, Volume 30, Issue 1, pp 21–29 | Cite as

Reading and solving arithmetic problems improves cognitive functions of normal aged people: a randomized controlled study



The relationship between mental exercise and mental aging is a controversial issue. People generally believe the so-called mental-exercise hypothesis, that is, the age-related decline in cognitive function is less pronounced for people who are mentally active, yet there is insufficient scientific evidence supporting this hypothesis. Previous randomized controlled trial studies showed convincing beneficial effects of cognitive training on directly targeted cognitive functions. In this study, we performed a single-blind, randomized controlled trial on cognitive intervention in 124 community-dwelling seniors (age range, 70 to 86) and estimated the beneficial effects of non-targeted cognitive functions. As for cognitive intervention, the subjects were asked to solve systematized basic problems in reading and arithmetic every day for 6 months. Neuropsychological measures were determined prior to and 6 months after the intervention (post-test) by mini-mental state examination (MMSE), frontal assessment battery at bed side (FAB), and digit-symbol substitution test (DST) of WAIS-R. The FAB and DST scores showed a statistically significant (p<0.001 and p<0.01, respectively) improvement in the post-test compared with the pre-test, such improvement was maintained up to 6 months of follow-up tests in only the experimental group. The transfer effect of cognitive intervention by reading and solving arithmetic problems on non-targeted cognitive functions was demonstrated in this study. This study shows that daily mental training can improve cognitive functions in normal adults. Although general interests in brain training have been increasing in the public, evidence for its beneficial effects, particularly the positive transfer effect on non-targeted cognitive function still remains insufficient. Here, we introduce a new cognitive intervention program for normal aged people, the concept of which is derived from the knowledge of both brain science and clinical studies. We performed a carefully designed single-blind, randomized controlled study, and the results of this study showed convincing evidence that cognitive training provides the beneficial transfer effect.


Prefrontal cortex Daily intervention Randomized controlled study Reading Arithmetic 



We thank Professor Ichiro Tsuji at the Graduate School of Medicine, Tohoku University, for suggestion and collaboration for experimental setup and design. We also thank all stuff members involved in “Tsurugaya Project”, and Kumon Learning Center c/o for technical support for cognitive measures and intervention. This study was supported by RISTEX, JST, and a collaborative study between Tohoku University and Sendai City (Gakuto collaboration research project).


