Exercise as a therapy for preventing cognitive decline

Summary: The recent paradigm for the treatment of cognitive impairment has shifted to non pharmacological interventions such as exercise.  Some results published recently have shown a positive role of exercise in preventing cognitive decline. The common message of all these studies involving different population and different cultures is that exercise is beneficial in preventing the cognitive decline. In the future,  evidence based exercise therapy can be introduced  by developing a thorough systematic exercise protocol  and integrating it with molecular profiling of the underlying cellular and molecular changes induced by the exercise protocol.   

Cognitive impairment is one of the major public health problem faced by the modern society affecting primarily the elderly population. It can have many possible causes such as metabolic and endocrine dysfunction, medicinal side effects, depression and Alzheimer’s disease. While there are some medications that are used as cognitive enhancers, no known medication that could prevent or treat the cognitive decline have been developed yet.  Developing a drug that could prevent or treat cognitive decline is a challenging prospect. Therefore, more efforts have been put into conventional or non pharmacological interventions such as diet and exercise. Assessing the current studies, the results are encouraging and in the near future we could be up for some type of exercise therapy for the prevention/treatment of cognitive impairment. Here, I am trying to summarize some of the studies related to exercise and cognition published in 2017. The common message of all these studies involving different population and cultures is that exercise is beneficial in preventing cognitive decline.

A systematic review published in the British Journal of Sports Medicine showed that physical exercise improves cognitive function in the elderly. This meta analyses took into the account 39 different studies till November 2016.  The study looked into several different types  of aerobic exercise, such as resistance training , multicomponent training and tai chi (Chinese martial art),  and found that moderate intensity aerobic exercise decreases the cognitive decline in patients older than 50 years irrespective of their cognitive status.

Similar result was obtained in another study published by Piedra et al. in the Journal of Alzheimer’s Disease. The study investigated the effects of exercise intervention on cognitive function in the elderly latinos/hispanic population (older than 60 years). The participants were examined for their cognitive function(baseline) before initiating the exercise intervention program.  Then, following the exercise intervention program, the cognitive function was again measured after 1 year and 2 year periods.   The results showed that participants involved in the exercise intervention program had higher cognitive function scores after 1 year and 2 year follow ups as compared to their initial baseline scores.

Not only is exercise beneficial to the elderly people. It is also beneficial to the adults of any age suffering from chronic diseases. The study published by Cai et al. in Clinical Interventions in Aging have found that exercise is beneficial in preventing the cognitive decline in the adults (older than 18 years) with chronic disease. This metaanalyses and systematic review took into account 36 different studies till September 2016. The studied participants were diagnosed with chronic diseases such as arthritis, asthma, cancer, COPD, diabetes, heart disease, or AIDS. This study found that exercise is beneficial in improving the cognitive function of patient suffering from chronic disease irrespective of  the type of clinical disease, type of exercise, frequency, and intensity of the exercise intervention.

These are some of the recently published studies related to exercise and cognition in 2017. The results of these studies clearly showed that exercise could potentially act as a non pharmacological therapy in preventing cognitive decline.  However, development of a systematic exercise protocol supported by molecular profiling of underlying exercise induced changes could be of immense help in establishing evidence based exercise therapy. 

Particularly,in regards to exercise, the rule of thumb is any amount of physical activity is beneficial and as the above studies suggest, it is beneficial to prevent/slow the cognitive decline as well.


Northey JM, Cherbuin N, Pumpa KL, Smee DJ, Rattray B. Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. Br J Sports Med. 2017 Apr 24. pii: bjsports-2016-096587. doi: 10.1136/bjsports-2016-096587. [Epub ahead of print] Review.

Piedra LM, Andrade FC, Hernandez R, Boughton SW, Trejo L, Sarkisian CA. The Influence of Exercise on Cognitive Function in Older Hispanic/Latino Adults: Results From the “¡Caminemos!” Study. Gerontologist. 2017 Mar 15. doi: 10.1093/geront/gnw256. [Epub ahead of print] 

Cai H, Li G, Hua S, Liu Y, Chen L. Effect of exercise on cognitive function in chronic disease patients: a meta-analysis and systematic review of randomized controlled trials.Clin Interv Aging. 2017 May 11;12:773-783. doi: 10.2147/CIA.S135700. eCollection 2017. Review.

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What is ‘attention’ and where is it in the brain?

