5 ms·

Is there any evidence that that affects things either way? (Genuinely curious)

darkmighty 13y ago
I'm not sure about scientific evidence, but it's almost the case you don't need scientific evidence to know that keeping an active mind severely mitigates dementia. I think there's a lot of research regarding Alzheimer's, but this kind of research has huge timeframes which make hard to draw good conclusions from because of experimental design limitations.
- cloverich 13y ago
  > but it's almost the case you don't need scientific evidence to know that keeping an active mind severely mitigates dementia What makes you say that? There's plenty of medical phenomena that exist / don't exist despite being logically appealing.
  - darkmighty 13y ago
    I meant there's limited evidence (see robbiep's post), but it seems as intuitive as 'exercise makes you physically stronger', although I've never read scientific evidence on that.
    - GravityWell 13y ago
      There is almost unlimited empirical evidence for exercise making one stronger, so I don't see how that is intuitive, a better term is common knowledge. Is it intuitive that eye exercises improve age related visual decline? (It doesn't, just an example)
    - mikeash 13y ago
      "Exercise makes you physically stronger" isn't intuitive at all. Are you stronger after you exercise? No! You're weaker than when you started. Rest makes you stronger, short-term. The increase in strength from exercise happens over a very long period of time and is tough to correlate with the exercise unless you study it fairly deeply. Furthermore, non-living objects almost universally decrease in strength from exercise. Without actually studying the question in some detail, I don't see how one could intuitively conclude that exercise increases physical strength.
      - samatman 13y ago
        Because we are human bodies, with all the intuition and wisdom that entails. It's less intuition and wisdom than many people think; gut feelings for example should be examined, though they're often telling you something important. I think it's reasonable to infer that, as we are human bodies, we would know how to make ourselves stronger. The idea that mental exercise keeps the brain sharp comes from a similar intuition; it is not surprising to see it confirmed through study.
        mikeash 13y ago
        Why, exactly, would it be reasonable to infer that we would know how to make ourselves stronger, just because our bodies are where we live? Sure, you could say that mental exercise keeping the brain shark comes from intuition. And I could say that it's intuitive that mental exercise depletes the brain and makes things worse. I don't see how you decide which one is right without going out and studying it.
        samatman 13y ago
        One cannot, of course. It would be somewhat fatuous to be surprised that exercise makes one stronger, when it has been advocated for thousands of years as the (only) method for doing so. This is as true of mental exercise as it is of physical. It is not typical of our community norms to downvote reasonable arguments you disagree with. Just FYI.
        mikeash 13y ago
        I'm not talking about "surprised" or anything. I merely object to "intuitive", both in that I don't see how intuition supports this, and I don't think intuition is worth anything here anyway. Don't assume the person downvoting you is the person you're replying to.
        samatman 13y ago
        Indeed, that is impossible ^_^ It was an aside for whomever did so. Intuition is not a particularly valuable or precise word, is it.
    - damarquis 13y ago
      "you don't need scientific evidence to know" "but it seems as intuitive" Knowledge can come only from reasoning based upon observations. You cannot know anything by intuition. You can believe your intuitions and feel that they must be true, but you cannot know they are true.
- pcrh 13y ago
  In the field, what you are referring to is described as "cognitive reserve". People with higher educations levels or who have a more active lifestyle suffer less from the earlier stages of dementia, because they are better able to develop coping strategies. So, it is similar to exercise in the way that if you are fitter, then you can better weather adverse events. However, cognitive reserve doesn't delay the underlying progress of Alzheimer's disease.
robbiep 13y ago
There is absolutely evidence that mental acuity is protective against Alzheimer's. From [1] Education > 15 years (cf. <12) has the lowest relative risk (0.48) of developing Alzheimer's of all investigated interventions Patterson, C. et al. CMAJ 2008;178:548-556 (for those that can, DOI: 10.1503/cmaj.070796 )
- mzs 13y ago
  That's good, thanks, but it doesn't really address the original question regarding games for example. Also what if dementia already has some effects early in life, just more subtle. So for example early stages could be more difficulty concentrating, variations in attention, or greater difficulty in internalizing ideas, memorization, or recall. Then those who would later show typical symptoms of dementia later in life would be more likely to end education early just because they had more difficulty with it than their peers.
  - robbiep 13y ago
    Hi Mzs, thats a really good question and you're right I don't directly address it. Basically it's impossible to examine for that at the moment because 'games' etc would rely on a person's recall of, say, how much they did the cross-word, that sort of thing whereas education is verifiable and, in this case, statistically meaningful. Regarding onset of dementia. There are early-onset dementias that can start from the late 40's to 60s. These are usually of a genetic variant (For example, 2 copies of ApoE4 gene, Amyloid Precursor Protein or a presenilin mutation, or Down's syndrome). Diabetes is a big risk factor as well. There are also a number of dementias that are of early onset that are not Alzheimer's such as Frontotemporal dementia and Semantic Dementia which are awful diseases and it's terrible to watch patients so young with such severe pathology. >Also what if dementia already has some effects early in life, just more subtle. Just to focus on the most common dementia, Alzheimer's - We know that it doesn't have more subtle effects early on. When you start to develop it, you start to develop it. The following things are the features of Alzheimer's, in order of progression: - Memory o Impaired anterograde episodic memory o delayed recall of stories o ‘Sparing’ of Working memory - Attentional and executive deficits o poor concentration - Language and Knowledge o Impaired semantics - Visuospatial and perceptual disabilities But It definitely is not apparent so early for example in people at 20 or 30 years of age. We know this because brain biopsies from post mortems of young people don't show the neuronal loss, amyloid plaques and 'tombsones' of Tau protein tangles on histology which is pathognomonic of the disease. In fact, Education seems to be so important at preventing the march of the disease not because higher levels of brain activity somehow decrease deposition of the characteristic histology findings, but because increased education increases so-called 'cognitive reserve', meaning that even when the damage starts to occur, the person is still able to function at such a high level because the decline in global cognitive capabilities has not yet been so great that the characteristic signs and symptoms have begun to manifest. Could you argue cause vs effect with regard to education and cognitive reserve? Sure, and I haven't examined the data closely enough with regard to education to know how or if they controlled for it. However I have read extensively from the original literature with regard to the origins and pathogenesis of the disease and trust that something that is trumpeted at being a major factor in delaying the development of AD, by way of the quality of the reporting literature (Lancet, NEJM, Nature and Nature Medicine) to not have been missed after extensive peer review over the course of several decades (?the argument from authority? I feel it is well enough established to be fact)

