The American Society of Aging asked me for an article on the topic, which I assume will become available online at some point and I will link to it. I will republish your comment as a blog post so that more readers can benefit from it.

Thanks!

However some good news for individuals did come out of the conference. Pages 7 & 8 of the “Systematic Evidence Review” (http://www.ahrq.gov/clinic/tp/alzcogtp.htm) provides a great snapshot of all the associated factors considered at the conference and their current status in terms of level of evidence. This document summarises the research from 25 systematic reviews and 250 primary research studies which were filtered from searches that located 6907 citations. The studies were evaluated for eligibility and quality, and data were abstracted on study design, demographics, intervention or predictor factor, and cognitive outcomes. The final report was peer reviewed. In terms of independence and weight of evidence this document is likely to provide the strongest position on the subject that we have today.

If we understand that all this evidence is still building but clearly has strong direction then I believe it is a good baseline (as of today) from which individuals may begin to make lifestyle choices. Of course as research progresses the baseline will change but for now I think it is a solid foundation from which to work. Personal preferences would guide choices but where the direction of association is categorised as .….
•“no evidence” we should probably consider ignoring
•“inadequate evidence” we should probably consider treating as suspicious
•“increasing or decreasing risk” we should probably consider to be strongly associated (but not definitive) and therefore offering promising (but not certain) lifestyle choices

So with any good risk management strategy our best bet is to diversify risk across several of the most likely factors. The “Systematic Evidence Review” clearly identifies the most likely risk factors. We don’t have certainty but we do have direction and I think that is an encouraging message for the public.

The good news for those interested in brain training is that in the findings for cognitive decline (page 8), cognitive training has the highest level of evidence.

I don’t think it “misrepresents” the research — what you are saying is consistent with what they are saying, you are each focusing on a different part of the puzzle. They could have communicated things better, putting things in at least some perspective by, for example, explaining cognitive reserve.

The problem is that we somehow seem to equate “there’s nothing proven to prevent Alzheimer’s” with “there’s nothing I can do to maintain/ enhance my cognitive fitness”. Those are 2 completely separate outcomes (that obviously influence each other), but we should all understand that they are separate outcomes; therefore, there are different tools and areas of research involved.

Think about like physical fitness — people today understand physical fitness is an outcome in itself for a variety of reasons, beyond the very important public health role it plays in preventing/ lowering risk of diseases. Even if the report says that physical exercise doesn’t have strong scientific evidence as a way to prevent Alzheimer’s…aren’t there many other reasons to engage in physical exercise?

I believe making this distinction clear would help educate and encourage the public and professionals to adopt/ promote better mindsets & behaviors, and also help accelerate research (in fact, I like many of the recommendations because they seem to go in precisely that direction).

Also, there is a difference between “nothing has been shown to prevent Alzheimer’s” (what they are saying, and good representation of research) and “there’s nothing I can do to lower the probability of developing Alzheimer’s symptoms” (which they are NOT saying, because it wouldn’t be true based on what we know).

At the end of the day, as individuals I think we would all be better served by thinking about neuroplasticity more as an invitation to lifelong cognitive development and maintenance rather than as a “prevention” of disease (even if it will obviously brings public health benefits too, at the population level).

Was there a conversation about all this when you were there? I saw that Yaakov Stern and Art Kramer were among speakers, haven’t talked to them.