Associate Professor Michael Valenzuela
Cognitive lifestyle is a concept that I’ve been interested in for a while now, which is really trying to think about the patterns of usage of your brain over your whole lifespan. What do you typically do with your brain? Are you someone who is always trying to find new information, learn new things, or are you quite happy not to learn new things, and just stay with the status quo? So I guess that’s the general concept, and we’ve done quite a bit of work trying to - being able to measure cognitive lifestyle in a more formal way.
Cognitive lifestyle, more and more research is showing, has a link to dementia risk in a similar way to when we’ve been considering social activity. People with, what I call, a poor or an unstimulated cognitive lifestyle, have high risk for dementia, and those individuals who have a very rich cognitive lifestyle, have a lower risk for dementia. Some years ago now, when we put this research together, we found that people with a very active or enriched cognitive lifestyle were about half the risk of dementia compared to an unenriched or low cognitive lifestyle. So that’s quite a big difference. And that’s true now, I’ve been shown in dozens of population health studies from around the world.
So when we talk about cognitive lifestyle, we talk about the lifespan. So some of that gets set up in young adulthood, particularly through education. Then, in the mid-life years, a lot of our cognitive lifestyle is related to the type of occupation we may be involved with, and then, in later life, particularly after retirement, it’s about those voluntary activities, where we’re getting out there and learning new things, meeting new people, and just doing things for interest that work our brain. So it depends what phase of life we’re talking about. If we’re talking about later life, then it’s really about the frequency of learning new material that challenges your mind, and also how challenging that is. Whether it’s just doing a crossword, which may be minimal, to learning a new language, which could be quite challenging.
The kind of research linking cognitive lifestyle to dementia breaks down in a few different ways. There’s been a lot of work in population health or the public health area, where you’re tracking, say, thousands of people for a number of years, and seeing who does develop dementia versus who doesn’t, and trying to work out what may be a risk factor or a protective factor. Time and again, it’s been shown that a more rich cognitive lifestyle is linked to lower dementia risk. More lately, my group and others have become quite interested in the idea of, well, if you’re presented with someone, an older person for example, what they’ve done early in life that’s fixed, what can they do going forward to enrich their cognitive lifestyle? And we’ve become very interested in brain training, or using cognitive exercises on the computer, as a kind of very formalised and encapsulated way of stimulating a cognitive lifestyle. So thinking of the brain like a muscle, brain training is like going to the gym and doing exercises for the brain.
We can’t get too prescriptive about what type of cognitive lifestyle is best for an individual, because there’ll always be a wide diversity of things. We may recommend one thing but, if the person doesn’t enjoy it, they won’t be able to sustain it for the rest of their life. So I think it really comes down to personal choice. Some people may be more attracted to kind of complex lifestyle activities. For example, like dancing, which may have a cognitive component, a physical component and a social component, and so that’s a kind of holistic cognitive lifestyle intervention. On the other hand, cognitive or brain training is quite specific, and is really trying to target specific cognitive skills in a repetitive way. I don’t think there’s any particular magic cognitive lifestyle activity to recommend. Rather, we have to do a lot of research and try and work out what are the strengths and weaknesses of all of those.
We developed a “lifetime of experiences” questionnaire because, at the time, there wasn’t really a good tool or assessment option to try and quantify someone’s cognitive lifestyle, whether they had a kind of impoverished or low cognitive lifestyle, intermediate, or quite enriched or high cognitive lifestyle. We developed this questionnaire which is intended to be filled out or carried out by an older person after retirement. Part of it we’re talking about, or asking them to reflect on what they did in the past as a young adult, in terms of education, during their working life, all the different occupations they participated in, and then there’s a very large section of the lifetime of experiences questionnaire where we try and really work out - what is the person doing now to stimulate the brain? What kind of activities are they participating in, how diverse they are, and how challenging they are. At the end of the day, we’re trying to put a number on cognitive lifestyle and then, through large studies, being able to determine a kind of bell curve for cognitive lifestyle, so that we could give someone like a percentile on this assessment tool.
So the lifetime of experiences questionnaire is broken up into phases of life. So we have early or young adulthood, where most of the questions are about education. How far did they get through the educational system? Then there’s mid-life, where a lot of the questions are about the different occupations they participated in. Not just the titles or the status, but also how many people were they in charge of? - what we call managerial experience. And then, for late life, which is I guess right now, what is the person doing with their brain now? What numbers of activities, diversity of activities, and how challenging those are.
所以我们可以将经验问卷的生命周期分成几个生命阶段。因此我们有早期或年轻的成年期，其中大部分问题是关于教育。他们通过教育系统有多远？然后有中年的生活，很多问题是关于他们从事的不同职业，不只是头衔或地位，还有他们负责多少人？ - 我们称之为管理经验。然后，对于晚年生活，这是我现在猜想，现在的人在做什么与他们的大脑有关的活动？什么数量的活动，活动的多样性如何，以及这些活动具有多大的挑战性。
In terms of which activities may be more important for lowering your risk for dementia, using our lifetime of experiences questionnaire, we don’t have that information yet, but I think that will be coming in the future, because, to answer that question, you really need data from thousands of individuals, tracked for many years, in order to know which activities specifically are protective or increase your risk for dementia. So we’re doing that right now in terms of pooling data from Australia, from France, from the UK, from the USA, so we have, at the end of the day, a really large sample and can drill down to specific activities. So it’s a great question, but we just don’t know the answer just yet.
Is it ever too late to start engaging in activities and thinking about your brain as a muscle? I don’t think so. I think more and more evidence, particularly clinical trials evidence, is showing that starting new challenging activities for your mind, such as brain training or complex leisure activities, is linked to better brain health, better cognitive outcomes. Whether that actually leads to lowering the incidence of dementia or the development of dementia, that’s still an open question, but we do know that it improves cognitive function and, in some cases, leads to better brain outcomes. So I think it’s never too late to think of your brain as a muscle and start new exercises for it.