Current evidence on diet, cognitive impairment and dementia.

The Scientific Advisory Committee on Nutrition (SACN) position statement on current evidence on diet, cognitive impairment and dementia.

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This position statement by SACN provides an overview of the currently available evidence on nutrition and cognitive impairment and dementia (including Alzheimer’s disease) in adults. It considers evidence relevant to the prevention – not the treatment – of cognitive impairment or dementia.

The position statement concludes that:

  • the evidence base in this area is very limited
  • there is no evidence that specific nutrients or food supplements affect the risk of cognitive impairment or dementia
  • there is some observational evidence that greater adherence to a Mediterranean dietary pattern may be associated with reduced risk of mild cognitive impairment and dementia

While there is no single Mediterranean diet, such diets tend to include higher intakes of vegetables, fruit, legumes, cereals, fish and monounsaturated fatty acids; lower intakes of saturated fat, dairy products and meat; and a moderate alcohol intake. Mediterranean type diets broadly align with current UK healthy eating recommendations as depicted in the Eatwell Guide (PHE, 2016).

Full document: SACN statement on diet, cognitive impairment and dementias

You can find more information about SACN online.

NHS Health Check: Dementia

A range of tools and resources on Dementia Risk Reduction

  • The NHS Health Check dementia leaflet has been developed to support the dementia information given to those aged 65-74 years of age during their appointment.  These leaflets are available to order free of charge in a variety of formats and languages through the Department of Health order line
  • NHS Health Check’s top tips draw on current evidence and aims to help inform local decisions on how the NHS Health Check programme is delivered.
  • The revised NHS Health Check 30 minute e-learning for practitioners to introduce the dementia risk reduction component, updated January 2018
  • A page providing links to Training tools and resourcesThese include:
    • 3 Videos-1) Dementia and the NHS Health Check; 2) Delivering the dementia component; 3) A walk through the dementia leaflet
    • A slide set on ‘Helping your brain to stay healthy’
    • NHS Health Check Dementia Component-Prompt sheet for Health Care Practitioners
    • References and statistics to support the dementia NHS Health Check slide deck
    • How to use the NHS Health Check dementia leaflet in your appointments

The video below highlights ways to reduce the risk of developing dementia:

 

Dementia prevention, intervention, and care

Livingston, G. et al. | Dementia prevention, intervention, and care | The Lancet , Volume 390 , Issue 10113 , 2673 – 2734

This article argues that there is a potential for better disease prevention and for care to offer more improvements to the lives of a growing number of people with dementia.

To reduce dementia incidence, article authors recommend active treatment of hypertension for all people over 45 without dementia. Furthermore, they estimate that interventions into such risk factors as childhood education, exercise, maintaining social engagement, reducing smoking, and management of hearing loss, depression, diabetes, and obesity might have the potential to delay or prevent a third of dementia cases.

Full paper available via The Lancet

 

Marriage may lower the risk of developing dementia

Marriage may help stave off dementia, study finds | Journal of Neurology Neurosurgery & Psychiatry

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Researchers combining the results of 15 studies including data on more than 800,000 participants have found  that lifelong singletons and widowers appear to have a heightened risk of developing dementia.

Analysis of the data showed that lifelong singletons were 42% more likely to develop dementia than those who were married, and widowers were 20% more likely to develop the condition. Part of this risk might be explained by poorer physical health among lifelong single people, suggest the researchers.  Marriage may help both partners to have healthier lifestyles, including exercising more, eating a healthy diet, and smoking and drinking less, all of which have been associated with lower risk of dementia. Couples may also have more opportunities for social engagement than single people – a factor that has been linked to better health and lower dementia risk, the researchers suggest.

Full reference: Sommerlad A, et al. | Marriage and risk of dementia: systematic review and meta-analysis of observational studies |  Journal of Neurology Neurosurgery & Psychiatry | published online 28 November 2017

Public Health Interventions for Decreasing Dementia Risk

Hankey, G. J.  | Public Health Interventions for Decreasing Dementia Risk | JAMA Neurol. Published online November 20, 2017. doi:10.1001

Dementia is projected to be the greatest global challenge for health and social care this century. Dementia is a neurocognitive syndrome specific to people with otherwise normal brain development, characterized by a decline in level of cognitive ability that compromises social functioning or activities of daily living. At present, it affects nearly 50 million people globally; the increasing life expectancy of the global population means dementia threatens to affect 75 million people by 2030 and 132 million by 2050, unless effective prevention strategies can be identified and implemented. Its impact on affected individuals, families, and caregivers, as well as the community and economy, is already substantial because of the lack of effective, disease course-modifying treatment.

This paper describes the current public health burden of dementia and the recent insights and ongoing research needs for effective, appropriate prevention.

