• Poor control of chronic diseases and bad habits such as smoking can speed up cognitive decline
• Pandemic-related factors such as lack of exercise, too much screen time, chronic stress and social isolation can also affect how the brain works
• A holistic approach of a healthy diet, regular exercise and keeping mentally active can improve brain health
• A brain fitness trainer offered some workouts to “train” the brain and the body

SINGAPORE — In case anyone needs even more reasons to keep healthy and fit during the Covid-19 pandemic, here is one more.

Social isolation, too much time spent looking at computer and mobile phone screens, and a lack of physical exercise are all contributing to a decline in brain function, medical researchers found.

That “brain fog” people are talking about? It may not just be a passing experience or happening only to Covid-19 survivors after a severe infection.

It is a term used to describe a general sense of fatigue, sluggishness, memory lapses and a feeling of the brain slowing down — and there have been anecdotal reports of this affecting even younger adults.

The good news is, there are ways to improve brain performance and it involves doing exercises such as sitting and standing while counting backwards from 99 by subtracting seven each time.

Yes, you read right, but more on that later. First, the science.

Dr Chong Yao Feng, associate consultant from the division of neurology  at National University Hospital (NUH), said: “Lower levels of physical exercise and increased social isolation have been robustly shown to impair various domains of cognition.”

While manageable levels of stress can improve performance, chronic stress and poor mental health have been shown to impair cognition.

Cognitive function usually declines after the age of 50 or 60, although studies suggest that the slowing down can also happen from as early as when a person is in the 20s, Dr Chong added.

There are many factors that speed up the process. For instance, excessive alcohol intake and smoking too much can damage brain cells and other organs.

Getting chronic diseases such as diabetes and hypertension, as well as diseases that directly damage the brain such as stroke, also accelerate the process, he said.

A report published in the journal Neuropsychopharmacology Reviews in August last year suggested that the Covid-19 pandemic has likely changed how the brain works, even in those who have not contracted the coronavirus.

Professor Barbara Sahakian, a neuroscientist from the University of Cambridge in the United Kingdom, found that isolation and loneliness during the pandemic have a profound impact on regions of the brain that can alter mood and affect memory.

In her research, Prof Sahakian found that even people who never had Covid-19 but were in lockdown reported having difficulties with concentration and memory, as well as depression.

And what about spending too much time on digital devices?

Ms Anna Milani, chief executive officer and founder of a gym here called Sparkd, said: “If I sit at home and do another Zoom call and don’t stimulate my brain in other ways, it will slow down. I’ve seen clients who say that their brain feels ‘slower’ these days.

“Our brains learn from stimuli. When we passively look at social media, we’re not physically reacting to it; we’re not moving. That’s not stimulating (to the brain).”

Sparkd, located in the River Valley Road area, offers brain fitness programmes that train the brain and body simultaneously.

It also houses a neuro-rehabilitation space with services for people with cognitive conditions such as Parkinson’s disease and Alzheimer’s disease. It has plans to launch a series of brain health fitness videos.

Ms Milani said that positive changes in the brain occur when it is exposed to environments that offer a variety of stimuli.

On the other hand, sedentary behaviour is linked to poorer brain function.

Indeed, research shows that just several hours of screen time each day may increase the risk of cognitive decline.

A study published in the journal Scientific Reports in 2019 already found that people who watched more than three hours of television a day faced a higher risk of cognitive decline in language and memory in the longer term. 

In another study published in the journal World Psychiatry in 2019, researchers found that heavy social media use was linked to memory deficits, especially the type of memory that involved deciding which information should be stored in or offloaded from the brain.

The report also suggested that engaging in multi-tasking on digital media did not translate to better multi-tasking performance in other settings.

What it did was affect people’s ability to ignore distractions while performing a task.

WORKOUTS TO ‘WAKE’ THE BRAIN

At Sparkd, instructors customise cognitive-motor training activities (this means training the brain and body simultaneously), depending on their clients’ goals and weaknesses.

For example, if poor memory is a weakness, they may be encouraged to include some cardiovascular exercises and activities that focus on memory, such as doing memory games while moving around and doing physical tasks, Ms Milani said.

The ability to move and perform cognitive tasks at the same time, also called dual-tasking, is a key aspect of daily life.

