Life­style changes may guard against Alzheimer’s

There’s no proof the rec­om­men­da­tions will work, but since they make good sense health­wise, why not in­cor­po­rate them into your rou­tine?

The Hamilton Spectator - - HEALTH - LAURAN NEERGAARD

WASH­ING­TON - There are no proven ways to stave off Alzheimer’s, but a new re­port raises the prospect that avoid­ing nine key risks start­ing in child­hood just might de­lay or even pre­vent about a third of de­men­tia cases around the world.

How? It has to do with life­style fac­tors that may make the brain more vul­ner­a­ble to prob­lems with mem­ory and think­ing as we get older. They’re such risks as not get­ting enough ed­u­ca­tion early in life, high blood pres­sure and obe­sity in mid­dle age, and be­ing seden­tary and so­cially iso­lated in the se­nior years.

Thurs­day’s re­port in the Bri­tish journal Lancet is provoca­tive — its au­thors ac­knowl­edge their es­ti­mate is the­o­ret­i­cal, based on sta­tis­ti­cal mod­el­ling.

Still, it’s never too early to try, said Lancet lead au­thor Gill Livingston, a psy­chi­a­try pro­fes­sor at Univer­sity Col­lege Lon­don. “Al­though de­men­tia is di­ag­nosed in later life, the brain changes usu­ally be­gin to de­velop years be­fore,” she noted.

Early next year, a $20 mil­lion U.S. study will be­gin rig­or­ously test­ing if some sim­ple day-to-day ac­tiv­i­ties truly help older adults stay sharp. In the mean­time, Alzheimer’s spe­cial­ists say there’s lit­tle down side to cer­tain com­mon-sense rec­om­men­da­tions.

“In­creased health of the body sup­ports in­creased health of the brain,” said cog­ni­tive neu­ro­sci­en­tist Laura Baker of Wake For­est School of Medicine in North Carolina, who will lead the up­com­ing U.S. study.

Con­sider phys­i­cal ac­tiv­ity, cru­cial for heart health. “If in fact it should also im­prove the prospects for cog­ni­tive func­tion and de­men­tia, all the bet­ter,” said Dr. Richard Hodes, di­rec­tor of the U.S. Na­tional In­sti­tute on Ag­ing and an avid ex­er­ciser.

Here’s the lat­est from this week’s Alzheimer’s As­so­ci­a­tion In­ter­na­tional Con­fer­ence on pos­si­ble ways to guard your brain:

A Lancet-ap­pointed panel cre­ated a model of de­men­tia risks through­out life that es­ti­mates about 35 per cent of all cases of de­men­tia are at­trib­ut­able to nine risk fac­tors — risks that peo­ple po­ten­tially could change.

Their re­sult­ing rec­om­men­da­tions: En­sure good child­hood ed­u­ca­tion; avoid high blood pres­sure, obe­sity and smok­ing; man­age di­a­betes, de­pres­sion and age-re­lated hear­ing loss; be phys­i­cally ac­tive; stay so­cially en­gaged in old age.

The the­ory: Th­ese fac­tors to­gether play a role in whether your brain is re­silient enough to with­stand years of silent dam­age that even­tu­ally leads to Alzheimer’s.

Last month, the U.S. Na­tional Academies of Sciences, En­gi­neer­ing and Medicine re­ported there’s lit­tle rig­or­ous proof. That re­port found some ev­i­dence that con­trol­ling blood pres­sure, ex­er­cise and some forms of brain train­ing — keep­ing in­tel­lec­tu­ally stim­u­lated — might work and couldn’t hurt.

Why? What’s good for the heart is gen­er­ally good for the brain. In fact, high blood pres­sure that can trig­ger heart at­tacks and strokes also in­crease risk for what’s called “vas­cu­lar de­men­tia.”

And ex­er­cis­ing your grey mat­ter may bulk up the brain, whether it’s from child­hood ed­u­ca­tion or learn­ing a new lan­guage as an adult. The more you learn, the more con­nec­tions your brain forms, what sci­en­tists call cog­ni­tive re­serve. Some U.S. stud­ies have sug­gested that gen­er­a­tions bet­ter ed­u­cated than their grand­par­ents have some­what less risk of de­men­tia.

Other fac­tors have less sci­en­tific sup­port. Stud­ies show peo­ple with hear­ing loss are more likely to ex­pe­ri­ence mem­ory loss, and have spec­u­lated that it’s be­cause hear­ing loss leads to de­pres­sion and so­cial iso­la­tion — or even makes the brain work harder to deal with gar­bled sound, at the ex­pense of other think­ing skills. There are no stud­ies prov­ing hear­ing aids re­verse that risk.

In fact, the strong­est ev­i­dence that life­style changes help comes from Fin­land, where a large, ran­dom­ized study found older adults at high risk of de­men­tia scored bet­ter on brain tests af­ter two years of ex­er­cise, diet, cog­ni­tive stim­u­la­tion and so­cial ac­tiv­i­ties.

Would those strate­gies help Amer­i­cans, who tend to be sicker, fat­ter and more seden­tary than Scan­di­na­vians? The Alzheimer’s As­so­ci­a­tion is fund­ing a study to find out, with en­rol­ment of 2,500 cog­ni­tively healthy but high-risk older adults to be­gin next year. They’ll test: • Walk­ing — su­per­vised, so no cheat­ing. Wake For­est’s Baker puts se­niors on tread­mills to avoid bumpy side­walks. She starts with 10 min­utes a day for two days a week and works up to longer walks on more days.

• A diet that in­cludes more leafy greens, veg­eta­bles, whole grains, fish and poul­try.

• Cer­tain brain games and what Baker called an “in­tel­lec­tual stim­u­la­tion bar­rage,” out­ings and other steps that keep peo­ple so­cial while they ex­er­cise their brains.

• Im­prov­ing con­trol of med­i­cal con­di­tions like high blood pres­sure and di­a­betes.

THINKSTOCK

Stay­ing ac­tive is cru­cial for heart health and is a way to com­bat one of the nine risk fac­tors for de­men­tia.

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