UCare generously supports MinnPost’s Second Opinion coverage; learn why.

Lifestyle habits may help slow mental decline in older adults, study finds

REUTERS/Lucy Nicholson
This study offers some of the best and most objective evidence to date that healthful lifestyle behaviors can have a positive effect on warding off certain types of age-related cognitive decline.

An intensive program that combines healthful eating, regular exercise, “brain training” and the medical management of risk factors associated with dementia (such as high blood pressure) may help slow down mental decline in older adults, according to a new study from Finland.

Yes, other research has linked each of those behaviors to better cognitive health in older people. But this is the first time that such lifestyle factors have been investigated in a large randomized controlled trial, according to the study’s authors. Such clinical trials are generally considered the “gold standard” for evaluating the effectiveness of a medical intervention.

Study details

The new study included 1,260 people, aged 60 to 77, from six different areas of Finland. At the start of the study, all the participants scored at or slightly below average for their age on standard cognitive performance tests. None, however, had been suspected of, or diagnosed with, dementia.

The participants were randomly assigned to either an intervention group or a control group. Those in the control group received standard health advice. Those in the intervention group, however, met regularly with physicians and other healthcare professionals.

During these meetings, they were given detailed guidance about diet, exercise and cognitive (“brain”) training. Their risk factors for heart disease and other chronic health problems were also assessed, and if a problem (such as high blood pressure) was identified, the participants were advised on what to do, including asking their family doctor about medications.

The diet advice generally focused on high amounts of fruits, vegetables and whole grains, as well as low-fat milk and lean meats. The participants were also encouraged to eat fish at least three times a week and to limit their alcohol consumption to no more than 5 percent of their daily calories and their sugar consumption to no more than 10 percent.  The recommendations were tailored to fit the needs and lifestyles of each individual participant. 

The exercise advice was two-fold: Participate in some kind of aerobic exercise (such as walking or biking) two to five times a week and in an anaerobic exercise program (progressive muscle strengthening) one to three times a week. Participants were provided guided training by physiotherapists at a gym.

For “brain training,” participants were given individual and group instruction on strategies for preserving and improving their cognitive skills and memory. Those strategies included regular home use of Web-based computer programs that randomized controlled trials had shown to be effective at building such skills.

Key findings

After two years, the participants had their cognitive skills re-tested. Those in the intervention group scored 25 percent higher, overall, than those in the control group. On certain parts of the test, the differences were even greater. Executive function — the high-level cognitive functions that make it possible to organize and prioritize thoughts and then make decisions — was 83 percent higher in the intervention group. Processing speed was 150 percent higher.  No difference was found between the two groups’ memory scores, however. 

The intervention group experienced no serious side effects, and none of them was hospitalized as a result of following the prescribed program. Thirty two (5 percent) of them did, however, developed exercise-related muscle pain, compared to none in the control group.

The participants in the intervention group reported a high rate of adherence to the program. For example, 100 percent of them said they followed at least some of the nutrition advice, and 90 percent said they did the same with advice about physical exercise.

Caveats

Like all studies — even randomized controlled clinical trials — this one has several limitations. The participants were all Finnish, so the findings may not be applicable elsewhere, including here in the United States. In addition, the four-part intervention program used in this study was very comprehensive and involved multiple health professionals. It’s not clear how practical — and affordable — such an intervention would be across much larger populations.

Another limitation of the study is that it wasn’t set up to determine how many of the individuals who were referred to their family physicians under the medical management part of the study received drug treatments for high blood pressure or other health issues. That factor could have affected the study’s results.

Finally, the study followed the participants for only two years, a relatively short time. The researchers do intend, however, to continue the study for at least another five years.

Still, this study offers some of the best and most objective evidence to date that healthful lifestyle behaviors can have a positive effect on warding off certain types of age-related cognitive decline.

The study was published online Thursday in The Lancet.

You can also learn about all our free newsletter options.

Comments (4)

  1. Submitted by Pat Berg on 03/13/2015 - 01:32 pm.

    Brain training

    So this conflicts with other findings that “brain training” has no measurable benefits?

    http://www.minnpost.com/second-opinion/2014/10/dont-fall-brain-game-hype-cognitive-experts-say

  2. Submitted by Connie Sullivan on 03/13/2015 - 03:51 pm.

    This kind of monitoring of seniors’ behaviors, from diet to exercise and pill-taking, seems very expensive. Therefore, hard to implement in any large-scale way. Especially in our country, where even ten minutes with one doctor costs up to $400.

    Also, why did they stop with people who are only 77 years or younger? Isn’t the one-out-of–three-will-get-Alzheimer’s or other dementia figure pertinent to those who live past 80?

  3. Submitted by beryl john-knudson on 03/14/2015 - 10:55 am.

    One small sidebar…

    As a close associate of one who had three heart valve excursions into his body and finally successful..one too small; second not too good a fit; third slid down over the second .. not a technical explanation, no….

    All’s fine now but….forgets a bit – anesthesia a heavy load to clear but pretty much okay now…however…as a working man he has clients and contractors and a word would escape him; experienced memory problem for a time But we found a temporary solution:

    Here’s the story…Brian Donnehy actor of much regard… was on Charlie Rose awhile back who spoke of another actor who never could remember his lines..so actor tells his fellow thespians…”If I forget my lines I’ll say “OH boy” and I’ll remember. If I say ‘oh boy’ twice give me more time etc.

    So I say to my ‘close associate’…”Try it next time on the phone or otherwise… as the pause that refreshes eh?”

    … and he says” but what if I’m up to five ‘oh-boys?”

    So I say…”not to worry by that time your ‘client won’t remember either and will start doing “oh boys too, hey?”

    Better times every day and funny how the mind works when hope comes calling, yes.

  4. Submitted by beryl john-knudson on 03/14/2015 - 12:21 pm.

    Do wonder, did the Finnish study include the real Finnish sauna?

    A spare thought dangling…what if other than randomized control studies, for the control part suggests, may suggest built in limitations I would say? And yes call it ignorance speaking from the sidewalk here I suppose but what if tests were done from a greater study/studies …and its’ effects on the human mice so alternatively viewed?

    Let’s say as a comparison study…a for instance; alternative studies were done on someone in or just let out of solitary – age not necessarily a factor – like a prison or someone forgotten in a nursing home. happens too often I betcha.

    Call it a ‘hostage situation’…as someone separated from familiar surrounds and voices that may comfort, as something valid or recognizable to remind them life is still a participatory noun?

    Studies often limit small truths rather than define a broader serious, viable clarification?

    We find old mice; men and women mice; we test them and let all old men/women mice actions supply answers or dominate all questions in ‘scientific study’. and they will perform as predicted?

    I say it’s the unexpected and the unconventional could provide more human answers – hard to corral to be sure?

    Call this a positive outlook as it’s prescribed format which would invalidate the study I suppose…well anyway, and even then arrive at a few inconsistent answers…no categories, to boxes, no boundaries of misunderstanding conceived in a lab or blind study, whatever.

    Just imagine a bad study but one worth exploring…demanding no preordained judgements on what the study achieves or a few consistent truths that is..way to go?

    At least it won’t be a blind study of or by either the mice or the lab mice whomever ?

    Now that I have raked a few ‘dead leaves’ out of my mind I will go back to raking the real ones…thanks for the fine ‘white space’ to explore my own cherished inconsistantsies..enjoy the day.

Leave a Reply