Published April 2020
Brain training is a fun and simple intervention to keep minds active in older age. However, there are many unknowns. What benefits does it have on the brain? And can people living with dementia realistically brain train using technology they’re not necessarily familiar with? Dr Lucy Beishon wanted to find out whether people living with dementia can do brain training at home using a computer, and to see if it has potential to bring benefits.
We sometimes forget that taking part in research can be beneficial for participants and patients. When I do future research, I’d like to take more time to think about how to make it as rewarding as possible for participants – not just the research teamDr Lucy Beishon
Brain training is an attractive idea based on the theory that playing games and solving puzzles everyday can improve memory.
Since appearing in the early 2000s, the popularity of brain training apps has grown into a multimillion pound industry. While scientists are still debating how effective brain training really is, there’s evidence that older people who use it regularly can show improvements in thinking and memory.
As well as exploring whether app-based brain training has a measurable effect on the brain, we set out to determine how accessible it is to older people living with dementia who might not be tech-savvy.
What do – and don’t – we know about brain training?
We’re not exactly sure what happens to the brain when people do brain training. Reviewing previous studies, I found that researchers have used various imaging techniques to see what happens but no one had looked at brain blood flow.
We think that blood flow is going to be really important in terms of brain health and the development or progression of dementia. The fact that we haven’t currently got any studies looking at how blood flow in the brain responds to cognitive training seems like we’re missing something significantDr Lucy Beishon
There’s increasing evidence that brain blood flow changes in the very early stages of dementia development. The brain needs a constant supply of blood flow for it to work effectively and problems with blood flow can affect memory or thinking. Even in healthy older adults, lower blood flow can predict the future risk of dementia. We wanted to see if the brain was capable of adjusting its blood flow if you keep stimulating it with brain training. Could it be a way of reducing the progression of dementia or delay the onset?
Putting people at the heart of research
To find out more, we designed and ran a feasibility study recruiting people living with dementia and, as comparisons, healthy older adults and people with mild cognitive impairment.
Using Transcranial Doppler Ultrasonography (TCD), we measured participant’s brain blood flow before and after completing a three month brain training programme. We also looked at other measures like mood, quality of life and everyday function, which we know are important to older people.
Putting people at the heart of the study design was key for its success. Through Alzhiemer’s Society dementia cafes and patient groups, we worked with people living with dementia and their carers. Their feedback led to changing the recruitment strategy, making the programme more manageable, and using interviews to collect feedback from participants.
Personally, I was surprised by how much the participants enjoyed seeing their results from the TCD. There aren’t many people who can say they’ve had the opportunity to see and hear their own blood flow and it’s a nice way for them to get something out of the research.
A promising start
Although the COVID-19 pandemic meant we had to stop the study early, we were still able to show that brain training is possible for people living with dementia and that there are indications of improved blood flow, which might be linked to better brain health. The training also helped to make people more aware of memory problems, triggering them to develop strategies to help themselves in their daily lives.
While using technology had the potential to cause frustration and anxiety – especially with older computers! – 75% of the dementia participants were able to complete the programme. Participants also said they found the training fun and stimulating, and carers enjoyed helping their loved ones take part.
We hope to move towards a larger, multi-centre trial in the future and have links with centres in the Netherlands, Southampton and Loughborough who are interested. We’re also interested in combining brain training with exercise to see if they work synergistically to enhance the effects on brain blood flow.
The DMT is a very personable funder, helping me to keep up clinical training alongside the Fellowship. They’re particularly supportive of early career researchers, putting on regular events and networking which I’ve found really useful. As well as my award, I got several other opportunities and I hope to do more projects with them in the future.
Find out more
The first paper from our research has been published in the Journal of Alzheimer’s Disease. You can also hear me talk about it here, which was recorded as part of Alzheimer’s Research UK 2021 Conference.
You can find out more about Alzheimer’s Society dementia cafes and read more about my experience of being a DMT Research Training Fellow.