Can Community Involvement Prevent Memory Loss?

If you complain to your doctor about memory loss, should she write a prescription for community involvement?  Maybe so. 

During the recent NIH State-of-the-Science conference, experts presented preliminary evidence that “cognitive engagement” might protect against memory loss.  Brain fitness programs and crossword puzzles might provide this engagement, but meaningful activity that also involves social connections and physical activity may be better, these experts said.

     Michelle Carlson, Ph.D.

One such program is Experience Corps, where people 55 and older volunteer in elementary schools for 15 or more hours per week.  They tutor and mentor students, help teachers in the classroom and run after-school programs.  With programs in 22 cities, Experience Corps benefits students and schools.   A study led by Michelle Carlson, Associate Director of the Center on Aging and Health at Johns Hopkins University, shows the program may also improve memory and thinking in the volunteer elders.

“We need to examine what staying mentally fit means, beyond prescriptions to do crossword puzzles,” says Dr. Carlson.   “That may improve skills at crossword puzzles, but may not necessarily exercise problem-solving skills and support brain regions critical to performing everyday activities and living independently.”

Change Your Routine, Change Your Brain?

It’s not clear how this kind of community involvement might work to prevent memory loss.   Previously inactive elders who volunteered for Experience Corps increased their level of physical activity.  Exercise may help memory and thinking, so this increase in physical activity may have contributed to the improvements in cognition.

Working with Experience Corps may also somehow build “cognitive reserve,” or the ability to continue to function despite problems in the brain.  One way this might happen is by increasing “plasticity,” where even older brains change and adapt in response to new experiences.

Along with using cognitive tests to measure improvements in memory and thinking, Dr. Carlson and her colleagues are using brain scans to test hypotheses about how the volunteers’ brains might be changing.   During a small pilot study, these brain scans showed that Experience Corps volunteers had increased activity in certain regions of the brain.
 
“Using fMRI [functional Magnetic Resonance Imaging], we are able to see how efficiently oxygen-rich blood travels to key regions of the brain while the brain is actively solving problems,” she says.  “This window into ‘the brain in action’ allows us to hypothesize and see how program activity gains are achieved, if they build with continued exposure, and if they are maintained after volunteer service.” 

Future Research

Dr. Carlson and her colleagues are recruiting participants in Baltimore for a larger trial, called the Brain Health Study.  What will make hundreds of study participants stick with this program?

“We have recruited 702 seniors under the premise that the ‘glue’ that will allow volunteers to stick to a more active lifestyle, such as the Experience Corps program, is not promoting the individual’s personal health so much as promoting the importance of sharing their time and wisdom with a younger generation of minds in need,” says Dr. Carlson.  “On any given morning, volunteers may not want to get out of bed, but they know that they have a binding social contract with children eager to see them.   My colleague, Erwin Tan, has just published a paper summarizing Experience Corps volunteers’ motivations in the American Journal of Public Health.”

Is Helping Others Better Than Taking a Pill?

So far, trial results for drugs and supplements to prevent memory loss have been discouraging.  Dr. Carlson, who was a principal investigator for GEMS, the negative Ginkgo biloba dementia prevention trial, knows this firsthand.  But she is excited by the potential of cognitive engagement to improve real-life function.

“I believe that social engagement, particularly with purpose, is an important and understudied key to enriching the mind and moving the body,” she says.  “The neocortex of the human brain, and specifically the frontal lobes, guide us through complex and unpredictable social interactions each day. These skills need to be maintained in new and different ways post- retirement.”
 
This research has public health implications, of course.  “The goal is to maintain and increase the brain’s natural plasticity so that we can increase reserve and recalibrate rates of aging, thereby delaying, or even preventing, dementia onset,” Dr. Carlson says.  “Delaying dementia onset by even two years will preserve the ability to age in place, and save individuals, caregivers, families, and the public millions of health care dollars.”

I doubt that any one thing is the key to preventing memory loss, but community involvement seems promising.  Thinking back to my father’s situation, he took pride in his year-long stint on a grand jury, and in his work on the board of his neighborhood association.  He loved working with dogs at an animal shelter.  While I doubt that any amount of social engagement could overcome the bleeding in his brain in the long run, it may have helped.  At least for some of us, helping others may do more for our brains than any pill.