Training a failing brain

Can a program shown to improve cognitive fitness in healthy adults make a difference for those with Mild Cognitive Impairment?

November 5,  2026 || by Sophie Lorenzo

Henri* is an active academic in his 80s who keeps up with scientific advances in his field and collaborates on projects with university colleagues. You’d probably be surprised to hear that, a year ago, he was diagnosed with mild cognitive impairment (MCI) — a lesser-known form of neurodegeneration. He and his spouse sought a diagnosis after a long trip abroad where Henri was disoriented and had a hard time understanding simple things – uncharacteristic for this usually sharp man.

“The problems experienced by people living with mild cognitive impairment are, as the name implies, still considered mild. While they are not as severe as symptoms of dementia, they extend beyond minor memory lapses and difficulty recalling names,” explains Étienne De Villers-Sidani, MD, a neurologist in the Neurocognitive Clinic at The Neuro (Montreal Neurological Institute-Hospital) and the principal investigator for a new NIH-funded study on MCI being conducted exclusively at The Neuro’s Clinical Research Unit. 

A Drop in the Right Chemicals

As we pass middle age, a chemical in our brain called acetylcholine naturally begins to decline, leading to minor problems with memory and concentration. Acetylcholine is what triggers neural plasticity – the brain’s ability to make new connections and to learn better.

People with MCI will experience a sharper than average drop in acetylcholine, resulting in more problems with memory, language, thinking and judgement. The Alzheimer’s Society of Canada notes that while these changes usually don’t interfere with their overall independence, the person living with MCI or their loved ones may still notice them.

“I was very surprised by the diagnosis,” explains Henri. “It’s been challenging because I don’t feel any different — I go to meetings; I keep up with the scientific literature. I feel that I am the same as I always ways,” However, the diagnosis explained certain behavioural changes that his wife of over 20 years, Mireille* had begun to notice. “The hardest part has been his irritability,” she explains. “It was completely unlike him. Also his dependence — he needs my input on everything in our day-today. It’s been a major change.

Targeting Age-Related Decline

“The causes of MCI aren’t well understood – they can be vascular in nature, or related to the same protein deposits that can cause Alzheimer’s. While we do know that it can increase a person’s risk of developing dementia, for others, the condition may remain relatively stable,” continues De Villers-Sidani.

Findings from a landmark clinical trial at The Neuro published last fall confirmed that we can in fact improve our cognitive fitness. A highly specialized brain training program used daily for 3 months was shown to increase acetylcholine in healthy adults to levels equivalent to someone 10 years younger. This was the first intervention of any kind (including medication) to demonstrate a reversal of cognitive decline.

So could this specialized brain training produce similar results in people living with mild cognitive impairment? That’s what the new clinical trial hopes to find out.

Like a Gym for Your Brain

Like any training program, consistency and repetition are key. The intervention being studied in the INHANCE-MCI trial uses an online program that will be completed at home, on a computer or tablet, for 30 minutes each day over the course of 3 months. The exercises in the program become increasingly challenging over time, involving several senses at once and requiring greater concentration to accomplish. The increasing speed of the exercises has the most impact on our brain’s processing speed, which is important for attention.

“In this new clinical trial, we are hoping to see that acetylcholine increases in individuals who are already experiencing some neurodegeneration. If this training could have a protective effect, that would be tremendous. We’re hopeful, but we’ll have to see what, if any, impact the program has,” concludes Dr. De Villers-Sidani.

Individuals diagnosed with mild cognitive impairment are eligible to participate. Contact the Clinical Research Unit at The Neuro: (514) 398-4988; neurocog-cru.neuro@mcgill.ca; or visit cru.mcgill.ca/ad_en.

*Pseudonyms have been used to protect patient confidentiality.