On Tuesday, August 27th we went live with Sarah Harlock, Program Director of the DENT Integrative Center for Memory, as she discussed Alzheimer’s Association International Conference Highlights. At this conference, researchers from all around the world came together to share information. A lot of the conference focused on lifestyle, which will be what Sarah focused on.
The Finger Studies
A program in Finland conducted a 2-year study and looked at lifestyle factors. This was the first randomized control trial that proved that these lifestyle factors can prevent cognitive decline. This study was so successful that the “Worldwide Finger Study” has been initiated, where about 10 countries have signed up to replicate The Finger Study in their own country.
The Pointer Study
In the United States, The Pointer Study will be starting soon. This two-year study will be operating out of specific universities in California, North Carolina, Texas, and Illinois.
“I am not sure if they have started recruiting yet. If they haven’t, they will be shortly,” said Sarah Harlock. “I am looking forward to hear more from The Pointer Study. I think we are going to see some really interesting data come out of that.”
Modifiable Risk Factors
At the conference, there were plenty of researchers that touched upon Modifiable Risk Factors. These are things that we can change, as opposed to Genes, which we cannot change. “These are modifiable, meaning we can control some of this,” explains Harlock.
These Modifiable Risk Factors include: smoking, depression, physical activity, social stimulation/social isolation, diabetes, and diet. All of these factors are things that we have some sort of control over. They also have a big impact on the risk of developing cognitive impairment. It is really important to address these factors to reduce our risk.
Same study, different results
A challenging part of research is that one week you can see an article that sounds great and has very positive results, and then a week later see a report that says the exact opposite. At the conference, that exact situation happened.
Two studies contradicted each other. Study #1 showed that the genetic high-risk group, meaning they have a genetic factor that increases their risk of developing Alzheimer’s Disease, were able to reduce their risk of developing cognitive decline using the mentioned lifestyle elements. Study #2 shows that lifestyle factors did not change the risk of cognitive decline in the high-risk genetic group.
Why are there differences? How can there be conflicting results?
“It turns out that between these two studies, the ages they were looking at were different, the way they defined genetic risk was different, the way the measured cognitive impairment was different – they were not using the same assessment tools, and the length of time that they were following the subjects was different too – by several years,” Sarah Harlock explains.
It can be hard to determine what is accurate and what to follow as these studies come in. There is a lot of research going on right now, and at DENT Neurologic Institute, we will report the most accurate information possible.
These Modifiable Risk Factors may not be news to everyone. We have known for a while that smoking is not good for you. It is not good for your heart, and whatever is not good for your heart is not good for your head.
The amount of studies done on exercise is tremendous. One study presented at the conference was called the “Intense Physical Activity And Cognition Study”. This study found that intense exercise is more beneficial to you that moderate to light exercise.
“I am just going to say that any exercise is better than no exercise,” says Harlock, “but what this study showed is that having an exercise that was more intense and got your heart rate up, had a more protective effect than those who did light exercise.”
Another study that was talked about was the “Fitness for the Aging Brain” study. In this study, participants were put through an exercise program, and then they measured their cognition at 6 months, 12 months, and 18 months. The results showed a positive effect on their cognition.
“What was interesting was that they tried to follow up with people 10 years later,” says Harlock. “They were not able to reach everyone in that study, but they were able to reach some. When they looked at the data, they did not see so much a cognitive benefit. Instead, they saw a benefit through the reduction of falls.”
Those who were participating in the exercise program were falling at a much lower rate than the non-exercise group. Benefits beyond cognition can be contributed to exercise.
Every country and region has different access to food. Because of that, no specific diet was identified to be the solution. Basically, the studies have suggested a healthy diet.
“I always tell people that if you have any questions about what a healthy diet is, contact your insurance company and ask for information,” says Harlock. “You can also talk to your primary care doctor. It is individualized based on your own unique needs and any conditions you might have.”
No “superfood” was brought to the spotlight either. There was a huge emphasis on a healthy diet. If you are someone who needs assistance, you can also get a referral to a dietitian from your primary care doctor or your health insurance company.
Sleep was another hot topic at the conference, as it is very important to memory and cognition. There are specific brain wave activities that occur in your sleep that help the hippocampus – the part of the brain responsible for short-term memory.
“These brainwave activities that happen during sleep encode information that is gained during the day,” Sarah Harlock explains. “So, if there is disruption in your sleep, there’s an opportunity for the process of encoding, remembering or storing this information to be disrupted. Again, sleep just becomes critical.”