  1. Appollonio I, Leone M, Isella V, Piamarta F, Consoli T, Villa ML, Forapani E, Russo A, Nichelli P (2005) The Frontal Assessment Battery (FAB): normative values in an Italian population sample. Neurol Sci 26:108–116PubMedCrossRefGoogle Scholar
  2. Ball K, Berch DB, Helmers KF, Jobe JB, Leveck MD, Marsiske M, Morris JN, Rebok GW, Smith DM, Tennstedt SL, Unverzagt FW, Willis SL (2002) Effects of cognitive training interventions with older adults. JAMA 288:271–2281Google Scholar
  3. Burbaud P, Degreze P, Lafon P, Franconi JM, Bouligand B, Bioulac B, Caille JM, Allard M (1995) Lateralization of prefrontal activation during internal mental calculation: a functional magnetic resonance imaging study. J Neurophysiol 74:194–2200Google Scholar
  4. Clark F, Azen SP, Zemke R, Jackson J, Carlson M, Mandel D, Hay J, Josephson K, Cherry B, Hessel C, Palmer J, Lipson L (1997) Occupational therapy for independent-living older adults: a randomized controlled trial. JAMA 278:1321–1326PubMedCrossRefGoogle Scholar
  5. Dehaene S, Tzourio N, Frak V, Raynaud L, Cohen L, Mehler J, Mazoyer B (1996) Cerebral activations during number multiplication and comparison: a PET study. Neuropsychol 34:1097–1106CrossRefGoogle Scholar
  6. Dubois B, Slachevsky A, Litvan I, Pillon B (2000) The FAB. A frontal assessment battery at bedside. Neurol 55:1621–1626Google Scholar
  7. Fillit HM, Butler RN, O’Connell AW, Albert MS, Birren JE, Cotman CW, Greenough WT, Gold PE, Kramer AF, Kuller LH, Perls TT, Sahagan BG, Tully T (2002) Achieving and maintaining cognitive vitality with aging. Mayo Clinic Proceedings 77:681–696PubMedCrossRefGoogle Scholar
  8. Folstein MF, Folstein S, Mchugh PR (1975) Mini Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 121:189–198CrossRefGoogle Scholar
  9. Hagoort P, Indefrey P, Brown C, Herzog H, Steinmetz H, Seitz RJ (1999) The neural circuitry involved in the reading of German words and pseudowords: a PET study. J Cognit Neurosci 11:383–398CrossRefGoogle Scholar
  10. Herbster AN, Mintun MA, Nebes RD, Becker JT (1997) Regional cerebral blood flow during word and nonword reading. Hum Brain Map 5:84–92CrossRefGoogle Scholar
  11. Hoyer WJ, Stawski RS, Wasylyshyn C, Verhaeghen P (2004) Adult age and digit symbol substitution performance: a meta-analysis. Psychol Aging 19:211–214PubMedCrossRefGoogle Scholar
  12. Hozawa A, Ebihara S, Ohmori K, Kuriyama S, Ugajin T, Koizumi Y, Suzuki Y, Matsui T, Arai H, Tsubono Y, Sasaki H, Tsuji I (2004) Increased plasma 8-isoprostane levels in hypertensive subjects: the Tsurugaya Project. Hypertension Res 27:557–561CrossRefGoogle Scholar
  13. Joy S, Fein D, Kaplan E (2003) Decoding digit symbol: speed, memory, and visual scanning. Assessment 10:56–65PubMedCrossRefGoogle Scholar
  14. Kawashima R, Taira M, Okita K, Inoue K, Tajima N, Yoshida H, Sasaki T, Sugiura M, Watanabe J, Fukuda H (2004) A functional MRI study of simple arithmetic: a comparison between children and adults. Cognit Brain Res 18:225–238CrossRefGoogle Scholar
  15. Kawashima R, Okita K, Yamazaki R, Tajima N, Yoshida H, Taira M, Iwata K, Sasaki T, Maeyama K, Usui N, Sugimoto K (2005) Reading aloud and arithmetic calculation improve frontal function of people with dementia. J Gerontol A Biol Sci Med Sci 60A:426–431Google Scholar
  16. Koizumi Y, Awata S, Kuriyama S, Ohmori K, Hozawa A, Seki T, Matsuoka H, Tsuji I (2005) Association between social support and depression status in the elderly: results of a 1-year community-based prospective cohort study in Japan. Psychiatry Clin Neurosci 59:563–569PubMedCrossRefGoogle Scholar
  17. Kreiner DS, Ryan JJ (2001) Memory and motor skill components of the WAIS-III Digit Symbol-Coding subtest. Clin Neuropsychol 15:109–113PubMedGoogle Scholar
  18. Lezak MD, Howieson DB, Loring DW (2004) Neuropsychological assessment, 4th edn. Oxford University Press, New YorkGoogle Scholar
  19. Mahncke HW, Connor BB, Appelman J, Ahsanuddin ON, Hardy JL, Wood RA, Joyce NM, Boniske T, Atkins SM, Merzenich MM (2006) Memory enhancement in healthy older adults using a brain plasticity-based training program: a randomized, controlled study. Proc Nat Acad Sci USA 103:12523–12528PubMedCrossRefGoogle Scholar
  20. Menon V, Rivera SM, White CD, Glover GH, Reiss AL (2000) Dissociating prefrontal and parietal cortex activation during arithmetic processing. Neuroimage 12:357–365PubMedCrossRefGoogle Scholar
  21. Merzenich MM, Jenkins WM (1993) In: Andersen P (ed) Memory concepts. Elsevier, Amsterdam, pp 437–453Google Scholar
  22. Miura N, Iwata K, Watanabe J, Sugiura M, Akitsuki Y, Sassa Y, Ikuta N, Okamoto H, Watanabe Y, Riera J, Maeda Y, Matsue Y, Kawashima R (2003) Cortical activation during reading aloud of long sentences: an fMRI study. Neuroreport 14:1563–1566PubMedCrossRefGoogle Scholar
  23. Miura N, Watanabe J, Iwata K, Sassa Y, Riera J, Tsuchiya H, Sato S, Horie K, Kawashima R (2005) Cortical activation during reading of ancient versus modern Japanese texts: fMRI study. Neuroimage 26:426–431PubMedCrossRefGoogle Scholar
  24. Price CJ, Wise RJ, Watson JD, Patterson K, Howard D, Frackowiak RS (1994) Brain activity during reading. The effects of exposure duration and task. Brain 117:1255–1269PubMedCrossRefGoogle Scholar
  25. Rickard TC, Romero SG, Basso G, Wharton C, Flitman S, Grafman J (2000) The calculating brain: an fMRI study. Neurophsycol 38:325–335Google Scholar
  26. Ritchie K, Artero S, Touchon J (2001) Classification criteria for mild cognitive impairment: a population-based validation study. Neurol 56:37–42Google Scholar
  27. Roland PE, Friberg L (1985) Localization of cortical areas activated by thinking. J Neurophysiol 53:1219–1243PubMedGoogle Scholar
  28. Rueckert L, Lange N, Partiot A, Appollonio I, Litvar I, Le Bihan D, Grafman J (1996) Visualizing cortical activation during mental calculation with functional MRI. Neuroimage 3:97–103PubMedCrossRefGoogle Scholar
  29. Salthouse TA (2006) Mental exercise and mental aging. Perspect Psychol Sci 1:68–87CrossRefGoogle Scholar
  30. Taki Y, Kinomura S, Awata S, Inoue K, Sato K, Ito H, Goto R, Uchida S, Tsuji I, Arai H, Kawashima R, Fukuda H (2005) Male elderly subthreshold depression patients have smaller volume of medial part of prefrontal cortex and precentral gyrus compared with age-matched normal subjects: a voxel-based morphometry. J Affect Disord 88:313–320PubMedCrossRefGoogle Scholar
  31. Wechsler D (1981) Manual for the Wechsler adult intelligence scale-revised. The Psychological Corporation, New YorkGoogle Scholar
  32. Willis SL, Schaie KW (1986) Training the elderly on the ability factors of spatial orientation and inductive reasoning. Psychol Aging 1:239–247PubMedCrossRefGoogle Scholar
  33. Willis SL, Tennstedt SL, Marsiske M, Ball K, Elias J, Koepke KM, Morris JN, Rebok GW, Unverzagt FW, Stoddard AM, Wright E (2006) Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA 296:2805–2854PubMedCrossRefGoogle Scholar
  34. Wielgos CM, Cunningham WR (1999) Age-related slowing on the Digit Symbol task: longitudinal and cross-sectional analyses. Exp Aging Res 25:109–120PubMedCrossRefGoogle Scholar
  35. Wingfield A, Grossman M (2006) Language and the aging brain: patterns of neural compensation revealed by functional brain imaging. J Neurophysiol 96:2830–2839PubMedCrossRefGoogle Scholar

Copyright information

© American Aging Association, Media, PA, USA 2008

Authors and Affiliations

  1. 1.Department of Functional Brain Imaging, IDACTohoku UniversitySendaiJapan

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