video games per week recorded better scores for <a href="https://cosmosmagazine.com/technology/can-games-tell-if-you-are-impulsive/" target="_blank" rel="noreferrer noopener">response inhibition</a> and working memory than those who never played. The article is <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797596?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=102422" target="_blank" rel="noreferrer noopener">published</a> in JAMA Network Open. Lead author Dr Bader Chaarani told Cosmos, “it makes sense that if you consider the brain is like a muscle, the more you train it, the better it performs.” Impulse control is considered important as it is linked to substance use in adolescence, while working memory is connected to IQ and language processing, Chaarani says. In the study, the children performed two tasks inside an MRI scanner. The first was a ‘stop signal task’ measuring impulse control. The task required children to press a button when arrows pointed left or right, but not press anything when the arrows point up. The second, a working memory task showed children pictures of faces and tested their recall. Children were also tested outside the scanner using oral and verbal tasks. In contrast to the findings of other research, the study did not find any significant difference between gamers and non-gamers in terms of mental health or behaviour. <div class="newsletter-box"> <div id="wpcf7-f6-p220302-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> <form class="wpcf7-form mailchimp-ext-0.5.62 spai-bg-prepared init" action="/technology/high-score-video-game-play-linked-to-better-cognitive-performance/#wpcf7-f6-p220302-o1" method="post" novalidate="novalidate" data-status="init"> <input class="wpcf7-form-control wpcf7-text referer-page" name="referer-page" type="hidden" value="https://cosmosmagazine.com/technology/" data-value="https://cosmosmagazine.com/technology/" aria-invalid="false" /> </form> </div> </div> Chaarani says, “many parents today are concerned about the effects of video games on their children’s health and development, and as these games continue to proliferate among young people, it is crucial that we better understand both the positive and negative impact that such games may have.” In Australia, 78% of children and teenagers play video games, averaging 106 minutes per day, according to <a href="https://igea.net/wp-content/uploads/2021/10/DA22-Report-FINAL-19-10-21.pdf" target="_blank" rel="noreferrer noopener">research commissioned</a> by the Interactive Games and Entertainment Association. In the University of Vermont study, non-video gamers (who spent zero hours a week playing games) and gamers (who played more than 21 hours a week) were recruited from a mix of 21 public, private and charter schools across the United States. The two groups did not differ in terms of characteristics such as age, BMI or IQ. However, the gamers group had a higher share of boys, and lower parental income on average. The research forms part of the <a href="https://abcdstudy.org" target="_blank" rel="noreferrer noopener">Adolescent Brain Cognitive Development Study</a>, the largest long-term study of brain development and child health in the United States. This allows children to be tracked over time into early adulthood to see if changes in video gaming behaviour are linked to changes in cognitive skills, brain activity, behaviour, and mental health. While the results showed an association between playing video games and higher cognitive performance, the paper notes it does not evidence for causality. This will be the focus of further research, given the Adolescent Brain Cognitive Development Study follows children every two years. Chaarani says they also plan to look at the effect of video game genre in future work. The current study did not differentiate by the type of video games children played, whether puzzle games, action adventure, sports, simulation or shooters; or single versus multi-player games. “There are some smaller studies reporting that different types of games may engage different areas in the brain, different functions of the brain… but because of the sample size we cannot trust them enough,” he says. “For the nine and ten years old, we’ve been looking at surveys done internationally. So, these kids tend to play more fast-paced games like action, adventure and shooters that give you immediate reward rather than slow paced games.”  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=220302&title=High+score%3A+Video+game+play+linked+to+better+cognitive+performance" width="1" height="1" />  <div id="contributors"> <a href="https://cosmosmagazine.com/technology/high-score-video-game-play-linked-to-better-cognitive-performance/" target="_blank" rel="noopener">This article</a> was originally published on Cosmos Magazine and was written by Petra Stock. Image: Getty Images </div>

Technology

Your dog can get dementia - here’s how to prevent it

Just like us, dogs can experience cognitive decline as they age. They can also risk developing a neurodegenerative condition called Canine Cognitive Dysfunction (CCD), a condition similar to Alzhheimer’s Disease. Like Alzheimer’s, symptoms dogs with CCD can experience include a loss of spatial awareness, memory deficiencies, disrupted sleep, and altered social interactions. Both CCD and Alzheimer’s also share symptoms found in the brain itself, including <a href="https://oversixty.com.au/health/mind/alzheimer-s-marker-found-in-the-brain" target="_blank" rel="noopener">the buildup of fragments of a protein called beta-amyloid</a> in between nerve cells. According to a new study published in the journal <a href="https://doi.org/10.1038/s41598-022-15837-9" target="_blank" rel="noopener">Scientific Reports</a>, the risk of developing CCD increases by 68 percent each year after dogs turn 10. The team studied a whopping 15,019 dogs that took part in a longitudinal study called the Dog Ageing Project. Between 2019 and 2020, the owners of participating pets completed two surveys about the health status and physical activity of their dogs. They also completed the Canine Social and Learned Behaviour survey, which tested for symptoms of CCD such as dogs failing to recognise familiar people. But, they also found that older pooches that were very active had a much smaller risk of developing the condition in comparison to less active dogs of the same breed and health - with the more sedentary dogs having a 6.47 times higher risk of having CCD. They stress that their study doesn’t show that a lack of physical activity causes CCD, and are calling for more research to determine whether CCD is caused by less physical activity or if the inactivity is caused by CCD. Because of the similarities between CCD and Alzheimer’s disease, the team argue that means that researching CCD could have implications for our understanding and treatment of Alzheimer’s, and vice versa. For example, the association between physical activity and lower risks of CCD come after numerous studies showing this relationship in rodents <a href="https://oversixty.com.au/health/mind/the-surprising-reason-exercise-improves-symptoms-of-alzheimer-s" target="_blank" rel="noopener">and in humans</a>. “These observations may reflect a variety of biologic mechanisms, including a reduction of pro-inflammatory cytokines in the brain that otherwise contribute to neural damage and death, and an increase in neural plasticity,” they write of the studies with rodents and people, adding that these mechanisms might also explain the link between physical activity and CCD risk. “Given increasing evidence of the parallels between canine and human cognitive disease, accurate CCD diagnosis in dogs may provide researchers with more suitable animal models in which to study ageing in human populations.” Image: Getty Images