There is that older generations do not need as much sleep – and that is simply not true. Studies are showing that people need 7 to 8 hours of sleep a night to avoid the amyloid deposit or amyloid buildup in the brain, which is common in Alzheimer’s.
Getting enough sleep is imperative, and insomnia is certainly an issue that can negatively impact your cognitive health. Recently, research has determined that insomnia can increase your risk of developing Alzheimer’s disease.
Insomnia and Sleep Apnea
Menopausal women are at a higher risk of insomnia than men of the same age. Researchers are identifying this as a possible reason that more women are developing Alzheimer’s than men.
Sleep Apnea is another issue that increases the risk of not only Alzheimer’s, but cardiovascular issues too.
“Again, it is really important that you are paying attention to your sleep,” emphasizes Harlock. “Trying not to nap during the day, watching your caffeine intake, and reducing screen time right before bed are all things that can certainly help with your sleep hygiene.”
It could be possible that a sleep test is needed. The DENT Sleep Center has a fully equipped diagnostic laboratory, including six private suites where patients sleep while being monitored by trained technicians.
This is another key component that is part of the Finger Study, and part of the modifiable risk factors. For the mental stimulation aspect, they talked about formal education. Beyond formal education, there is lifelong learning that we can be doing that will help assist us with building up brain reserves. This goes beyond watching TV.
“You need to be doing more for your brain,” says Harlock. “Find activities that are enjoyable, challenge your brain, and make you think about things in a new way.”
As people age, it is not uncommon to see them become more isolated. They may have mobility issues that stop them from doing social activities or going to the gym. They might also no longer have their driving privileges and can no longer enjoy the things they use to.
Combining the Modifiable Risk Factors
Not everything has to happen in isolation. Our social activities can happen at an exercise program, our exercise can happen while as we’re walking to the library or our mental stimulation, we can eat a healthy meal while with friends. Combining these lifestyle choices so you don’t think about setting up a whole new plan for getting through your day will help make sure you tackle all of these elements.
5 Key Points
Key Point 1 – Modifiable Risk Factors can counteract genetic risk for Alzheimer’s
Making adjustments to your lifestyle to support at least 4 of these Modifiable Risk Factors can reduce your risk of Alzheimer’s by 60%, as opposed to those who do not make any efforts, or only do one of them.
“This is exciting,” Harlock says, “and very, very important to adhere to the healthy lifestyle as it may counteract the genetic risk for Alzheimer’s disease. A lot of people say that Alzheimer’s is in their genes, and there is nothing they can do about it. The reality is, there is something they can do about it.”
Key Point 2 – Cognitive Stimulation can counteract some negative things, like air pollution
These studies are showing that we may be able to reduce our risk of having a higher cognitive reserve built through formal education and cognitive stimulation. This benefits the aging brain by reducing the risk of dementia among people who were exposed to high levels of air pollution.
“That was a really interesting study that came out as well,” says Harlock, “So this idea of brain reserve and cognitive stimulation and so on can counteract some of the negative things – like air pollution.”
Key Point 3 – Early Adult to Midlife smoking can be associated with cognitive impairment
The conference confirmed that early adult to midlife smoking can be associated with cognitive impairment, as early as when people are in their 40’s.
“So, once again it’s one of those things that if you are smoking, talk to your doctor about this. We do know that it’s one of those modifiable risk factors,” explains Sarah Harlock.
Key Point 4 – Drinking too much can increase the risk of dementia
Alcohol use disorder can significantly increase the risk of dementia in older women. Studies in the past have discussed diets that promote a small or moderate amount of alcohol as safe or beneficial to the brain. A study presented at the conference presented that too much alcohol increases the risk of dementia in women later in life.
“Alcohol is something that needs to be moderated and make sure that you are using safe levels,” says Harlock.
Key Point 5 – We must be looking at the condition much earlier than they are now
Rather than waiting for signs of memory loss, language problems, or cognitive issues, we need to be looking at and adjusting our lifestyle choices much, much earlier than we are now.
Never too early or too late
There was a study called My Brain Robbie that was aimed at school-aged children and them adapting to a healthy lifestyle. The children ended up taking the information home to their parents, which helped the parents make healthier choices as well.
“You are never too young to start these healthy brain habits,” says Harlock. “But, it is also important to note that is it never too late to start them, either.”
Making these healthy choices can not just lower your risk of developing these conditions, but it may slow down cognitive loss. Click here if you or someone you know is interested in DENT’s Memory Center.