Sunday, July 27, 2014

Lifestyle Choices Determine the Risk of Alzheimer's & Mild Cognitive Impairment

Exercising the Mind & Body 
 Prevents Alzheimer’s & MCI

 
Evelyn E. Smith

MS in Library Science, University of North Texas (2012)
Adopt a Lifelong To-do List: 

  • Stimulate the mind by reading and playing games of skill;
  • Cut back on watching TV;
  • Make and keep a support network of close friends;
  • Participate in aerobic exercise for 30-minutes daily;
  • Maintain a healthy, low-fat Mediterranean diet;
  • Don’t smoke;
  • Keep blood pressure and cholesterol levels low.

Sometimes a footnote in a Wikipedia article spurs a Boolean search for details beyond what the original sources suggested.  Thus, while Marina Koren summarizes the findings of a 2013 Neurology article on cognitive aging, the original  published research on this subject details how lifestyle can determine susceptibility to Alzheimer’s.

Koren, Marina. (2013, July 3).  Being a lifelong bookworm may keep you sharp in old age. Surprising Science.  Smithsonian.  Retrieved from http://www.smithsonianmag.com/science-nature/being-a-lifelong-bookworm-may-keep-you-sharp-in-old-age-6786112/

Although Websites like Luminosity.com and MyBrainTrainer promise that their brain teasers and games will enhanced memory and attention span, researchers have determined that simply reading might confer the same benefits (Koren, 2013, July 3, para. 2). Apparently, reading and writing slows down cognitive decline, and those individuals who have actively challenged themselves mentally throughout their lives show slower declines in memory and mental acuity (Koren, 2013, July 3, para. 3).

After an almost six-year period of testing memory as well as questioning 294 octogenarians on their reading and writing habits, Robert S. Wilson and other researchers from the Rush University Medical Center in Chicago confirm that reading regularly into old age reduces the rate of cognitive decline 32 percent”, although even participating in a limited amount of reading and writing activities proves beneficial.  Conversely, those older adults who didn’t do any reading or writing had a 48 percent faster rate of mental decline (Koren, 2013, July 3, para. 4-5). Indeed, whether or not older adults engaged in active learning “accounted for 15 percent of the difference in memory decline beyond what could be explained by plaque buildup” (Koren, 2013, July 3, para. 6).

Reading, for example, takes more “mental energy” than passively watching an image on TV while writing merges new data with already learned knowledge (Koren, 2013, July 3, para. 7).  However, it’s important to start the reading habit early, for mental dexterity peaks at age 22 (Koren, 2013, July 3, para. 7).
Turning to the original sources that most likely occasioned Koren’s articles furnishes some left out but necessary details:

Wilson, Robert S., Boyle, Patricia, et al. (2013, July 23).  Life-span cognitive activity neuropathologic burden & cognitive aging. Neurology, 81(4), 314-321. doi: 10.1212/WNL.0b013e31829c5e8a  [Abstract]. Retrieved from http://www.neurology.org/content/81/4/314

After a mean of 5.8 years of questioning and testing “late-life” adults and adjusting for “age at death, sex, education, gross and microscopic infarction, neocortical Lewy bodies, amyloid burden and tangle density”, this Rush University Medical Center longitudinal study found that a lifetime of mental activity slows cognitive decline (Abstract).

Wilson, R. S., Scherer, P. A., et al.  (2007).  Relation of cognitive activity to risk of developing Alzheimer disease. Neurology, 69, 1911-1920.  Retrieved from

The Rush Memory and Aging Project  has examined the relation of cognitive activity to the development of Alzheimer’s since contemporary prospective studies have already established that mentally active older adults are less likely to develop Alzheimer’s.  Researchers, however,  have yet to determine whether this decline in cognitive activity signifies dementia or  simply reflects  a lack of cognitive activity and socioeconomic advantages earlier in life (Wilson, 2007, p. 1911).

Thus, starting in 1997, researchers coupled yearly clinical evaluations, including a battery of 20 cognitive tests, a questionnaire mentioning variously types of mental activities along with their frequency (regularly, once a year, or everyday) and brain autopsies to determine whether exercising the mind could be linked with a less likely chance of developing Alzheimer’s, but if it also might deter its onset.  Mental activities included such options as reading a newspaper, playing games like chess or checkers, visiting a library, and attending a play (Wilson, 2007, p. 1912). Additionally, the study  adapted the 1985 Health Interview Survey to determine if participants regularly exercised.  For instance, they asked if they had walked during the last two weeks (Wilson, 2007, p. 1913).  Finally, researchers also used data from the 1920 census to determine the education of the participants’ mothers and dads as well as their father’s occupation (Wilson, 2007, p. 1913).

