The relation between lifestyle and Alzheimer’s disease has been previously described in many studies. It has become well established that lifestyle interventions can prevent the onset of the disease in about 40% (as we reported in a previous NF based on the 12 Alzheimer’s disease prevention factors listed by The Lancet commission on Dementia). The Finnish FINGER study (Finnish Geriatric Intervention Study 2015) has also already impressively shown these correlations
However, most studies are directed at primary prevention, that is, how to prevent the onset of the disease in symptom-free or previously healthy individuals. Not so many studies have examined the effect of lifestyle measures in reducing symptoms or modifying disease progression in individuals who already have cognitive complaints.
Hypothetically, patients in early stages of cognitive decline can still make themselves significant changes in lifestyle. Also, their brains still have sufficient neuroplasticity to modify the natural evolution of the disease.
But would these patients really benefit from lifestyle interventions? What would be the impact of these interventions if symptoms are already present?
To answer these questions, a proof-of-concept study was developed and published in September 2020. It should, as the name suggests, test the hypothesis and provide evidence for its correctness.
119 community-dwelling individuals, aged older than 65 were selected and divided in two groups:
The control group received online informational modules about how to prevent dementia including Mediterranean diet, physical activity and cognitive engagement. After each module participants were given one week with no educational activities to allow them to implement the information in their own daily life. After this week, the next module of the online course started.
The intervention group completed the same online educational modules, but in the weeks between undertaking the modules, the intervention group took part in practical activities including meeting with nutritionists, personal trainers and completing brain training. These activities thus reinforced the practical implementation of the contents learned in the online course.
All participants had been previously diagnosed with mild cognitive impairment by a medical professional or reported experiencing subjective cognitive decline. The terms “subjective cognitive impairment” and “mild cognitive impairment” are used to classify early-stage Alzheimer’s disease. In the first case, the cognitive changes are perceived by those affected, but are often misinterpreted and not associated with Alzheimer’s disease. Mild cognitive impairment, on the other hand, causes a slight but noticeable and measurable decline in cognitive abilities, including memory and thinking skills.
After 8 weeks, participants in the intervention group had improved cognition. Besides that, lifestyle intervention was able to significantly decrease exposure to lifestyle risk factors for Alzheimer’s disease and also increased exposure to protective factors.
These findings provide evidence that multimodal lifestyle changes can also be successful in secondary prevention: the lifestyle intervention was able to improve cognition in the early stages of the disease, even in a very short period of time. It also significantly reduced the exposure to lifestyle-related risk factors for Alzheimer’s disease.
It made clear that an effective and sustained implementation of lifestyle changes is important to revert symptoms. Furthermore, it supports the inclusion of nutrition, physical activity and brain training (among others) as key components in the treatment of early stages of Alzheimer’s disease, such as subject or mild cognitive impairment.
In the USA, Dr. Dale Bredesen has been implementing these principles therapeutically for years. He has developed a multifactorial lifestyle concept that has already been successfully applied to many Alzheimer’s patients in the early stages of the disease. Here you can find more information about this promising therapy programme.
This small study opens the way for larger, longer future trails to get even more detailed information on how a sustained lifestyle improvement can affect cognition. The results can already encourage patients in the early stages of the disease not to give up, but to invest in lifestyle measures to effectively revert symptoms and delay cognitive decline. Secondary prevention interventions are able to modify the course of the disease!
Many previous studies have already confirmed the importance of lifestyle intervention to prevent or delay the beginning of Alzheimer’s disease but its role in reversing symptoms of early stages has not been so well studied. Now it starts to become more clear that a healthy lifestyle is also a key factor in improving the first symptoms and in reducing disease progression. It’s never too late to engage in a healthy lifestyle and protect your brain from dementia!
- McMaster M, Kim S, Clare L, Torres SJ, Cherbuin N, DʼEste C, Anstey KJ. Lifestyle Risk Factors and Cognitive Outcomes from the Multidomain Dementia Risk Reduction Randomized Controlled Trial, Body Brain Life for Cognitive Decline (BBL-CD). J Am Geriatr Soc. 2020 Nov;68(11):2629-2637
- Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015 Jun 6;385(9984):2255-63.
- Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-446.