I still love doing crossword puzzles; never did it as “brain therapy,” though. Thanks for your vitamin D explanation to Terry Hilsberg in the Comments section, since that one seems all the rage in recent years. Many thanks for your clarifying and informative articles.
Your reasons for why to be skeptical about these findings are not well thought out or particularly original. The idea that it is implausible that behavior alters neurobiology ignores probably tens of thousands of findings. Entire fields of study are based on this premise. Saying that this or that research question isn't worthy of study is an odd mindset, and quite frankly in this case one that I don't think you are qualified to make. All of your other concerns about effect size, clinical significance, etc etc are generic criticism that apply to many studies.
Thanks for the comment. I’m not going for originality, just accuracy. I’d love to be wrong and be convinced that staying mentally engaged prevents a horrific degenerative neurological disease. I just have seen no evidence that even vaguely suggests that. Feel free to point me in the right direction.
Who said anything about preventing AD? Neither the WaPo article or the JAMA article say anything about prevention. The study is testing whether or not a behavior alters disease course in a specific population likely to develop AD. Are you suggesting there is no basis to expect a behavioral intervention to alter neurobiology? Or that NIA should only fund research testing drugs that target Tau or A beta?
I am also suspicious that you lack the expertise to properly contextualize the changes ADAS-Cog. Have you ever used that scale? Published research on it?
Scrabble played with people who are not particular about correct spelling is better than crossword puzzles. Funner and requires recognition of letters. And i believe you said they did the test using crossword puzzles on computers showing the lack of understanding of the subject group.
Always enjoy reading your articles Dr. Cifu. My 98-year-old mom has been addicted to crosswords since childhood. She's independently living in senior housing where they do all the meals and housekeeping. I can't point to much of anything except good genes to explain her abilities. She must do 2-3 crosswords daily and kicks butt in Scrabble. She is losing memory but very slowly!
My Mom is 97 and in assisted living as well. She walks for 30 minutes a day, reads books, plays solitaire, has two glasses of wine per day, and eats Sees candy.
I'm pretty sure it's her genes that got her this far although I tell the people at Sees that it's the candy.
Vit D is linked to calcium absorption for bone mineralization and renewal. Aging reduces Vit D production in the skin. Despite being an outdoor enthusiast I learned my D level was quite low after breaking a femur in a minor fall. Should have been tested much earlier for bone density and D levels than 65.
The headline drew my attention immediately because I don’t want to be asked to do puzzles. I like them ok, but 4 years ago we downsized and I have no place for a 500 or 1000 piece puzzle littering my space. I’d rather be working on sewing projects.
I’m 71 in a few weeks. Here are some of my observations about my mental decline, word finding, loosing a thought once I have the attention of my listener, recognition of place, sometimes faces, but not faces I know well. These phenomena aren’t that nice but I’m not sure what to do about them so I try to release these things from my mind. From what’s I know of neuroscience and myself I suspect worry, depression and isolation may be a contributor to cognitive decline. It seems possible that exposure to chemicals (so many and so many chemical combinations in my lifetime to soil, air & water) may have an effect, and one that might be involved with other body systems. I’ve been studying neuroscience since my 20’s and used it in my work as an ergonomist. It is fascinating. Out bodies are endlessly fascinating.
I enjoyed your wit. I hope to look at more of your entries. I seek to find your definitions of, for instance, churnalism et al. I’ll look for your podcast. Thanks for your thoughts and the time you took to post them.
If keeping the mind active actually does prevent things like dementia and cognitive decline, I would think we have a natural experiment running right now. The near universalism of smartphones and their constant need for attention would seem to be the obvious way to make it work.
Perhaps we should look at how those who didn’t grow up with smartphones and people who did. See if there’s any differences between the two in cognitive outcomes.
The use of change from baseline is a violation of the RCT design. A parallel-group RCT should compare parallel groups, not compare change from baseline. Baseline should only appear as an adjustment covariate, which unlike the authors' analysis will handle floor and ceiling effects and regression to the mean.
[iii] is my mantra. If I get demented I won’t know it so meantime I’ll do my best to hydrate, eat correctly to the best of my ability, exercise, and avoid articles that suggest medical miracles.
Thank you for allaying my fears. I have never liked crossword puzzles and have never done them.