Family & Pets

Vitamin C deficiency linked to cognitive impairment

A new study has found a link between poor brain function and how much Vitamin C older people have, and that a deficiency could have some serious effects on the brain. Cognitive impairment is common among older, hospitalised patients, and can result in poor memory and concentration, as well as finding decision-making difficult. The team from Flinders University in Adelaide tested the cognitive function and vitamin C level of 160 people over the age of 75 who were admitted to the university’s medical centre. From this, 91 patients were found to have cognitive impairment, and 42 of this group were found to have such low levels of vitamin C - below 11 micromoles per litre - they were at risk of developing scurvy. “Our findings showed that cognitive function scores were significantly lower among patients who were vitamin C deficient, with further analysis suggesting vitamin C deficiency was almost three times more likely to be associated with cognitive impairment after adjustment for other factors,” Associate Professor Yogesh Sharma, the study’s lead author, <a href="https://www.scimex.org/newsfeed/low-vitamin-c-linked-to-cognitive-impairment-in-older-australians" target="_blank" rel="noopener">said</a>. The researchers stressed that the two were associated, not that vitamin C deficiency causes cognitive impairment. They also noted that many of the symptoms of low vitamin C levels - including skin issues, bruising and bleeding - are common in this age group because of a number of conditions. “It may, therefore, be difficult to diagnose vitamin C deficiency solely on looking for these particular symptoms in older hospitalised patients,” Associate Professor Sharma said. “Given we know vitamin C deficiency is common among older hospitalised patients, medical professionals need to remain vigilant for this condition and confirm a patient’s vitamin C status in suspected cases.” With this link, the researchers said they will need to conduct more studies to confirm the link and determine whether replacing a patient’s vitamin C levels could help prevent or reverse cognitive impairment. The study was published in the journal <a href="https://doi.org/10.3390/antiox11030463" target="_blank" rel="noopener">Antibiotics</a>. Image: Getty Images

Body

Air pollution may impair cognitive function

<div> <div class="copy"> A joint China-US research team has found that exposure to even short-term air pollution may impair cognitive function. Air pollution is a growing cause of sickness and death globally, with a <a href="https://cosmosmagazine.com/climate/air-pollution-pandemic-warning/" target="_blank" rel="noreferrer noopener">recent study</a> estimating that it caused an extra 8.8 million premature deaths in 2015, surpassing the 7.2 million caused by tobacco smoking. It has well-established effects on the lungs and the heart – it has been linked with spikes in <a href="http://jaha.ahajournals.org/content/5/5/e002742" target="_blank" rel="noreferrer noopener">heart attacks, strokes</a> and <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180522" target="_blank" rel="noreferrer noopener">asthma</a>, and is a carcinogen known to cause lung cancer. Increasingly, research is also associating air pollution with other health impacts including <a href="https://cosmosmagazine.com/biology/kidney-disease-linked-to-air-pollution/" target="_blank" rel="noreferrer noopener">kidney disease</a>, <a href="https://cosmosmagazine.com/climate/could-air-pollution-contribute-to-psychiatric-illness/" target="_blank" rel="noreferrer noopener">psychiatric illness</a> and <a href="https://cosmosmagazine.com/biology/air-pollution-link-to-alzheimer-s-mooted/" target="_blank" rel="noreferrer noopener">Alzheimer’s</a>. What causes air pollution? <ul> <li>Air pollution is the release of pollutants into the air that have detrimental effects on human or planetary health.</li> <li>It can have natural sources, such as desert dust or bushfire smoke, but is increasingly created by humans, primarily from burning fossil fuels.</li> <li>There are two main types: smog occurs when emissions from burning fossil fuels react with sunlight, while soot is made up of tiny particles made up of smoke, soil, dust, allergens or chemicals. Anything that combusts fossil fuels can cause this, including vehicle exhaust, power plants, incinerators and more.</li> </ul> Now, in a new study <a href="https://doi.org/10.1038/s43587-021-00060-4" target="_blank" rel="noreferrer noopener">published</a> in the journal Nature Ageing, researchers have linked poor air quality with decreased brain health. The team studied a sample of 954 Caucasian males (with an average age of 70) from the Boston area in the US, who were participants in the Veterans Affairs Normative Aging Study. Their cognitive function was measured by a series of assessments to test their attention, learning and memory, as well as an screening to help detect early signs of dementia. This was compared to the average levels of fine particulate matter (PM2.5, smaller than 2.5 micrometres in size) in the area, both on the day of each test and in the 28 days prior. The team found the participants tended to score lower when levels of PM2.5 were higher in the month before the tests – even when levels were still below what is considered as “hazardous”. “The findings were quite startling,” write cognitive health researchers Joanne Ryan and Alice J. Owen, in an <a href="https://dx.doi.org/10.1038/s43587-021-00062-2" target="_blank" rel="noreferrer noopener">accompanying article</a>. “Even relatively small increases in the levels of PM2.5 in the 3–4 weeks prior to testing were associated with consistently worse cognitive performance.” Ryan and Owen, both from Monash University in Australia and both not involved in the study, point out that Boston “has by no means the worst air quality in the USA or the world, and yet significant detrimental effects of air pollution on cognitive function were observed”. While a decline in brain function in older adults is common, it can be exacerbated – and accelerated – by environmental factors. Evidence is <a href="https://doi.org/10.3233/jad-180631" target="_blank" rel="noreferrer noopener">mounting</a> that air pollution could be a risk factor for dementia and could, over the long term, be <a href="https://dx.doi.org/10.1016%2Fj.neuro.2016.06.004" target="_blank" rel="noreferrer noopener">associated</a> with cognitive declines. “The results of the current study are especially important because they provide some of the first evidence that even relatively low-level, short-term increases in PM2.5 are detrimental for thinking and memory, as well as global cognition in older adults,” Ryan and Owen write. The results may point to a general trend in the larger population, given that air pollution <a href="https://www.unicef.org/environment/files/Danger_in_the_Air.pdf" target="_blank" rel="noreferrer noopener">affects brain development</a> in kids, and women seem to be <a href="https://doi.org/10.1289/ehp.0900994" target="_blank" rel="noreferrer noopener">more strongly affected</a> than men. Interestingly, the researchers also found that the participants who were prescribed NSAIDs (nonsteroidal anti-inflammatory drugs, such as aspirin) were less adversely affected. This may be because the health impacts of air pollution tend to involve activating the body’s inflammatory response. But caution is warranted; there may be many other differences between participants who do and don’t use NSAIDs. This study also had a relatively small sample size and focused on a certain geographical area, so further research is needed to solidify the link between air pollution and cognitive function. However, Ryan and Owen emphasise the importance of the results. “The implications for public health, and consequent health, societal and economic costs of air pollution, are immense,” they write. “This should be a further wake-up call about the urgent need for action. “It has been estimated that 90% of the world’s population breathe polluted air. Breathing clean air is fundamental to our health but represents a global challenge and one of substantial inequity, disproportionally affecting the most vulnerable.” Image credits: Getty Images  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=149918&title=Air+pollution+may+impair+cognitive+function" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /> </div> <div id="contributors"> This article was originally published on <a href="https://cosmosmagazine.com/health/air-pollution-may-impair-cognitive-function/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Lauren Fuge. </div> </div>

