Lifestyle recommendations to prevent cognitive decline
Alzheimer’s disease (AD) is the most common form of dementia, accounting for 60-80% of cases, and is characterized by problems with memory, thinking, and behavior. AD is progressive; symptoms worsen over time, with individuals eventually losing the ability to carry on tasks of daily living. AD results from changes in the brain including increases in plaques and tangles. Plaques are caused from abnormal accumulation of the protein beta amyloid in the extracellular spaces of the brain (i.e., outside of neurons). In the healthy brain, beta amyloid is broken down and removed so that plaque formation does not occur. Tangles are caused from abnormalities of the tau protein, which form twisted fibers or microtubules inside the cells. Since microtubules help transport nutrients (and other substances) along the neuron, tangles result in impaired transport and communication within and between neurons. These molecular changes in the brain cause cellular death and eventually the loss of brain volume, especially in areas important for learning and memory such as the hippocampus.
Fortunately, AD is not a part of normal aging. Recent research shows that the prevalence of AD can be modified through specific lifestyle changes. In fact, a new statistical model indicates that eliminating certain risk factors could prevent 35% of all dementia cases (https://pubmed.ncbi.nlm.nih.gov/28816113/). These risk factors include: physical inactivity, smoking, midlife hypertension, midlife obesity, diabetes, depression, and low educational attainment. Other studies indicate that social isolation and midlife hearing loss may serve as additional risk factors.
On July 19, 2017, the World Wide FINGERS network was initiated at the Alzheimer’s Association International Conference (AAIC). World Wide FINGERS (http://wwfingers.com/) is “an interdisciplinary network to share experiences, harmonize data, and plan joint international initiatives for the prevention of cognitive impairment and dementia. It’s main goal is to generate robust evidence to define effective preventative approaches for various at-risk groups and settings.”
This collaborative developed out of a 2-year study that assessed the effects of a multi-domain intervention on cognitive decline in at-risk elderly individuals (https://pubmed.ncbi.nlm.nih.gov/25771249/). 2,654 individuals were screened and 1,260 were enrolled in this study that took place in Finland. Participants were individuals between the ages of 60 to 77 who were at risk for cognitive decline. Participants were randomly assigned to an intervention group or a control group. The control group received regular health advice, whereas the intervention group received 4 interventions based on diet, exercise, cognitive training, and vascular risk monitoring. Before and after the intervention, cognitive functioning was assessed via a neuropsychological test battery that examined executive function, memory, and processing speed. Participants who engaged in the multimodal intervention showed a significantly decreased risk for cognitive decline, performing 25% better in overall cognitive functioning than the control group. This was the first large-scale, long-term randomized controlled trial to assess the effects of multidimensional healthy lifestyle changes on cognitive functioning in aging.
These studies indicate that incorporating healthy lifestyle changes even after the age of 60 can help decrease the risk of cognitive decline and perhaps prevent the risk of dementia and AD. Here is a list of healthy lifestyle changes that are recommended to help improve your cognitive abilities.
The, Lancet Neurology. "Pointing the way to primary prevention of dementia." The Lancet. Neurology 16.9 (2017): 677.
Ngandu, T., Lehtisalo, J., Solomon, A., Levälahti, E., Ahtiluoto, S., Antikainen, R., ... & Lindström, J. (2015). 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 randomized controlled trial. The Lancet, 385(9984), 2255-2263.