I remember a neuro scientist being interviewed on the radio about his research ( probably 10 or so years ago likely NPR) At the end of the interview the radio host asked the question “What’s the best exercise for the brain?” The scientist answer,”take a walk outside everyday”. I remember the host being taken aback and replied something like “that’s it?”(not those exact words but the sentiment). He was very low key throughout the interview and explained in the same simple manner that walking helps circulation and your brain gets stimulated more outdoors.
Will walking outside cure Alzheimer’s, probably not but it’s at least as stimulating as a crossword and has many other health benefits.
"Alzheimer’s there is an overproduction and/or decreased clearance of amyloid beta peptides. The pathogenesis also involves the hyperphosphorylation and aggregation of the tau protein."...is this the now-becoming debunked theory of Alzheimer's and the amyloid proteins? I have been reading about the possible lies the research in pharmacological intervention has been going on...with all their eggs in one basket?
Yes it's my understanding that these proteins are indisputably linked to Alzheimers but that treatments which target the proteins have been mostly ineffective at alleviating dementia. Despite repeated failures, there also seems to be a bias in research institutions towards continued research in this area. I read about it in a good article from The Free Press https://www.thefp.com/p/where-is-the-cure-for-alzheimers
Good reply. I think what we have learned is that it is complicated. More advanced imaging supports the relationship but we don't have any good targeted therapy yet.. Definitely not an either or.
Hasn't the fraud around Sylvaine Lesne's research and the failure of all drugs targeting amyloid or tau, and the realization that many patients with amyloid or tau have no dementia cast serious doubt on these compounds being causative?
I think what we have learned is that it is complicated. More advanced imaging supports the relationship but we don't have any good targeted therapy yet.. Definitely not an either or.
Love your articles because they are factual & quite interesting too.
I love puzzles & always have...
I'm talking about the boxed puzzles where you put the pieces together.
I am very good at it & always have been.
I'm 70 & figure if I started having cognitive problems doing them; that would then be a sign that I might need to have myself checked by a physician who specializes in dementia, etc.
Other than that I don't worry about it much...too many other important things than to pay attention to these studies that skew evidence the way they want.
I agree with you re- your comments on the above-mentioned study. Nevertheless, I was surprised re- your comment re- recent VD3, coffee and exercise studies as being "crazy". My impression was that the most recent RCT and longitudinal observational studies had all turned towards showing these interventions as yielding positive results in large populations. Could you please cite the sources of your thoughts re- the lack of efficacy of these three interventions. Perhaps I have been leading a sheltered life and having search problems on PUBMED!
My aggravation with those studies is that they tend to be highly flawed observational studies that are either terribly confounded or can be made to show anything. Some of our initial churnalism articles get at the problem. As to Vit D. There are lots of reasons to think it is helpful in immunity. High levels are associated with less severe COVID. Supplementation doesn't help. You could read these results as that it is a prevention, not a treatment, or that the protective signal is the product of confounding. We don't know.
I did just re-watch it before putting the link in this thread, but I can't remember if they took care to administer the vitamin D with enough lead time for it to be metabolized into 25(OH). I also don't remember if the study involved periodic measurements of the participants' blood levels leading up to any illness. I guess I need to watch it again.
I haven't had a seasonal cold since the winter of 2008-9, when I started A. using a neti pot fairly regularly and B. taking significant amounts of vitamin D3. Starting at I think 2000 IU/day, and increasing over time to 5000 IU/day. I haven't checked my blood level in over a year, but it was right around 60 ng/ml.
It's easy to imagine that there might be a synergistic effect between cellular melatonin and vitamin D, such that deprivation of NIR from sunlight would greatly limit the effect of the person's vitamin D from whatever source, and also that *some* sunlight might provide less than enough vitamin D, but enough NIR to synergize with total vitamin D from sunlight *and* supplementation (and diet).
I’m not speaking to covid specifically but health in general. It is well established that vitamin D is a key component for a healthy immune system and the vast majority of North Americans are vitamin D deficient. A robust immune system will enable your body to fight off a virus, corona or otherwise.
I still love doing crossword puzzles; never did it as “brain therapy,” though. Thanks for your vitamin D explanation to Terry Hilsberg in the Comments section, since that one seems all the rage in recent years. Many thanks for your clarifying and informative articles.
Your reasons for why to be skeptical about these findings are not well thought out or particularly original. The idea that it is implausible that behavior alters neurobiology ignores probably tens of thousands of findings. Entire fields of study are based on this premise. Saying that this or that research question isn't worthy of study is an odd mindset, and quite frankly in this case one that I don't think you are qualified to make. All of your other concerns about effect size, clinical significance, etc etc are generic criticism that apply to many studies.
