Study Shows the Cognitive Benefits of a Healthy Lifestyle Even for Those With the Presence of Alzheimer’s Disease or Other Common Pathologies in the Brain

Alzheimer’s disease and related dementia (AD/ADRD) affect 55 million people globally, and the prevalence of these diseases is expected to triple in the next 30 years. While no cure exists currently for AD/ADRD, studies focused on understanding and preventing risk factors have shown links to lifestyle choices. A recent study revealed five healthy lifestyle choices positively impacted brain function in older adults, regardless of whether they have Alzheimer’s or other disease that causes dementia.  
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 By Alzheimer's Prevention Bulletin

Can a Healthy Lifestyle Reduce the Risk of Cognitive Problems Despite the Presence of Alzheimer’s Disease and Other Common Pathologies in the Brain? 

According to the U.S. Department of Health and Human Services, Alzheimer’s disease and related dementia (AD/ADRD) affects as many as five million people and nearly 40% of the population aged 85 and older. Roughly 13.2 million older Americans are projected to have AD/ADRD by 2050. 

 An ever-growing number of studies have focused on AD/ADRD modifiable risk factors to identify interventions to decrease the risk of or slow the progression of AD/ADRD. Studies have found that 30%-40% of dementia cases globally can be connected to risk factors within an individual’s control. 

 A recent study published in JAMA Neurology showed a positive impact of lifestyle interventions on cognition (brain function) in older adults as a preventive measure- even for those with Alzheimer’s and other neurodegenerative pathologies in their brains. 

 Five lifestyle factors that support cognitive function 

The study, conducted by the Rush Memory and Aging Project (MAP), revealed a strong association between a healthy lifestyle score and memory and thinking ability in older adults regardless of the individual’s level of AD/ADRD pathology in their brain (for example, the number of plaques and tangles that are the hallmarks of Alzheimer’s disease). The factors used to determine lifestyle score included: 

  1. Diet: Based on Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) 
  2. Physical activity: Time spent weekly walking for exercise, gardening or yard work, calisthenics or general exercise, bicycle riding, and swimming  
  3. Cognitive engagement: Reading, visiting a museum, and playing games like cards, checkers, crosswords, or puzzles. 
  4. Smoking
  5. Alcohol consumption 

“These five lifestyle factors may support prevention of dementia and resilience to Alzheimer’s and other brain diseases,“ said Bryan D. James, PhD, one of the MAP study authors and epidemiologist at Rush Alzheimer’s Disease Center. “Cognitive benefits were observed even for those who had substantial levels of neurodegenerative pathologies.” 

Higher lifestyle score improved cognitive function 

Lifestyle score ranges were 0-5 with a higher score reflecting a healthier lifestyle. In the study, higher lifestyle scores were associated with better global cognitive functioning proximate to death. A 1-point increase in lifestyle score was linked to improvement in global cognitive scores. Neither the strength nor the significance of the relationship changed substantially when common dementia-related brain pathologies were considered.  

This study found that in older adults, a healthy lifestyle may provide a cognitive reserve to maintain brain function independent of Alzheimer’s disease and other common neuropathologies of dementia. 

A lifelong commitment to prevention through healthy lifestyle choices 

Over the past few years, an increasing recognition of risk factors operating over all life stages has influenced studies and the idea of a “life course approach” to manage modifiable risk factors that does not just start in older age. The MAP study followed participants up to 24 years (through death) with lifestyle being reviewed through follow-up visits and self-reporting. 

In this study, optimal lifestyle scores resulted from: 

  1. A high Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet score 
  2. 150 minutes of physical activity weekly 
  3. High cognitive engagement 
  4. Not smoking 
  5. Minimal alcohol intake 

“Further research, such as a life-course study that takes into account healthy lifestyle over decades, should investigate shifts to a better lifestyle,” added Dr. James. “Understanding the duration and change in lifestyle will help us better understand the association with cognition independent of pathology.” 

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