Aerobic Exercise and Heart-Healthy Diet May Slow Development of Memory Problems

Journal of the American Geriatrics Society Research Summary

Cognitive impairment without dementia (CIND), or mild cognitive impairment, is a condition that affects your memory and may put you at risk for Alzheimer’s disease and dementia. According to the U.S. National Library for Medicine, signs of mild cognitive impairment may include frequently losing things, forgetting to go to events and appointments, and having more trouble coming up with words than other people of your age.

Sine experts believe that risk factors for heart disease also are risk factors for dementia and late-life cognitive decline and dementia. Recently, researchers examined two potential ways to slow the development of CIND based on what we know about preventing heart disease. They published the results of their study in the Journal of the American Geriatrics Society.

The research team had a theory: That the healthy lifestyle behaviors that slow the development of heart disease could reduce heart disease risk and also slow cognitive decline in older adults with CIND. These behaviors include regular exercise and a heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet.

In order to investigate their theory, the researchers designed a study titled “Exercise and NutritionaL Interventions for coGnitive and Cardiovascular HealTh EnhaNcement” (or ENLIGHTEN for short). The goal of the study was to examine the effects of aerobic exercise (sometimes known as “cardio” or “cardiovascular” exercise because it involves activities that increase the circulation of oxygen through the blood) and the DASH diet on cognitive functioning in older adults with CIND.

The ENLIGHTEN study examined 160 adults 55-years-old or older. The study participants were older adults who didn’t exercise and had memory problems, difficulty thinking, and making decisions. They also had at least one additional risk factor for heart disease, such as high blood pressure (also known as hypertension), high cholesterol, diabetes, or other chronic conditions.

Participants took a number of tests to measure their heart disease risk factors and cognitive ability. Researchers also assessed participants’ dietary habits and ability to perform daily activities. The participants were then randomly assigned to one of four groups: a group doing aerobic exercise alone, a group following the DASH diet alone, a group doing aerobic exercise and following the DASH diet combined, or a group receiving standard health education.

People in the exercise group did 35 minutes of moderate intensity aerobic exercise (including walking or stationary biking) three times per week for six months. They were supervised for three months and then exercised unsupervised at home for three months. Participants in the exercise group did not receive any counseling in the DASH diet and were encouraged to follow their usual diets for six months.

People in the DASH eating plan group received instruction about how to meet DASH guidelines in a series of weekly sessions for three months and then bi-weekly for the remaining three months. Participants in the DASH group were asked not to engage in regular exercise until the completion of the six-month study.

People in the exercise and DASH group followed the exercise and DASH programs for six months. The participants who were enrolled in the health education group received weekly educational phone calls for three months and then bi-weekly calls for three months. Phone calls were conducted by a health educator on health topics related to heart disease. Participants were asked to maintain their usual dietary and exercise habits for six months until they were re-evaluated.

At the conclusion of the six-month intervention and assessment, participants were free to engage in whatever activity and dietary habits they desired, with no restrictions.

The results of the research team’s study showed that exercise improved the participants’ ability to think, remember, and make decisions compared to non-exercisers, and that combining exercise with the DASH diet improved the ability to think, remember, and make decisions, compared to people who didn’t exercise or follow the diet—even though they didn’t perfectly follow the programs they were assigned to during the six-month interventions.

The researchers concluded that their findings are promising proof that improved ability to think, remember, and make decisions can last one year after completing a six-month exercise intervention. They suggested that further studies would be needed to learn more.

This summary is from “Longer Term Effects of Diet and Exercise on Neurocognition: One Year Follow-Up of the ENLIGHTEN Trial.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are: James A. Blumenthal, PhD; Patrick J. Smith, PhD; Stephanie Mabe, MS; Alan Hinderliter, MD; Kathleen Welsh-Bohmer, PhD; Jeffrey N. Browndyke, PhD; P. Murali Doraiswamy, MBBS, FRCP; Pao-Hwa Lin, PhD; William E. Kraus, MD; James R. Burke, MD; and Andrew Sherwood, PhD.

Have Sleep Apnea? Using Your CPAP Device Consistently May Slow Memory Loss

Journal of the American Geriatrics Society Research Summary

Mild cognitive impairment (MCI) refers to having problems with your memory and decision-making abilities. Usually, people with MCI experience few if any problems with performing their daily activities. Experts say that MCI could be a stage between normal aging and Alzheimer’s disease.