A concise information related to attention

This is the third in a series on Understanding Attention Deficit/Hyperactivity Disorder (ADHD). Today we look closer at the nature of attentiveness and its location in the brain.

english_brainAttention is the ability of the brain to selectively concentrate on one aspect of the environment while ignoring other things. There are two types of attention in two separate regions of the brain. The prefrontal cortex (directly behind the forehead) is in charge of willful concentration; if you are studying for a test or writing a novel, the impetus and the orders come from there. But if there is a sudden, riveting event – the attack of a tiger or the scream of a child – it is the parietal cortex (behind the ear) that is activated. Scientists have learned that these two brain regions sustain concentration when the neurons emit pulses of electricity at specific rates – faster frequencies for the automatic processing of the parietal…

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Nutrition and Neurodegenerative diseases

“You are what you eat”. The importance of nutrition for the human health has been known since the ancient times. There is no doubt that nutrition is one of the prime factors that affect the health of any living being, plants or animals alike.

Recently, a lot of research has been focused in the role of nutrition in human health. Epidemiological studies in human and experimental animal studies have been conducted to see if there is any particular association between human diet and diseases.

One of the areas that scientists are prioritizing is Neurodegenerative diseases which include dementia and Alzheimer’s disease. It has been estimated that 30% of the total population will be over 65 years of age by 2050. With the increasing population, there will also be an increase in the economic burden to take care and to treat the age related disorders which might call for the measures for preventing or even reversing the age related health disorders. Among the potential option for achieving this is the use of nutritional substances for the prevention of the age related diseases.

The relationship between nutrition and cognitive decline is complex and it might be multifactorial involving several environemental factors such as nutrients, pollutants, chemicals, physical activity, lifestyle, physical and mental stress.

Epidemiological studies have shown that micronutrients such as Vitamin B, C D and E, flavonoids, polyunsaturated omega-3-fatty acids to have protective role in the prevention of cognitive decline, dementia and AD. So, consumption of these foods containing these micronutrients might help in preventing the neurodegeneration and other health related disorders associated with aging.

One of the mechanisms behind the age related disorders is oxidative stress. It is involved in almost all of the diseases associated with old age such as neurodegenerative diseases, diabetes and cardiovascular diseases. To decrease the oxidative stress in our cells, we have to have proper nutrition containing antioxidants. In addition meditation, exercise might also help in reducing the stress which might be involved in oxidative stress.

Brain is a plastic organ that can be molded into different ways and nutrition definitely plays a big role in molding the brain by facilitating in creating the good brain environment. However, we should not forget a big picture that a proper nutrition is beneficial not only to our brain, but also to all the organs of our body.


Exercise increases academic performance in children

Throughout the human history, physical activity has been the mainstay for the survival of mankind. But with the emergence of new technologies, there is sudden change in the lifestyle leading human to embrace a sedentary life style and forget the principal component of evolution. Paradoxically, with the increase in research in this area, the relevance of physical activity has become even important today irrespective of the age and moreover for the children as it impacts their academic life.

If the result of research published in the British Journal of Sports Medicine is to be believed, exercise helps in improving the academic performance of children, specifically the girls.The more intensive the exercise, the greater was the influence on the test results.

The study test the relationship between physical activity and academic performance in adolescents. Physical activity of 4755 children were analyzed objectively by accelerometer when there were 11 years. Then the academic performance of these children was measured at 11 and was followed up at 13 years and 16 years.

Results showed an increase in performance in English in both sexed and increase in the performance of science in female only. Going by the results, female students benefit more from exercise than their male peers.

In brief, this study showed a long term positive impact of physical activity in the academic performance of children.

There are also a lot of other researches that are focused on exercise and academic performance. Barring a few, most of these researches have shown a positive influence of physical activity in the academic performance of children.
The increase in academic performance as a result of physical activity is also well supported by brain research done in animals. Increase in synaptic plasticity proteins is well documented in animal brain following physical activity or exercise. Increase in these synaptic plasticity proteins specifically in hippocampus is crucial for learning and memory.

To sum up, physical activity should be encouraged in schools and care should be taken that children are familiar not only with modern day gadgets, but also with the importance of physical activity that was the prime driver of human evolution.

Booth JN,Leary SD, Joinson C, et al.Br J Sports Med 2014;48:265–270

Picture source: http://www.clemson.edu/extension/hgic/graphics/4032/activities_kids.gif

Note: Some of the views expressed here are not related to the reference article.

