Don’t Surrender to Cognitive Aging and Dementia

SAN FRANCISCO, Dec. 20, 2017 (GLOBE NEWSWIRE) -- Dr. Henry Mahncke, CEO of Posit Science, commented on a group of review articles published yesterday, which claimed no intervention of any kind has demonstrated the ability to address the risks of age-related cognitive decline or dementia. “We are a science-based company, and we must speak up for the science when it is mischaracterized,” Dr. Mahncke said. “Most authorities agree there are steps you can take to improve brain health. And people need to know what’s the best advice science has for them right now - not what might be discovered at some point in the future.”

The group of review articles were published in The Annals of Internal Medicine. They are the by-product of a literature review conducted by the Minnesota Evidence-based Practice Center (MEPC) under a government contract to provide input for a policy evaluation about how to address cognitive aging by the National Academies of Sciences, Engineering and Medicine. The original review looked at many areas of intervention (e.g., cognitive training, physical exercise, anti-dementia medications, hypertension treatments, NSAIDs, diet, nutraceuticals, vitamins, multimodal approaches, diabetes treatments, music, sleep interventions, and social engagement). In each area, including cognitive training, physical exercise, and medications, the reviewers found the evidence lacking — concluding that the literature shows there is nothing you can do today to address cognitive decline.

Yet, based on this and other data, the National Academies provided quite different advice —  recommending three actions for people who want to be proactive about their brain health, noting that: “three classes of interventions are supported by encouraging, although inconclusive, evidence: cognitive training, blood pressure management in people with hypertension, and increased physical activity.”

When it was unveiled in draft form a year ago, the MEPC literature review was widely criticized both for its omission of important studies and its conclusion that there is nothing you can do to improve brain health as you age.

The advice that “there is nothing you can do” runs contrary to the advice of a number of authorities, including AARP and the Alzheimer’s Association, who spoke at the open hearing on the draft report, as well as the National Academies, for whom the report was prepared.

“The key question that these reviewers failed to address is: ‘Based on the evidence to date, what is it I can do to maintain brain health as I age?’” Dr. Mahncke observed. “Fortunately, others have tackled this in a more comprehensive way, that people concerned about cognitive health can put to use.”

“For example, as a researcher involved in scores of trials on cognitive training, I noted that more than 90 percent of that literature was not even included in the MEPC review.” Dr. Mahncke continued. “In the five other recent systematic reviews and meta-analyses—led by Drs. Mewborn, Shao, Lampit, Howren, and Kueider — each of which included far more than the 11 trials reviewed here, researchers found cognitive training is effective.”

Alzheimer’s researchers from five institutes in Australia took this a step further in helping patients, by conducting the only systematic review of commercially-available brain training products targeting older adults. They found only the exercises from Posit Science platform were backed by multiple high-quality studies.

Last month, in a breakthrough result, researchers from the NIH-funded ACTIVE Study reported in Alzheimer’s & Dementia: Translational Research & Clinical Interventions, a peer-reviewed journal of the Alzheimer’s Association, on results from following more than 2,800 older adults for 10 years. Participants were randomized into three different kinds of cognitive training and a control group. The study showed not all cognitive training is the same. Only those engaged in plasticity-based speed of processing training showed a significant decrease in the risk of dementia – with a 29 percent risk reduction at any point in time, and more risk reduction for those who trained more. An updated version of that training is exclusively available as the “Double Decision” exercise on the online and in app BrainHQ platform from Posit Science.

“While aware of that result, the reviewers excluded it from their report,” Dr. Mahncke noted.  “They also failed to review five trials in people on the cusp of dementia (with mild cognitive impairment) in studies led by Drs. Lin, Klados, Gooding, Styliadis, and Rosen. That’s in addition to scores of other publications they omitted on the impact of cognitive training on cognition and functional independence.”

“It’s always hard for everyone to agree on what evidence is conclusive – after all, there’s still a Flat Earth Society – but a literature review should review all the relevant literature,” Dr. Mahncke concluded. “The science should be allowed to speak for itself.”

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