The Science Behind Dementia Prevention
As the instances of disease states like Dementia and Alzheimer’s have become so prevalent in aging populations, the need to research into treatment and possible cures have never been more important.
The unfortunate truth is there is no cure for these diseases.
The only fundamental truth that we know and understand about Dementia specifically is that once you have been diagnosed with the condition, there’s no return.
Treatment options at this point become ways to slow the progression of the disease, but the end result is the same.
While this may be a bleak outlook for those who have very serious concerns about getting Dementia, we are lucky that science has shown efficacy in results in methods of prevention.
Prevention, meaning taking steps to avoid the occurrence, will trump any treatment or cure, for never having to experience the disease at all.
The science behind this provides us evidence that Dementia can indeed be prevented, by utilizing a methodology called the “Multi-Domain Approach.”
What is a “Multi-Domain Approach?”
Several scientific studies agree that physical activity, diet and cognitive stimulation are all foundational to preventing or slowing age-related cognitive decline.
These “Brain fitness” interventions have been shown to have sustained effects lasting 10 years or more.
Physical exercise enhances the growth of new brain cells, essential for learning and memory.
Other behavioral approaches, including social engagement, good sleep, hygiene, sound nutrition, and meditation, can promote healthy cognitive aging and are likely to provide cognitive resilience in older ages (5, 6, 7).
Two large studies were conducted to determine how effective all these strategies are when combined in a multi-domain approach to preventing age-related cognitive decline.
The Studies
The FINGER study is a landmark study. This randomized assessment of people aged 60-77 was done over several years and included about 1200 people total, with about 600 in each group. The intent was to see if multiple measures combined can have a positive impact on cognitive health.
The overall conclusion was that multi-domain intervention combining changes for brain-healthy nutrition, exercise (weight training and cardiovascular), and specific types of cognitive training over 2 years, led to improved cognitive outcomes (1).
The second study, which tested the effects of Omega 3 supplementation with multi-faceted interventions (physical activity, cognitive training, and nutritional advice) showed no significant effects on cognitive decline (2).
The subjects in this study, however, were older (average 75), suggesting that if you start late in life when there are already signs of dementia, this approach may be ineffective.
More recently, The Lancet Commission brought together 24 international experts to consolidate the huge strides that have been made in our knowledge and understanding of Dementia risk factors, treatment and care, and, the emerging knowledge as to what we should do to prevent and manage dementia (3).
The Commission conducted a new review and meta-analysis; incorporating potentially modifiable risk factors from across the life-span, they proposed a novel life-course model of risk, highlighting the opportunity for prevention.
The combined evidence to date shows that roughly 35 percent of all cases of Dementia are attributable to nine potentially modifiable risk factors. Many of the risk factors occur at particular life stages but some, such as smoking and hypertension, are likely to make a difference at ALL life stages. Modifiable risk factors include:
- Early life – Education to a maximum of age 15
- Mid-life – Hypertension; Obesity; Hearing loss
- Later life – Depression; Diabetes; Physical inactivity; Smoking; Low social contact
Another recent review (4) of the available evidence found the following risk factors for Alzheimer’s disease (AD):
- Diabetes Mellitus
- Hypertension
- Renal Dysfunction
- Alcohol and smoking patterns
- High cholesterol
- Coronary heart disease
- Depression
- Low cognitive activity, and
- Diet
These factors combined account for more than half of the attributable risk for AD.
The report concluded: “AD offers a large array of potentially modifiable risk factors (lifestyle, exposure, environment, comorbid disease) that are excellent targets to personalize the approach to medical care.
Precision medicine approaches specifically target the heterogeneity of AD by identifying person-specific risk factors and applying a customized intervention directed against this risk profile.”
ProtectMyBrain – Dementia Prevention Program
In the development of our flagship program, ProtectMyBrain, all the elements of the multi-domain approach form the basis of the syllabus that we teach to our participants.
The identification of modifiable risk factors for every participant and specific application of the principles of the multi-domain approach provide us the scientific evidence to confirming the efficacy of the program.
If you would like to find out more about our ProtectMyBrain Dementia Prevention program, please click the link below.
ProtectMyBrain Dementia Program by BrainFit Resorts
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- 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;385:2255-2263.
- Andrieu S, Guyonnet S, Coley N, et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol. 2017;16:377-389.
- Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, Ballard C, Banerjee S, Burns A, Cohen Mansfield J, Cooper C, Fox N, Gitlin LN, Howard R, Kales HC, Larson EB, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N. Dementia prevention, intervention, and care. Lancet, 2017 Jul 19. pii: S0140-6736(17)31363-6. [Epub ahead of print] Review.
- Galvin JE. Prevention of Alzheimer’s Disease: Lessons Learned and Applied. J Am Geriatr Soc, 2017 Aug 2. doi: 10.1111/jgs.14997. [Epub ahead of print]
- Northey JM, Cherbuin N, Pumpa KL, et al Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis Br J Sports Med Published Online First: 24 April 2017.
- Karr JE, Areshenkoff CN, Rast P, & Garcia-Barrera MA. An empirical comparison of the therapeutic benefits of physical exercise and cognitive training on the executive functions of older adults: A meta-analysis of controlled trials. Neuropsychology 2014, 28(6), 829-845.
- Smith GE. Healthy cognitive ageing and dementia prevention. American Psychologist 2016, 71(4), 268-275.