Exercise Your Brain to Improve Mild Cognitive Impairment

Mild cognitive impairment (MCI) and early Alzheimer’s disease can make everyday thinking tasks feel harder, whether that means remembering names, following a conversation, or feeling confident in a new place.

Many experts believe that slowing cognitive decline is still possible for people with MCI — and some research suggests that exercising your brain can help.

“Exercising” your brain means doing activities that require thinking, learning, remembering, focusing, or problem-solving, says Dylan Wint, MD, the director of the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas.

“Brain exercise could include reading a challenging book, attempting a tough crossword or jigsaw puzzle, having a thoughtful conversation, navigating a new route home, or learning a new hobby or musical instrument,” says Dr. Wint.

MCI can be an “important window of opportunity,” he says. “The goal is to give the brain every available advantage, even if there are signs that it is under attack.”

For people with MCI, some of the strongest evidence is for structured cognitive training or rehabilitation programs, especially those that teach memory strategies you can use in daily life.

“A review of randomized controlled trials found that cognitive rehabilitation is associated with improvements in cognitive performance," says Wint. "At least one five-year study also found that the benefits can be long-lasting.”

In that study, 145 older adults with MCI were assigned to either cognitive training, a psychosocial program, or no intervention. The cognitive training program taught memory strategies such as visual imagery, face-name association, and attention control over eight weekly sessions.

This type of structured exercise is usually led by an occupational therapist (OT), neuropsychologist, or cognitive rehabilitation specialist.

For example, OTs can create a cognitive fitness routine for a person based on several factors, including cognitive strengths and weaknesses, personal preferences, skill level, and time availability, says Lindsay Miller, an occupational therapist at Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas.

There is evidence that computerized games may help with MCI, but it's somewhat inconsistent, says Davangere Devanand, MD, a professor of psychiatry and neurology and a cofounder of the Memory Disorders Center at Columbia University Irving Medical Center in New York City.

While brain-training apps may be a little more entertaining or accessible, “the objective evidence favors techniques like crossword puzzles and other systematic cognitive training methods,” says Devanand.

The evidence on how improving at these exercises translates to real life is unclear — it may not always carry over into daily functioning, says Wint.

Learning something new can be especially valuable because it asks the brain to build or strengthen connections rather than simply repeat a well-worn routine.

“The brain benefits highly from novel activities, so try to pick something you haven’t done before, or at least recently,” says Miller.

These activities can include:

• Learning a language
• Taking up an instrument
• Joining a class in a new topic that interests you
• Trying a new card game
• Taking on a hobby that requires planning and practice

Immersing yourself in art can be a brain exercise that also expands your world. “Artistic creation is novel by definition — most of us do not challenge our brains creatively in everyday life,” says Wint.

Artistic activities could include:

• Visual arts: painting, drawing from a live model, photography
• Writing and literary arts: creative writing, book clubs, storytelling
• Crafts and hands-on making: collage, pottery, handicraft
• Museum or gallery visits: art galleries, museums, and exhibitions
• Cultural attendance: theater, concerts, opera, cinema, heritage activities, films

Music may be especially rich because it draws on many brain systems at once. “Participation in musical activities — playing, singing, dancing — is associated with a range of cognitive functions such as auditory processing, motor skills, memory, timing, and executive function,” says Wint.

Reading can be a simple, low-cost way to keep the brain engaged, especially when it requires focus, following a storyline or argument, remembering details, and thinking about new information.

A good cognitive fitness routine should include variety. Miller compares it to physical fitness: You would not train only one muscle group forever, and the brain also benefits from different kinds of challenges.

“I always recommend that people develop a cognitive fitness ‘repertoire,’ or a variety of different activities they can get to in order to challenge and stimulate their brain in various ways,” says Miller.

That repertoire might include crossword puzzles, app-based training, bingo with friends, a book club, bridge, a writing class, a music group, or a community-center program, says Miller. It can evolve over time to fit your interests, goals and abilities, she adds.

• Brain exercise for MCI or early Alzheimer’s should involve effort, attention, memory, learning, problem-solving, creativity, or social connection.
• Formal cognitive training has some of the strongest MCI-specific evidence, especially when it teaches practical memory strategies.
• Exercise can include crosswords, brain games, reading, music, art, and new skills; the best routine is varied, realistic, and enjoyable enough to stick with.