I'm not sure about scientific evidence, but it's almost the case you don't need scientific evidence to know that keeping an active mind severely mitigates dementia. I think there's a lot of research regarding Alzheimer's, but this kind of research has huge timeframes which make hard to draw good conclusions from because of experimental design limitations.

cloverich 13y ago
> but it's almost the case you don't need scientific evidence to know that keeping an active mind severely mitigates dementia What makes you say that? There's plenty of medical phenomena that exist / don't exist despite being logically appealing.
- darkmighty 13y ago
  I meant there's limited evidence (see robbiep's post), but it seems as intuitive as 'exercise makes you physically stronger', although I've never read scientific evidence on that.
  - GravityWell 13y ago
    There is almost unlimited empirical evidence for exercise making one stronger, so I don't see how that is intuitive, a better term is common knowledge. Is it intuitive that eye exercises improve age related visual decline? (It doesn't, just an example)
  - mikeash 13y ago
    "Exercise makes you physically stronger" isn't intuitive at all. Are you stronger after you exercise? No! You're weaker than when you started. Rest makes you stronger, short-term. The increase in strength from exercise happens over a very long period of time and is tough to correlate with the exercise unless you study it fairly deeply. Furthermore, non-living objects almost universally decrease in strength from exercise. Without actually studying the question in some detail, I don't see how one could intuitively conclude that exercise increases physical strength.
    - samatman 13y ago
      Because we are human bodies, with all the intuition and wisdom that entails. It's less intuition and wisdom than many people think; gut feelings for example should be examined, though they're often telling you something important. I think it's reasonable to infer that, as we are human bodies, we would know how to make ourselves stronger. The idea that mental exercise keeps the brain sharp comes from a similar intuition; it is not surprising to see it confirmed through study.
      - mikeash 13y ago
        Why, exactly, would it be reasonable to infer that we would know how to make ourselves stronger, just because our bodies are where we live? Sure, you could say that mental exercise keeping the brain shark comes from intuition. And I could say that it's intuitive that mental exercise depletes the brain and makes things worse. I don't see how you decide which one is right without going out and studying it.
        samatman 13y ago
        One cannot, of course. It would be somewhat fatuous to be surprised that exercise makes one stronger, when it has been advocated for thousands of years as the (only) method for doing so. This is as true of mental exercise as it is of physical. It is not typical of our community norms to downvote reasonable arguments you disagree with. Just FYI.
        mikeash 13y ago
        I'm not talking about "surprised" or anything. I merely object to "intuitive", both in that I don't see how intuition supports this, and I don't think intuition is worth anything here anyway. Don't assume the person downvoting you is the person you're replying to.
        samatman 13y ago
        Indeed, that is impossible ^_^ It was an aside for whomever did so. Intuition is not a particularly valuable or precise word, is it.
  - damarquis 13y ago
    "you don't need scientific evidence to know" "but it seems as intuitive" Knowledge can come only from reasoning based upon observations. You cannot know anything by intuition. You can believe your intuitions and feel that they must be true, but you cannot know they are true.
pcrh 13y ago
In the field, what you are referring to is described as "cognitive reserve". People with higher educations levels or who have a more active lifestyle suffer less from the earlier stages of dementia, because they are better able to develop coping strategies. So, it is similar to exercise in the way that if you are fitter, then you can better weather adverse events. However, cognitive reserve doesn't delay the underlying progress of Alzheimer's disease.

