Failures in executive function, a set of mental skills that control behavior and govern decision-making, can manifest years before a formal dementia diagnosis, according to neuroscientist Dr. Adrian Owen. These cognitive slip-ups, which can include impaired judgment, difficulty planning, and problems managing tasks, are increasingly being linked to the early stages of diseases like Alzheimer's.
Owen, who has spent over 35 years studying the brain, notes that executive functions are managed by the frontal lobe, a region responsible for impulse control, working memory, and the ability to pursue goals. Damage or decline in this area can lead to uncharacteristic rudeness, inappropriate behavior, and difficulties with tasks that were once simple.
Research published in the journal Alzheimer’s & Dementia in 2016 indicated that cognitive deficits unrelated to long-term memory could emerge up to 14 years before an Alzheimer's diagnosis. This suggests that early intervention, potentially aided by identifying these executive function failures, could be crucial for slowing disease progression, especially as many Alzheimer's drugs in development show promise for early-stage treatment.
Techniques to improve working memory, such as 'chunking' information into smaller parts and using the 'memory palace' method—associating information with familiar locations—have shown potential in early Alzheimer's patients. A 2017 study in the British Journal of Psychiatry demonstrated that patients trained in chunking improved their ability to recall structured sequences, maintaining their cognitive performance while an untrained group declined.
Another critical aspect of executive function is inhibitory control, or willpower. A test called 'Double Trouble,' which requires participants to name the color of a word when the word itself is a different color (e.g., saying 'blue' when the word 'red' is written in blue ink), has been used by Owen's lab to assess this. In 2023, an algorithm developed by Owen's team using such cognitive tests accurately identified patients with dementia-like impairment more than 80% of the time, suggesting that early failures in inhibitory control could predict the onset of dementia.
Owen emphasizes that correctly identifying who will develop Alzheimer's is as important as identifying those who will not, particularly given the cost and side effects of some dementia medications. Simple, inexpensive online tests of executive function could play a significant role in this identification process.
Beyond specific disease prediction, maintaining executive function involves lifestyle choices. Regular aerobic exercise, adequate sleep, stress management, and a balanced diet rich in flavonoids (found in fruits like blueberries and grapes) can all support brain health. Even simple practices like writing a to-do list can aid executive function and memory.
While a cure for Alzheimer's remains distant, Owen's work points towards a future where simple mental strategies and training can help slow memory loss and maintain cognitive function for longer, even after the disease has taken hold. This approach offers a more immediate prospect than a complete cure.
Simple practices like writing a list can aid executive function.
