Lifestyle Interventions and Alzheimer Disease

Alireza Atri, MD, PhD: One of the major things that we have hope for is prevention, and we’d rather not do it with a drug. Are there things, Lynn, that involve lifestyle? How may they maybe not change the disease but prevent the manifestations of disease and dementia? What are some things you can think of for mitigating the risk of developing dementia?

Lynn Shaughnessy, PsyD, ABPP/CN: This has been a heavy focus recently, which particularly gained focus after the FINGER study was conducted in Finland a few years ago suggesting this kind of multimodal intervention looking at exercise, overall diet, cognitive activity, and management of cerebrovascular risk factors. All these things kind of come together and can really help prevent, or possibly delay, the onset of dementia down the road. These modifiable risk factors are something that I certainly really focus on with the patients I see—things like making sure that they address these cerebrovascular risk factors such as hypertension, high cholesterol, or other things people can do in their daily life. Particularly in their midlife, addressing hearing loss. And getting extra education and exercise. These things are all really important.

Alireza Atri, MD, PhD: Great. All of this leads to what we tell our patients. What do you tell your patients about exercise and mitigating their cerebrovascular risk factors?

Mary A. Norman, MD: Absolutely. I think that’s 1 of the critical parts of my patient visits, annual wellness visits, and follow-up visits. It’s a vital sign now. “What are you doing to take care of yourself?” We spend a lot of time looking at healthy diet. The Mediterranean style diet has the best data in terms of helping improve cognitive health in middle age.

These are all lessons learned for myself as well. Importance of daily exercise and strength training, particularly for seniors. While it may not treat Alzheimer disease, it certainly helps mitigate falls and fractures and other things that will certainly worsen the disease. Socialization. I ask what they’re enjoying doing and use this as a spot for progression of disease too. Are they still doing the things they love? And barriers to care. “What is it that’s in your way, that is stopping you from doing these things that we know are helpful?”

Transcript edited for clarity.