Boomers are worried about dementia. Many have witnessed their parents suffering from Alzheimer disease or other neurodegenerative disorders. Not only do the individuals fade away in a cloud of not-remembering, families struggle to care for them. Until recently, experts believed that there was nothing you could do to reverse the course. Recently, a panel of advisors told the FDA it ought to approve a new drug, donanemab, to clear amyloid plaque from the brain. Even more exciting, a randomized controlled trial demonstrated that healthy lifestyle changes can make a positive difference against Alzheimer disease.
Studying Healthy Lifestyle Changes:
The scientists from institutions across the country and even around the world recruited 51 adults diagnosed with mild cognitive impairment or early dementia due to Alzheimer disease (Alzheimer’s Research & Therapy, June 7, 2024). Ages ranged from 45 to 90 but most were in their 70s. For five months, half the volunteers saw their physicians for their usual care. At the same time, the other half (selected randomly) learned to make important lifestyle changes. The researchers offered intensive coaching to help them.
What Changes Did the Volunteers Make?
Plant-Based Diet:
First, they changed their diets. Instead of consuming a standard American diet, they switched to emphasize minimally processed plant foods with very little fat, refined foods, alcohol or sweeteners. Dr. Dean Ornish is the lead author on this study, so if you are familiar with his recommendations you’ll have some idea of what the participants ate. The scientists provided volunteers with their meals and snacks to help them stay on track. (Two of the initial 26 volunteers didn’t like the diet and withdrew from the study.)
Previous studies have suggested that a plant-based diet is useful in helping to ward off cognitive decline. Other research offered evidence that a Mediterranean-style diet rich in vegetables, fruits, fish and olive oil could be beneficial.
Supplements:
The researchers also provided participants with supplements for which there is prior evidence of benefit. Here is what the volunteers took:
- Omega-3 fats with curcumin
- Multivitamin and mineral, no iron
- Coenzyme Q10
- Vitamin C
- Vitamin B12
- Magnesium L-threonate
- Hericium erinaceus (lions’ mane)
- Super Bifido Plus Probiotic
Plenty of Physical Activity:
The volunteers did a lot more than eat differently. They increased their levels of physical activity. The intervention had them engaged in strength training and aerobic exercise for at least half an hour a day. Previous research has found that staying active is a good way to keep the brain functioning.
Stress Management:
In addition, they learned meditation and other stress management techniques such as stretching and breathing and practiced them daily. To help them relax, the study provided flashing-light glasses at an appropriate frequency and soothing music. Participants were urged to get adequate sleep and presumably most did so.
Support Groups:
Investigators offered support groups for the study participants and their partners three times a week. When people are altering their habits, strong support can help them with healthy lifestyle changes.
What Changes Did the Scientists Observe?
At the beginning of the study, all the participants in both groups had low amyloid beta ratios suggestive of Alzheimer disease, with no clear differences between the groups. This is determined through a blood test. Levels of C-reactive protein, HbA1c, LDL cholesterol and similar health markers were also similar between groups.
Extensive cognitive testing at the beginning of the trial provided similar findings between groups for the Alzheimer’s Disease Assessment Scale (ADAS-Cog). Strikingly, people in the intervention group improved their scores by the end of the trial. In contrast, those in the control group slipped further. A different assessment tool, the Clinical Dementia Rating sum of Boxes (CDR-SB), showed that both groups deteriorated. However, the intervention group lost much less ground than the control group.
The investigators determined the intervention group had statistically significant improvement in three of four standardized measures used. Improvement in cognitive measures was correlated with the changes in lifestyle the volunteers accomplished. By comparison, the control group got worse.
The authors concluded:
“In summary, in persons with mild cognitive impairment or early dementia due to Alzheimer’s disease, comprehensive lifestyle changes may improve cognition and function in several standard measures after 20 weeks. In contrast, patients in the randomized control group showed overall worsening in all four measures of cognition and function during this time.”
