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Nexus Clinical References

Nexus uses the latest clinical findings in its goal of slowing the effects of dementia. This page contains information and links to the results the program is based on.

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  • Nexus uses the latest clinical findings in its goal of slowing the effects of dementia. Browse the studies that inform each pillar below. 


    1. Physical Exercise

    Mounting evidence is showing that physical activity (a total of 150 minutes of aerobic activity ie,. brisk walking) has significant benefits to the brain.

    Examples: Walking club, Fitbit Move-it, Ballroom Dance Club, Rock and Roll Club, Zumba, Latin Zumba, Dog walking club, Golfing, Ping Pong

    • Longitudinal studies show an association between higher levels of physical activity and a reduced risk of cognitive decline and dementia.
    • Blondell, Sarah J., Rachel Hammersley-Mather, and Jacob Lennert Veerman. "Does physical activity prevent cognitive decline and dementia?: A systematic review and meta-analysis of longitudinal studies." BMC public health 14.1 (2014): 510. Read more.

    • Exercise increases hippocampal volume and levels of brain derived neurotropic factor and improves memory.
    • Erickson, Kirk I., et al. "Exercise training increases size of hippocampus and improves memory." Proceedings of the National Academy of Sciences (2011): 201015950. Read more.

    • Physical activity has been found to both delay onset and slow the progression of Alzheimer’s Disease.
    • Myuri Ruthirakuhan, et al, “Use of Physical and Intellectual Activities and Socialization in the Management of Cognitive Decline of Aging and in Dementia: A Review,” Journal of Aging Research, 2012. Read more.

    • Significant age-related atrophy of the medial temporal lobe of the brain was not seen in those with higher levels of exercise as compared to those with lower levels of exercise.
    • Bugg, Julie M., and Denise Head. "Exercise moderates age-related atrophy of the medial temporal lobe." Neurobiology of aging 32.3 (2011): 506-514. Read more.

    • Exercise has been associated with higher levels of brain-derived neurotropic factor (a nerve growth factor)
    • Coelho et al, “Acute aerobic exercise increases brain-derived neurotrophic factor levels in elderly with Alzheimer's disease.” Journal of Alzheimer’s Disease. 2014;39(2):401-8 Read more. 

    • Exercise benefits executive function (planning, coordination, working memory, abstract thinking, judgment) 
    • Smith PJ, Blumenthal JA, Hoffman BM, et al. "Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials." Psychosomatic Medicine 2010; 72(3):239Y252. Read more.

    • Aerobic exercise has been found to be associated with significantly larger brain hippocampal volumes and better spatial memory, Randomized clinical trials have found that in MCI and dementia, participants had better cognitive scores after 6-12 months of exercise.
    • Ahlskog et al, “Physical exercise as a Preventative or Disease- Modifying Treatment of Dementia or Brain Aging” Mayo Clinic Proceedings, Sept 2011, 86(9), 876-884 Read more.
    • Daily physical activity aside from specific exercise can lead to more gray matter in the brain
    • Shannon Halloway, Konstantinos Arfanakis, JoEllen Wilbur, Michael E Schoeny, Susan J Pressler; Accelerometer Physical Activity is Associated with Greater Gray Matter Volumes in Older Adults Without Dementia or Mild Cognitive Impairment, The Journals of Gerontology: Series B, , gby010, Read more.


    2. Cognitive exercise

    Games and strategies that reinforce cognitive skills that remain to compensate for those lost to dementia.

    Examples:  Learning memory enhancing techniques and strategies, building fluency, creative storytelling, Mad -Libs, Writing Club, i-pad club, Scrabble club

    • A double blind study of 2,832 elderly adults receiving training on memory, reasoning, or processing speed, found that training resulted in improved cognitive scores of the area they trained in for five years.
    • Aguirre, Elisa, et al. "Cognitive stimulation for dementia: a systematic review of the evidence of effectiveness from randomized controlled trials." Ageing research reviews 12.1 (2013): 253-262. Read more.

    • Cognitive stimulation can improve cognitive functioning in people with dementia. 
    • Woods, Bob, et al. "Cognitive stimulation to improve cognitive functioning in people with dementia." The Cochrane Library (2012) Cochrane Database Syst Rev 2012; 2: CD005562. Read more.

    • Engagement in cognitively stimulating activities early in the course of Alzheimer’s was associated with slower cognitive decline.
    • Treiber, Katherine A., et al. "Cognitive stimulation and cognitive and functional decline in Alzheimer's disease: the Cache County Dementia Progression Study." The Journals of Gerontology Series B: Psychological Sciences and Social Sciences (2011): gbr023. Read more.

