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Star Tribune - St. Paul, Minneapolis

Maura Lerner - reporter, Star Tribune

March 19, 2007 - At age 81, Honor Hacker is on the cutting edge of the latest fitness fad: Exercising the brain. Once a day, she gives her mind a workout -- solving math problems and playing memory games -- on a special touch-screen computer at Lakeview Commons, an assisted living center in Maplewood.

It's all based on a concept that's sweeping the medical world: that what you do in your spare time can affect your risk of Alzheimer's disease and other types of dementia.

So far, experts admit, there's no direct evidence that "mental stimulation" can prevent anyone from getting Alzheimer's, a degeneration of the brain that affects 4.5 million Americans.

Yet a new wave of products is flooding the market, promising to stimulate brain cells and help stave off memory loss.

Last week, a California company called SharpBrains presented what it calls the world's first home-workout DVD of exercises for the brain. Another, called HappyNeuron, sells computerized brain teasers to subscribers for $9.95 a month. Even Nintendo has a game called "Brain Age" to keep "your brain in shape. "It's all wishful thinking," said Dr. David Knopman, an Alzheimer's researcher at the Mayo Clinic in Rochester.

But advocates -- including many doctors and the Alzheimer's Association -- say there's good reason to believe in links between lifestyle, including diet, exercise and activities that stimulate the brain, and the risk of dementia.

They point to population studies that have shown, for example, that people with higher education have a lower risk of Alzheimer's, as do people who are more physically and socially active. Obesity, high blood pressure and smoking also have been associated with a higher risk of memory loss.

As a result, many mainstream groups have jumped on the brain-health bandwagon. In January, Hennepin County Medical Center sponsored a dinner lecture called "Boot Camp for Your Brain," with tips on which foods, nuts, vitamins and hobbies may be good for the brain.

Even the menu was "brain-healthy": salmon, salad, veggies and wine.

Nationally, the Alzheimer's Association offers "Maintain Your Brain" classes with advice on everything from diet (more fish, less fat) to exercise (physical and mental) to keep the mind fit.

"We're not telling people that they can prevent this [disease]," said Michelle Barclay, director of program services for the Alzheimer's Association of Minnesota and North Dakota. But, she said, "people can reduce their risk."

An SAT for older folks

At Lakeview Commons, two dozen elderly volunteers have been testing the "[m]power cognitive fitness system" since December. The Maplewood senior home is one of 11 sites nationwide taking part in a pilot project to see how well it works.

Dakim Inc., the manufacturer, describes it as "an innovation in the fight against Alzheimer's disease and dementia," and a way to "help build and maintain mental agility."

It's a bit like a mini-SAT test on a computer. Only here, the math, history and geography questions are designed to be entertaining, with music and images from the 1930s and 1940s to appeal to the World War II generation.

Hacker, a retired schoolteacher, says the daily 20-minute exercises have helped her brush up on old skills. "My math is coming back," she said, and "[I'm] looking at things more carefully." Beyond that, she said, "You just get kind of a sense of accomplishment."

To Kathy Bakkenist, who brought the computer program to Lakeview Commons, that's a start.

"I hoped that it would engage people," said Bakkenist, a vice president of Lakeview's parent company, Ecumen. But the ultimate goal, she said, is to help residents stay sharp, and independent, longer.

Staying realistic

Not even the most avid supporters suggest that brain stimulation can reverse or stop dementia once it's started. But they argue that, along with proper diet and exercise, it encourages the growth of new brain cells. And that, in turn, may act as a buffer if Alzheimer's sets in and starts destroying other brain cells.

"What you're trying to do is create brain reserves," said Dr. Anne Murray, a geriatrician at the Augustana Senior Care Clinic in Minneapolis. "So if you take a hit, you still have some reserve to fall back on."

Dr. Richard Golden, a Twin Cities neurologist and Alzheimer's specialist, agrees. "It's not a cure by any means," he said. But, he said, the hope is that brain-healthy habits may slow down the effects of the disease. "You will maintain your brain function longer, even if you have Alzheimer's disease."

But Knopman, of the Mayo Clinic, is unconvinced. "It's plausible," he said, but entirely unproven.

The studies have been ambiguous, he said, and certainly haven't shown that mental calisthenics can affect the course of Alzheimer's.

"Either you prove that it works, or you don't make the claim," Knopman said. "Why are we holding this to a different standard?"

Golden, for one, doesn't disagree with Knopman, but he added that scientists are only starting to explore links between lifestyle and dementia.

"When you look at it in the daylight ... it's not been proven," he said. "The proof is going to be 40 years down the road."