Contrary to popular belief, many studies suggest that Alzheimer’s disease can be prevented, or at least delayed in onset. As I have previously presented, regular exercise diminishes the likelihood of developing this condition. In addition, food intake such as Mediterranean diets can be helpful. Finally, regular mental stimulation of most types (note the picture above) can also retard the deterioration of brain function.
Let’s examine first the diets that can be helpful. Researchers have found that people who stuck to a diet that included foods like berries, leafy greens, and fish had a major drop in their risk for memory-sapping disorders, which affect more than 5 million Americans over age 65. This eating plan is called the MIND diet. Here’s how it works. MIND stands for Mediterranean-DASH Intervention for Neurodegenerative Delay. It’s similar to two other healthy meal plans, i.e., the DASH diet and the Mediterranean diet. This approach specifically includes foods and nutrients that medical literature and data show to be good for the brain, such as berries, but extending to these 10 food groups:
- Green leafy vegetables (like spinach and salad greens): At least six servings a week
- Other vegetables: At least one a day
- Nuts: Five servings a week
- Berries: Two or more servings a week
- Beans: At least three servings a week
- Whole grains: Three or more servings a day
- Fish: Twice or more a week
- Poultry (like chicken or turkey): Two times a week
- Olive oil: Use it as your main cooking oil.
- Wine: One glass a day
Foods to avoid:
- Red meat: Less than four servings a week
- Butter and margarine: Less than a tablespoon daily
- Cheese: Less than one serving a week
- Pastries and sweets: Less than five servings a week
- Fried or fast food: Less than one serving a week
One study showed that people who stuck to the MIND diet lowered their risk of Alzheimer’s disease by 54%. That’s big. But maybe even more importantly, researchers found that adults who followed the diet only part of the time still cut their risk of the disease by about 35%.
Scientists need to do more research on the MIND approach, but it’s a very promising start. It shows that what you eat can make an impact on whether you develop late-onset Alzheimer’s, which is the most common form of the disease.
Simply reducing cholesterol, at least by the commonly prescribed “statin” drugs can also produce a similar desirable result.
One recent study showed that, based on a sample of 399,979 Medicare beneficiaries, men and women who took statins two years or more lowered their risk of Alzheimer’s in the period spanning 2009 to 2013. The incidence of Alzheimer’s disease was reduced for beneficiaries frequently prescribed statins (high users), compared to low users, USC and University of Arizona researchers found. Among women who were high users, the incidence rate was 15 percent lower. Among men, the rate was 12 percent lower.
These data further support the idea that many sufferers of Alzheimer’s disease may share a common origin with arteriosclerosis (hardening of the arteries), which likely means that controlling the various known risk factors provides a likely way to avoid not only Alzheimer’s disease, but also to reduce cardiovascular diseases such as heart attacks and strokes.
PUTTING IT ALL TOGETHER: Multifactor lifestyle modification
A recent study from Finland showed that an intervention that targets nutrition, exercise, and metabolic and cardiovascular risk factors can improve cognition and memory in older adults, and prevent them from developing Alzheimer’s disease. Most striking, this program produced the greatest change in those who carried the highest risk, i.e., those subjects with a strong hereditary predisposition for this disease.
The randomized, controlled FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) trial was designed to show how a multimodal lifestyle intervention might not only slow or prevent cognitive decline, but help improve cognition among patients who are already experiencing decline. It enrolled 1,260 participants aged 60-77 years who were cognitively normal at baseline but at increased risk for decline.
All participants were followed for two years and randomized to 1) a control group provided with usual care by their regular physicians, or 2) the intervention group, which consisted of the following::
- Dietary counseling with recommendations to consume increased amounts of fruit, vegetables, whole grains, lean protein, and healthy fats.
- Progressive aerobic exercise and weight training, conducted by physical therapists, several times each week.
- Cognitive training several times a week with a computer program that targeted executive processes, working memory, episodic memory, and mental speed.
- Managing metabolic and cardiovascular risk factors, including blood pressure, weight, and body mass index. This was addressed in group sessions and with visits to participants’ own physicians.
The primary endpoint was change in mental function, which was conducted at baseline and at months 12 and 24. Also assessed were memory and processing speed.
By the end of the study, subjects in the intervention group experienced a significant, 25% greater improvement on the overall score than did those in the control group. Improvements on the secondary measures were significant for the intervention group as well: 150% better than the control group in processing speed, and 40% better in short-term memory. Measures of cognitive decline increased by 30% in the control group, whereas subjects in the intervention group experienced no deterioration.
This study also included preliminary data on how the intervention improved overall function and quality of life. Although there was some decline after 2 years in the control group, the intervention group remained stable or showed a significant improvement in general health. Moreover, although general daily function was good for all subjects at baseline, by the end of the study, significant differences had emerged, for the control group actually had a 50% increased risk for at least one new difficulty with activities of daily living.
The program was not associated with any serious adverse events. The results also appeared to have a lasting impact, which boded well for better sustained later outcomes. At the end of the study, the intervention group participants had decreased their body weights by about 4-5 lbs, which was significantly more than for control group subjects. Most of the former group reported that they were still eating fish and vegetables every day, and exercising at least twice a week.
This was the first long-term trial to show that a multidomain intervention like this one can maintain and improve not only cognitive decline but also more robust physical outcomes and quality of life. Of special importance, it carries no risks.
WHAT NATIONAL TRENDS CAN TELL US
Over the past 20 years, we have witnessed a gradual reduction of prevalence of cardiovascular disease in the U.S., attributable to lifestyle improvements mentioned above. Also fitting well with this concept, a corresponding reduction in cognitive impairment was identified in a National Health and Retirement Study (HRS) surveyª. Although these latter trends were less clear, they seem to provide further optimism that we may have the means to ward off much mental deterioration in the future.
ª Rocca WA, et al. Trends in the incidence and prevalence of Alzheimer’s disease, dementia, and cognitive impairment in the United States. Alzheimers Dement. 2011 Jan; 7(1): 80–93. doi: 10.1016/j.jalz.2010.11.002