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Key Takeaways

Plain English Takeaway

Sticking to healthy habits like exercise, good food, and brain activities for just two years can help older adults keep their minds sharp for many years after.

Study Aim

The study set out to find out if a two-year program that encouraged healthy habits—such as exercise, better eating, brain training, and managing heart health—could help older adults keep up these habits and maintain better thinking skills for up to 11 years. The researchers wanted to see if people who participated more in the program would have better long-term results. Simply put: The study wanted to see if healthy habits learned in a short program could last and help memory over many years.

Study Design

Researchers conducted a randomized controlled trial with 1,259 adults aged 60 to 77 who were at higher risk for dementia. Participants were randomly assigned to either a control group that received regular health advice or an intervention group that took part in a two-year program. This program included exercise, nutrition counseling, brain training, and help managing blood pressure and other heart risks. Participants were followed up at about 5, 7, and 11 years after starting. The study measured lifestyle habits using a questionnaire and thinking skills with a set of memory and cognition tests. People in the intervention group were further divided based on how much they participated in the program. Simply put: The study followed older adults for 11 years after a two-year healthy living program to see how well they kept up good habits and thinking skills.

Findings

The research demonstrates that people who took part in the two-year healthy living program kept up better habits—like eating well, staying active, and doing brain activities—up to seven years later compared to those who only got regular advice. Older adults and those who participated more in the program maintained these habits the longest. People who dropped out early tended to have less healthy lifestyles. Thinking skills improved for everyone during the first two years, but only those who were most engaged in the program kept these benefits for up to seven years, and compared to less engaged participants, up to eleven years. The authors argue that even a short, focused program can have lasting benefits, especially for those who stick with it. They recommend using similar programs to help prevent memory problems in older adults. Simply put: People who really joined in the healthy habits program kept up good routines and better thinking for years, showing these programs can help long-term.

Abstract

BACKGROUND: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) previously showed that a 2-year multidomain lifestyle intervention has a beneficial effect on cognitive function among at-risk older adults. Furthermore, both participation in the intervention activities and the lifestyle changes achieved were associated with more improvement in cognition. We investigated the long-term effects of the intervention on lifestyle and cognition over 11 years. METHOD: FINGER included 1259 individuals, aged 60-77 years with an increased risk of dementia. The participants were randomized to receive either regular health advice (control) or an intervention comprising of exercise training, dietary counselling, cognitive training, and management of vascular risk factors (intervention) lasting for 2 years. Participants were invited to follow-up visits approximately 5, 7 and 11 years after the baseline visit. Lifestyles were measured with an index comprising self-reported questions on diet, physical activity, cognitive and social activities, smoking and alcohol use. The participants were categorized into 4 groups based on their engagement in intervention activities: the control group; the intervention group with low participation; the intervention group with intermediate participation; and the intervention group with high participation. Neuropsychological test battery composite score was applied to measure cognition. RESULT: The beneficial effect of intervention on lifestyles was sustained until 7 years after baseline (p = 0.005 for intervention vs. control at 7 years). The lifestyles were maintained better among older participants and those with high participation during the intervention period, compared with the control group throughout the entire 11 y period. Early drop-out from the study was linked to worse lifestyles. Overall, cognitive performance level increased until 2 years and declined thereafter. Individuals with high intervention engagement had better cognitive trajectories compared with the control group until 7 years (p = 0.003) and compared with those with low engagement until 11 years (p = 0.002). CONCLUSION: This study provides the first evidence that multidomain, lifestyle-based interventions lasting for 2 years can have beneficial effects on lifestyles and cognition even several years after the intervention. Especially participants who adhered well to the intervention had sustained benefits. These findings further support the implementation of such preventive activities.

Referenced In

The REAL Dementia Risk Factors Doctors Won't Tell You

Dr. Gil Carvalho of Nutrition Made Simple reviews the latest research on preventing and combatting dementia risk that he says have changed the way he thinks about the inevitability of dementia. The 2024 Lancet Commission report as mentioned by other users, provides 14 modifiable lifestyle factors that could prevent 45% of dementia cases, including 2 new factors that were added due to the recent weight of evidence: Vision Loss and Plaque buildup as measured by High LDL Cholesterol.

In addition to the Lancet report, he also reviews a two year Finnish landmark trial that gave high risk dementia individuals a targeted program to prevent cognitive decline. The intervention included a healthy diet, both cardio and weight lifting exercise, cognitive training exercises, regimented social activity, and measuring and managing health parameters through a nurse and doctor. The the intervention group saw cognitive performance improved by 25% versus the control group including 83% improvement in executive function and 150% increase in processing speed.

Even better, a follow on study found the effects lasted 7 years after the intervention if the lifestyle was maintained. And the groups that benefitted the most had the greatest genetic risk!

The biggest takeaway to understand was given by one of the overseeing researchers:

What is good for your heart is also good for your brain

-Professor Miia Kivipelto

This means that associated risks for heart disease and other CVD diseases are also risks for dementia. That means getting things like your blood pressure, blood sugar, and APOB checked and managed have the double impact of preventing dementia.

Dr Carvalho summarizes his personal list of things he does personally as his own checklist to combat dementia.

  1. Check blood pressure often - consistently high blood pressure overtime damages your blood vessels

  2. Regular Exercise - incorporate cardio and weight lifting regularly, 3 to 5 times a week

  3. Healthy Diet - especially monitoring diabetes and blood sugar risks

  4. Blood Work - get a lipid panel, measuring your LDL, APOB, and LP(A) which are signs of plaque buildup

  5. Hearing and Vision Check - even if you're young, hearing loss and vision loss have high association with dementia risk either due to additional cognitive strain or social isolation

  6. Cognitive Activity - keeping the mind healthy with continued learning and puzzles

  7. Social Activity - Social isolation adds to your personal stress which may triggers cortisol that damages your brain long term. Dr. Carvolho says that this is one of the beneficial and underutilized factors for preventing dementia.

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