New study shows how dementia may be prevented

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Ageing is accompanied by a decline in several measures of cognitive function, such as memory, reasoning, and psychomotor speed. Differences in the rate of change in cognitive function can be substantial between individuals, highlighting the importance of identifying modifiable factors that are associated with favourable cognitive ageing trajectories. An impaired cognitive status can affect the lives of individuals and their ability to live independently but this issue is also a hallmark of Alzheimer’s disease and related dementias.

A new study of more than 29,000 older adults has identified six habits — from eating a variety of foods to regularly reading or playing cards — that are linked with a lower risk of dementia and a slower rate of memory decline. 

1. Eating a balanced diet,
2. Exercising the mind
3. Exercising the body regularly,
4. Having regular contact with others,
5. No drinking
6. No smoking

These six “healthy lifestyle factors” were associated with better cognitive outcomes in older adults, in a large Chinese study  conducted over a decade and published in the BMJ on January 25,  2023.

 While researchers have long known that there is a link between dementia and factors such as social isolation and obesity, the size and scope of the new study adds substantial evidence to a global body of research that suggests a healthy lifestyle may help brains age better.

 The study also suggests that the effects of a healthy lifestyle are beneficial even for people who are genetically more susceptible to memory decline — a “very hope-giving” finding for the millions of individuals around the world who carry the APOEε4 gene, a major risk factor for Alzheimer’s disease, said Eef Hogervorst, chair of biological psychology at Loughborough University, who was not involved in the study.

                     "An increasingly urgent public health priority" --BMJ Editorial

 As evidence is emerging on the association of sleep duration with cognitive outcomes, whether this variable should also be included is unclear. Additionally, the American Heart Association developed an ideal cardiovascular health score, combining seven biological and lifestyle factors,7 that is also associated with lower risk of dementia.

 A further area of concern is the age at which healthy behaviours need to be adopted. Future research on prevention should evaluate a wider range of possible risk factors and identify specific exposures associated with the greatest risk while also considering the risk threshold and age at exposure for each one.

 Risks of cognitive decline and dementia are likely to be shaped by multiple factors. The multifactorial risk paradigm introduced by the Framingham study has led to a substantial reduction in cardiovascular disease. A similar approach should be taken with dementia prevention, identifying not only the factors that matter most but also the threshold at which they matter, and the age when intervention is likely to be most effective, as the WHO underlined in its recent report on brain health. This public health priority is becoming increasingly urgent.

Sources: BMJ 

Healthy lifestyles for  dementia  prrevention J 2023; 380 doi: https://doi.org/10.1136/bmj.p117 (Published 25 January 2023) Cite this as: BMJ 2023;380:p117

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