Eat well. Move more. Stress less. Connect with others. These lifestyle factors, when applied intensively, may slow the progression of mild cognitive impairment (MCI) and dementia due to Alzheimer’s disease, according to a recent study published in Alzheimer’s Research & Therapy. The study, led by Dean Ornish, MD, of the Preventive Medicine Research Institute, builds on mounting evidence that nutrition, exercise, mental well-being and social connection are all essential to incorporate into dementia prevention and care plans.
In many ways, the findings are not surprising. There is ample research linking lifestyle improvements with the successful treatment of other chronic diseases. According to the American Heart Association, a healthy diet and physical activity are key to managing hypertension or cardiovascular disease, and similarly for diabetes. The National Diabetes Prevention Program is a 1-year lifestyle change program targeting adults who have pre-diabetes or are at risk for type 2 diabetes. Nutrition and exercise are also of paramount importance to cancer care.
Movement, mindfulness and “food as medicine” were cornerstones of Milken Institute Founder Michael Milken’s own cancer treatment and recovery plan more than three decades ago, as discussed in his book, “Faster Cures.” Health experts at the Milken Institute 2023 Future of Health Summit agree underlying risks and protective factors cut across chronic diseases. Blue Zones’ Dan Buettner offered similar insights on the panel, “Longevity Lab: Can You Live to 100?” at the Milken Institute 2024 Global Conference.
The Ornish study is important because it demonstrates a causal effect between lifestyle factors and how MCI and early-stage dementia due to Alzheimer’s disease can progress. “In short, the more these Alzheimer’s disease patients changed their lifestyle in the prescribed ways, the greater was the beneficial impact on their cognition and function,” Ornish and his more than two dozen co-authors concluded. The study targeted a small group of men and women ages 45–90 who were diagnosed with mild cognitive impairment or early dementia due to Alzheimer’s. The comprehensive lifestyle modifications included a vegan diet, aerobic activity and strength-training, meditation, and group support meetings.
‘It’s never too early or too late to start making changes.’
A growing body of evidence links lifestyle factors with the onset and progression of dementia and Alzheimer’s disease—the most common type of dementia. The landmark 2015 Finnish Geriatric Study to Prevent Cognitive Impairment and Disability (FINGER) Study demonstrated that a multidomain lifestyle intervention can improve cognitive function in older adults who have an elevated risk of developing dementia. Healthy food, physical activity, mental stimulation, social engagements, and monitoring of cardiovascular risk factors are the core of the FINGER model of dementia prevention.
New studies are underway in more than 60 countries as part of a worldwide network established by the FINGERS Brain Health Institute, led by Miia Kivipelto, PhD (a co-author on the Ornish study) and Maris Hartmanis, PhD. Similarly, the “Lancet Dementia prevention, intervention, and care 2024” report cites 14 modifiable risk factors that account for nearly half of worldwide dementia cases—dementia that could be prevented or delayed.
The Alzheimer’s Association reports that Alzheimer’s disease afflicts nearly 7 million Americans, and that number is expected to rise to 13 million by 2050. The Alliance to Improve Dementia Care and its members are accelerating efforts to publicize the importance of lifestyle modifications in dementia prevention—and treatment.
The Alzheimer’s Association urges people to make lifestyle changes to reduce the risk of cognitive decline by exercising, adopting a healthy diet, and staying mentally and socially active. The AARP Brain Health Action initiative advocates choosing similar “brain-healthy” lifestyles. Blue Zones and the American College of Lifestyle Medicine this past May announced a partnership to address the health crisis of rising chronic disease rates by accelerating a “lifestyle first” approach to healthcare.
A consensus is emerging: Nutrition, exercise, stress management and social connection are essential to dementia prevention and care. It’s never too early or too late to start making changes. CNN’s chief medical officer, Sanjay Gupta, MD, features Ornish and his collaborator’s research in an hour-long documentary, “The Last Alzheimer’s Patient,” which aired this past July and is available to stream. Gupta emphasizes that daily decisions—eating healthy, moving more, connecting with loved ones, and learning new things—can lead to better health for our brains.
We once thought there was little, if anything, we could do to slow or prevent MCI or early dementia due to Alzheimer’s. That is no longer the case. New pharmaceutical treatments are now on the market, and lifestyle modifications show promise. However, access to healthy food, nutrition counseling, and fitness programs require resources, and that’s a barrier we must address. Early detection is also important; intervening at an early stage may slow the risk and progression of disease, whether it’s Alzheimer’s, heart disease or diabetes.
Diane Ty, MBA, is managing director, Future of Aging, at Milken Institute Health in Washington, DC. Jennifer Rossano, MAPP, is a project lead, Future of Aging, at Milken, is affiliated with the Positive Psychology Center at the University of Pennsylvania, and is pursuing a master’s degree in Public Health at Johns Hopkins University.
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