Good sleep promotes communication between your neurons (by inducing formation of new synapses).

A good night sleep is essential for refreshing oneself after a hectic day. It’s now known to us that sleep is essential not only for healthy body, but also for healthy mind. The role of sleep in the consolidation of memory has already been established. But the cellular and molecular processes behind this sleep induced memory consolidation are not yet known.

Researches have shown conflicting views regarding the role of sleep in synaptic plasticity. Some research supports the idea of synaptic down-scaling, whereas other supports the idea of synaptic up scaling during sleep.

A study conducted by Yang et al at New York University, School of Medicine, showed that sleep promotes formation of post-synaptic dendritic spines on a subset of branches of individual layer V pyramidal neurons in the mortor cortex of mice.

The study can be divided into two parts. In 1st part, they assessed spine formation following training. For this, they used two groups of mice. The experimental group consisting of mice that were given motor training for 2 days and the control group consisting of untrained mice. Rotarod motor training was given to the experimental group. The results were analyzed based on  time frame of experiment. Firstly, within 6 hours of motor training and then within 24 hours and after 24 hours of motor training. In 2nd part, they gave rotarod training to mice and divided the mice into two categories: non-sleep deprived and sleep deprived mice.  Then, they assessed the formation of new dendritic spines in sleep deprived vs non sleep deprived mice.

The results showed significantly higher formation of dendritic spines in trained mice in first 6 hours of training as compared to untrained controls. This formation of dendritic spines in trained mice was continuous in the 1st day. The spine formation remained confined to about 30% of dendrities after 24 hours of motor learning.  Likewise, there was significant reduction in dendritic spines in  sleep deprived mice as compared to non-sleep deprived mice. The reduction in the dendritic spines after sleep deprivation cannot be compensated either by motor training or by sleeping again.

Sleep consist of two phases: Rapid eye movement(REM) phase and NREM(non rapid eye movement) phase. Sleep deprivation in  REM phase did not disrupt the  formation of dendritic spines. Its in the NREM phase of sleep that dendritic spines are formed. Also, the study showed via calcium imaging that it’s the same neurons that are activated during neuronal activation at wakefulness and NREM phase of sleep. This neuronal reactivation during NREM phase is critical in the formation of new dendritic spines.

Concluding the results, rotarod training is important for the formation of new synapses as shown by increase in dendritic spines in trained mice as compared to untrained controls in the 1st part of the experiment. However, there was significant reduction of dendritic spines in sleep deprived mice undergoing motor training  suggesting that sleep is necessary for  formation of new synapses after learning. Formation of new synapses after learning occurs during NREM phase of sleep and neuronal reactivation is responsible for it.


Guang Yang et al, Sleep promotes branch-specific formation of dendritic spines after learning, Science 344,1173 (2014); DOI: 10.1126/science.1249098

Aerobic training might be an answer to alzheimer’s disease(AD)


Picture taken from http://guardianlv.com/

Alzheimer’s disease(AD) is a neurodegenerative disease responsible for most cases of dementia in elderly population. A lot of trials with drugs are ongoing in order to find the prevention and cure of AD. But recent research have shown life style modification and behavioral changes to be as effective as drugs in the prevention of AD.

A study published in the journal of gerontology has shown 6 months of aerobic exercise effective in reducing the symptoms of AD in the elderly population.

This study used 6-month cycling intervention to older adults of a selected community with mild-to-moderate AD. The exercise was a standardized, supervised, and individualized, moderate intensity cycling for 15 to 45 min a session (excluding 10-min warm-up and 10-min cool-down activities), 3 times a week for 6 months.

The outcomes of this training regimen were evaluated by measuring the cognition, ADL(Activities of daily living), BPSD(Behavioral and psychological symptoms of dementia) and caregiver distress at the end of the experiment.

The data was collected from older adults with mild to moderate AD and they were followed up for 6 months. The results showed neither significant cognitive decline nor deterioration of the neuropsychiatric symptoms during the 6 month period. Also, aerobic exercise significantly reduced the stress in the caregivers.

There are other papers which have shown the benefit of exercise in neuropsychiatric as well as neurological disorders. Nevertheless, every research paper has its own limitations. But this finding that showed the effectiveness of exercise in preventing the progression of AD is very encouraging. Although, more detailed and precise research need to be done, opening of sports center for the elderly people to engage them in mild-moderate intensity aerobic exercise might be a good idea. Like they say prevention is better than cure, these type of sports center for elderly people might help in preventing AD, thus preventing the social as well and economic burden in the future.

