Preventing Alzheimer's Disease: What is Known!

Can Cognitive Training Prevent Alzheimer's Disease?

Cognitive training involves structured activities designed to enhance memory, reasoning, and speed of processing. There is encouraging but inconclusive evidence that a specific, computer-based cognitive training may help delay or slow age-related cognitive decline. However, there is no evidence that it can prevent or delay Alzheimer's-related cognitive impairment.

Studies show that cognitive training can improve the type of cognition a person is trained in. For example, older adults who received 10 hours of practice designed to enhance their speed and accuracy in responding to pictures presented briefly on a computer screen ("speed of processing" training) got faster and better at this specific task and other tasks in which enhanced speed of processing is important. Similarly, older adults who received several hours of instruction on effective memory strategies showed improved memory when using those strategies. The important question is whether such training has long-term benefits or translates into improved performance on daily activities like driving and remembering to take medicine.

Some of the strongest evidence that this might be the case comes from the NIA-sponsored Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial. In this trial, healthy adults age 65 and older participated in 10 sessions of memory, reasoning, or speed-of-processing training with certified trainers during 5 to 6 weeks, with "booster sessions" made available to some participants 11 months and 3 years after initial training. The sessions improved participants' mental skills in the area in which they were trained (but not in other areas), and improvements persisted years after the training was completed. In addition, participants in all three groups reported that they could perform daily activities with greater independence as many as 10 years later, although there was no objective data to support this.

Findings from long-term observational studies—in which researchers observed behavior but did not influence or change it—also suggest that informal cognitively stimulating activities, such as reading or playing games, may lower risk of Alzheimer's-related cognitive impairment and dementia. For example, a study of nearly 2,000 cognitively normal adults 70 and older found that participating in games, crafts, computer use, and social activities for about 4 years was associated with a lower risk of MCI.

Scientists think that some of these activities may protect the brain by establishing "reserve," the brain's ability to operate effectively even when it is damaged or some brain function is disrupted. Another theory is that such activities may help the brain become more adaptable in some mental functions so it can compensate for declines in others. Scientists do not know if particular types of cognitive training—or elements of the training such as instruction or social interaction—work better than others, but many studies are ongoing.

Can Eating Certain Foods or Diets Prevent Alzheimer's Disease?

People often wonder if a certain diet or specific foods can help prevent Alzheimer's disease. The recent NASEM review of research did not find enough evidence to recommend a certain diet to prevent cognitive decline or Alzheimer's. However, certain diets and healthy eating patterns have been associated with cognitive benefits. Studies of diets, such as the Mediterranean diet and the MIND diet—a combination of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets—are underway. Learn more about what we know about diet and the prevention of Alzheimer's disease.

For more information, read What Do We Know About Diet and Alzheimer's Prevention?

Targets of Alzheimer's Disease Prevention Research

Researchers are exploring these and other interventions that may help prevent, delay, or slow Alzheimer's dementia or age-related cognitive decline. Other research targets include:

• New drugs to delay onset or slow disease progression
• Diabetes treatment
• Depression treatment
• Blood pressure- and lipid-lowering treatments
• Sleep interventions
• Social engagement
• Vitamins such as B12 plus folic acid supplements and D
• Combined physical and mental exercises

Be Cautious About Alzheimer's "Cures"

Because Alzheimer's disease is so devastating, some people are tempted by untried or unproven "cures." Check with your doctor before trying pills or any other treatment or supplement that promises to prevent Alzheimer's. These "treatments" might be unsafe, a waste of money, or both. They might even interfere with other medical treatments that have been prescribed.

What's the Bottom Line on Alzheimer's Prevention?

Alzheimer's disease is complex, and the best strategy to prevent or delay it may turn out to be a combination of measures. In the meantime, you can do many things that may keep your brain healthy and your body fit.

You also can help scientists learn more by volunteering to participate in research. Clinical trials and studies are looking for all kinds of people—healthy volunteers, cognitively normal participants with a family history of Alzheimer's, people with MCI, and people diagnosed with Alzheimer's disease or related dementia.

To find study sites near you, contact NIA's Alzheimer's and related Dementias Education and Referral (ADEAR) Center at 1-800-438-4380 or email the ADEAR CenterOr, visit NIA's clinical trials finder to search for trials and studies.

This article is from NIA- The National Institute on Aging

“The National Aging Institute's Web site (www.nia.nih.gov) is an institute of the NIH, a U.S. Federal Government agency that provides accurate, up-to-date information about aspects of aging research, information about clinical trials, educational materials and resources about aging for the general public, and information for researchers and health professionals.”