A workout for your brain

Can an exercise routine really help keep your mental "muscles" in good shape?

Meditating or tai chi may increase the brain's capacity to switch between different tasks.
Image: Michael Carroll Photography/Thinkstock

Fear of losing your memory and thinking skills is one of the greatest concerns of getting older. Maybe that's behind the increasing number of clinics offering brain fitness programs. "Brain training" isn't a typical exercise program; it incorporates a number of activities and lifestyle changes to help boost brain function.

"People come in with problems accessing words or memories or making decisions, and we do see them improve, although we can't say it's from any one therapy," says neurologist Dr. Alvaro Pascual-Leone, director of the Brain Fit Program at Harvard-affiliated Beth Israel Deaconess Medical Center.

What's involved?

A typical brain fitness program incorporates the following.

• Physical exercise. "Exercise increases activity in parts of the brain that have to do with executive function and memory and promotes the growth of new brain cells. But most of us don't work hard enough to realize the benefit. You have to push yourself, and that requires being cleared to exercise and wearing a monitor to get your heart rate to a certain zone. It's a different heart rate for everyone, and we supervise it," says Dr. Pascual-Leone.
• Cognitive training. This is exercise for your thinking skills that uses computer or video games and pushes you to sharpen your response times and attention. Does it work? It's been hard to prove that computer training works. Studies have been mixed. It's difficult to show that areas of improvement in a game translate to daily activities. Computer training alone doesn't work.
• Nutrition. The diet that seems to have the most evidence to promote brain health and lessen the risk of developing memory problems is the Mediterranean diet. It features whole grains, fruits and vegetables, and healthy fats from fish, nuts, and oils. Tailoring calorie intake is also included. "There's a fair amount of research suggesting that not eating enough is bad for the body and brain, but overeating is also a bad thing. So it appears that eating just enough to maintain a healthy weight may help with cognition," says Dr. Pascual-Leone.
• Better sleep. Poor sleep can undermine cognition. Restoring sleep can help. Brain fitness programs typically check for underlying causes of sleep loss, such as a medication side effect, sleep apnea (when a blocked airway during sleep causes you to stop breathing periodically), or an overactive bladder that interrupts sleep for trips to the bathroom.
• Meditation. "Meditation or exercises such as tai chi appear to increase something called cognitive reserve," says Dr. Pascual-Leone. That's the capacity of the brain to switch between different tasks, allocate resources, and handle unexpected stressors in a way that makes us better able to cope with day-to-day life. 

Finding a program

Hospitals and research facilities offer brain fitness programs, and so do private practices. "Ideally you want people who have done this for a long time and who offer a multidisciplinary approach, with a neurologist, psychologist, social worker, physical therapist, and dietitian," says Dr. Pascual-Leone.

Beware of promises of cures, and don't assume that doing well on a computer game means you're improving. "If you do one thing often, you'll get better at that one thing. But you want to get better in everyday activity, not just at the clinic," warns Dr. Pascual-Leone.

Look for programs that measure the biological effects of the training, and experts who'll explain the results and how the information will help you.