Lifestyle changes can protect cognition

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Acting on lifestyle risk factors of dementia could drastically lower risk. Image credit: Oliver Nasteski/Stocksy.
  • The number of people worldwide living with Alzheimer’s disease is expected to hit 153 million by 2050.
  • Although a definitive way to prevent the disease is not yet known, researchers know health and lifestyle modifications can help decrease a person’s risk.
  • Researchers at University of California — San Francisco (UCSF) have found that personalized health and lifestyle changes may be able to delay and even prevent memory loss in people at high risk for Alzheimer’s disease.

With researchers estimating the number of people globally living with Alzheimer’s disease to reach 153 million by 2050, scientists have been working recently to develop new preventions and treatments for this type of dementia.

As the exact cause of Alzheimer’s disease is still unknown, there is not currently a definitive way to prevent the disease.

However, previous research shows certain healthy lifestyle modifications may help lower a person’s risk for the condition, including a healthy diet, regular physical exercise, getting enough sleep, staying socially connected, and managing health issues like high blood pressure and diabetes that can increase a person’s risk for cardiovascular disease.

Adding to this knowledge is a new study from researchers at the University of California — San Francisco (UCSF) that personalized health and lifestyle changes may be able to delay and even prevent memory loss in people at high risk for Alzheimer’s disease.

The study was recently published in the journal JAMA Internal Medicine.

Dr. Kristine Yaffe, vice chair and professor in the UCSF Departments of Neurology, Psychiatry, and Epidemiology and Biostatistics, and first author and lead investigator of this study told Medical News Today they decided to study the effect of a personalized health and lifestyle approach because while clinicians know about lifestyle risk factors for Alzheimer’s disease, it is not clear if reducing those risk factors leads to improved cognition.

“It is hard to get people to change health and behavior,” Dr. Yaffe continued. “Our hypothesis was that a personalized approach, in which people’s individual risk factors are assessed — not one size for all — and the person can choose their goals and ways to improve their risk factor — e.g. sleep, physical activity, social engagement — that we would be able to reduce risk and this would translate to better cognition.”

“No one has tried this approach before and we found that we could improve risk factors and cognition even though this occurred during COVID,” she added. “Furthermore, there are only a handful of trials that have ever shown cognition benefits with interventions on these health and lifestyle factors.”

While generalized health and lifestyle changes can certainly be effective, those who are less motivated to make these adjustments may benefit from a personalized plan.

A personalized health and lifestyle modification plan allows a person to take charge of their health by specifying what areas they want to target for change.

And as every person is different, a personalized approach allows medical advisors to tailor their suggestions to one person rather than to all people.

A study published in June 2021 found that people receiving personalized nutrition advice improved their dietary intake more than those receiving generalized diet advice.

Another study published in June 2021 reported those who followed a personalized nutrition plan experienced improved lifestyle habits and reductions in body weight and BMI.

And research published in October 2019 discovered that personalized lifestyle advice given to seniors helped improve resilience and motivation, and helped provide a reduction in body fat percentage and hip circumference, compared to those receiving generic lifestyle advice.

For the study, Dr. Yaffe and her team recruited 172 study participants between the ages of 70 to 89 years. All participants had at least two of eight dementia risk factors at the start of the 2-year study.

These risk factors included:

  • physical inactivity
  • uncontrolled hypertension
  • uncontrolled diabetes
  • poor sleep
  • use of prescription medications associated with risk of cognitive decline
  • high depressive symptoms
  • social isolation
  • being a current smoker.

Half of the participants received personalized coaching from a nurse and health coach and were allowed to select specific risk factors they wanted help with.

These participants received coaching sessions every few months to review their goals. The meetings switched from in-person to telephone during the pandemic.

The other half of the study participants had general educational material on dementia risk reduction mailed to them every 3 months.

After 2 years, researchers found participants who received personalized coaching experienced a modest boost in cognitive testing, amounting to a 74% improvement over the nonpersonalized group.

Additionally, the personalized coaching group also had a 145% improvement in risk factors and an 8% improvement in quality of life compared to the nonpersonalized group.

“We were thrilled to see such a big difference in the groups,” Dr. Yaffe said. “This provides clear evidence that if one can reduce these modifiable risk factors with this personalized approach, one can improve cognition and prevent decline which most likely would prevent Alzheimer’s disease.”

MNT also spoke with Dr. Shannel Kassis Elhelou, geropsychology and neuropsychology fellow at Pacific Neuroscience Institute’s Brain Wellness and Lifestyle Programs in Santa Monica, CA, about this study.

Dr. Elhelou, who was not involved in the research, said she found these findings promising and encouraging as they suggest that personalized health and lifestyle interventions can have a positive impact on cognitive functioning in older adults at high risk for Alzheimer’s disease, which could potentially open new avenues for nonpharmacological approaches.

These findings could influence how providers discuss health and lifestyle interventions with their patients at high risk for Alzheimer’s disease by opting for a personalized approach as opposed to a one-size-fits-all approach. In addition, providers may be more inclined to refer their patients to health coaches [who] can address specific needs and preferences, as well as assist with motivation to adhere to lifestyle changes.”

– Dr. Shannel Kassis Elhelou

Dr. Elhelou said she would like to see future research on this topic continue to explore the effectiveness of additional non-pharmacological approaches such as cognitive training and stress management.

“Additionally, it would be valuable to conduct larger, longer-term studies to further validate the effectiveness of personalized interventions and non-pharmacological approaches in delaying or preventing cognitive decline in individuals at risk for Alzheimer’s disease,” she added.