As a specialist in Alzheimer's prevention, Jessica Langbaum knows that exercising her mental muscles can help keep her brain sharp.
But Langbaum, who holds a doctorate in psychiatric epidemiology, has no formal mental fitness program. She doesn't do crossword puzzles or play computer brain games.
"Just sitting down and doing Sudoku isn't probably going to be the one key thing that's going to prevent you from developing Alzheimer's disease," she says.
Instead of using a formal brain training program, she simply goes to work.
"My job is my daily cognitive training," says Langbaum, the associate director of the Alzheimer's Prevention Initiative at the Banner Alzheimer's Institute in Phoenix.
And that's true of most working people. "While you're still in the work force you are getting that daily challenge of multitasking, of remembering things, of processing information," she says.
Langbaum offers that perspective as someone who has spent years studying the effects of brain training programs, and as someone who has seen Alzheimer's up close.
"My grandfather was diagnosed with mild cognitive impairment when I was in graduate school getting my Ph.D.," she says. "That transitioned into full-blown Alzheimer's dementia."
So Langbaum began to ask herself a question: "How can I in my career help ensure that we aren't suffering from the disease when we reach that age?"
And she realized early on that puzzles and games weren't the answer because they tend to focus on one very narrow task. The result is like exercising just one muscle in your body, Langbaum says. That muscle will get stronger, but your overall fitness isn't going to change.
The brain training programs used in research studies are more promising and much more demanding. "They're hard," says Langbaum, who tried them herself while she was part of a groundbreaking study on the effects of brain training.
In the study of about 2,800 people age 65 and older, most spent more than five weeks doing exercises that tested memory, reasoning or speed. Two of the interventions, reasoning and processing speed, helped a bit even 10 years later, Langbaum says.
"They delay the onset of cognitive impairment," she says. "They keep your brain working at the same level longer, compared to people who did not receive those same cognitive training interventions."
But it remains unclear whether brain training can also prevent or delay Alzheimer's. And more recent research suggests that social interaction may be a better form of mental exercise than brain training.
"People who have a lot of social interactions, particularly in mid-life, have a lower risk of Alzheimer's dementia in later life," Langbaum says. "There's something about being around people that's helpful for our brains."
Langbaum's in good shape on the social front. Between her family, her two kids, her colleagues at work, and her friends, she says, the social areas of her brain get a vigorous daily workout.
So brain training isn't for Langbaum. But it may be useful for people who are out of the workforce and more isolated, she says.
And she has some advice for anyone looking for a way to keep their brain healthy.
"If you like crossword puzzles, do them," she says. "But try something new. And trying something new that brings you enjoyment is key. Don't do it if you don't like it."
NOEL KING, HOST:
As scandals around clerical sex abuse hit the Catholic Church, a three-week-long assembly of bishops is underway in Rome. They're focused on how to make the church relevant to young people. But as NPR's Sylvia Poggioli reports, the assembly, which is known as a synod, will likely be dominated by what many analysts call Catholicism's worst crisis since the Reformation.
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UNIDENTIFIED SINGERS: (Singing in foreign language).
SYLVIA POGGIOLI, BYLINE: In the synod's opening mass, Pope Francis urged the more than 250 participating priests, bishops and cardinals to dare to dream and to hope.
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POPE FRANCIS: (Speaking Italian).
POGGIOLI: And he prayed for God's help to ensure the church does not let itself be extinguished or crushed by the prophets of doom and misfortune by our own shortcomings, mistakes and sins. Spiraling sex abuse scandals have hurt the pope. A new Pew Research Center poll found Francis' favorability rating in the United States is 51 percent, 19 points down since January 2017. And as the synod opened one block from St. Peter's Square, some 20 abuse survivors voiced their anger at the church.
UNIDENTIFIED PERSON: (Speaking Italian).
POGGIOLI: "We victims must unite," a man shouted. "That's the only way we can bring this evil to an end." Arturo Borelli says he was abused by a priest who fled both civil and church justice. Nearby, some 20 people - Italians and other Europeans - held placards demanding no more cover-ups and make zero-tolerance real.
CHRISTIAN WEISNER: I think we are in the deepest crisis in the Roman Catholic Church.
POGGIOLI: Christian Weisner is one of the German founders of the progressive Catholic movement We Are Church. He believes Francis is doing the best he can handling the crisis but needs much more support from bishops.
WEISNER: Especially now at the youth synod, the bishops - they have to face this problem. They have to give answers. They have to take responsibility.
POGGIOLI: It's not the only issue haunting the church. On the eve of the synod, a group of Catholic women activists met in Rome to demand decision-making positions in the church for women. But Chantal Gotz, founder of the movement Voices of Faith, acknowledged nothing will change as long as clericalism prevails, that culture of clergy entitlement and unaccountability.
CHANTAL GOTZ: The whole governance structure is crippled and paralyzed by clericalism. It cannot just be repaired somehow but must die and be resurrected in a totally new form.
POGGIOLI: Celia Wexler, author of a book on women's struggles in the church, said that it's hard for Catholic women to speak out because they have always been taught to obey.
CELIA WEXLER: No. I think we have to come to the point where we don't ask permission. We speak out and speak up and talk to one another.
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UNIDENTIFIED CROWD: Pope Francis, let women vote. Knock, knock. Who's there? More than half the church.
POGGIOLI: Making their voices heard as bishops and cardinals were entering the assembly hall, these women came to protest gender discrimination. At the synod, laymen participants can vote, but the few laywomen cannot. The peaceful protest ended when police officers in plainclothes and others with bulletproof vests intervened, manhandling several of the women. Sylvia Poggioli, NPR News, Rome.
(SOUNDBITE OF ERNEST GONZALES SONG, "UP AND AWAY (WHILE ON SATURN'S RINGS STONERMIX)") Transcript provided by NPR, Copyright NPR.