Can an active lifestyle help prevent Alzheimer’s?

The closure of schools, libraries, gyms and extracurricular activities due to the Covid-19 pandemic has worried parents and teachers about the toll children are learning and developing. But children are not the only ones at risk. Adolescents need enrichment to build cognitive capacity, while adults, especially older people, need it to maintain cognitive capacity and prevent neurodegeneration. In particular, decades of research show that mental, physical and social stimulation is one of the possible ways to prevent Alzheimer’s disease.

Studies have compared the cognitive performance of mice living alone in empty cages with those living in large houses equipped with colorful Lego blocks for mental stimulation, running wheels for exercise and other mice for social engagement. When mice lived in rich environments, their brains underwent physical changes: more neurons were generated in the brain’s memory center, the hippocampus, and strong synaptic activity supported learning. Even mice that had their genomes altered to develop the equivalent of Alzheimer’s experienced increased brain activity and did better in maze tests they had done before.


Spiritual stimulation can take various forms, from higher education or work at a challenging job to reading a book, playing cards, or doing puzzles.

The human need for enrichment does not differ so much. For us, spiritual stimulation takes many forms, from higher education or work at a spiritually challenging job to reading a book, playing cards, or doing puzzles. Using our brain helps maintain and increase its sharpness. A classic study published in 2000 in the journal PNAS showed that London taxi drivers, who have to learn to navigate thousands of places in the city, show an enlargement in the brain region responsible for spatial navigation.

Similarly, studies have shown that people who regularly engage in spiritually stimulating activities can maintain their cognitive function and prevent the onset of Alzheimer’s. For example, in a study of one community in Chicago, older adults were scored with how much they participated in a mind-stimulating activity using a 5-point scale, 5 being the most and 1 the least. Four years later, those who scored higher were found to be less likely to develop Alzheimer’s. In fact, a one-point increase in activity score was associated with a 64% reduction in disease risk.

When it comes to physical exercise, cognitive researchers prefer aerobic exercises such as jogging and cycling over anaerobic exercises such as weightlifting. Aerobic exercise can pump our heart, increase blood flow to the brain, increase oxygen and nutrients, protect neurons from oxidative stress, and fight inflammation. An analysis of ten studies with 23,000 participants found that older physically active adults were 40% less likely to develop Alzheimer’s.

A man paints a landscape at a care home for Alzheimer’s patients in Germany, 2018.


Photo:

Peter Kneffel / picture alliance / Getty Images

In terms of social engagement, researchers emphasize two components: maintaining a substantial social network of family and friends and regularly participating in social activities such as clubs, religious services, or volunteering. Socialization involves talking, listening and relating to others, mobilizing various brain areas that also support memory and other cognitive activities. Social support also reduces stress, which in turn can improve cognitive function. Studies show that older adults who have a larger social network and participate in more social activities have less cognitive decline and a lower risk of dementia.

All of these findings come from observational studies that look at people’s existing lifestyle and cognitive health, as opposed to providing a ‘lifestyle treatment’ and then evaluating cognitive outcomes. The gold standard in modern medicine is randomized, blind, placebo-controlled trials, which are more quantifiable and objective, and few such trials have been done with lifestyle treatments for dementia and Alzheimer’s.

Those that exist have shown divergent results. A study published in the journal Applied Neuropsychology in 2003 found that while mental exercises can train people to do better with specific tasks such as recalling words from a list, the effect did not translate into general cognitive improvement. not. Clinical trials on social involvement are currently lacking.

One reason why the cognitive benefits of lifestyle enrichment have not been adequately studied is that non-pharmacological treatments such as physical exercise cannot be easily patented, so pharmaceutical companies do not want to invest. It is also difficult to use placebos. In drug trials, a similar sugar pill and a test drug are randomly assigned to participants, but there is no equivalent of a sugar pill for enrichment activities. Instead, the control group receives no intervention, a fact that cannot be easily hidden to prevent prejudice, or they also receive other interventions that may have the consequences of their own and uncomfortable results.

Furthermore, the benefits of enrichment activities may not propagate well in a laboratory environment. A study published in the journal Neurobiology of Disease in 2009 found that when transgenic Alzheimer’s mice are given a walking wheel and exercised of their own free will, they experience more cognitive benefits than when they sit on a motor-driven treadmill. become and let go. The researchers testified that “mental distress associated with forced running … mitigated the beneficial effects of voluntary exercise.” The same can be true for people: running on a treadmill in a lab can have other consequences than exercising at home.

The nature of enrichment activities is contrary to the philosophy of modern clinical trials. Clinical trials are about the isolation and purification of chemical treatments to determine their specific effects. But real enrichment activities involve several sources of stimulation: attending a math lecture or playing cards is mentally interesting, but it can also involve a great deal of social interaction. Dance and Tai Chi make our body move, but also require us to remember choreography.

In terms of cognitive benefits, what we do is less important than doing it: reading a book, traveling with friends, learning chess, joining the chorus – living your life as if someone had left the gate open. Is not that what we should do anyway? If it ultimately helps our brain, it’s just the cherry on top.

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