With a few exceptions, the more mentally and physically active the participants were both in the past as well as in the present enjoyed both a higher socioeconomic status and better cognitive functioning (Wilson, 2007, p. 1914).  Additionally, researchers associated mental ability with a less rapid rate of cognitive decline (Wilson, 2007, p. 1915).  Finally, while regularly taking part or abstaining from brain-stretching pastimes predicted the development of mild cognitive Impairment, MCI didn’t necessarily predict a decline in pastimes that required reasoning and thinking skills (Wilson, 2007m p. 1917).

Similarly, even a popular tabloid article can serve as an effective search tool that directs the reader to documented references that correlate mental stagnation with dementia. However, even the Daily Mail admits that exercising the mind also needs to be only one healthy life style choice that can help prevent dementia:

Hope, Jenny. (2012, January 13).  A life of brain-teasing could beat Alzheimer’s with reading, writing, and puzzles.  Health.  Daily Mail.  Retrieved from http://www.dailymail.co.uk/health/article-2090848/A-life-brain-teasing-beat-Alzheimers-disease-reading-writing-puzzles.html

The findings of a University of California, Berkeley, study suggest that lifetime learning  and intellectual stimulation reduces the levels of beta amyloid protein, a plaque found in the brains of Alzheimer’s patients (Hope, 2013 January 13, para. 1-3). Researchers used PET scans and attached  radio-active iodine tags to protein in 65 healthy 65-year-old volunteers and then compared the amount of beta amyloid protein in their brains with the brains of their Alzheimer Disease peers as well as a very small sampling of  25-year-old controls culled from the University of California, Berkeley, and its surrounding area whereupon they found that the 65-year-olds with the highest level of brain activity matched the beta amyloid protein levels of the 25-year-old control group while those with the least amount of brain activity had amyloid plaque levels similar to those diagnosed with dementia (Hope, 2013, January 13, para. 7-13).   

Even so, University of California, Berkeley researcher Susan Landau cautioned that “cognitive activity is just one component of a complex set of lifestyle practices linked to Alzheimer’s Disease risk” (Hope, 2012, January 13, para. 11). Furthermore, Anne Corbett of the British Alzheimer’s Society added a disclaimer that this study involved only a very small number of individuals, and it didn’t furnish a follow-up study to determine whether the 65-year old volunteers went on to develop dementia (Hope, 2013, January 13, para. 14-15).  

Corbett then encouraged older adults not only by continuing to stretch their minds by reading, writing, and playing games but to also cut their risk of Alzheimer’s by exercising regularly, adhering to a low-fat diet, not smoking, and keeping their blood pressures and cholesterol in check (Hope, 2013, January 13, para. 16-17).'

Landau, Susan M. Marks, Shawn M., et al.  (2012, May).  Association of lifetime cognitive engagement and low β-Amyloid deposition.  Archives of Neurology, 65(5), 823-629.  Retrieved from  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747737/

Taking part in “cognitively stimulating activities” in early and mid- life correlates with lower levels of beta amyloid deposits throughout the brain cortex, although 20 to 30 percent of the cognitively-healthy controls showed significant levels of beta amyloid (Landau, 2012, May, para. 3).  Similarly, those who are most likely to mentally challenge themselves are most likely influenced by other occupational, social, or recreational factors (Landau, 2012, May, para. 5).  The study then determined the frequency of such behaviors as reading books and newspapers, composing letters or e-mails, visiting the library, or playing games on a five-point scale, and participants also completed a physical activities interview wherein they listed all leisure exercise activities, including cycling, walking, dancing and yoga (Landau, 2012, May, para. 7 & 9).

Healthy older controls also completely an extensive neuro-psychological battery as well as subjectively rating their memory and mental functions with others their age.  All participants additionally underwent a high-resolution structural MCI brain scan (Landau, 2012, May, para. 10-12). 

Researchers subsequently concluded that participating in stimulating cognitive activities early in life and into middle age correlated with lower accumulations of beta amyloid plaque and that increased cognitive activity also reduced amyloid beta plaque levels before the onset of dementia (Landau, 2012, May para. 32-33).
 
Accordingly, similar articles stress that exercising the mind is just one of the activities on a long “to-do list” that might help prevent or delay Alzheimer’s, including daily performing 30 minutes of aerobic exercise, maintaining a  healthy low-fat diet, not smoking, and keeping blood pressure and cholesterol low.


Taking a brisk 30-minute walk helps keep the mind active as well.

Nordqvist, Christian. (2013, July 13).  How to prevent Alzheimer’s disease and dementia. Medical News Today.  Retrieved from http://www.medicalnewstoday.com/articles/263769.php

If senior adults and their families could read only one article on preventing Alzheimer’s this is the article to read since Christian Nordqvist has summarized a series of articles on its prevention along with providing URL links to the original articles.  This balanced approach argues that lifestyle choices prevent or delay Alzheimer’s, including not only staying mentally and physically active, but also maintaining a healthy well-balanced diet, preventing cardiovascular health, and not smoking, lessen the chance of developing Alzheimer’s by 50 percent (2013, July 13, para. 1-3).

