Neuroscience Bulletin

, Volume 35, Issue 2, pp 253–266 | Cite as

Activation of the Brain to Postpone Dementia: A Concept Originating from Postmortem Human Brain Studies

  • Qiong-Bin Zhu
  • Ai-Min BaoEmail author
  • Dick Swaab


Alzheimer’s disease (AD) is characterized by decreased neuronal activity and atrophy, while hyperactivity of neurons seems to make them resistant to aging and neurodegeneration, a phenomenon which we have paraphrased as ‘use it or lose it’. Our hypothesis proposes that (1) during their functioning, neurons are damaged; (2) accumulation of damage that is not repaired is the basis of aging; (3) the vulnerability to AD is determined by the genetic background and the balance between the amount of damage and the efficiency of repair, and (4) by stimulating the brain, repair mechanisms are stimulated and cognitive reserve is increased, resulting in a decreased rate of aging and risk for AD. Environmental stimulating factors such as bilingualism/multilingualism, education, occupation, musical experience, physical exercise, and leisure activities have been reported to reduce the risk of dementia and decrease the rate of cognitive decline, although methodological problems are present.


Dementia Genes Environmental stimulation Brain activation Cognitive reserve Use it or lose it 



This review was supported by the National Natural Science Foundation of China (31571048), the Program of Introducing Talents of Disciplines to Universities of China (B13026) and the Fund for Cultivation of Innovative Talents, 985 Project of Zhejiang University, China (188310*193226201[3]). We thank Ms. W.T.P. Verweij for polishing the English language.


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Copyright information

© Shanghai Institutes for Biological Sciences, CAS 2019

Authors and Affiliations

  1. 1.Department of Neurology, Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhouChina
  2. 2.Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of NeurobiologyZhejiang University School of MedicineHangzhouChina
  3. 3.Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and SciencesAmsterdamThe Netherlands

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