As a specialist in Alzheimer's prevention, Jessica Langbaum knows that exercising her mental muscles can help keep her brain sharp.
But Langbaum, who holds a doctorate in psychiatric epidemiology, has no formal mental fitness program. She doesn't do crossword puzzles or play computer brain games.
"Just sitting down and doing Sudoku isn't probably going to be the one key thing that's going to prevent you from developing Alzheimer's disease," she says.
Instead of using a formal brain training program, she simply goes to work.
"My job is my daily cognitive training," says Langbaum, the associate director of the Alzheimer's Prevention Initiative at the Banner Alzheimer's Institute in Phoenix.
And that's true of most working people. "While you're still in the work force you are getting that daily challenge of multitasking, of remembering things, of processing information," she says.
Langbaum offers that perspective as someone who has spent years studying the effects of brain training programs, and as someone who has seen Alzheimer's up close.
"My grandfather was diagnosed with mild cognitive impairment when I was in graduate school getting my Ph.D.," she says. "That transitioned into full-blown Alzheimer's dementia."
So Langbaum began to ask herself a question: "How can I in my career help ensure that we aren't suffering from the disease when we reach that age?"
And she realized early on that puzzles and games weren't the answer because they tend to focus on one very narrow task. The result is like exercising just one muscle in your body, Langbaum says. That muscle will get stronger, but your overall fitness isn't going to change.
The brain training programs used in research studies are more promising and much more demanding. "They're hard," says Langbaum, who tried them herself while she was part of a groundbreaking study on the effects of brain training.
In the study of about 2,800 people age 65 and older, most spent more than five weeks doing exercises that tested memory, reasoning or speed. Two of the interventions, reasoning and processing speed, helped a bit even 10 years later, Langbaum says.
"They delay the onset of cognitive impairment," she says. "They keep your brain working at the same level longer, compared to people who did not receive those same cognitive training interventions."
But it remains unclear whether brain training can also prevent or delay Alzheimer's. And more recent research suggests that social interaction may be a better form of mental exercise than brain training.
"People who have a lot of social interactions, particularly in mid-life, have a lower risk of Alzheimer's dementia in later life," Langbaum says. "There's something about being around people that's helpful for our brains."
Langbaum's in good shape on the social front. Between her family, her two kids, her colleagues at work, and her friends, she says, the social areas of her brain get a vigorous daily workout.
So brain training isn't for Langbaum. But it may be useful for people who are out of the workforce and more isolated, she says.
And she has some advice for anyone looking for a way to keep their brain healthy.
"If you like crossword puzzles, do them," she says. "But try something new. And trying something new that brings you enjoyment is key. Don't do it if you don't like it."