Men and women with Alzheimer's disease benefited from computer-based "games" designed to provide mental stimulation and enhance brain activity, researchers report. The virtual stimulation enhanced the effects of Alzheimer's medicines, allowing people in the earlier stages of Alzheimer's to perform better on tests of memory and tasks of daily living.
The findings add to a growing body of research showing that mental challenges, such as doing crossword puzzles, solving brain teasers, learning a new language, taking up a new hobby, or playing a musical instrument, can provide a mental boost that helps to preserve brain function in normal individuals. Such activities are often recommended as a way to help keep the brain young in healthy seniors.
Mental stimulation using computer-based games, these findings show, may also be good for those with Alzheimer's, at least in the earlier stages of the disease. The researchers, from the Fundación ACE, Institut Català de Neurociències Aplicades in Barcelona, Spain, and the University of Pittsburgh School of Medicine, found that Internet-accessible computer activities were even more successful than classic exercises of mental stimulation, such as music and art therapy, commonly used in people with dementia. The findings appeared in the Journal of Neurology, Neurosurgery and Psychiatry.
"The interactive multimedia Internet-based system, in combination with the standard pharmacological treatment of Alzheimer's disease, provides for better cognitive function in these patients, demonstrating that they are capable of benefiting from cognitive stimulation, even after the disease has advanced," said Mr. Tárraga, lead investigator of the study and developer of the computer-based "game" tool.
"This study shows that tasks aimed at increasing or maintaining mental function have a place in treating Alzheimer's alongside pharmacotherapy," said Oscar Lopez, M.D., professor of neurology at the University of Pittsburgh School of Medicine, and a co-author on the study. "While further study is needed, it is encouraging to find that an Internet-based program can work for cognitive stimulation, making it easily available and accessible to many people."
What the Study Showed
The study, conducted at an adult day-care center and referral clinic for people with dementia in Barcelona, enrolled 46 people who were diagnosed with Alzheimer's disease. All were being treated with cholinesterase inhibitors (such as Aricept, Exelon, and Razadyne), the most common medicines for Alzheimer's, for at least one year prior to enrolling in the study. All participants remained on a medication for the duration of the study.
Participants were randomly assigned to one of three groups:
1) The first group received no special treatments. They lived at home and did not participate in the daily activities at the day-care center.
2) The second group participated in an Integrated Psychostimulation Program (IPP), which was a daily program that included two-and-a-half to three-and-a-half hours of mentally stimulating tasks, music therapy, arts and crafts, physical activity, and programs that reinforced key activities of daily living.
3) The third group participated in IPP as well, and used an interactive multimedia internet-based system (IMIS), which allowed them to carry out a variety of different cognitive stimulation tasks at varying levels of difficulty throughout the day. IMIS sessions (20 minutes each) were held three times a week for 24 weeks.
At the start of the study, and after 12 and 24 weeks of treatment, participants were given memory and thinking skills tests. After 12 weeks of treatment, the group that received both IPP and IMIS had higher scores on both tests as compared to those who received neither (the control group); these improvements were maintained at 24 weeks. The group that received only IPP showed improvement over the control group at 12 weeks, but the effects diminished by 24 weeks.
"While Alzheimer's disease is a progressive degenerative condition, studies have shown that in the early stages, the brain is still able to learn and change," says James T. Becker, Ph.D., professor of psychiatry, neurology and psychology at the University of Pittsburgh, and a co-author on the study. "This indicates that increasing brain activity, especially in regards to memory and cognition, may help stave off cognitive loss in people with Alzheimer's."
We at the Fisher Center believe that mental stimulation is important in caring for people with Alzheimer's. However, it is not always possible for a person with Alzheimer's, even in the early stages of the disease, to operate even a simple computer or machine. Some, but not all, early stage patients suffer from a loss of "executive function," which has to do with the ability to operate or manipulate tools and information. If you are caring for someone with Alzheimer's and they can operate a computer game, that's great. But if they can't, don't try to force them.
For more on non-drug treatments for Alzheimer's disease, as well as ways to help keep the mind sharp regardless of age, visit www.ALZinfo.org.
L Tárraga, M Boada, G Modinos, A Espinosa, S Diego, A Morera, M Guitart, J Balcells, O L López, and J T Becker: "A randomised pilot study to assess the efficacy of an interactive, multimedia tool of cognitive stimulation in Alzheimer's disease." Journal of Neurology, Neurosurgery, and Psychiatry, Volume 77, Number 10, October 2006, pages 1116-1121. Press Release, University of Pittsburgh Medical Center.