A new randomized trial has confirmed what some researchers have thought for years. In only two years, comprehensive changes in lifestyle can improve memory, thinking, and cognitive processing speed in elderly people.
For decades, scientists have observed that healthy lifestyles, like those described in First Steps on Cognitive Vitality, are associated with less risk of dementia and cognitive decline. But some critics have argued that this protection is not as strong as it appears. Could the people who make healthy choices share other characteristics that lower their risk? Could poor health choices be a consequence rather than a cause of emerging cognitive decline?
Miia Kivipelto, MD PhD and other researchers implemented a randomized trial in over 1200 older people at risk of dementia to find out if their cognitive abilities could be improved with a comprehensive lifestyle intervention including nutritional guidance, exercise, cognitive training, social activity, and the management of metabolic and vascular health. The trial is called FINGER: the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability.
The results? After only two years, normal older adults who went through the multi-domain lifestyle intervention had better overall cognitive abilities, including improved memory, thinking, and processing speed.
It’s too early to know whether these benefits will translate into protection from dementia, but a longer follow-up study will address that question. Given these early results, it seems reasonable that the intervention will substantially delay the onset of dementia in many people. Delaying dementia by only a few years could have a tremendous impact on the lives of older individuals and our society at large. The Alzheimer’s Association has projected that, if a treatment to delay Alzheimer’s disease by five years were implemented by 2015, it would reduce the number of people with the disease in 2050 by 43 percent and save Medicare $283 billion in 2050 (1).
The FINGER trial is only one of three large randomized trials underway in Europe that is testing the idea that a combination of treatments including lifestyle interventions will protect against dementia in a more powerful way than individual treatments. The preDIVA trial is testing whether the risk of dementia and disability can be reduced in over 3500 elderly people by intensive multi-component care for vascular health, including advice on exercise, diet, and smoking. The MAPT trial is testing whether independently living older adults can be protected from cognitive decline with a comprehensive treatment regimen that includes vascular care, cognitive training, advice on diet and exercise, and a supplement of the omega-3 fatty acid DHA at 800 mg/day (2).
The FINGER trial results were presented last week by Dr. Kivipelto at the Alzheimer’s Association International Conference (AAIC) in Copenhagen, Denmark. The results are not yet published but can be reviewed briefly in Medscape and are summarized in an AAIC press release.
1. Association, L.G.f.t.A.s. Changing the Trajectory of Alzheimer's Disease: A National Imperative. 2010; Available from: www.alz.org/trajectory.
2. Richard, E., et al., Methodological challenges in designing dementia prevention trials - the European Dementia Prevention Initiative (EDPI). J.Neurol.Sci., 2012. 322(1-2): p. 64-70.
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