By Andrew M. Seaman
NEW YORK (Reuters Health) - A program that emphasizes healthy eating, brain and social engagement, physical activity and heart health may slow dementia among people at risk for Alzheimer’s disease, says a new preliminary report from Sweden.
The findings can’t guarantee that healthy living will prevent Alzheimer’s disease but they add to growing evidence that suggests overall health is tied to dementia risk.
“This is really hard evidence that we can do something for brain health,” said Dr. Miia Kivipelto, the study’s lead author, from the Karolinska Institute in Stockholm.
The findings also show that it’s not too late to help brain health since the participants were all at risk for Alzheimer’s disease, Kivipelto added.
She and her colleagues presented their findings at the Alzheimer’s Association International Conference in Copenhagen, Denmark.
An estimated 35.6 million people are living with dementia worldwide, according to the World Health Organization. Alzheimer’s disease is the most common form of dementia.
Another study presented at the same conference also suggested that controlling certain risk factors, such as high blood pressure, obesity and diabetes, may reduce the worldwide prevalence of Alzheimer’s by almost a third.
People with Alzheimer’s experience memory loss, which worsens with time. The disease leads to problems with decision making and an inability to perform daily tasks. Eventually, the complications from Alzheimer’s disease lead to death.
Alzheimer’s is the sixth leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. About 5.3 million Americans have the disease.
For the new study, the researchers recruited 1,260 Finnish adults between the ages of 60 and 77 years to take part in the two-year trial.
All of the participants scored above a cutoff point on a list of lifestyle risk factors for cognitive impairment and Alzheimer’s, and on a neurological test, all had cognitive performance that was average or slightly below average for their age.
The participants were randomly assigned to a group that received basic health advice or a group that took part in a multi-component program targeting diet, exercise, heart health and brain and social engagement.
The multi-component intervention was delivered during a series of group sessions over the course of the study.
After two years, the researchers found the group that just got basic health advice experienced substantially more cognitive decline than the program participants.
“We saw about a 40 percent difference between the intervention and the control groups,” Kivipelto said. “It was clear the intervention group improved from baseline.”
She said the difference was robust but it’s difficult to say whether the participants experienced a noticeable difference. A longer trial that’s in the works will have to look at the real-world effect on people who stick with the program and whether the intervention prevents Alzheimer’s.
"I think the evidence is that this delays onset for people who don’t have it,” said Dr. Sam Gandy, who was not involved in the new study. “For people that do, it slows the progression. Whether it completely protects everyone, I would doubt it. Maybe there are people who have a mildly increased risk and this could prevent it."
Gandy directs the Center for Cognitive Health at Mount Sinai Hospital in New York City.
Kivipelto cautioned that a healthy lifestyle is no guarantee that a person won’t develop Alzheimer’s.
“We know that there are people who get other diseases even if they’re living in a healthy way,” Kivipelto said. "We don’t want to label anybody who has Alzheimer’s that 'this is because of your life.'"
Still, she said, it’s not too early to recommend interventions that target diet, exercise, heart health and brain and social engagement. Many of those interventions also target other chronic health conditions.
“It’s not too early,” she said. “We’ve already had observational studies showing the same thing.”
Gandy said he already gives his patients and their caregivers similar advice.
"I tell them both that these are the most important things they can do to keep their brains healthy," he said.