robbiep 13y ago

There is absolutely evidence that mental acuity is protective against Alzheimer's. From [1] Education > 15 years (cf. <12) has the lowest relative risk (0.48) of developing Alzheimer's of all investigated interventions Patterson, C. et al. CMAJ 2008;178:548-556 (for those that can, DOI: 10.1503/cmaj.070796 )

mzs 13y ago
That's good, thanks, but it doesn't really address the original question regarding games for example. Also what if dementia already has some effects early in life, just more subtle. So for example early stages could be more difficulty concentrating, variations in attention, or greater difficulty in internalizing ideas, memorization, or recall. Then those who would later show typical symptoms of dementia later in life would be more likely to end education early just because they had more difficulty with it than their peers.
- robbiep 13y ago
  Hi Mzs, thats a really good question and you're right I don't directly address it. Basically it's impossible to examine for that at the moment because 'games' etc would rely on a person's recall of, say, how much they did the cross-word, that sort of thing whereas education is verifiable and, in this case, statistically meaningful. Regarding onset of dementia. There are early-onset dementias that can start from the late 40's to 60s. These are usually of a genetic variant (For example, 2 copies of ApoE4 gene, Amyloid Precursor Protein or a presenilin mutation, or Down's syndrome). Diabetes is a big risk factor as well. There are also a number of dementias that are of early onset that are not Alzheimer's such as Frontotemporal dementia and Semantic Dementia which are awful diseases and it's terrible to watch patients so young with such severe pathology. >Also what if dementia already has some effects early in life, just more subtle. Just to focus on the most common dementia, Alzheimer's - We know that it doesn't have more subtle effects early on. When you start to develop it, you start to develop it. The following things are the features of Alzheimer's, in order of progression: - Memory o Impaired anterograde episodic memory o delayed recall of stories o ‘Sparing’ of Working memory - Attentional and executive deficits o poor concentration - Language and Knowledge o Impaired semantics - Visuospatial and perceptual disabilities But It definitely is not apparent so early for example in people at 20 or 30 years of age. We know this because brain biopsies from post mortems of young people don't show the neuronal loss, amyloid plaques and 'tombsones' of Tau protein tangles on histology which is pathognomonic of the disease. In fact, Education seems to be so important at preventing the march of the disease not because higher levels of brain activity somehow decrease deposition of the characteristic histology findings, but because increased education increases so-called 'cognitive reserve', meaning that even when the damage starts to occur, the person is still able to function at such a high level because the decline in global cognitive capabilities has not yet been so great that the characteristic signs and symptoms have begun to manifest. Could you argue cause vs effect with regard to education and cognitive reserve? Sure, and I haven't examined the data closely enough with regard to education to know how or if they controlled for it. However I have read extensively from the original literature with regard to the origins and pathogenesis of the disease and trust that something that is trumpeted at being a major factor in delaying the development of AD, by way of the quality of the reporting literature (Lancet, NEJM, Nature and Nature Medicine) to not have been missed after extensive peer review over the course of several decades (?the argument from authority? I feel it is well enough established to be fact)