This news release describes a small study that appears to show an increase in brain volume and improved memory among some low-income seniors who participated in a civic engagement program. We say “appears” because it’s debatable whether the study did, in fact, show any such benefits. In the results section of this study, the researchers acknowledge that their analysis of the full study sample “revealed no significant intervention effects” on brain volume. However, they highlight the findings of a “sex-stratified” analysis in the abstract that seems to indicate a benefit. But that positive result was found only in men, who comprise only about 28% of the subjects, or just 16 men in each group — a very tenuous base to support any claims of effectiveness.
A plainer way to state the findings would be that there was no significant difference between the groups overall — a simple acknowledgment that we never receive in the study abstract or the news release. Instead, the release keeps the spin cycle going by suggesting that this intervention can help “reverse part of the aging process” and “improve memory.” But no memory test results are actually reported in the study to show that there was any “improvement.” The only results provided show a correlation between brain volume and memory performance — there’s nothing to show that that the intervention itself produced a change in this outcome compared with the control group. So again, there’s a disconnect between the actual study results and what’s getting reported to the media and news consumers.
We’re all for exploring non-drug interventions that may help stave off dementia, and the Baltimore Experience Corps could possibly help do so through a combination of cognitive and social stimulation, as well as participation in purposeful, meaningful activity. (Who doesn’t love the idea of grandpas growing their brains by reading to schoolchildren!) But nobody is helped by studies that overstate the importance of their results or attempt to spin negative results as positive. Nor is it helpful for news releases to pass along such findings without providing some level of critical appraisal.
The program under study welcomes study participants as volunteers, so there is no “cost” to them. It is not a drug or device, but we still might encourage the next release to quantify the costs a bit better. Bare minimum Satisfactory for this mention: “Experience Corps is a national program, however it can be costly and isn’t available everywhere.”
The description of benefits is certainly not as clear as it could be, and arguably represents an attempt to put a positive spin on a study showing no overall effect. As noted above, the release focuses almost entirely on results in men. It never acknowledges that there was no statistically significant difference between the intervention and control groups as a whole. Moreover, the headline’s suggestion that the intervention “improves memory” isn’t quantified or supported by evidence in the paper. The only results reported in the paper show a correlation between brain volume and memory — there’s no direct evidence that the intervention improved memory results.
Due to the nature of the intervention – which was volunteering in a school setting – it’s difficult to imagine harms occurring. There was no mention of harms in the release, but we won’t penalize the release for that omission.
In our view, the release overstates the study findings, and never warns readers about the limitations of the sex-stratified analysis involving less than a third of the overall study population. The release says brains in the study “maintained their size,” but that was not a statistically significant finding. (To be fair, this is merely an extension of an overstatement that exists in the conclusion of the original study being reported on.) The researchers obliquely allude to the “limited power” of their study, but suggest — with unjustified optimism, in our view — that the most likely effect of this limitation was “an underestimation of program benefits”. Highlighting the results in men might have been more acceptable if the authors were able to cite other data indicating activity-based sex-differences on brain effects, which they don’t, and which to our knowledge haven’t been shown.
There was no disease-mongering in this report on cognitive decline.
The release clearly lists the funding sources.
While this study suggests that social activity (in a special program) may be nourishing to brain health, it does not compare or mention other research into possible methods for preserving brain mass and preventing cognitive decline. For instance, a healthy diet, exercise, not smoking, drug therapy, etc.
We don’t believe that the availability of volunteering is an issue, but the story does note that this particular program — the Experience Corps — isn’t available everywhere.
The study concept — a randomized controlled trial of a civic engagement program — is novel and builds upon findings from a smaller pilot study. However, the release doesn’t establish what is new or different about the study compared with previous research.
The suggestion that this study demonstrates “reversing part of the aging process,” based on such a small subgroup of a small study, is an exaggeration.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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