By Brittany Mosser
We all change as we age. Changes related to aging are normal, and many of the causes of these changes are beyond our control. Likewise, many risk factors for Alzheimer’s disease and related dementias, including age and genetics, are beyond our control. However, we are learning more about how important lifestyle choices we control, including diet and exercise, may influence how we age and our risk of developing Alzheimer’s disease. People like Nancy Johnson, who are living with Alzheimer’s disease, can make lifestyles choices to slow the diseases progression and change their outlook after a diagnosis.
“After I was diagnosed I looked at pictures and realized I was gaining weight and didn’t even know it,” Nancy says. “It’s hard because if you’re at home with no work to do, the default is to start nibbling.” Nancy began integrating exercise and healthy eating habits into her everyday life; both are lifestyle changes we know to be beneficial to cognitive health. The unexpected benefit was the community of support created by exercising with neighbors and starting a community garden.
This summer, two articles published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association presented findings from a large research study out of Rush University suggesting that adherence to a specific heart healthy diet known as the MIND (Mediterranean-DASH Intervention for Neurocognitive Delay) diet may lower risk of developing Alzheimer’s (Morris et al., 2015a; Morris et al., 2015b). The MIND diet suggests consuming green leafy vegetables, nuts, berries, other vegetables, beans, whole grains, fish, poultry, olive oil and one glass of wine per day while limiting or avoiding red meat, butter, margarine, cheese, pastries, sweets and fried foods.
Strong evidence links Mediterranean Diets to reduced risk of heart disease (Estruch et al, 2013; Kastorini et al, 2011). Research has also found evidence that links poor cardiovascular health with increased risk of developing Alzheimer’s disease (de Bruijn & Ikram, 2014). And it tastes good too. Nancy planted a shared garden with her neighbors to eat more fresh fruits and vegetables and started to notice changes in what she chose to nibble on. “You become more addicted to the vegetables than junk food after a while,” she says.
One of the articles mentioned above suggests that adherence to the MIND diet slows cognitive decline associated with aging (Morris, 2015b). The other article suggests that strict adherence to the MIND diet reduced risk of developing Alzheimer’s disease by 53% (Morris, 2015a). Perhaps more exciting, the same study found that risk of developing Alzheimer’s disease dropped by 35% with just moderate adherence to the MIND diet (Morris, 2015a). These articles suggest that our choices about the food we eat might slow some of the normal cognitive changes associated with aging and may prevent Alzheimer’s disease, even without a strict adherence to a restrictive diet.
Nutrition is an important component of overall health and wellness, as are exercise and physical activity. Results from multiple studies were presented at the Alzheimer’s Association International Conference in Washington, D.C., (AAIC) this summer that added to an already strong body of evidence that physical activity may protect against development of Alzheimer’s disease and other dementias. Other findings presented at AAIC suggested that physical activity may improve symptoms for individuals living with memory loss, Alzheimer’s disease and other dementias –something Nancy has noted herself. She walks with a neighbor three to four times a week to keep her energized and help her sleep at night. Nancy’s healthy community has begun to grow, “It’s not just the physical part, its social too. Sometimes we have four or five people walking with us,” she says.
Maintaining overall physical health can give your cognitive health a boost. An article published just last month in Molecular Psychiatry suggests that body mass index (BMI) is associated with age of Alzheimer’s onset (Chuang et al., 2015). BMI is a measure of weight associated with height and can be a measure of body fat. Using longitudinal data, the study found that individuals with a higher BMI at age 50 were more likely to develop Alzheimer’s earlier than those with a lower BMI. The study also suggests that the age of Alzheimer’s onset moved forward about 6 months with each increase in BMI.
While none of these studies show direct cause and effect, each of them present a relationship between overall health in midlife and future development of Alzheimer’s disease. Together, they join a strong body of evidence suggesting that nutrition, exercise and wellness play a role in how we age and our risk of developing Alzheimer’s. We cannot choose our age or our genetics but, like Nancy, we can choose to eat right and get moving!
Brittany Mosser, MSW is the Helpline Coordinator & Care Consultant at the Washington State Chapter of the Alzheimer’s Association. In that role, she provides telephone based support, consultation, and resources to community members that contact the Alzheimer’s Association’s 24/7 Helpline at 1-800-272-3900.
Morris, M.C., Tangney, C.C., Wang, Y., Sacks, F.M., Bennett, D.A., & Aggarwal, N.T. (2015). MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 11:9, 1007 – 1014. doi: http://dx.doi.org/10.1016/j.jalz.2014.11.009
Morris, M.C., Tangney, C.C., Wang, Y., Sacks, F.M., Barnes, L.L., Bennett, D.A., & Aggarwal, N.T. (2015). MIND diet slows cognitive decline with aging. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 11:9, 1015 – 1022. doi: http://dx.doi.org/10.1016/j.jalz.2015.04.011
Estruch, R., Ros, E. Salas-Salvado, J., Covas, M.I., Corella, D., Aros, F., … Martinez-Gonzalez,M.A. (2013). Primary prevention of cardiovascular disease with a Mediterranean diet. New England Journal of Medicine, 368 (14), 1279-1290. DOI: 10.1056/NEJMoa1200303
Kastorini, C., Milionis, H.J., Esposito, K., Giugliano, D., Goudevenos, J.A., & Panagiotakos, D.B. (2011). The effect of Mediterranean diet on metabolic syndrome and its components. Journal of The American College of Cardiology, 57 (11), 1299-1313. DOI:10.1016/j.jacc.2010.09.073
Chaung, Y-F., An, Y., Bilgel, M., Wong, D.F., Troncoso, J.C., O’Brien, R.J…Thambisetty, M. (2015). Midlife adiposity predicts earlier onset of Alzheimer’s dementia, neuropathology and presymptomatic cerebral amyloid accumulation. Molecular Psychiatry, advance online publication, 1 September 2015. doi: 10.1038/mp.2015.129