Healthy lifestyle linked to Alzheimer prevention

Avoiding obesity may cut risk, researchers report

July 20, 2004|By Jonathan Bor | Jonathan Bor,SUN STAFF

PHILADELPHIA -- Many people can reduce the risk of Alzheimer's disease by losing weight, eating healthy foods, and staying mentally and physically active, researchers told an international conference yesterday.

New studies in the United States and Scandinavia have strengthened earlier research that identified a healthy lifestyle as a path to a healthy mind.

Many of the suggested activities are also recommended for the prevention of heart disease and stroke, raising the possibility that the conditions have common origins.

And, because Alzheimer's appears to develop in the brain for a decade or two before symptoms such as memory loss and confusion appear, scientists recommended that people adopt healthier lifestyles by middle age -- if not earlier.

Even so, a Swedish study presented at the International Conference on Alzheimer's and Related Disorders suggested that social and intellectual activities begun late in life can lower a person's risk.

Together, the studies indicate that people might be best off if they fight the disease on several fronts.

"There is not one particular thing that is important, but a combination," said Dr. Marilyn Albert, a Johns Hopkins neurologist who heads the medical and scientific advisory board of the Alzheimer's Association, the conference sponsor.

Alzheimer's disease is fast becoming one of the nation's major public health concerns. The number of cases is expected to rise from an estimated 4.5 million people this year to as many as 16 million by 2050.

The explosion of new cases is expected to have a huge economic cost as well. Alzheimer's Association President Sheldon Goldberg said Medicare expenditures for people with the disease will triple by 2015, to $189 billion. At the same time, state and federal Medicaid spending for nursing care is expected to rise only from $19 billion in 2000 to $27 billion in 2015.

In one of the prevention studies reported yesterday, people who were obese in middle age were at least three times as likely to develop Alzheimer's later in life than those of normal weight.

Researchers at the Karolinska Institute in Sweden followed the health of 1,500 Finns for 20 years. Among the obese, scientists found the risk of Alzheimer's was further magnified -- up to six times -- by high blood pressure and elevated cholesterol.

The results could have profound implications for societies trying to prevent both Alzheimer's and cardiovascular disease -- the leading cause of death in the United States and much of the developed world.

Both diseases appear linked to obesity, which can easily be tracked by calculating a person's body mass index -- a function of weight and height. "If we can reduce weight, we can also reduce blood pressure and lipids," said Dr. Miia Kivipelto of the Karolinska Institute. "We can affect several risk factors."

In another study, researchers at Harvard Medical School found that women who eat diets rich in green, leafy vegetables and cruciferous vegetables -- such as broccoli, cauliflower and brussels sprouts -- were more likely to preserve mental functioning as they entered their 70s.

Jae Hee Kang, who culled the information from a long-term study of 13,000 women, said the effects were modest but could have a significant impact for societies trying to deal with the social and economic burdens of aging populations.

For an individual woman, the diet might delay mental decline by a year or two, but thousands of dementia cases could be prevented each year if people adopted the healthy-food diet on a widespread basis, she said.

Although the study did not examine the mechanism by which vegetables affect the mind, Kang said that they might do so through anti-oxidant compounds that protect cells from destruction.

The Harvard researchers did not study men, although Kang said she expects the same principles would apply.

Meanwhile, it appears that people who remain physically and mentally active run a lower risk of developing Alzheimer's than the sedentary and isolated.

Studying subjects 75 and older, the Swedish researchers found that the elderly fared better if they played games, gardened, got involved in political or social activities, or engaged in light physical activity.

The scientists interviewed people about the activities they had engaged in during the preceding six years and then tracked their mental status over the next six years. Those who frequently took part in one of those activities lowered their risk by 30 percent, while those who were involved in multiple activities reduced their risk by as much as 60 percent.

Dr. Laura Fratiglioni of the Karolinska Institute said the best activities were both socially and intellectually engaging, such as card games, political involvement or discussion groups.

Though activity early in life is important, she said, the study shows that people who exercise their body and mind later in life can also benefit. "It is possible to do something when we reach 70 to 75 to maintain our good cognitive function," she said.

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