For more details, see the reference article below:

Impact of 6-Month Aerobic Exercise on Alzheimer’s Symptoms                                     Fang Yu, William Thomas, Nathaniel W. Nelson, Ulf G. Bronas, Maurice Dysken,and Jean F. Wyman, Journal of Applied Gerontology published online 11 December 2013,DOI: 10.1177/0733464813512895


Active Brain and Brain Exercise

A brain is called an active brain when it is involved in the activities that fire or stimulates the neurons. Active brain, also called busy brain is a state of brain in which the neurons are firing continuously or are involved in the activities that fire or stimulate neurons. The main key to active brain is that neurons should be stimulated continuously so that they become habituated to stimulation once the necessity arises. It can be achieved through physical exercise or mental exercise. Mental exercise can also be called brain exercise. Based on the mechanism, brain exercise can be classified into two types:

  • Direct: Brain exercise that directly engages the neurons. For example: mental stimulating games, chess, Sudoku.
  • Indirect: Indirect brain exercise involves physical activity that does not directly engage the neurons. For example jogging, running.

Chess, a good mental exercise

Some games like football, basketball or cricket which requires strategic thinking and planning have direct as well as indirect effects in making the brain active.

Advantages of active brain and brain exercise:

Like we need to do weightlifting regularly if we want to build our triceps and biceps and run regularly to be a sprinter or marathon runner, to be a mental athlete, we need to exercise the brain regularly. Brain exercise has similar effect to our brain as the weightlifting have to our muscles.

Dementia is a collective symptom for the decrease in cognitive capacity. It involves memory loss, poor judgement, challenges in planning or solving problems. Exercising the brain regularly can halt or slow the progress of dementia. It increases the cognitive reserve in the elderly population.

Aging is a physiological process that affects each cell and organ of our body. Every organ tend to slow down with aging and so as our brain and the neurons. The normal brain aging can be further worsened by deposition of deposition of harmful substances leading to brain disease. Memory loss is the most common problem encountered during aging. The problem is neurons are less active or the brain is less active during old age. In a sense, then tend to become lazy and do not fire when needed. These lazy neurons must be activated or we should try to maintain the active neurons. This is possible only through active brain and brain exercise is the key to active brain. If you experience the memory loss, then you need to counteract the memory loss by activating your neurons through memorization of your day-to-day activities at the end of the day. If you make the habit of memorizing, then that will provide your neurons the necessary stimulus to become activated and helps you in halting or stopping memory loss.

Here are some simple tips for making your brain active:

  • Memorizing daily activities at the end of day before sleep.
  • Playing board games like chess, tiger moving.
  • Solving puzzles, crosswords and playing Sudoku.
  • Involving oneself in intellectual activities in society like debate and quiz.
  • Learning new language.
  • Make the habit of reading books.
  • Try to make the habit of critical thinking, multidimensional way of observing things.

There are a lot of ways of making the active brain. The key to the active brain is engaging yourself in the activities that are brain storming. Besides, don’t forget about the diet and exercise. These are equally important for active brain and healthier brain. To sum up, brain exercise is a simple and cost-effective way of achieving brain health. The key to brain exercise is active brain and active body.

Dementia Prevention and Awareness


Dementia is a common problem of the elderly population. There are about 40 million cases of dementia today. Alzheimer’s disease comprises more than half of the cases of dementia.This trend just seems to be unstoppable. According to the Alzheimer’s Disease International, it is set to treble worldwide by 2050 causing a global epidemic. Given that there will be a lot of people suffering from Alzheimer’s disease and dementia, the health care budget will significantly rise. So, effort must be made to reduce the cost of dementia care by raising the dementia awareness and prevention strategies.

There is no established method for the prevention of dementia and Alzheimer’s disease. But a small change in your diet or lifestyle can mean a lot for preventing dementia. New prevention strategies that are being studied are focused on lifestyle and dietary factors. Micronutrients like folic acid, vitamin B12, vitamin D and magnesium are thought  to maintain and improve brain health.The results with turmeric and vitamin B are promising. Fish oil, which contains omega-3 fatty acid is also beneficial for the neurons. Similarly exercise has been shown to be effective in preventing amnesia associated with aging. Playing board games like chess, solving puzzles and cross words provides mental stretching to the brain. Experiments have shown these games to be helpful for the prevention of dementia.