Thanks for the comment. I’m not going for originality, just accuracy. I’d love to be wrong and be convinced that staying mentally engaged prevents a horrific degenerative neurological disease. I just have seen no evidence that even vaguely suggests that. Feel free to point me in the right direction.
Who said anything about preventing AD? Neither the WaPo article or the JAMA article say anything about prevention. The study is testing whether or not a behavior alters disease course in a specific population likely to develop AD. Are you suggesting there is no basis to expect a behavioral intervention to alter neurobiology? Or that NIA should only fund research testing drugs that target Tau or A beta?
I am also suspicious that you lack the expertise to properly contextualize the changes ADAS-Cog. Have you ever used that scale? Published research on it?
Scrabble played with people who are not particular about correct spelling is better than crossword puzzles. Funner and requires recognition of letters. And i believe you said they did the test using crossword puzzles on computers showing the lack of understanding of the subject group.
Always enjoy reading your articles Dr. Cifu. My 98-year-old mom has been addicted to crosswords since childhood. She's independently living in senior housing where they do all the meals and housekeeping. I can't point to much of anything except good genes to explain her abilities. She must do 2-3 crosswords daily and kicks butt in Scrabble. She is losing memory but very slowly!
My Mom is 97 and in assisted living as well. She walks for 30 minutes a day, reads books, plays solitaire, has two glasses of wine per day, and eats Sees candy.
I'm pretty sure it's her genes that got her this far although I tell the people at Sees that it's the candy.
Ah yes! My mom has red wine every day. She’s on exactly one medication Donepezil. Maybe that’s the winning combination?
Love it. Remind me never to play her!
Vit D is linked to calcium absorption for bone mineralization and renewal. Aging reduces Vit D production in the skin. Despite being an outdoor enthusiast I learned my D level was quite low after breaking a femur in a minor fall. Should have been tested much earlier for bone density and D levels than 65.
The headline drew my attention immediately because I don’t want to be asked to do puzzles. I like them ok, but 4 years ago we downsized and I have no place for a 500 or 1000 piece puzzle littering my space. I’d rather be working on sewing projects.
I’m 71 in a few weeks. Here are some of my observations about my mental decline, word finding, loosing a thought once I have the attention of my listener, recognition of place, sometimes faces, but not faces I know well. These phenomena aren’t that nice but I’m not sure what to do about them so I try to release these things from my mind. From what’s I know of neuroscience and myself I suspect worry, depression and isolation may be a contributor to cognitive decline. It seems possible that exposure to chemicals (so many and so many chemical combinations in my lifetime to soil, air & water) may have an effect, and one that might be involved with other body systems. I’ve been studying neuroscience since my 20’s and used it in my work as an ergonomist. It is fascinating. Out bodies are endlessly fascinating.
I enjoyed your wit. I hope to look at more of your entries. I seek to find your definitions of, for instance, churnalism et al. I’ll look for your podcast. Thanks for your thoughts and the time you took to post them.
Thanks so much. Please do follow the links to our first churnalism articles. They are a recurring series.
If keeping the mind active actually does prevent things like dementia and cognitive decline, I would think we have a natural experiment running right now. The near universalism of smartphones and their constant need for attention would seem to be the obvious way to make it work.
Perhaps we should look at how those who didn’t grow up with smartphones and people who did. See if there’s any differences between the two in cognitive outcomes.
Sooo--it makes you crazy when articles suggest there is a benefit to vitamin D? Such a crazy notion. Such ignorant people. Shocking.
The use of change from baseline is a violation of the RCT design. A parallel-group RCT should compare parallel groups, not compare change from baseline. Baseline should only appear as an adjustment covariate, which unlike the authors' analysis will handle floor and ceiling effects and regression to the mean.
[iii] is my mantra. If I get demented I won’t know it so meantime I’ll do my best to hydrate, eat correctly to the best of my ability, exercise, and avoid articles that suggest medical miracles.
Thank you for allaying my fears. I have never liked crossword puzzles and have never done them.
I remember a neuro scientist being interviewed on the radio about his research ( probably 10 or so years ago likely NPR) At the end of the interview the radio host asked the question “What’s the best exercise for the brain?” The scientist answer,”take a walk outside everyday”. I remember the host being taken aback and replied something like “that’s it?”(not those exact words but the sentiment). He was very low key throughout the interview and explained in the same simple manner that walking helps circulation and your brain gets stimulated more outdoors.
