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New Study Gives Hope for Alzheimer’s Prevention

By David Fein, MD
Medical Director

Alzheimer’s Disease is now a leading cause of death, just behind heart disease and cancer, with more than 5 million Americans currently living with it. The disease is believed to be related to a buildup of a protein in the brain, called beta-amyloid, which may play a role in the gradual death of brain cells.  Although several drugs that target beta-amyloid are currently in clinical trials, none have yet been able to demonstrate that they significantly alter the course of the disease.

Even though pharmacologic treatments for Alzheimer’s are so far proving to be very disappointing, there is some very encouraging news from this summer’s Alzheimer’s Association Internal Conference in Copenhagen.  A study presented at the conference has shown dramatic effects in preventing the development of Alzheimer’s Disease, not with drugs but with changes in lifestyle.

Researchers have previously noted that in developed nations the average age of onset of Alzheimer’s is later in life now than it was 30 years ago.  This is thought to be related to improved heart health and levels of education in those countries.  The data suggests that lowering cardiovascular risk factors also lower the overall risk for Alzheimer’s Disease, not just the age of onset. (Those gains may not last. The growing incidence of diabetes and obesity may soon cause this trend to reverse and lead to higher rates of dementia.)

The study presented at the conference, from a two year clinical trial in Finland, followed 1,260 adults aged 60 to 77 considered to be at risk for Alzheimer’s disease.  Participants were divided into two groups; one received an intervention that included nutritional guidance, physical exercise, cognitive training, social activities, and management of heart health risk factors, while the control group received regular health advice.

They found that after just 2 years of follow up there was a significant difference between the two groups.  Those who had made the lifestyle changes with better nutrition and exercise performed significantly better on a comprehensive cognitive examination. In addition to performing better overall, the intervention group did significantly better on specific tests of memory, executive function (complex aspects of thought such as planning, judgment, and problem-solving), and speed of cognitive processing.

According to the study’s lead investigator, Dr. Miia Kivipelto, “this is the first randomized control trial showing that it is possible to prevent cognitive decline using a multi-domain intervention among older at-risk individuals. These results highlight the value of addressing multiple risk factors in improving performance in several cognitive domains.”

The underlying cause of Alzheimer’s Disease remains poorly understood.  Genetics, environmental factors, infectious causes and other health issues may all play a role.  So far, our ability to prevent the onset or modify the progression of the disease has been very limited.  These results show that with the right approach to maintaining physical fitness, healthy nutrition and minimizing other health risk factors (particularly cardiovascular disease) before the symptoms of dementia start, it may be possible to prevent or delay the onset of Alzheimer’s Disease.

Since it is very likely that the loss of brain cells begins many years before the earliest cognitive changes begin to appear, the earlier you start making those lifestyle changes, the more effective it may be.

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