Further detail at JAMA Network

Effectiveness of dementia risk reduction messaging in NHS health checks.

NHS health check 40-64 dementia pilot research findings | Alzheimer’s Society

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The NHS Health Check programme is a statutory public health intervention commissioned by all local authorities in England. It aims to improve the health and wellbeing of adults aged 40-74 years through the promotion of earlier awareness, assessment, and management of the major risks factors and conditions driving premature death, disability and health inequalities in England.

The overall aim of the research was to evaluate the pilot and assess the feasibility of extending the NHS Health Check for 40-64 year olds to include a dementia risk reduction component. Specific objectives of the research included first, to understand the impact of the NHS Health Check on an individual’s knowledge and awareness of dementia risk reduction and the impact of the intervention on individuals’ intention to change behaviour.

The second objective was to identify (where sample sizes allowed) whether any differences in the delivery of the intervention between pilot sites had any effect on individual’s awareness and understanding of dementia risk reduction.

The third objective was to understand professional awareness and confidence in promoting dementia risk reduction messages and to identify further training requirements, resources and support.

The final objective was to assess any implications for services and commissioners and provide PHE with advice on any further longer-term evaluation that will be required.

Full report here

 

Is use of the internet in midlife associated with lower dementia incidence?

Study suggests that use of internet by individuals aged 50 years or older is associated with a reduced risk of dementia

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Objectives: Dementia is expected to affect one million individuals in the United Kingdom by 2025; its prodromal phase may start decades before its clinical onset. The aim of this study is to investigate whether use of internet from 50 years of age is associated with a lower incidence of dementia over a ten-year follow-up.

Methods: We analysed data based on 8,238 dementia free (at baseline in 2002–2004) core participants from the English Longitudinal Study of Ageing. Information on baseline use of internet was obtained through questionnaires; dementia casesness was based on participant (or informant) reported physician diagnosed dementia or overall score on the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Cox proportional hazards regression analysis was used for examining the relationship between internet use and incident dementia.

Results: There were 301 (5.01%) incident dementia cases during the follow-up. After full multivariable adjustment for potential confounding factors, baseline internet use was associated with a 40% reduction in dementia risk assessed between 2006–2012 (HR = 0.60 CI: 0.42–0.85; p < 0.05).

Conclusion: This study suggests that use of internet by individuals aged 50 years or older is associated with a reduced risk of dementia. Additional studies are needed to better understand the potential causal mechanisms underlying this association.

Full reference: Eleonora d’Orsi, et al.  Is use of the internet in midlife associated with lower dementia incidence? Results from the English Longitudinal Study of Ageing
Aging and Mental Health |Published online: 10 Aug 2017

Dementia in older age: barriers to primary prevention and factors

Evidence review showing that changing some behaviours in midlife can reduce the chances of getting dementia in older age | PHE

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These documents help commissioners and researchers make decisions about prioritisation of primary prevention measures relevant to dementia.

This review, by the Personal Social Services Research Unit (PSSRU) at the London School of Economics and Political Science (2016), shows that there is evidence that the risk of dementia is increased by:

  • physical inactivity
  • current smoking
  • diabetes
  • hypertension in mid-life
  • obesity in mid-life and depression

It also shows that mental activity can reduce the risk of dementia.

To promote primary prevention of dementia, it is important to understand both the barriers to primary prevention and factors which facilitate primary prevention.

Read the full overview here

How physical exercise prevents dementia

Physical exercise seems beneficial in the prevention of cognitive impairment and dementia in old age, numerous studies have shown. Now researchers have explored in one of the first studies worldwide how exercise affects brain metabolism | ScienceDaily

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In order to further advance current state of knowledge on the positive influence of physical activity on the brain, gerontologists and sports physicians at Goethe University Frankfurt have examined the effects of regular exercise on brain metabolism and memory of 60 participants aged between 65 and 85 in a randomised controlled trial. Their conclusion: regular physical exercise not only enhances fitness but also has a positive impact on brain metabolism.

 

Daily crosswords linked to sharper brain in later life

Online trial finds that the more regularly people report doing word puzzles such as crosswords, the better their brain function in later life. |  Via ScienceDaily

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Image source: Jessica Whittle Photography – Flickr // CC BY-NC-ND 2.0

Experts at the University of Exeter Medical School and Kings College London analysed data from more than 17,000 healthy people aged 50 and over, submitted in an online trial.  The study, one of the largest of its kind, used tests from online cognitive test systems to assess core aspects of brain function. They found that the more regularly participants engaged with word puzzles, the better they performed on tasks assessing attention, reasoning and memory.

From their results, researchers calculate that people who engage in word puzzles have brain function equivalent to ten years younger than their age, on tests of grammatical reasoning speed and short term memory accuracy.

Read more at ScienceDaily