That means keeping physically and mentally active for as long as possible to reduce the chance of Alzheimer’s.  Thus, retiring later, being (or becoming) bilingual, and keeping the brain active through mental exercise throughout life delay or avert dementia (Nordqvist, 2013 July 13, para. 32-41).

But keeping mentally active isn’t the only strategy necessary to inhibit Alzheimer’s since individuals must also regularly participate in aerobic exercise, restrict caloric intake, and follow a healthy Mediterranean diet because as Nordqvist suggests, “What’s good for the heart is good for the brain”, for 80 percent of brain autopsies of patients with Alzheimer’s disease also showed evidence of cardiovascular disease (2013, July 13, para. 6-9).

Accordingly, high cholesterol disease and metabolic syndrome—a deadly combination of obesity, high blood pressure, high cholesterol, and high blood pressure—put women at risk not only for stroke, heart disease, and diabetes, but also for Alzheimer Disease (Nordqvist, 2013, July 13, para. 8-10).  What’s more, obesity in old age impairs cognitive function in men while obesity in middle age in both genders also raises the risk of Alzheimer’s later in life as does diabetes (Nordqvist, 2013 July 13, para. 11-13).

However, a Mediterranean diet rich in olive oil, fruits, vegetables, legumes, and a moderate amount of seafood protects against vascular disease. This diet high in Omega-3 fatty acid and vitamins C, B, D, and E improves mental functioning since eating broiled or baked fish at least once weekly preserves the brain’s gray matter (Nordqvist, 2013, July 13, para. 17-18). By way of contrast, adults over age 70 who consume over 2,100 calories daily are 50 percent more likely to develop dementia (Nordqvist, 2013, July 13, para. 17).

Researchers at the Cooper Institute in Dallas, Texas, also have shown that individuals who regularly perform aerobic exercise throughout their lives, starting with the mothers’ exercise while their babies are still in the womb, are less likely to develop dementia, although even a brief spurt of intense exercise boosts memory, late-life exercise decreases the risk of Alzheimer’s, and daily moderate exercise over a 12-month period reverses hippocampus shrinkage (Nordqvist, 2013, July 13, para 19-30).

Moreover, getting enough REM sleep influences how the brain functions as well as the sleeper’s susceptibility to Alzheimer’s since research associates lack of sleep with a buildup of amyloid plaques (Nordqvist, 2013, July 13, para. 42-45).

Finally, heavy smoking in males significantly raises the risk of Alzheimer’s, but the medically supervised use of nicotine patches might possibly help Mild Cognitive Impairment patients delay the onset of Alzheimer’s (Nordqvist, 2013, Jul 13, para. 50-53).

Preventing Alzheimer’s Disease: What do we know?  (2012, September). Alzheimer’s Disease Education and Referral Center. (Updated 2014, March 24).  National Institute on Aging. Retrieved from http://www.nia.nih.gov/alzheimers/publication/preventing-alzheimers-disease/search-alzheimers-prevention-strategies

The National Institute on Aging takes a holistic approach similar to Nordqvist’s except that it includes “social engagement” along with “intellectual stimulation” as factors that correlate with a lower risk of Alzheimer’s, noting that longitudinal studies in religious communities of priests and nuns show a relationship between everyday social interaction and regular cognitive activity (National Institute on Aging, 2012, September, para. 27-29).  Moreover, the National Institute on Aging notes that even less formally educated older adults perform as well as their university educated peers on mental tests if they regularly either read, do crossword puzzles, or write letters, although cognitive training as found on Websites like Luminosity can possibly be beneficial (2012, September, para. 30-31).

Daily aerobic exercise also has its benefits.  For instance, studies of older rats and mice show that exercise increases the number of small blood cells that supply blood to the brain as well as the number of connections available between never cells.  Moreover in a year-long study that compared aerobic exercise with walking 40 minutes daily found that walkers had improved their brain’s connectivity and executive functions more than those who  only exercised (National Institute on Aging, 2012, September, para. 11-12). 
Baked or broiled fish rich in Omega-3 fatty acids guards against dementia.

Adhering to a Mediterranean Diet may lower the risk of Mild Cognitive Impairment 28 percent and diminish the chance of Alzheimer’s 48 percent while a weekly serving of fish high in Omega 3 fatty acid decreases the risk of Alzheimer’s, although it doesn’t improve the cognitive functioning of those already diagnosed with Mild Cognitive Impairment and/or Alzheimer’s.  As expected, rats fed a diet high in saturated fats and carbohydrates also performed much worse on memory tests than those fed a low-fat diet (National Institute on Aging, 2012, September, para. 14-16).   Observational studies additionally show that cardiovascular disease, high blood pressure, heart disease and type 2 diabetes all greatly increase the chance of developing MCI and Alzheimer’s (National Institute on Aging, 2012, September para. 12-17).
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The links furnished on this Web page represent the opinions of their authors, so they complement—not substitute—for a physician’s advice.