Mind

Often fooled by optical illusions? Here’s why

If you have ever seen an optical illusion and wondered why you may have been tricked by it, you’re not the only one. Researchers interested in cognitive science and visual perception have used optical illusions to see how our brain works - even when we’re not being amazed or tricked by a deceptive image. “Illusions help us understand the rules our brain uses to create reality, based on the input it receives from our senses,” says Mark Williams, an honorary professor of cognitive science at Macquarie University. “What we actually see or hear or feel or taste or smell isn’t actually what’s out there, but what we think is out there. “Because we don’t see the world as it actually is, illusions help explain to us how we are creating the world we actually perceive.” This means that our brains don’t see the world wholly, instead responding to everything it perceives and filtering out what it doesn’t think is important. “Our sensory systems respond to the sum of all contextual information in which the relative information is more important than the absolute,” says Dr Spehar, a psychologist from the University of New South Wales “So for example, you perceive colour relative to the background, or you see orientation relative to the frame of reference. Let’s put our perceptions of reality to the test with this multicoloured illusion. Is it moving? <img style="width: 500px; height:375.2900232018562px;" src="https://oversixtydev.blob.core.windows.net/media/7843585/109a9c3cc8949eb4a12d252545fb759c.jpg" alt="" data-udi="umb://media/9693caf172e54a1e8d66f94106e45659" /> Image: Wikimedia Commons Though this image appears to move, staring at the centre of the image makes it stop. This illusion, known as rotating snakes, triggers receptors in your eyes that detect movement in your peripheral vision. Dr Spehar says that though we don’t fully know how the illusion works, it appears to involve the differences in contrast between the black, white, and coloured areas. “The illusion has a lot of light and dark elements, of both high and low contrast scattered everywhere,” Dr Spehar says. “[These] stimulate motion-sensitive neurons in the periphery of our visual field.” Even when you blink or move your eyes, parts of the illusion are projected onto different parts of your eye, meaning that it appears to move in a clockwise or counterclockwise movement. Image: Wikimedia Commons

