Can health and lifestyle changes protect the elderly from Alzheimer’s?
[Dec. 5, 2023: JD Shavit, The Brighter Side of News]
This study highlights the potential of personalized health and lifestyle changes in delaying or even preventing memory loss in older adults at higher risk of developing the disease. (CREDIT: Creative Commons)
In a groundbreaking study led by researchers from UC San Francisco and Kaiser Permanente Washington, new hope has emerged in the fight against Alzheimer's disease. As the pursuit of federal approval for Alzheimer's medications intensifies, this study highlights the potential of personalized health and lifestyle changes in delaying or even preventing memory loss in older adults at higher risk of developing the disease.
The results of this two-year study reveal promising insights into the role of personalized interventions in Alzheimer's prevention, offering a glimmer of hope for millions affected by this debilitating condition.
The SMARRT Study: A Personalized Approach to Alzheimer's Prevention
The study, known as the Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT), stands out in a field marred by contradictory findings regarding the effects of health and lifestyle interventions. What sets SMARRT apart is its tailored approach to each participant, providing personalized coaching that addresses specific risk factors associated with Alzheimer's disease.
Landmark study shows cognitive improvements when participants keep active, sleep better, are socially engaged, and control blood pressure and diabetes. (CREDIT: Creative Commons)
Dr. Kristine Yaffe, the vice chair of research in psychiatry at UCSF, who served as the lead investigator, emphasized the significance of this approach. She stated, "This is the first personalized intervention, focusing on multiple areas of cognition, in which risk factor targets are based on a participant's risk profile, preferences, and priorities, which we think may be more effective than a one-size-fits-all approach."
A Promising Discovery: Delaying Cognitive Decline
The study involved 172 participants, all between the ages of 70 and 89, who were enrolled in Kaiser Permanente Washington. These individuals shared a common trait - they each had at least two of the eight recognized risk factors for dementia: physical inactivity, uncontrolled hypertension, uncontrolled diabetes, poor sleep, the use of prescription medications associated with cognitive decline, high depressive symptoms, social isolation, and current smoking status.
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Half of the participants received personalized coaching sessions aimed at improving their health and lifestyle choices in areas that posed a higher risk of Alzheimer's, such as diabetes management and physical activity. The other half served as the control group and received educational materials every three months on dementia risk reduction.
The results of the study were remarkable. The group that received personalized coaching experienced a notable improvement in cognitive testing, amounting to a 74% enhancement over the control group. Furthermore, improvements were observed in the measurement of risk factors and quality of life, translating to approximately 145% and 8% improvements, respectively.
Addressing the Motivation for Change
Dr. Yaffe explained that the motivation for change among older adults was a driving force behind the study. A prior survey involving 600 older adults revealed their deep concern about Alzheimer's disease and related dementias. These individuals were eager to understand their personal risk factors and were highly motivated to make lifestyle changes that could lower their risk of developing dementia.
Dr. Kristine Yaffe, the vice chair of research in psychiatry at UCSF, who served as the lead investigator. (CREDIT: UCSF)
The personalized approach adopted in the SMARRT study resonated with these motivated individuals. It allowed participants to work closely with nurses and health coaches to select and address specific risk factors. These goals ranged from managing hypertension to incorporating more physical activity into their daily routines or enrolling in educational classes. The coaching sessions, initially conducted in person, transitioned to phone calls during the pandemic, ensuring continuity in support.
Resilience in the Face of the Pandemic
Remarkably, the positive outcomes of the SMARRT study remained intact despite the challenges posed by the COVID-19 pandemic. Social distancing measures and isolation had a significant impact on the cognitive, social, and mental health of older adults. However, the intervention group fared better during this period, exhibiting improved cognitive function and fewer risk factors. Dr. Eric B. Larson, the co-lead investigator, highlighted this resilience, stating, "We were pleasantly surprised that the positive results of the trial were not offset by the impact of the pandemic."
SMARRT trial study. (CREDIT: JAMA)
Unlike some expensive anti-amyloid medications currently under investigation, risk-reduction programs like the one in the SMARRT study offer a cost-effective and inclusive approach to Alzheimer's prevention. They do not necessitate strict eligibility criteria or extensive monitoring for side effects, making them more accessible and feasible for a broader population.
Dr. Yaffe envisioned a future where Alzheimer's disease management mirrors cardiovascular disease management, combining risk-reduction strategies with targeted drugs addressing disease mechanisms. This approach holds promise in not only delaying Alzheimer's but also potentially preventing it in those at risk.
As more research is conducted in this promising field, the potential to transform the landscape of Alzheimer's management becomes increasingly evident. With these groundbreaking findings, we move one step closer to a future where Alzheimer's disease is not merely treated but prevented, offering hope to millions around the world affected by this devastating condition.
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