TV Watching Leads to Impaired Cognition

TV Watching.jpgHow can we build up foundational, long-lasting healthy habits while young? We know it’s important—a perennial question, if not one we face day-to-day. By building those habits early on, we can set ourselves up for healthier living long-term, and place our children on a better track for a healthier, more positive adolescence and early adulthood.

In fact, the habits we establish (or don’t) in our youth often prevail. The less healthy ones show up frequently as potential indicators, precursors, or critical risk factors for adverse health outcomes. It’s not altogether surprising that more inactivity and greater on-screen time, such as television watching, affects our physical health.

But how do inactivity and time before the tube affect us mentally? Cognitively?

In a recent study by Coronary Artery Risk Development in Young Adults (CARDIA), researchers set out to determine just that: the effects of early TV viewing habits and levels of physical activity on midlife cognition.

The study is one of the first to demonstrate the links between these risky behaviors and cognitive aging—highlighting the possibility and perhaps need to take preventive action against cognitive decline even before middle age.

Researchers collected and analyzed data from questionnaires, taken by 3247 adults between the ages of 18 and 30 years. For repeated visits (≥3 assessments) over a period of 25 years, participants reported on patterns of television viewing and physical activity.

The physical activity portion of the questionnaire focused on 13 types of vigorous-intensity exercise (running, jogging, cycling) and moderate-intensity exercises (walking, hiking, gardening). Activity scores were calculated based on intensity level and duration of exercise.

Television viewing times for each participant were established at years 5, 10, 15, 20, and 25. High viewing patterns were defined as reporting activity within the top quartile of visits, for more than two-thirds of total visits; the remaining participants fell into low to moderate viewing patterns.

After 25 years, interviewers gave participants a number of cognitive tests: the Digit Symbol Substitution Test (DSST), the Stroop test, and the Rey Auditory Verbal Learning Test (RAVLT). Collectively, these tests assessed individual participants’ processing speed, executive function, and verbal memory.

What did they find?

Well, for participants that had high television viewing and low physical activity, researchers found their behaviors to be associated with worse midlife cognitive performance—specifically, a slower processing speed and worse executive function.

Verbal memory, however, was not associated.

The study has left behind some interesting questions, as well as avenues for future study. For example, to what degree does content and level of cognitive engagement mitigate (or exacerbate) screen-time as a risk factor for cognitive impairment? More stimulating sedentary activities, such as video games, may differ in their effect.

In the meanwhile, what can you do to boost your grey matter? To increase your odds of higher cognitive functioning, that will last and sustain you until you’re grey on top?

Here’s one strategy. Get out a sheet of paper and write down a number of physical activities you enjoy. Start with five. Think about where the activity takes place, how much time it would take, and who you would do it with. Getting others involved—friends, partners, your kids—is a great way to increase the odds of your turning this from a one-off occurrence into a legit habit.

Next, look at your schedule. What’s realistic? If you’re being honest with yourself, what blocks of time or parts of your day are more flexible than others? Creating a plan in this way, something you can hold, track and follow, share with someone else, will help it come to fruition.


Effect of Early Adult Patterns of Physical Activity and Television Viewing on Midlife Cognitive Function. Tina D. Hoang, MSPH; Jared Reis, PhD; Na Zhu, MD, MPH; David R. Jacobs Jr, PhD; Lenore J. Launer, PhD; Rachel A. Whitmer, PhD; Stephen Sidney, MD; Kristine Yaffe, MD

JAMA Psychiatry. doi:10.1001/jamapsychiatry.2015.2468 Published online December 2, 2015.

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Media Makes PTSD Much Worse


PTSDIt was a sunny October day in 1989. Game 3 of the Battle of the Bay baseball World Series between Oakland and San Francisco. Then the largest earthquake in almost a hundred years hit the bay area.

I was, as it happens, in my therapist’s office, my wife was at work. I rushed home to make sure that all was well, it took her three hours to make it home because of the terrible traffic as everyone rushed to get back to their loved ones.

The Bay Bridge collapsed. Parts of the Marina district were on fire.

We were horrified, but it was very hard to know how bad things were. We turned on the television and stayed glued to it late into the night, as did most of the people living in San Francisco at the time, except where the electricity was out.

Through the night we were drawn to the pictures of injuries, damage and fire. We listened as the newscasters talked of looting in the downtown area. Things seemed to be getting worse by the hour.

I wondered if we would be safe in our house.

We slept poorly that night and in the morning it was hard to escape the sense that things were spiraling out of control.

As it happened, the worries we had that night and the next day were completely misplaced. There was a very small amount of looting. Bay area residents rallied, many heroically to rescue those injured and recover from the earthquake.

Stop replaying the tragedy

I later concluded that the worst thing that you could do after a natural disaster was stay glued to the screen (which realization, by the way, had no impact on me on 9/11).

But how bad is it to watch TV?

Researchers recently published a study that looked at the development of acute stress responses in those who directly witnessed several recent tragedies, including 9/11, the Boston Marathon bombing (BMB) and the Sandy Hook Elementary School shooting and in those who did not see the events but watched them on TV (Holman EA et al., Proc Natl Acad Sci U S A 2014 Jan 7; 111:93).

They discovered that watching traumatic events for hours on the media leads to acute stress — even more stress (in many cases) than actually being at the site of a tragedy.

Their study surveyed 846 Boston-area residents, 941 New York City residents, and 2888 people from other parts of the country after the BMB. The questionnaire assessed acute stress responses to the BMB as well as the number of hours spent watching media stories. Among 4652 respondents, 10% were at or near the site of the BMB, and roughly a quarter of participants had direct exposure to 9/11, the Sandy Hook Elementary School shooting, or Superstorm Sandy.

Watching video over and over again is worse than being there

Levels of stress after the BMB were associated with prior mental health problems (almost every study finds this to be the case), 6 or more hours of daily BMB media exposure, and direct exposure to 9/11 and Sandy Hook, but not with direct exposure to Superstorm Sandy or the BMB itself.

Six or more hours of media exposure resulted in much higher stress than direct BMB exposure.

In most disasters, the thing that you can do that is most likely to cause you to develop acute stress symptoms is to watch the TV or video on the internet. And this is especially true if you have been exposed to a previous traumatic event or have a history of depression or anxiety.

Except in the most catastrophic events (9/11 and Sandy Hook), media exposure is worse than direct exposure to the events.

Now the challenge is to use this information to change our behavior. After all, it seems essential to know what is going on, in the moment.

One option that can work is to switch from video reports to written ones (track the events on the New York Times blogs, for example). Pictures have a greater effect than words in terms of causing acute stress reactions.