Mind

How this New Zealand songbird provides insights into cognitive evolution

When we think about animals storing food, the image that usually comes to mind is a squirrel busily hiding nuts for the winter. We don’t usually think of a small songbird taking down an enormous invertebrate, tearing it into pieces and hiding these titbits in the branches of trees to snack on later in the day. But this is also a form of caching behaviour, where food is handled and stored for later consumption. For caching animals, the ability to recall where food is hidden is crucial for survival. My <a href="https://www.sciencedirect.com/science/article/abs/pii/S0960982219303252">research</a> into the spatial memory performance of a caching songbird, the New Zealand robin (Petroica longipes), shows male birds with superior memory abilities also have better breeding success. <img src="https://images.theconversation.com/files/298439/original/file-20191024-119449-v1ha09.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" alt="" /> Male toutouwai with better spacial memory also raise more chicks. Supplied, <a href="http://creativecommons.org/licenses/by-nd/4.0/" class="license">CC BY-ND</a> Why memory matters There’s no argument that New Zealand is home to a host of unusual birds, including the nocturnal, flightless parrot kākāpō (Strigops habroptila), or the hihi (Notiomystis cincta), the <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1474-919X.1996.tb08834.x">only bird in the world known to mate face to face</a>. By outward appearances, the small, grey toutouwai (Māori name for P. longipes) is not particularly remarkable. But its noteworthy behaviour includes <a href="https://www.doc.govt.nz/globalassets/documents/science-and-technical/docts13.pdf">feasting on some of the world’s largest invertebrates</a>. There is only so much of a 30cm earthworm a 30g bird can eat, and rather than waste the leftovers, toutouwai will cache any surplus prey they don’t want to eat immediately. <img style="display: block; margin-left: auto; margin-right: auto;" src="https://images.theconversation.com/files/298440/original/file-20191024-119463-1bfg3en.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" alt="" /> Toutouwai are the only known caching species in New Zealand. An accurate <a href="https://www.annualreviews.org/doi/abs/10.1146/annurev-ecolsys-110512-135904">spatial memory is therefore crucial</a> for recovering caches and it has long been assumed that spatial memory is under <a href="https://www.ncbi.nlm.nih.gov/pubmed/2919184">strong selection pressure in caching species</a>. For selection to act on a trait, there must be individual variation that is passed onto offspring and that influences survival and reproduction. While researchers had looked at how spatial memory influences <a href="https://www.sciencedirect.com/science/article/abs/pii/S0960982219300077">winter survival in caching mountain chickadees</a>, no one had examined whether memory performance influences reproductive success in any caching species. Our <a href="https://www.sciencedirect.com/science/article/abs/pii/S0960982219303252">research</a> tackles this issue. Measuring memory in the wild We measured the spatial memory performance of 63 wild toutouwai during winter. We gave the birds a circular puzzle that had a mealworm treat hidden inside one of eight compartments. For each bird, we put the puzzle at the same location in their territory several times in a single day, with the food always hidden in the same spot. <img style="display: block; margin-left: auto; margin-right: auto;" src="https://cdn.theconversation.com/static_files/files/765/spatial_test.gif?1571875385" alt="" width="100%" /> Wild toutouwai looking for a hidden mealworm treat. SOURCE Over time, toutouwai learned the location of the hidden treat and began opening fewer compartments to find the mealworm. We then followed these same birds through the next breeding season and looked at whether their spatial memory performance (measured as the number of compartments they had to open to find the mealworm) was linked to their ability to feed chicks, and whether it influenced the survival of their offspring. Our results suggested that spatial memory performance influences reproductive success in toutouwai. Males with more accurate memory performance successfully raised more offspring per nest and fed larger prey to chicks. By contrast, we did not find the same patterns for females. This is the first evidence that spatial memory is linked to reproductive fitness in a food caching species. Evolving intelligence If there is such a great benefit for males in having an accurate recall of locations, why aren’t all males the best they can possibly be in terms of spatial memory performance? In other words, why didn’t all the male toutouwai we tested ace our memory task? Intriguingly, our results suggest a role for conflict between the sexes in maintaining variation in cognitive ability. We found no effect of memory performance on female reproductive success, suggesting that the cognitive abilities that influence reproductive behaviour may well differ for females. Such a difference between the sexes would ultimately constrain the effect of selection on male spatial memory, preventing strong directional selection from giving rise to uniformly exceptional memory in our toutouwai population. Our work produced some tantalising evidence for both the causes and consequences of variation in cognitive ability, but it also raises several more questions. For example, while we’ve shown that memory performance matters for males, we still need to examine how it influences caching behaviour. Another mystery that remains is why spatial memory ability may have less of an influence on female toutouwai fitness. One possibility is that longer-term spatial memory for specific locations (rather than the short-term memory we measured) may matter more for female reproduction, because females do all of the nest building and incubation. So far, we’ve only provided one piece of the puzzle. To get the full picture of how cognition evolves, we have many more avenues left to explore.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/125304/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rachael-shaw-764893">Rachael Shaw</a>, Rutherford Discovery Fellow, <a href="http://theconversation.com/institutions/victoria-university-of-wellington-1200">Victoria University of Wellington</a> This article is republished from <a href="http://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/a-small-new-zealand-songbird-that-hides-food-for-later-use-provides-insights-into-cognitive-evolution-125304">original article</a>.

Music

Could cochlear implants improve your cognitive function?

