About 32% of Americans older than 85 have been diagnosed with Alzheimer’s disease. This debilitating condition gradually affects memory, thinking, behavior and executive functions leaving the afflicted unable to perform daily tasks and gradually unaware of the world around them. Often, people with Alzheimer’s disease are also diagnosed with other types of dementia such as that caused by vascular disease. Worldwide, it is estimated that about 50 million people have some form of dementia. As the world’s population ages, without a cure, it is estimated that by 2050 more than 130 million people worldwide may suffer from dementia with 60 – 70% having Alzheimer’s and another 20 – 25% having a vascular form of the disease.
Because so many people worldwide are affected by Alzheimer’s disease, many drugs have been developed in the hopes of treating and ultimately curing the disease. But, over 200 experimental drugs intended to treat or cure the disease have failed in the last 30 years. Another 100 drugs are currently in clinical trials, so far without strong success.
In the April 2017 edition of Scientific American, Miia Kivipelto and Krister Håkansson discuss the results of a study they (Kivipelto) led titled the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). The results of this study were the first to be published in a larger group of lifestyle change studies.
In the FINGER study, 631 men and women in the treatment group aged 60 – 77 and 629 in the control group participated. Further, the pool of subjects was chosen to consist of individuals who, according to scores on a test for dementia risk, were determined to be at an elevated risk for cognitive decline. Those in the control group received health advice and had their cardiovascular health checked regularly. If health problems such as high blood pressure were identified, these control group members were referred to a physician. The regimen for those in the treatment group consisted of four parts:
- Nutritional guidance – aimed at a healthy balance of protein, fat, carbohydrates, dietary fibers and salt, restrictions on consumption of trans-fatty acids, refined sugar and alcohol (all in accordance with recommendations by the Finnish National Nutrition Council).
- Cognitive training – used a computer program to train on different cognitive tasks to enhance executive function (particularly planning and organizing), memory improvement and mental speed. This training consisted of two – three sessions per week in intervals of 10 – 15 minute sessions.
- Physical exercise – included muscle-strength training, aerobic exercise and postural balance eventually ramping up to two or three gym sessions of 60 minutes a week.
- More intensely monitored cardiovascular status – included regular checkups on metabolic and vascular health, measures of weight, blood pressure and hip and waist circumference averaging every four months and meetings at roughly the same intervals with physicians to discuss these results and using the results as a basis, encouraged the participants to change their daily health habits.
(Photo from Scientific American)
See the results below!
Although the FINGER standards involved intensive intervention for most participants, only 12 percent dropped out, usually citing health problems. Also encouragingly, only 46 of the 631 participants in the intervention group experienced any difficulty completing the tasks. So, the authors conclude that “a comprehensive program of changes to one’s daily activities later in life is practical to implement.”
After the two years of the FINGER study, overall cognitive performance improved for both the treatment and control groups. But, the treatment group benefited 25% more than the control group! Additional analysis looking at the risk of “waning cognitive performance” showed this undesirable condition to be 30% higher in the control group than in the intervention group! Further differences between the control and intervention group include the intervention group having, with respect to the control goup:
- An 83% improvement in executive function;
- A 150% better score in speed of processing (i.e., the time needed to perform mental tasks);
- A 40% performance increase in complex memory tasks (e.g., ability to remember long lists).
(Photo from Scientific American)
Buoyed by these results, the FINGER study is being extended to see whether the parameters of the study can delay the onset of dementia. Further, the FINGER results are being compared to results from other regions of the world. Kivipelto and Håkansson state:
“It will not be necessary to wait another decade for health care professionals to start making recommendations to their patients. Already FINGER has provided enough evidence to start suggesting that patients take up the health measures we investigated. If the NIH decides to convene a new [dementia] conference, it might now come to a more optimistic conclusion than the one held seven years ago that was unable to endorse any preventive steps.”
The authors conclude:
“In the face of a multitude of drug failures, prevention may prove the best way to manage the dementia epidemic, as it has for many other chronic diseases. The take-home message from FINGER is that it may never be too early to take measures to prevent Alzheimer’s – and fortunately, it may never be too late either: changes to the way one lives seem to help some people even after cognitive decline has already begun.”
I am very hopeful that this research continues to be promising! For those with Alzheimer's Disease and their families, this is certainly good news!
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