How Not to Forget Your Next Appointment: Use Technology to Combat the Effects of Aging

Brian D. Beitzel

SUNY Oneonta, United States

The terms mentally sharp and elderly are typically not expected to describe the same person. Because cognitive acuity tends to decrease later in life, strategies to diminish the severity of this decline have long been sought.

Despite the disheartening prospect of eventual dementia, there are some promising possibilities emerging from research that indicate some activities which might at least delay cognitive decline.

Wilson et al. (2010) showed that, among a group of elderly residents within a single geographic area, those who regularly engaged in activities that were “cognitively stimulating” postponed the mental deterioration experienced by their peers who did not engage in the same level of cognitive activity. They did not necessarily escape the most-dreaded Alzheimer disease nor its severity once they were diagnosed—but the total amount of time spent in dementia was reduced, presumably due to the cognitive activities they had participated in.

Pillai et al. (2011) demonstrated a similar outcome, claiming that their sample of elderly participants who regularly completed crossword puzzles experienced a 2.5-year delay in the onset of dementia.

One leading theory regarding the beneficial effects of cognitive activity on maintaining mental acuteness is the notion of cognitive reserve. Although the concept of cognitive reserve suffers from multiple-definition disorder, the general idea is that individuals have a reservoir of cognitive capacity along a continuum of strong to weak capabilities. Those elderly who demonstrate mental acuteness later in life are said to have more cognitive reserve than those who suffer from dementia at the same age. Activities such as completing crossword puzzles are thought to help build or fortify one’s cognitive reserve (Fratiglioni, Paillard-Borg, & Winblad, 2004; Gatz, 2005).

Verghese et al. (2003) showed that certain leisure activities (dancing, playing a musical instrument, reading, and playing board games) had a “protective effect” on the risk of developing dementia. In other words, even leisure activities—not particularly regarded as cognitive—can contribute to cognitive reserve, boosting mental acuity into old age.

There is even a suggestion in the medical literature that maintaining healthy social relationships might strengthen cognitive reserve (Fratiglioni et al., 2004). A good network of friends is known to improve the risk of cardiovascular disease and contribute to longevity; might it also have a protective effect on cognitive reserve? We don’t yet know, but given the existing evidence of social relationships yielding other health benefits, it is plausible that a positive effect of social relationships on cognitive outcomes could be demonstrated.

One question that is difficult to answer from research is whether the elderly person who keeps mentally active, physically active, and socially connected is a different type of person than the elderly person who participates in none of the above. We must rely mostly on descriptive research about the voluntary activities of the elderly to answer questions about the relationship between their activity and their mental condition because randomly assigning them to treatments believed to be ineffective has ethical problems. Therefore, in the absence of randomized controlled trials, we must be cautious about making causal claims regarding the effects of these activities on aging. Nevertheless, the existing evidence is promising enough to recommend a healthy dose of exercise—cognitive, physical, and social—to ameliorate the less attractive outcomes of aging.

A healthy social network inherently demands a group of individuals collaborating for mutual benefit. Other activities mentioned above are also typically viewed as group events (e.g., playing a board game). The intellectual exchanges implicit within these social activities are yet another potential avenue for strengthening cognitive reserve.

Technology can play a central role in all of these pursuits. There is no shortage of “apps” and technological devices that compete for the attention of the elderly—and no shortage of claims about their effectiveness in sustaining cognitive functioning well into the sunset years. Research satisfactorily demonstrating these effects is practically nonexistent; however, given the evidence cited above, a rational approach would be to make use of a variety of technological innovations to keep the mind and body active.

The ways to leverage technology for cognitive benefit are endless. One could learn to blog, text, or tweet. Or start a ning or a Facebook account. Or create a DVD movie or use a smartphone app to play a word game with a remote friend. Or learn to play the Wii or an electronic keyboard. Variety seems to be important to cognitive acuity, so getting into a “rut” of continually interacting with the same technology is probably not a good idea.

The prescription, then, is to keep learning new technologies, maintain those social networks, and get out for a walk regularly. It’s never too early to start, and the mental stimulation may build cognitive reserve that will deliver mental advantages for years to come. With sufficient mental exercise, you might even remember all of your appointments!

References

Fratiglioni, L., Paillard-Borg, S., & Winblad, B. (2004). An active and socially integrated lifestyle in late life might protect against dementia. The Lancet Neurology, 3(6), 343–353. doi:10.1016/S1474-4422(04)00767-7

Gatz, M. (2005). Educating the brain to avoid dementia: Can mental exercise prevent Alzheimer disease? PLoS Medicine, 2, 38–40.

Pillai, J. A., Hall, C. B., Dickson, D. W., Buschke, H., Lipton, R. B., & Verghese, J. (2011). Association of crossword puzzle participation with memory decline in persons who develop dementia. Journal of the International Neuropsychological Society, 17, 1006–1013.

Verghese, J., Lipton, R. B., Katz, M. J., Hall, C. B., Derby, C. A., Kuslansky, G., ... Buschke, H. (2003). Leisure activities and the risk of dementia in the elderly. New England Journal of Medicine, 348(25), 2508–2516. doi:10.1056/NEJMoa022252

Wilson, R., Barnes, L., Aggarwal, N., Boyle, P., Hebert, L., Mendes de Leon, C., & Evans, D. (2010). Cognitive activity and the cognitive morbidity of Alzheimer disease. Neurology, 75(11), 990–996. doi:10.1212/WNL.0b013e3181f25b5e