Cochlear implants could be associated with improved speech perception and cognitive function in adults with profound hearing loss who are 65 years or older. Here is a comprehensive break-down of the associated options. What is a cochlear implant? It is a small electronic hearing device that provides a sense of sound to profoundly deaf patients by electronically stimulating the hearing nerve and bypassing damaged parts of the inner ear. It has both internal and external parts. The complex technology essentially emulates the function of an ear to receive, process and transmit sound waves. The external part of a cochlear implant is placed just above the ear and involves a microphone and sound processor, which selects and arranges sound. While the transmitter converts the signals from the processor and converts them into electric impulses. The impulses are sent to the internal part of the implant, which is put in place surgically under general anaesthesia. This internal part involves a receiver and magnet under the skin behind the ear and a series of electrodes placed in the cochlear. The electrodes collect the impulses and send them to different regions of the auditory nerve. A cochlear implant for someone who is considered deaf is a useful representation of sound in the environment and helps them to understand speech. It bypasses the damaged portions of the ear and directly stimulates the auditory nerve. Although it takes some time to learn or relearn, hearing by a cochlear implant allows the user to recognise warning signals, understand environmental noises and even have conversations. Who needs them? Cochlear implants are useful for children or adults who are deaf or severely hard-of-hearing. Many children who are deaf at birth receive cochlear implants from 12 months of age. However, adults who lose hearing later in life also frequently use the devices. These individuals are then able to associate the provided signals with sounds they remember, negating the need to learn lip-reading or sign language. According to the Australian Communication Exchange, three in every four Australians over 70 are affected by hearing loss. This is largely due to the damage we expose our ears to on a day-to-day basis. Loud or excessive noise damages the hair cells in the cochlear, which unfortunately don’t regrow. As well as gradual hearing loss, many people may also have incidents that cause them to suddenly lose their hearing, meaning they will also require the assistance of these devices. Implantation Use of a cochlear implant requires both a surgical procedure and significant therapy. Cochlear implantations are almost always safe, however, as with all surgical procedures there is always a small risk. Cochlear implants are quite costly, and the learning process is quite lengthy, however, the benefits are considered to be usually worthwhile. Cochlear implant or hearing aid? Hearing aids simply amplify sounds and can be easily fitted on the external part of the ear, requiring no surgical procedure. There are a variety of hearing aids available, which generally consist of a microphone, amplifier, miniature loudspeaker and battery. Hearing aids pick up and amplify surrounding sounds and help to make speech more intelligible. People with profound hearing loss or residual low frequency hearing will likely receive no benefit from hearing aids and will be considered for a cochlear implant. Costs Cochlear implants are an expensive piece of technology, possible adding up to around $40,000. Depending on your state Department of Health, funding is usually provided for a limited number of cochlear implants per year. Most Australian private health fund cover the costs of the implant and hospital expenses and holders of Gold Veteran Affairs cards are usually fully covered. As well as financial costs, time costs must also be taken in to consideration. The assessment period usually takes three months, and then there is usually a few week’s wait for surgery. After surgery, the MAP (the programming for the cochlear implant) will need to be adjusted to the needs of its user. Benefits Several studies have shown benefits. One that adult cochlear implant patients allow a more marked improvement physically, psychologically and socially than hearing aid patients. This means that cochlear implants can bring as much benefit to those with profound hearing loss as hearing aids bring to those with less severe hearing loss. Another found that cochlear implants vastly improve the quality of life of deaf patients over 50. Cochlear implants are found to be a cost-effective solution in this age group, due to their increase in health and emotional-related quality of life. Increases in speech perception scores showed a strong correlation with magnitude of health utility gains. More recent research which was published online by JAMA Otolaryngology - Head and Neck Surgery. This research indicates that cochlear implantation is positively associated with improved cognitive function and speech perception in adults 65 years and older with profound hearing loss. Hearing impairment correlates strongly with cognitive decline, and in cases where hearing aids are not sufficient, cochlear implantation is seen to be highly beneficial for older patients. This study also showed that cochlear implants not only improve speech perception – in both quiet and noise – however, they can also improve quality of life and show less incidence of depression. More than 80% of the 94 patients in the study with impaired cognitive function improved their brain function scores one year after implantation. Who to see If you have suddenly or gradually become profoundly hard-of-hearing, it is important to seek professional medical advice immediately. Help is available and seeking advice early could increase your quality of life. Options are to either visit an otolaryngologist, a doctor specialising in the diagnosis of ear, nose and throat diseases; an audiologist, who has specialised training in identifying and measuring the type and degree of hearing loss and recommends option; or a hearing aid specialist, who conducts and evaluate basic tests and offers counselling. Because cochlear implantation is for more serious hearing loss, you will need to see a specialist and then be referred to receive surgical treatment. Written by Greta Mayr. Republished with permission of <a href="https://www.wyza.com.au/articles/health/could-cochlear-implants-could-improve-your-cognitive-function.aspx">Wyza.com.au.</a>

Technology

Here's the best science on how you can avoid dementia

This week, an Australian report on ageing summarised the best available research on preventing cognitive decline and dementia. The report’s lead author, Professor Kaarin Anstey, has revealed that in order to ward off dementia, you should do an activity you're bad at. If you can play the piano, pick up the guitar. If you can solve the cryptic crossword in 10 minutes, tackle Sudoku. Although many people have strategies to deal with the financial aspect of their retirement, many are not taking the same action for their mind. Professor Anstey said, “It’s like investing in your superannuation. You need to invest in your brain over the course of your life so you have a nice healthy brain when you’re old.” The report, published by the Centre of Excellence in Population Ageing, highlights the top lifestyle risk factors for brain decline, including physical inactivity, midlife obesity and low education attainment. <img width="500" height="309" src="https://oversixtydev.blob.core.windows.net/media/7817438/1_500x309.jpg" alt="1 (117)"/> Here is what the report suggests you do to avoid dementia: 1. Do an activity you are a bad at If can do crosswords well but continue to do them, you are not necessarily keeping your brain fit. The brain needs new challenges, not just ones that are mentally demanding. Professor Anstey says activities such as learning a new instrument or studying a new language are good ways to keep your brain fit. “People who can do a cryptic crossword in 10 minutes flat, it’s not challenging their brain any more.” Studies also show that people who read, go to the theatre and visit museums regularly have a lower risk of cognitive decline. 2. Have healthy relationships Previous research has found that living with someone, being married and volunteering all make women more resilient to dementia. Professor Anstey believes the result of this Canadian study was down to the differences in education between men and women. "We’re finding those educational differences are diminishing now with a younger cohort," she said. For both genders, having friends and allocating time to socialise is very important to maintain a healthy mind. “When you’re interacting with another person, that’s an intellectually stimulating activity. You’re using a lot of your brain to do that,” said Dr Maree Farrow, a researcher at the Wicking Dementia Research Centre in Hobart. 3. Stay fit Dementia is also linked to poor heart health, particularly obesity, high-blood pressure and cholesterol. Exercise also reduces depression and pumps oxygen into your brain. What do you do on a daily basis to keep your mind fit?

