Even stronger evidence coming for the effect of lifestyle interventions in Alzheimer's disease

In Beating the Dementia Monster we discussed some results of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER).  The study showed remarkable results with respect to controlling the advance of cognitive decline through lifestyle interventions. The Alzheimer's Association subsequently organized a network of research organizations to try replicating the Finnish results.  (We discussed the American effort, The US POINTER study.)

While there were many previous studies associating good and poor lifestyle choices with Alzheimer's disease, the FINGER study was novel in that it made actual changes to lifestyles and then measured the results.  This type of study is called a "randomized controlled trial."  Up to this point, researchers relied on a type of "longitudinal study" that simply followed the progress of a population and then tried to discern the causes of improvement and decline from what was known about the population.  The FINGER study was superior because it measured consequences of specified changes.  It also used coaches for participants to verify the lifestyle changes and to accurately record results.  These results were compared to a similar population that did not change any features of their lifestyle.

So how are these network studies going?  It's a bit early to tell for sure, but what we have so far is very encouraging.  (The US POINTER study has nothing to share yet.)  We wrote recently about the Alzheimer's Association International Congress (San Diego, July 31 -- August 4).  During the conference several studies shared some preliminary results -- the Australian "Maintain Your Brain" study, the Alzheimer's Disease Cooperative Study's (ADCS's) EXERT study, and the South Korean SUPERBRAIN-AD study.

The “Maintain Your Brain” study delivered digital personalized coaching in physical activity, diet, and brain health, finding that these boosted cognition in its participants over three years.  

The EXERT Phase 3 trial compared light versus moderate exercise in people with MCI, finding that cognition held stable in both groups over a year. The study lacked a control group, but a matched group of participants from the Alzheimers Disease Neuroimaging Initiative (ADNI) declined in that same amount of time, suggesting that both interventions may have done some good.

SUPERBRAIN-AD also reported promising findings from its suite of lifestyle interventions among cognitively impaired people with amyloid plaques.

These studies are not identical, but they may be the tip of the iceberg for ... something. 

In reading about these studies one thing that struck me was the likely influence of social connection on the results.  For example, some suggest that social interactions between subjects and the coaches in some studies may have contributed to improved memory and cognition.  You will recall that #2 in our "Dementia Toolkit" is "maintain or increase social activity."

We look forward to more news on these important studies!