However, ageing and lack of stimulation can cause the neurons to become “lazy”, she said.

Practising cognitive-motor training skills can help stimulate and “wake” the brain, she added.

“Your neurons will be firing up as your brain is doing two tasks at once. The important thing is not to slow down even if your brain cannot think fast enough to maintain the same speed while executing the physical activities.”

The following are some simple workouts to fire up the brain, each with a lower-impact version for people of different fitness levels.

1. To boost the brain’s executive function

This hones a set of mental skills that include working memory, flexible thinking and self-control.

Jog on the spot while counting backwards from 99 by subtracting seven each time. That will be 99, 92, 85 and so on.

Alternatively, if jogging is not advisable, sit and stand while doing that.

2. To boost verbal ability

Do star jumps or jumping jacks while naming words in alphabetical order. For example, “A is for apple, B is for boy, C is for cat” and so on.

Alternatively, march on the spot while doing this.

3. To boost memory

Pick 20 cards randomly from a deck of poker cards and perform exercises at the fastest time.

Each card’s symbol and number will determine the exercise and number of repetitions.

Spade is for squats, heart is for high knees (lifting knees high while jogging on the spot), club is for jumping jacks, diamond is for reverse lunges (one leg bends at 90 degrees while the other stretches backwards).

For instance, if you draw a three of spades card, do three squats.

You may reduce the intensity of the workouts for each card with a lower-impact exercise.

For example, spade is for stand and sit, heart is for march on the spot, club is for extended arm rotation, diamond is for single-leg balance.

4. To boost processing speed

This exercise should be done with a workout partner.

Place different coloured papers on the floor or a table and stand a distance away depending on how much you want to do.

Have your partner call out different colours while you walk or sprint towards the papers to touch the correct colour as fast as possible.

For a less strenuous version, the player may stand closer to the papers and just step and tap the colour instead of sprinting towards it.

You may raise the difficulty of this workout by calling out two or more different colours at a time, for example, yellow and blue, or green, red and orange.

COMBINE EXERCISE WITH A HEALTHY LIFESTYLE

Ms Milani said that although it is not possible to reverse cognitive impairment when it already happens, the brain has the ability to potentially rewire itself, and re-organise and create new connections in response to stimuli and new learning — a concept called neuroplasticity.

Moving your body and getting your heart pumping is one way to do this.

The Health Promotion Board recommends aiming for at least 150 minutes of physical activity a week for adults and older adults to reap substantial health benefits.

This can be done as 10-minute sessions accumulated over the week to achieve 150 minutes of moderate intensity. This means activities that cause a noticeable increase in breathing and heart rate, such as brisk-walking or low-impact aerobics.

Or else, target to do 75 minutes of vigorous intensity physical activity a week.

Dr Chong of NUH said that while long-term regular aerobic exercise such as jogging and swimming has the best evidence for improving cognition, there is no strong evidence that one type of aerobic activity is superior to another.

“As long as you choose an activity that makes you perspire and gets your heart pumping, that should be good enough.”  

Dr Chong added that increased levels of physical activity may significantly reduce the risk of developing dementia and some age-related neurological diseases, but it should not be done in isolation.

To achieve the best outcome for brain health, he advised using a holistic approach that includes having a healthy balanced diet and doing regular physical exercise and mentally stimulating activities.

“Remain mentally active through work, social activities, reading, learning new skills and taking up new hobbies.

“From the perspective of brain health, it is good to remain employed for as long as possible and avoid social isolation.”

As for whether physical exercise can potentially stimulate the growth of new brain cells and clear toxins from the brain, Dr Chong said that some of these assertions have been more convincingly shown in animal studies.

For sure, physical exercise does increase blood flow to the brain and it can also improve mental health by reducing levels of anxiety, stress and depression, which have been demonstrated to impair cognition, he added.

For people with chronic diseases such as diabetes and hypertension, they should ensure that they have good control over their conditions.

Dr Chong said: “By controlling these diseases better, you reduce the risk of developing complications (that directly damage the brain) such as stroke or dementia.”

He also advised patients with disabilities or neurological conditions to always seek advice from a healthcare professional regarding the appropriate type of exercise that can help them.