Mind

Research links diabetes to long-term cognitive decline

New research has made a stunning link between diabetes and long-term cognitive decline, suggesting a correlation between blood sugar levels and brain function. The study, completed by scientists at the School of Public Health Imperial College London and Peking University Clinical Research institute and <a href="http://www.diabetologia-journal.org/" target="_blank">published in the Diabetologia journal</a>, suggests higher levels of glycated haemogloblin could results in a higher rate of decline in executive function, cognitive function and memory. "Our study provides evidence to support the association of diabetes with subsequent cognitive decline," researcher Dr Wuxiang Xie said. "Our findings suggest that interventions that delay diabetes onset, as well as management strategies for blood sugar control, might help alleviate the progression of subsequent cognitive decline over the long term." What are your thoughts?

Mind

5 expert tips to reduce your risk of cognitive decline with age

Hayley Wright is a Research Fellow at Coventry University. Her research focuses on cognitive ageing and the neuropsychology of stroke and dementia. Research into how we can <a href="https://www.alzheimers.org.uk/news/article/234/dementia_education_on_risk_inspires_people_in_midlife_to_consider_healthier_lifestyles" target="_blank">keep our brains healthy</a> as we age has gained momentum in recent years. There is now an increased focus on the changes that we can makes to our health and lifestyle, which may prevent dementia. Here are some things that research has shown reduce a person’s risk of cognitive decline with age. 1. Sex Our <a href="https://www.ncbi.nlm.nih.gov/pubmed/28645192" target="_blank">latest study</a> shows that having more sex is associated with better cognitive function. We recruited 28 men and 45 women, aged between 50 and 83, to take part in our study. We found that those who had sex weekly scored on average 2 per cent higher on some cognitive tests than those who had sex monthly, and 4 per cent higher than those who never had sex. These results were shown on tests of verbal fluency (such as naming as many animals as possible in one minute) and visuo-spatial abilities (drawing familiar objects from memory or copying complex pictures). The association could be the result of the heightened levels of intimacy and companionship inherent in sexual relationships (that is, an increase in social contact), or there could be a purely biological explanation – where regular surges in arousal and release of sex-related hormones (such as oxytocin and dopamine) could be affecting brain function. Of course, as with the age-old nature/nurture debate, our answer could lie in a combination of the social and biological impact of sexual activity. 2. Sleep Many studies show that getting enough sleep is important for preventing cognitive decline. A <a href="https://www.ncbi.nlm.nih.gov/pubmed/22560827" target="_blank">study</a> of cognitively healthy people aged 65 and over showed that daytime napping is associated with a lower risk of cognitive decline at two-year and ten-year follow-ups. Conversely, excessive daytime sleepiness and getting less than six-and-a-half hours of sleep at night are associated with an increased risk of cognitive decline at ten-year follow-up. A more recent <a href="http://www.sciencedirect.com/science/article/pii/S1074742716304208" target="_blank">study</a> showed that longer sleep duration and poorer sleep quality are both associated with poorer memory in men and women aged 65 and older. These studies all support the advice that we should be getting around eight hours of sleep a night. Sleep disturbance in early adulthood is associated with <a href="https://academic.oup.com/innovateage/article/1/suppl_1/156/3902539/SLEEP-EARLIER-IN-LIFE-AND-LATE-LIFE-COGNITION" target="_blank">poorer cognitive function in later life</a>, which just goes to shows how sleep can affect our brain health across the lifespan. 3. Active leisure New studies show that increased participation in social, mental and physical activities is linked to a <a href="https://academic.oup.com/biomedgerontology/article/68/2/205/544371/Late-Life-Leisure-Activities-and-Risk-of-Cognitive" target="_blank">slower rate of cognitive decline</a> in older adults. This research shows a “dose-response” relationship, where the more activities we do, the slower the rate of decline becomes. The following activities are good examples of the types of mental, social and physical leisure activities that are good for your brain: <ul> <li>Mental: <a href="https://www.alzheimers.org.uk/info/20054/our_achievements/766/have_a_go_at_brain_training" target="_blank">puzzles, games and quizzes</a>, reading or even adding up your shopping bill in your head as you go around the supermarket.</li> <li>Social: visiting friends and family, regular phone or email conversations with people, going to the cinema or doing some <a href="https://www.gvi.co.uk/resources/over-50s-volunteering/" target="_blank">volunteer work</a>.</li> <li>Physical: gardening, housework, walking for around 30 minutes a day, or doing <a href="http://www.nhs.uk/Livewell/fitness/Pages/sitting-exercises-for-older-people.aspx" target="_blank">chair-based or sitting exercises</a>.</li> </ul> 4. Gender equality Studies have found that women may be at reduced risk of cognitive decline, simply because of the activities they choose. There is little that we can do to change our gender, without drastic surgery of course – but we can be aware of the gender stereotypes and expectations that are all around us, which can affect the activities we engage in. In a study of <a href="http://content.iospress.com/articles/journal-of-alzheimers-disease/jad130143" target="_blank">Australian older adults</a>, there were notable gender differences in the leisure activities that people took part in. For example, women were more likely to engage in social activities, reading and volunteer work, all of which are known to slow cognitive decline. The way that cultures or societies perceive gender roles can affect people’s expectations of themselves and others. If this changes the lifestyle and leisure activities that men and women engage in, then it could well have an <a href="http://journals.sagepub.com/doi/full/10.1177/0956797617708634%20" target="_blank">effect on cognitive abilities</a> in later life. 5. Get an early (in life) start When it comes to doing things to prevent cognitive decline, it’s never too early to start. <a href="https://www.ncbi.nlm.nih.gov/pubmed/28359749" target="_blank">Some studies</a> show that interventions in older adults have little effect – but that could be because the participants are already suffering from cognitive decline. Studies mapping the rate of cognitive decline in <a href="http://www.sciencedirect.com/science/article/pii/S1568163717300235" target="_blank">older participants who do not yet have dementia or cognitive impairment</a>, however, show promising results. We all experience cognitive decline as we age. This is a natural process and occurs at different rates for everybody, much like declines in physical abilities with age. But it’s time we started addressing this much earlier in life, rather than waiting till middle age or older. It’s time for us to take a lifelong approach to keeping our brains healthy as we age. Written by Hayley Wright. Republished with permission of <a href="http://theconversation.com/The%20Conversation" target="_blank">The Conversation</a>. <a href="http://theconversation.com/The%20Conversation" target="_blank"></a>