Will walking outside cure Alzheimer’s, probably not but it’s at least as stimulating as a crossword and has many other health benefits.
Oh c’mon Dr Cifu, all my assisted living residents know that Word Search is better for your memory than crossword puzzles, just ask ‘em. :-)
😂
"Alzheimer’s there is an overproduction and/or decreased clearance of amyloid beta peptides. The pathogenesis also involves the hyperphosphorylation and aggregation of the tau protein."...is this the now-becoming debunked theory of Alzheimer's and the amyloid proteins? I have been reading about the possible lies the research in pharmacological intervention has been going on...with all their eggs in one basket?
Yes it's my understanding that these proteins are indisputably linked to Alzheimers but that treatments which target the proteins have been mostly ineffective at alleviating dementia. Despite repeated failures, there also seems to be a bias in research institutions towards continued research in this area. I read about it in a good article from The Free Press https://www.thefp.com/p/where-is-the-cure-for-alzheimers
Good reply. I think what we have learned is that it is complicated. More advanced imaging supports the relationship but we don't have any good targeted therapy yet.. Definitely not an either or.
Hasn't the fraud around Sylvaine Lesne's research and the failure of all drugs targeting amyloid or tau, and the realization that many patients with amyloid or tau have no dementia cast serious doubt on these compounds being causative?
I think what we have learned is that it is complicated. More advanced imaging supports the relationship but we don't have any good targeted therapy yet.. Definitely not an either or.
Love your articles because they are factual & quite interesting too.
I love puzzles & always have...
I'm talking about the boxed puzzles where you put the pieces together.
I am very good at it & always have been.
I'm 70 & figure if I started having cognitive problems doing them; that would then be a sign that I might need to have myself checked by a physician who specializes in dementia, etc.
Other than that I don't worry about it much...too many other important things than to pay attention to these studies that skew evidence the way they want.
I agree with you re- your comments on the above-mentioned study. Nevertheless, I was surprised re- your comment re- recent VD3, coffee and exercise studies as being "crazy". My impression was that the most recent RCT and longitudinal observational studies had all turned towards showing these interventions as yielding positive results in large populations. Could you please cite the sources of your thoughts re- the lack of efficacy of these three interventions. Perhaps I have been leading a sheltered life and having search problems on PUBMED!
My aggravation with those studies is that they tend to be highly flawed observational studies that are either terribly confounded or can be made to show anything. Some of our initial churnalism articles get at the problem. As to Vit D. There are lots of reasons to think it is helpful in immunity. High levels are associated with less severe COVID. Supplementation doesn't help. You could read these results as that it is a prevention, not a treatment, or that the protective signal is the product of confounding. We don't know.
Here's a presentation by some YT doctors:
https://youtu.be/9eEyWlbToI4
Thats a interesting one. Multiple studies showing it's sunlight thats giving the health benefit, not the Vit D.
You get Vitamin D from sunlight. Or you can take supplements.
Watch the video, the supplements have no effect.
I did just re-watch it before putting the link in this thread, but I can't remember if they took care to administer the vitamin D with enough lead time for it to be metabolized into 25(OH). I also don't remember if the study involved periodic measurements of the participants' blood levels leading up to any illness. I guess I need to watch it again.
I haven't had a seasonal cold since the winter of 2008-9, when I started A. using a neti pot fairly regularly and B. taking significant amounts of vitamin D3. Starting at I think 2000 IU/day, and increasing over time to 5000 IU/day. I haven't checked my blood level in over a year, but it was right around 60 ng/ml.
It's easy to imagine that there might be a synergistic effect between cellular melatonin and vitamin D, such that deprivation of NIR from sunlight would greatly limit the effect of the person's vitamin D from whatever source, and also that *some* sunlight might provide less than enough vitamin D, but enough NIR to synergize with total vitamin D from sunlight *and* supplementation (and diet).
Thanks all. See my comment to Terry above.
I’m not speaking to covid specifically but health in general. It is well established that vitamin D is a key component for a healthy immune system and the vast majority of North Americans are vitamin D deficient. A robust immune system will enable your body to fight off a virus, corona or otherwise.
Agreed. I was taken aback by his comment on vitamin D as well.