Qualy #16 - How much does cognitive activity ward off cognitive decline？
Episode Stats
Words per Minute
182.59723
Summary
In this episode of the Qualies, Dr. Peter T.J. McDaid discusses the link between mental activity and the risk of developing Alzheimer's disease, and the benefits of music and other forms of mental activity.
Transcript
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welcome to the qualies a subscriber exclusive podcast qualies is just a shorthand slang for
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how much does mental activity ward this off you know we hear so often the anecdote of
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bernie was working his little tail away beavering away and then when he retired to play golf it all
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went to hell in a handbasket and then the other one you often hear anecdotally is once so-and-so's
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spouse passed away oh my god the remaining spouse just regressed completely and seemed to have this
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accelerated case of Alzheimer's intervention so the the idea here being once that person retired and
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they weren't cognitively engaged and they were not to say golf is cognitively bankrupt but presumably
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it's less cognitively engaging than whatever that person was doing before or once the sense of purpose
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the social support vanishes again anecdotally this seems overwhelmingly the case is there any data to
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support that so yes but it's complicated the cognitive reserve can't one thing just be freaking
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simple no Alzheimer's prevention no no man this is this you sound like me man yeah everything's
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complicated everything's complicated i wish i could give you a concise bullet point state you know like
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i want a bumper sticker yeah live tv you got to give them like a quick snapshot not on this topic so
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early life risk factors for Alzheimer's are different than midlife and late life and early
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life risk can be mitigated most so by long-term educational attainment that's the best evidence
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we have we also have to be clear has that been normalized for socioeconomic status it strikes me as
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almost impossible to normalize that for socioeconomic status above my pay grade don't know the literature as
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well as i need the point here being like people who go on to get secondary and tertiary education
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are going to have lower risk is it because of the things that enable them to do that perhaps having
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more resources lead to them doing other healthy lifestyle things that go beyond the education as i hope
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the studies have controlled for that but i know it's impossible to control for everything but that being
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said i think early life educational attainment for example musical experience midlife and midlife
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musical experience as well as early life absolutely can get built up greater cognitive reserves that
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when you get Alzheimer's you're more resilient you have this resiliency the other aspect is and i don't
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know enough about music but when you were the cello playing to bass guitar playing guy what part of the
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brain is getting exercise when you do that very multimodal it's the parietal lobe is the music side
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maybe on the right side the you know reading music notes is kind of like language so it'd be the left
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side of the brain and that's visual it's basically an association cortices basically the whole brain is
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talking to each other so i think music is a great way to recruit different parts of the brain to work
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together and the stronger those pathways get the better the person does and again teleologically that
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makes so much sense i guess it begs the question i would argue we will never know the answer to this
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question because if we're going to have to rely on very loose epidemiology which can never be fully
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controlled and suffers from all of the usual problems that epidemiology suffers from the question
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ought to be is there any harm in believing that the epidemiology is right attaining a higher level
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of education staying more mentally engaged sustaining more loving social supporting relationships having a
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greater sense of purpose learning to play a musical instrument i mean is there a chance that doing
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those things increases your risk well i don't think that there's been any evidence to suggest that it
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increases risk but then there's this whole you know the naysayers will say but what is the
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cost what are the trade-offs what's the opportunity cost what's also the how much does it like music
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lessons you're going to pay money to do music lessons or buy a guitar but shouldn't you be like
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buying healthy food so there's a lot of confusion and there's when we get reviewers of our papers
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this comes up all the time so i'm not sure all i can say is when you build a better backup pathway in
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the brain and you there's a saying if you don't use it you lose it well someone that has alzheimer's
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is very cognitively engaged and has a good backup pathway they're not going to decline as quickly
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that being said once the disease takes hold and maybe they stop working or they stop the loser sense
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of purpose you can have a much more sharper decline so people with high cognitive reserve high cognitive
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backup systems are resistant to the effects of the amyloid but there's a time that comes when they
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decline and those people decline much more sharply than others because they had like this emergency backup
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system but sometimes when the parachute fails the person goes down and an alzheimer's disease
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that's a subtle that's a nuance i wouldn't have predicted it makes sense the mechanism that you
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postulate makes sense and you know you gave the other example of the woman whose husband passed away
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and then she just went downhill because when you have a collaborative relationship and you know when
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one person's brain isn't working well but you have another person to cover for you and do the dishes
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and feed you and and then that person has gone aside from depression serotonin you have all that
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oh i see this all the time like i i knew she had it but then the husband and you know caregivers of
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alzheimer's patients have terribly higher medical illnesses and when when a husband dies and he was
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the primary caregiver and the wife has alzheimer's that person will decline absolutely exponentially
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i saw this in a high school teacher of mine i i mean i see this all the time i hope you enjoyed
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