It is estimated that up to 4 in 10 cases of dementia
could be prevented
if the world's population adopted a healthy lifestyle.
It is known that Alzheimer's disease (its most common form) is not an inevitable consequence of aging and more and more studies support that the risk of developing it can be avoided or delayed.
Added to this evidence are the results of research published this month in an article in the journal
JAMA
, which showed that older adults most adept at complying with five habits considered protective also obtained a
better overall cognitive score
until shortly before their death. regardless of the pathological burden related to dementia.
"Overall, the evidence from population-based studies is promising," the authors say that "lifestyle factors may
play a role in preventing
dementia, as a healthy lifestyle is associated with lower life expectancy." to live longer and, at the same time, to live a greater proportion of their remaining years free of Alzheimer's disease (AD).
However, they maintain that the conditions that favor AD - such as the accumulation of amyloid beta proteins and phosphorylated tau - begin
years before the appearance of symptoms
.
As a result, researchers from the Institute for Healthy Aging and the Alzheimer's Disease Center at Rush University (in Chicago, Illinois, United States) asked
what impact
lifestyle interventions have as a preventive measure. life on the cognitive function (i.e., the ability to process thought) of older adults.
To answer the question, they analyzed autopsies of the brains of
almost 600 participants
of the
Rush Memory and Aging Project
(MAP) who, while alive, periodically provided information about their habits and underwent cognitive tests.
70% were women and the average age at the time of death was 90 years.
The Rush MAP is a longitudinal clinicopathological study - begun in 1997 and still ongoing - on aging and dementia involving older adults living in retirement communities, nursing homes, and private homes in Chicago.
All participants signed informed consent to undergo annual evaluations and to donate their brain at the time of death for research purposes.
The importance of cognitive reserve
After analyzing data collected over 24 years of follow-up, the authors concluded that "a healthier lifestyle was associated with better cognitive function at the time of death, independently of the common neuropathologies of dementia, suggesting that "Lifestyle factors may provide cognitive reserve to
maintain cognitive abilities
in older adults."
Cognitive reserve is described by some authors as the brain's ability to
better tolerate the changes
produced as a result of some pathology (such as dementia) or due to aging itself.
Card games, checkers, crosswords or puzzles are considered stimulating activities.
Photo Shutterstock.
What did this study find?
That cognitive function (measured through the tests performed) was better in older adults with healthy lifestyles (according to the scores obtained in five key factors), even if a burden of pathologies was observed in post-mortem studies brain disorders related to dementia (including deposits of beta-amyloid and phosphorylated tau tangles).
Likewise, a higher lifestyle score was also associated with a lower beta-amyloid load in the brain.
Five protective habits
Lifestyle factors were assessed annually and considered low risk or “healthy” based on adherence to the MIND diet, cognitive activity scores in old age, not currently smoking, moderate or vigorous exercise activities for at least 150 minutes a week and limiting alcohol consumption.
MIND Diet
The MIND diet combines the benefits of the Mediterranean and DASH diets (focused on preventing and controlling hypertension), and focuses on foods from each that
specifically improve brain health
, such as grains, green leafy vegetables, red fruits, nuts.
(To read more about the MIND Diet and how to incorporate it, click here).
Cognitive activities
Late-life cognitive activities were assessed using a structured questionnaire that measured participation in cognitively stimulating activities, including reading, visiting a museum, and playing games such as cards, checkers, crosswords, or puzzles.
Physical activity
Participants reported time spent doing
moderate or vigorous activities
, such as brisk walking, gardening, calisthenics, bicycling, and/or swimming.
It is recommended to add at least 150 minutes per week.
No Smoking
Smoking information was provided at the baseline interview, in which participants specified whether they were current smokers, former smokers, or not.
Limit alcohol consumption
Light to moderate alcohol consumption was included (up to 15 g/day for women and up to 30 g/day for men).
However, the recommendation is that
alcohol consumption, even light, should not be encouraged
.
The MIND diet combines recommendations from the Mediterranean and the DASH.
Photo Shutterstock.
"The findings suggest that lifestyle may provide cognitive benefits even for people who have begun to accumulate dementia-related pathologies," Klodian Dhana, leader of the research, told MedPage Today.
"However," he clarified, "we must keep in mind that this is an observational study using pathological autopsy data, and
additional clinical studies are needed
to support these findings."
One of the
strengths
of the work highlighted by the authors points precisely to the large sample of post-mortem data obtained thanks to the enrollment of older adults without dementia at the beginning of the study, who were then followed up until their death.
However,
limitations
include that this sample was predominantly composed of white volunteers who accepted annual evaluations and organ donation, which limits the generalization of the findings to individuals of other ethnicities.
Reduce the burden of dementia
Alzheimer's disease and other dementias are pathologies that affect more than 55 million people around the world.
And this figure is expected to increase as the world's population ages.
"To date, there is no cure to stop or reverse disease progression, underscoring the critical need to develop primary or secondary prevention strategies that target modifiable risk factors to
delay or prevent the onset of clinical symptoms.
" wrote Yue Leng and Kristine Yaffe of the Department of Psychiatry and Behavioral Sciences at the University of California, in an editorial commentary published in JAMA alongside the research article.
The results of this study add to others that show that the risk of suffering from cognitive decline and dementia can be reduced through the incorporation of a healthy lifestyle that includes regular physical exercise, not smoking, and avoiding alcohol consumption. harmful alcohol, control body weight, follow a healthy diet and keep blood pressure, cholesterol and blood sugar levels under control.
Additional risk factors for dementia include depression, social isolation, low educational attainment, cognitive inactivity, and air pollution.
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