The cog­ni­tive or brain reserve hypoth­e­sis states that it is pos­si­ble to build up the brain’s resilience to neu­ronal dam­age and delay the onset of Alzheimer’s symp­toms. The con­cept of brain reserve stems from the repeated obser­va­tion that the rela­tion­ship between clin­i­cal symp­toms and actual brain pathol­ogy is not direct. For exam­ple, Katz­man and col­leagues (1989) described 10 cases of cog­ni­tively nor­mal older adults who, at death, were dis­cov­ered to have advanced Alzheimer’s dis­ease pathol­ogy in their brains. The researchers hypoth­e­sized that these indi­vid­u­als did not show symp­toms of Alzheimer’s because they had larger brains, that is more neu­rons. The idea is that hav­ing a larger reserve of neu­rons and abil­i­ties can off­set the losses caused by Alzheimer’s. The con­cept of cognitive/brain reserve is thus defined as the abil­ity of an indi­vid­ual to tol­er­ate pro­gres­sive brain pathol­ogy (includ­ing Alzheimer’s plaques and tan­gles) with­out demon­strat­ing clin­i­cal cog­ni­tive symptoms.

Sub­se­quent research has shown that fre­quent par­tic­i­pa­tion in men­tally stim­u­lat­ing activ­i­ties reduces the risk of Alzheimer’s dis­ease, pos­si­bly by increas­ing brain reserve. As a con­se­quence, brain activ­ity or exer­cise in gen­eral is hypoth­e­sized to help increase brain reserve.

In our view, brain train­ing is more than the stim­u­la­tion trig­gered by chal­leng­ing daily activ­i­ties. We define brain train­ing as the struc­tured use of cog­ni­tive exer­cises aimed at improv­ing spe­cific brain func­tions (see Chap­ter 3).

Rig­or­ous and tar­geted brain train­ing has been used in clin­i­cal prac­tice for many years as a way of help­ing patients recov­er­ing from the effects of trau­matic brain injury, stroke, and other neu­ro­log­i­cal dis­or­ders. It can help improve mem­ory, atten­tion, con­fi­dence and com­pe­tence, rea­son­ing skills, and even reduce anxiety.

Past research out­side the clin­i­cal domain has shown that cog­ni­tive abil­i­ties can also be trained sys­tem­at­i­cally in healthy indi­vid­u­als. Indi­vid­u­als trained in a spe­cific task usu­ally will become bet­ter at this task (see for instance Willis et al., 2006 or Ball et al., 2002). What is even more impor­tant, such train­ing some­times has gen­er­al­ized effects improv­ing per­for­mance on other, sim­i­lar tasks.

Although it has been long thought that “you can­not teach old dogs new tricks, many stud­ies show that cog­ni­tion can be trained at all ages. In par­tic­u­lar, many stud­ies have shown that mid­dle age indi­vid­u­als as well as older indi­vid­u­als can learn tech­niques to boost their mem­ory (see for exam­ple Brooks et al., 1999; Der­winger et al., 2003 or the meta-analysis pub­lished by Ver­haeghen et al. in 1992).

If we could sum­ma­rize a vari­ety of research fields and find­ings into a few use­ful guide­lines, we would say that ¨good¨ brain exer­cise requires vari­ety, chal­lenge and nov­elty.  Read the guide­lines below.

Var­ied, novel and chal­leng­ing exer­cises will nec­es­sar­ily induce learn­ing. Learn­ing is crit­i­cal. When one learns a new fact or a new way of accom­plish­ing a task, neu­rons and synapses “ con­nec­tions “ in the brain change. This is neu­ro­plas­tic­ity as defined early. The changes asso­ci­ated with learn­ing may help increase one’s brain reserve, con­tribut­ing to gen­eral brain health.

Learn­ing and chang­ing is never easy. This requires effort. As Dr. James Zull points out learn­ing and chang­ing require get­ting out of our com­fort zones. Often, the fear of fail­ing is a key obsta­cle to learn­ing.

Recipe for a good men­tal exercise

• Vari­ety: Exces­sive spe­cial­iza­tion is not the best strat­egy for long-term brain health. A bet­ter strat­egy is to stim­u­late the mul­ti­ple func­tions of the brain. This can be done by cre­at­ing a men­tal work­out cir­cuit sim­i­lar to a phys­i­cal exer­cise cir­cuit in a health club since our brains are com­posed of mul­ti­ple struc­tures with mul­ti­ple functions.

• Chal­lenge:  The goal is to be exposed to increas­ing lev­els of chal­lenge, so that a task never becomes too easy or routine.

• Nov­elty:  Try­ing new things is impor­tant since very impor­tant parts of the brain, such as the pre­frontal cor­tex, are mostly exer­cised when we learn to mas­ter new cog­ni­tive challenges.

These are the recipe for a good men­tal exercise

Keep learn­ing by read­ing more arti­cles in the Resources sec­tion, and also please con­sider join­ing our free monthly Brain Fit­ness eNewsletter

This new online resource is based on the con­tent from the book The Sharp­Brains Guide to Brain Fit­ness (May 2009, $19.95), by Alvaro Fer­nan­dez and Dr. Elkhonon Goldberg.

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