Mind

The key to cutting your risk of dementia

Dr Kate Gregorevic is a geriatrician with a research interest in health and lifestyle factors that are associated with healthy ageing and recovery from illness. The more we learn about the dementia, the more we learn how much of it is preventable. <a href="https://www-ncbi-nlm-nih-gov.ezp.lib.unimelb.edu.au/pubmed/21775213" target="_blank">Worldwide, increasing physical activity could prevent up to a million new cases of dementia each year.</a> Our brains are also like muscles as they need exercise and challenge to maintain peak performance. <a href="http://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-016-0315-1" target="_blank">A recent review published in BMC Geriatrics found that a combination of physical and cognitive exercise is even better</a> for avoiding dementia, but what does this mean and how can you incorporate this into everyday life? Many of our daily activities use our bodies and brains simultaneously. When we cook dinner we are conceptualising the meal we want to create. We plan the ingredients needed then take them from our pantry and fridge. We prepare them using our hands. We move around the kitchen, aware of the space around us, as we put things on to cook and remove them when they are done. Planning and preparing a meal is a surprisingly complex activity. This is called dual tasking. Cognitive exercises have also been shown to improve memory, spatial awareness and executive function. Executive function refers to the complex planning and reasoning that is performed by the frontal parts of the brain in humans. It includes the ability to perform abstract thought, to reconsider a situation and change your mind and to think before acting. This part of the brain contributes to the ability to focus attention. People who have dysfunction in the frontal lobes of the brain can also become more apathetic and experience labile mood with frequent mood swings. In a study that looked at a combined intervention using exercise and cognitive training, even watching an educational DVD and answering questions afterwards was as effective as computer training. The participants also attended exercise classes at the local YMCA, which included 30 minutes of aerobic activity, 10 minutes of strength along with some stretching. All groups in this 12-week trial had improvement in cognitive testing. Many of the family members of dementia sufferers are terrified of suffering the same fate as their loved ones and developing dementia. Sadly, there is still no cure for dementia, but the rates of dementia are going down. An 85-year-old today is less likely to have dementia than 20 years ago. This demonstrates the great strides we are making in preventing dementia by controlling cardiovascular risk factors, such as blood pressure and decreased rates of smoking. By including an enjoyable physical activity as a routine part of life, whether it is a brisk walk or an exercise class with friends, you can significantly decrease your chance of dementia. It doesn’t seem to matter which cognitive activity you choose, as long as it is a challenge. It’s probably not enough to watch an interesting documentary on television, but there is increasing evidence for computer based brain training. Even better, try a physically and mentally challenging activity like yoga or tai chi. Our research found that a successful training program includes cardiovascular or strength training sessions combined with attention, or executive function/working memory practice. It seems that both cardiovascular and strength exercises are needed for the training to exert a positive influence on cognitive performance. However, there is no one best cognitive and physical activity to prevent dementia. The key is consistency, so that you can stay motivated. It is not enough to make a temporary lifestyle change, dementia is a chronic disease, and prevention takes long-term change. The best motivation to exercise is by doing something that is enjoyable today! To find out more information about ageing well, visit <a href="http://elderhealthaustralia.com/" target="_blank">Elder Health Australia here.</a> Related links: <a href="/health/caring/2016/09/kate-gregorevic-older-people-living-longer-and-stronger/">The extremely pleasant upsides to getting older</a> <a href="/health/body/2016/05/four-pillars-of-happy-and-healthy-ageing/">The 4 pillars of happy and healthy ageing</a> <a href="/health/mind/2016/09/trick-to-keep-your-brain-young-as-you-age/">Trick to keep your brain young as you age</a>

