Keeping mentally active may help stave off Alzheimer's disease, but once someone is diagnosed with the condition, brain exercise may actually speed up cognitive decline—that’s the finding of a 1,100 person longitudinal study conducted by researchers at Rush University in Chicago, IL. "More frequent cognitive activity was related to slower cognitive decline in those without cognitive impairment and more rapid cognitive decline in Alzheimer's disease, with no effect in mild cognitive impairment," according to Robert S. Wilson, PhD and colleagues. Their investigation taps into other research suggesting that mental activity can help maintain cognitive abilities even as an underlying condition grows with age—until dementia wins the tug of war with mental acuity. "If cognitive activity does somehow allow the brain to tolerate more pathologic changes, those with high premorbid cognitive activity are likely to have a higher pathologic burden than those with low premorbid activity at the time of dementia onset and therefore to experience a more rapidly progressive dementia course," the researchers theorize. "In effect, these results suggest that the benefit of delaying the initial appearance of cognitive impairment comes at the cost of more rapid dementia progression,” said the researchers. “These observational data suggest that interventions designed to enhance cognitive plasticity may prove beneficial in compressing the cognitive morbidity of Alzheimer's disease.” In other words staying mentally active may shorten the period of time in which patients must live with a diagnosis of Alzheimer's disease, as they remain mentally healthy deeper into old age and then decline quickly. Though they point out that there are limitations to their analysis, they suggest that cognitive enrichment interventions may need to be started before the development of cognitive impairment.
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