I am honored to interview him today about recent brain research findings focused on how to maintain a healthy, strong brain.

Alvaro Fernandez (AF): Dr. Kramer, thank you for your time. Let's start by trying to clarify some existing misconceptions and controversies. Based on what we know today, and your recent Nature piece (Note: referenced below), what are the 2-3 key lifestyle habits would you suggest to a person who wants to delay Alzheimer's symptoms and improve overall brain health?

Dr. Kramer (DK): First, Be Active. Do physical exercise. Aerobic exercise, 30 to 60 minutes per day 3 days per week, has been shown to have an impact in a variety of experiments. And you don't need to do something strenuous: even walking has shown that effect. There are many open questions in terms of specific types of exercise, duration, magnitude of effect...but, as we wrote in our recent Nature Reviews Neuroscience article, there is little doubt that leading a sedentary life is bad for our cognitive health. Cardiovascular exercise seems to have a positive effect.

Second, Maintain Lifelong Intellectual Engagement. There is abundant prospective observational research showing that doing more mentally stimulating activities reduces the risk of developing Alzheimer's symptoms.

Let me add, given all media hype, that no "brain game" in particular has been shown to have a long-term impact on Alzheimer's or the maintenance of cognition across extended periods of time. It is too early for that-and consumers should be aware of that fact. It is true that some companies are being more science-based than others but, in my view, the consumer-oriented field is growing faster than the research is.

Ideally, combine both physical and mental stimulation along with social interactions. Why not take a good walk with friends to discuss a book? We lead very busy lives, so the more integrated and interesting activities are, the more likely we will do them.

AF: Great concept: a walking book club! Now, part of the confusion we observe is due to the search of "magic solutions" that work for everyone and everything. We prefer to talk about several pillars of brain health, and different priorities for different individuals. Can you elaborate on what interventions seem to have a positive effect on specific cognitive abilities and individuals?

DK: Perhaps one day we will be able to recommend specific interventions for individuals based on genetic testing, for example, but we don't have a clue today. We are only beginning to understand how the environment interacts with our genome.

But I agree on the premise that there probably won't be a general solution that solves all cognitive problems, but we need a multitude of approaches. And we can't forget, for example, the cognitive benefits from smoking cessation, sleep, pharmacological interventions, nutrition, social engagement.

Physical exercise tends to have rather broad effects on different forms of perception and cognition, as seen in the Colcombe and Kramer, 2003, meta-analysis published in Psychological Science (Note: referenced below).

Cognitive training also works for a multitude of perceptual and cognitive domains - but has shown little transfer beyond trained tasks.

No single type of intervention is sufficient. Today there is no clear research on how those different lifestyle factors may interact. The National Institute on Aging is starting to sponsor research to address precisely that.

AF: To wrap up, what's in your mind the best way to explain the relative benefits of physical vs. cognitive exercise? From a fundamental point of view, it seems clear that physical exercise can help enhance neurogenesis (Note: the creation of new neurons), yet learning/ cognitive exercise contributes to the survival of those neurons by strengthening synapses, so I see more how those two "pillars" are complimentary than "one or the other".

DK: I agree. Given what we know today I would recommend both intellectual engagement and physical exercise. However, we do know, from a multitude of animal studies, that physical exercise has a multitude of effects on brains beyond neurogenesis, including increases in various neurotransmitters, nerve grown factors, and angiogenesis (the formation of new blood vessels).

AF: Dr. Kramer, many thanks for your time.

DK: You are welcome.

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