Mind

The 4 pillars of happy and healthy ageing

Dr Kate Gregorevic is a geriatrician with a research interest in health and lifestyle factors that are associated with healthy ageing and recovery from illness. For all of us, life is finite. In my work as a geriatrician, I have the privilege of looking after many people at the end of their time. This is a constant reminder to me to make every day meaningful. It is never too soon to start living the best life you can today to get the most out of the years ahead. Most people value health, but focus on denial as the way to stay healthy. The positive health movement looks at individual and community resources that promote health and wellbeing. Living well today and living to age well are one and the same. Successful ageing doesn't just mean living as long as possible, but living as well as possible. The pillars of successful ageing are social engagement, nutrition, physical activity and cognitive challenges. By finding meaning and enjoyment in every day, we can lead the longest, healthiest life possible. Social engagement “What's critical is allowing yourself to love others, and being able to take people in – as in, I've got you under my skin.” – George Vaillant People with higher levels of social engagement have decreased mortality and maintain their higher health status for longer. It is not just about the number of friends someone has, it is the quality of these relationships. Supportive and rewarding relationships must be cultivated. A higher level of social engagement can even help recovery from illness and can even decrease the chance of leaving hospital with a new disability. Social engagement can only happen if you are an active and giving participant in your relationships with friends and family. Life lesson: Finding ways to spend time with close family and friends everyday is joyful and good for your health. Nutrition Food is one of the central pleasures of life. As people age nutritional needs change. Most people spend their entire lives trying to lose weight. In old age, priorities need to change. Losing weight usually means losing precious muscle mass. Unless weight loss is accompanied by an exercise program and adequate protein intake, there is a risk of muscle loss leading to a decrease in strength. Unlike younger people, older adults do not easily regain muscle when it is lost. Unfortunately, even in this age group obesity is still associated with increased disability and dementia. So what does this all mean? To maintain muscle mass to maintain the ability to be independent, it is really important to ensure that all meals have protein and a variety of fruit and vegetables to provide all the required nutrition. Some older people are at particular risk of malnutrition, especially if they have a small appetite. In this group frequent small meals and snacks can help to stave off weight loss. Life lesson: Focus on preparing delicious meals with as much nutritional goodness as you can fit on your plate. Physical activity Almost everyone can find a form of physical activity that is fun. It is not really clear how much physical activity is the optimal amount. The best form of physical activity is the one that you enjoy and that you can fit in. As people age, there is a loss of muscle mass. If this reaches a critical level, it can stop people doing their activities of day-to-day living, like hanging out washing. It can also contribute to a loss of balance. Ideally physical activity should be something that also promotes balance and strength. Activities like Tai Chi and yoga can improve balance and decrease the risk of falls. The other great benefit of physical activity is that healthy body promotes healthy mind. Exercise at age 60 is associated with a decreased risk of dementia at age 90. So a brisk walk today, may help your brain stay healthy for many years to come. Life lesson: Find an activity you enjoy, so it can be something you look forward to every day. Cognitive challenges The old adage of “use it or lose it” is very true for our brains. Our brains retain the ability to learn and change well into old age. It is not enough to keep doing the same routine, to protect our brains against decline, we need to keep challenging ourselves. In a study of older adults who were given brain training in memory, reasoning and speed of processing, this actually improved their level of functioning in activities of daily living. Like physical activity, the right cognitive activity is one that you are interested in. Life lesson: Learning anything new can improve memory, reasoning and speed of processing, so the right activity is anything you want it to be! Living well It is rare that someone can live their life making everyday decisions based on future health. It is hard to say no to the piece of cake in your hand, because of how your health might be in ten years. The live well-age well philosophy is about making positive changes to make today a better day. The pillars of successful ageing work best when they are combined. Starting a yoga class will challenge you physically and mentally as you learn new ways to move your body. Ask a friend to teach you something new on the computer. Cook a meal with a grandchild because eating a nutritious meal always tastes better with loved ones. The choices are only limited to your imagination! What does living well mean to you? Tell us in the comments below. Related links: <a href="/health/mind/2016/04/how-to-become-the-happiest-person-you-know/">How to become the happiest person you know</a> <a href="/health/body/2016/03/waking-yourself-up/">8 tips for waking yourself up</a> <a href="/health/mind/2016/03/simple-ways-to-remain-positive/">8 simple ways to remain positive</a>

Body

Cochlear implants shown to reverse cognitive decline

A new study has found that cochlear implants in older people not only help with hearing loss but may also help thinking and memory.Researcher Isabelle Mosnier, of Assistance Publique-Hopitaux de Paris, examined the effect of cochlear implants on people with profound hearing loss aged 65 to 85. The study, published in the journal JAMA Otolaryngology-Head & Neck Surgery, is the first to measure the effect of cochlear implants on memory and mental flexibility in elderly patients.The study found after being fitted with cochlear implants and with hearing and speech therapy, there was marked improvements in three areas: speech perception, quality of life (depression) and cognitive performance.The findings of the study have global relevance.“Our study demonstrated that hearing rehabilitation using cochlear implants in the elderly is associated with improvements in impaired cognitive function,” Mosnier wrote. “Given the projection of an increase to more than 100 million people with dementia worldwide by 2050, any study that suggests a way to offset that decline, even temporarily, has enormous public-health significance.”Related links: <a href="/health/hearing/2015/01/facts-about-cochlear-implants/" target="_blank">What you need to know about cochlear implants</a><a href="/health/hearing/2015/01/why-look-after-hearing/" target="_blank">5 reasons to cherish your sense of hearing</a><a href="/health/hearing/2014/11/signs-of-hearing-loss-to-keep-an-ear-on/" target="_blank">Signs of hearing loss to keep an ear on</a>

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