A growing number of studies suggest that obstructive sleep apnea (OSA), or “sleep-disordered breathing,” is associated with a higher risk for memory problems and for problems with thinking and making decisions. OSA is a common condition in older adults who have MCI. Symptoms include disturbed sleep due to reduced or momentarily stopped breathing at night.

If your healthcare practitioner diagnoses you with OSA, she may recommend treatment with continuous positive airway pressure (CPAP), a pressurized mask worn during sleep. CPAP treatment eliminates obstructive sleep apnea. However, to be effective, people must use the CPAP machine regularly for at least four hours per night. Only 30 to 60 percent of people who are prescribed CPAP therapy use the machine regularly as prescribed. Additionally, few studies have confirmed whether or not CPAP treatment delays cognitive decline. Now researchers in a new study examined whether using CPAP treatment had an effect on slowing cognitive decline. Their study was published in the Journal of the American Geriatrics Society. Continue reading

Helping Prevent Falls in Older Adults with Dementia

Journal of the American Geriatrics Society Research Summary

Annually, about one-third of all American adults aged 65 or older experience a fall. Falls are a major cause of medical problems, especially among those who have dementia. In fact, twice the number of older adults with dementia experience falls, compared to people without dementia.

What’s more, older adults with dementia or other cognitive problems who fall are five times more likely to be admitted to long-term care facilities, and are at higher risk for fractures, head injuries, and even death, compared to older adults without dementia who experience a fall.

Researchers have recently focused on the role that dementia and other cognitive problems may play in falling, in hopes of discovering ways to manage and prevent falls. They published their study in the Journal of the American Geriatrics Society. Continue reading

Can Special Training Improve Memory and Thinking Abilities in Older Adults with Mild Cognitive Impairment?

JAGS graphicJournal of the American Geriatrics Society Research Summary

Cognition is the ability to think and make decisions. Medication-free treatments that maintain cognitive health as we age are attracting the attention of medical experts. Maintaining the ability to think clearly and make decisions is crucial to older adults’ well-being and vitality.

Mild cognitive impairment (MCI) is a condition that affects people who are in the early stages of dementia or Alzheimer’s disease. People with MCI may have mild memory loss or other difficulties completing tasks that involve cognitive abilities. MCI may eventually develop into dementia or Alzheimer’s disease. Depression and anxiety also can accompany MCI. Having these conditions can increase the risk of mental decline as people age.

A new, first-of-its-kind study was published in the Journal of the American Geriatrics Society by scientists from research centers in Montreal and Quebec City, Canada. They designed a study to learn whether cognitive training, a medication-free treatment, could improve MCI. Studies show that activities that stimulate your brain, such as cognitive training, can protect against a decline in your mental abilities. Even older adults who have MCI can still learn and use new mental skills.

For their study, researchers recruited 145 older adults around the age of 72 from Canadian memory clinics. The participants had been diagnosed with MCI, and were assigned to one of three groups. Each group included four or five participants, and met for eight weekly sessions for 120 minutes.

The three groups were:

  • Cognitive training group. Members of this group participated in the MEMO program (MEMO stands for a French phrase that translates to “training method for optimal memory”). They received special training to improve their memory and attention span.
  • Psycho-social group. Participants in this group were encouraged to improve their general well-being. They learned to focus on the positive aspects of their lives and find ways to increase positive situations.
  • Control group. Participants had no contact with researchers and didn’t follow a program.

During the time the training sessions took place, 128 of the participants completed the project. After six months, 104 completed all the sessions they were assigned.

People in the MEMO group increased their memory scores by 35 to 40 percent, said Sylvie Belleville, PhD, a senior author of the study. “Most importantly, they maintained their scores over a six-month period.”

What’s more, the improvement was the largest for older adults with “delayed recall.” This means memory for words measured just 10 minutes after people have studied them. Because delayed memory is one of the earliest signs of Alzheimer’s disease, this was a key finding.

Those who participated in the MEMO group said they used the training they learned in their daily lives. The training gave them different ways to remember things. For example, they learned to use visual images to remember names of new people, and to use associations to remember shopping lists. These lessons allowed them to continue maintaining their memory improvements after the study ended.

The people in the psycho-social group and the control group didn’t experience memory benefits or improvement in their mood.

This summary is from “MEMO+: efficacy, durability and impact of cognitive training and psychosocial intervention in MCI.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Sylvie Belleville, PhD; Carol Hudon, PhD; Nathalie Bier, PhD; Catherine Brodeur, MD; Brigitte Gilbert, PhD; Sébastien Grenier, PhD; Marie-Christine Ouellet, PhD; Chantal Viscogliosi, PhD; and Serge Gauthier, MD.