Alzheimer's - Latest NIH Report

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A bunch of broccoliExcerpt From The National Institute of Health Publication on Alzheimer's, October, 2009

Lifestyle Factors

We know that physical activity and a nutritious diet can help people stay healthy as they grow older. A healthy diet and exercise can reduce obesity, lower blood cholesterol and high blood pressure, and improve insulin action. In addition, association studies suggest that pursuing intellectually stimulating activities and maintaining active contacts with friends and family may contribute to healthy aging. A growing body of evidence now suggests that these lifestyle factors may be related to cognitive decline and AD. Researchers who are interested in discovering the causes of AD are intensively studying these issues, too.

We know that physical activity and a nutritious diet can help people stay healthy as they grow older. A healthy diet and exercise can reduce obesity, lower blood cholesterol and high blood pressure, and improve insulin action. In addition, association studies suggest that pursuing intellectually stimulating activities and maintaining active contacts with friends and family may contribute to healthy aging. A growing body of evidence now suggests that these lifestyle factors may be related to cognitive decline and AD. Researchers who are interested in discovering the causes of AD are intensively studying these issues, too.

We know that physical activity and a nutritious diet can help people stay healthy as they grow older. A healthy diet and exercise can reduce obesity, lower blood cholesterol and high blood pressure, and improve insulin action. In addition, association studies suggest that pursuing intellectually stimulating activities and maintaining active contacts with friends and family may contribute to healthy aging. A growing body of evidence now suggests that these lifestyle factors may be related to cognitive decline and AD. Researchers who are interested in discovering the causes of AD are intensively studying these issues, too.

Physical Activity and Exercise
Exercise has many benefits. It strengthens muscles, improves heart and lung function, helps prevent osteoporosis, and improves mood and overall well-being. So it is not surprising that AD investigators began to think that if exercise helps every part of the body from the neck down, then it might help the brain as well.

Epidemiologic studies, animal studies, and human clinical trials are assessing the influence of exercise on cognitive function. Here are a few things these studies have found:

  • Animal studies have shown that exercise increases the number of capillaries that supply blood to the brain and improves learning and memory in older animals.

  • Epidemiologic studies show that higher levels
    of physical activity or exercise in older people are associated with reduced risk of cognitive decline and reduced risk of dementia. Even moderate exercise, such as brisk walking, is associated with reduced risk.

  • Clinical trials show some evidence of short-term positive effects of exercise on cognitive function, especially executive function (cognitive abilities involved in planning, organizing, and decision making). One trial showed that older adults who participated in a 6-month program of brisk walking showed increased activity of neurons in key parts of the brain.

More clinical trials are underway to expand our knowledge about the relationship of exercise to healthy brain aging, reduced risk of cognitive decline, and development of AD. (See "Participating in a Clinical Trial" for more information).

If you want to know more about the benefits of exercise and physical activity and learn ways to be active every day, NIA has free information just for you! Call 1-800-222-2225 or visit www.nia.nih.gov/Exercise.

Diet
Researchers have explored whether diet may help preserve cognitive function or reduce AD risk, with some intriguing findings. For example, studies have examined specific foods that are rich in antioxidants and anti-inflammatory properties to find out whether those foods affect age-related changes in brain tissue. One laboratory study found that curcumin, the main ingredient of turmeric (a bright yellow spice used in curry), can bind to beta-amyloid and prevent oligomer formation. Another study in mice found that diets high in DHA (docosahexaenoic acid), a type of healthy omega-3 fatty acid found in fish, reduced beta-amyloid and plaques in brain tissue.

Other studies have shown that old dogs perform better on learning tasks when they eat diets rich in antioxidants, such as vitamin E and other healthful compounds, while living in an “enriched” environment (one in which the dogs have many opportunities to play and interact with people and other dogs).

Scientists also have examined the effects of diet on cognitive function in people. A very large epidemiologic study of nurses found an association between participants who ate the most vegetables (especially green leafy and cruciferous vegetables) and a slower rate of cognitive decline compared with nurses who ate the least amount of these foods. An epidemiologic study of older adults living in Chicago found the same association. The researchers do not know the exact reason behind this association, but speculate that the beneficial effects may result from the high antioxidant and folate content of the vegetables.

Dietary studies, such as the curcumin study in mice or the vegetables study in nurses, generally examine individual dietary components so that scientists can pinpoint their specific effects on an issue of interest. This approach has obvious limitations because people do not eat just single foods or nutrients. Several recent epidemiologic studies have taken a different approach and looked at an entire dietary pattern.

In one of these studies, researchers worked with older adults living in New York who ate the “Mediterranean diet”—a diet with lots of fruits, vegetables, and bread; low to moderate amounts of dairy foods, fish, and poultry; small amounts of red meat; low to moderate amounts of wine; and frequent use of olive oil. The researchers found that sticking to this type of diet was associated with a reduced risk of AD and that the association seemed to be driven by the whole approach, rather than by its individual dietary components. A follow-up study found that this pattern also was associated with longer survival in people with AD.

All of these results are exciting and suggestive, but they are not definitive. To confirm the results, scientists are conducting clinical trials to examine the relationship of various specific dietary components and their effect on cognitive decline and AD.

Full-scale AD prevention trials are under-way as well. One such trial, Prevention of Alzheimer’s Disease with Vitamin E and Selenium (PREADVISE), is being conducted in conjunction with a National Cancer Institute-funded trial called the Selenium and Vitamin E Cancer Prevention Trial (SELECT). SELECT is evaluating whether taking selenium and/or vitamin E supplements can prevent prostate cancer in healthy men older than 60 years. PREADVISE is evaluating whether these supplements can help prevent memory loss and dementia by protecting brain cells from oxidative damage (see "The Aging Process" for more on oxidative damage).

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