Regular exercise, healthy diet and mental stimulation can also be called the three pillars of brain healthy lifestyle. Exercise increases blood circulation and reduces the cholesterol level. Healthy diet provides energy and prevents the formation of harmful chemicals in the brain. Games like Chess and Sudoku gives you the mental stimulation needed for keeping the brain active. And active brain helps in resisting degeneration of brain cells which is responsible for dementia.

For those wanting to know further details about dementia, find it on What is dementia? The signs, symptoms and causes of dementia – Medical News Today.

If you are worried about the recent cognitive decline or fearing that you might have dementia or Alzheimer’s Know the 10 signs of Alzheimer’s disease from Alzheimer’s association.

Related articles:

Playing chess, a way of achieving healthier brain

Chess is widely considered as an intellectual game. It requires a lot of visuospatial capability and calculation. Some researchers have even found chess players to be more intelligent than the other, while other have rejected this hypothesis. The purpose of writing this blog is not to argue about this point. What i am trying to tell is chess definitely helps in making your brain healthy. Playing this game during old age prevents the age related cognitive decline and dementia.

File:Chess board opening staunton.jpg

What the research tells?

Researchers at Universidad de Laguna, Spain compared the students playing chess and those playing soccer or basketball. Their results showed that students playing chess have improved cognitive and problem solving capacity than the counterparts playing soccer or basketball. The findings of this research correlates well with the results of  functional magnetic resonance imaging(fMRI). Researchers at University of Minnesota, USA reported  bilateral activation of frontal, parietal and occipital areas in fMRI  while playing chess. Its the frontal area of our brain that is involved in problem solving and intelligence.

While there are research favoring the importance of chess in brain development, there are some which denies this idea. By using Tower of London test( A psychological test for executive functioning), German researchers dismissed the idea that chess player has superior planning performance as compared to non chess players. Though they thefind planning performance to be superior in the chess players, there was no difference in the intelligence between the chess players and the non chess players.
So the research divides the opinion regarding the superior planning performance and intelligence in chess player. Further research need to be done before we become sure about the effect of playing chess in brain. But what we should not forget is chess is a brain stimulating game and it has been proved by the brain imaging that it helps in the activation of the brain areas.

What are the benefits of playing chess? 

 Psychological and intelligence test conducted on chess  players dismiss the idea of chess players being intelligent or being more efficient planner or thinker than those who don’t play chess. But there are other studies which tend to differ. Here are some benefits of playing chess as mentioned in the website  http://www.chessvibes.com/reports/10-big-brain-benefits-of-playing-chess: 

  • Increases the IQ
  • Prevents Alzheimer’s disease
  • Increases creativity and problem solving skills
  • Improves memory,reading skills and concentration
  • Promotes the growth of dendrites in the brain

For more information about the benefits, visit the webpage by clicking the above link.

How often do you need to play chess?

There are no clear studies indicating the frequency and time one need to spend . Playing chess is just like doing meditation or your daily routine training like jogging,swimming or cycling. The more you play, the more your chance of reaping the benefits. Like the exercise training or meditation, its never late to start learning chess

Reference and related articles:

  1. Atherton MZhuang JBart WMHu XHe S, A functional MRI study of high-level cognition. I. The game of chess. Brain Res Cogn Brain Res. 2003 Mar;16(1):26-31

  2. Aciego RGarcía LBetancort M, The benefits of chess for the intellectual and social-emotional enrichment in schoolchildren. Span J Psychol. 2012 Jul;15(2):551-9
  3. Unterrainer JMKaller CPLeonhart RRahm B., Planning abilities and chess: a comparison of chess and non-chess players on the Tower of London taskBr J Psychol. 2006 Aug;97(Pt 3):299-311
  4. Unterrainer JMKaller CPLeonhart RRahm B.Revising superior planning performance in chess players: the impact of time restriction and motivation aspects. Am J Psychol. 2011 Summer;124(2):213-25
  5. Frontal Lobe Function in Chess Players.  http://acta.tums.ac.ir/files/journals/1/articles/4501/public/4501-4858-1-PB.p
  6. Ten big brain benefits of playing chess.                http://www.chessvibes.com/reports/10-big-brain-benefits-of-playing-chess