    • A recent meta-analysis reviewed the benefit of complex education, occupation and mental activity and concluded that the higher brain reserve was associated with a 46% reduced risk of dementia
    • Valenzuela, Michael J. "Brain reserve and the prevention of dementia." Current opinion in psychiatry 21.3 (2008): 296-302. Read more.


    3. Stress Reduction

    Examples: Guided meditation, Yoga, Tai-chi

    • Meditation may offer considerable promise for improving cognition, mood, sleep, and related outcomes in adults with or at risk for cognitive impairment.
    • Innes, Kim E., and Terry Kit Selfe. “Meditation as a Therapeutic Intervention for Adults at Risk for Alzheimer’s Disease – Potential Benefits and Underlying Mechanisms.” Frontiers in Psychiatry 5 (2014): 40. PMC. Read more.

    • The hippocampus is activated during meditation.
    • Engström, Maria, et al. "Functional magnetic resonance imaging of hippocampal activation during silent mantra meditation." The Journal of Alternative and Complementary Medicine 16.12 (2010): 1253-1258. Read more.

    • A study of patients with MCI found that those who did mindfulness-based stress reduction through yoga and meditation had less brain atrophy than those who did not.
    • Wells, Rebecca Erwin, et al. "Meditation's impact on default mode network and hippocampus in mild cognitive impairment: A pilot study." Neuroscience letters 556 (2013): 15-19. Read more.

    • Chanting meditation increases cerebral blood flow.
    • Khalsa, Dharma Singh, et al. "Cerebral blood flow changes during chanting meditation." Nuclear medicine communications 30.12 (2009): 956-961. Read more.


    4. Ongoing engagement in purposeful social activities

    Mounting evidence is showing that increased social activity and strong social connections modifies the effect of Alzheimer’s Disease pathology in the brain by lowering one’s risk of cognitive impairment. It is felt that it does this by building one’s cognitive reserve of healthy brain cells and strengthening the connections between them.

    Examples: Kid’s Club, Volunteers/clubs with a purpose ie., making items for others, USO Club, Residents teach others a previous skill (piano, Spanish, dance), Cooking club,

    • Larger social networks have a protective influence on cognitive function in elderly women.
    • Crooks VC, Lubben J, Petitti DB, et al.” Social network, cognitive function, and dementia incidence among elderly women.” American Journal of Public Health 98.7 (2008): 1221. Read more.

    • A strong social network including close social ties protected against cognitive decline. 
    • Andrew, M. K., & Rockwood, K. (2010). “Social vulnerability predicts cognitive decline in a prospective cohort of older Canadians”. Alzheimer's & Dementia, 6.4 (2010), 319-325. Read more.  

    • Social network size modified the association between pathology and cognitive function in Alzheimer’s Disease.
    • Bennett, David A et al, “The effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal cohort study.” The Lancet Neurology 5.5 (2006): 406-412. Read more.


    5. Support groups

    • Early-stage memory loss support groups show significant benefits in quality of life.
    • Logsdon, Rebecca G., et al. "Early-stage memory loss support groups: outcomes from a randomized controlled clinical trial." The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 65.6 (2010): 691-697. Read more.
    • Support groups for individuals with early stage dementia showed positive feelings of purposefulness, gratification, belongingness and survival.
    • Snyder, Lisa, et al. "Supportive seminar groups: An intervention for early stage dementia patients." The Gerontologist 35.5 (1995): 691-695. Read more.

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Nexus Pillars

Physical Exercise

WEB45 Nexusphysicalexercise THUMBNAIL

Physical activity and aerobic exercise have been found to have significant brain benefits.

Stress Reduction

WEB45 Nexusstressreduction THUMBNAIL

Methods such as guided meditation, Yoga, Tai-chi and more have been shown to provide benefits such as improved activity in the hippocampus.

Cognitive Exercise

WEB45 Nexuscognitiveexercise THUMBNAIL

Engagement in cognitively stimulating activities early in the course of Alzheimer’s has been associated with slower cognitive decline.

Purposeful Social Activities

WEB45 Nexussocialactivities THUMBNAIL

A strong social network involving purpose-oriented activities has been found to protect against cognitive decline.

Support Groups

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Studies suggest that support groups may benefit individuals with dementia by reducing depression and improving quality of life and self–esteem.

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