The Times

Chris Smyth Health Editor

As always Gerry Gajadharsingh writes a comment at the end of each newsletter/blog article to give his clinical perspective.

Daily exercise, diet and puzzles can markedly improve the brainpower of older people at risk of dementia; the first gold-standard trial has showed.

Older people who ate healthily and went to the gym over two years scored 25 per cent higher on cognitive tests than a control group and were twice as good at some mental tasks.

Researchers said the findings provided encouragement that older people could reduce their risk of the disease.

About 850,000 people in Britain have dementia, and a series of observational studies have suggested that exercising and eating fruit and vegetables can protect the brain as well as the heart. However, today’s study, published in The Lancet, is the first time this has been tested in a clinical trial.

Finnish researchers took 2,654 normal people aged 60-77 thought to be at risk of dementia because of factors such as weight and blood pressure. Half were given an exercise programme involving two gym sessions and three of running or swimming a week as well as help on cutting down on fat, sugar and salt and computer-based, brain-training puzzles.

The control group was given health advice and after two years, there was a clear difference in mental abilities between the two. The study will now continue to see if there are differences in dementia rates.

Miia Kivipelto of the Karolinska Institutet in Stockholm, who led the research, said: “Previous research has shown there are links between cognitive decline in older people and factors such as diet, heart health and fitness. However, our study is the first large randomised controlled trial to show that an intensive programme aimed at addressing these risk factors might be able to prevent cognitive decline in elderly people at risk of dementia.”

She said it was unclear whether the diet, exercise or brain training made the difference, but advised people to “try to find an activity that is both physically, mentally and socially active, such as dance”.

Doug Brown, director of research and development at the Alzheimer’s Society said: “The message that you can preserve brain health through healthy living, exercise and keeping mentally active is a very positive one.

“As shown in this trial, giving people a helping hand with their health in later life has a significant impact on brain functions including attention and thought-processing speed. However, we need to learn more about how these choices can protect the brain in the longer term before we know for sure how they can ward off dementia.”

Gerry Gajadharsingh writes:

Mild cognitive impairment (MCI) is a term used to describe a condition involving problems with cognitive function (mental abilities such as thinking, knowing and remembering). People with MCI often have difficulties with day-to-day memory, but such problems are not bad enough to be defined as dementia.

Memory loss and other cognitive problems can arise from many different causes. For some people diagnosed with MCI, memory loss will be the first sign of Alzheimer’s disease, the most common from of dementia.

Different studies suggest that between 5 and 20 per cent of older people have MCI of some form at any one time.

In studies carried out in memory clinics, 10-15 per cent of people with MCI went on to develop dementia in each year that the research results were followed up.

Medical conditions such as depression, diabetes and high blood pressure from middle age onwards are all clearly linked to a raised risk of developing dementia. It is therefore important that these are diagnosed and treated early. Other studies show that smoking, drinking too much; raised cholesterol levels and obesity also all raise the risk of dementia. Everyone, and especially someone with MCI, should reduce their risk by not smoking, drinking in moderation, eating a healthy, balanced diet and taking regular and appropriate exercise.

There is some evidence that exercising the mind as well as the body can also help reduce the risk of MCI and dementia. Intellectually stimulating leisure activities such as card games or crossword puzzles in mid-life may allow the brain to build up a ‘reserve capacity’ that can help prevent or delay the onset of dementia. Keeping socially active may also help to reduce risk.

There is mounting evidence that a significant factor in developing Alzheimer’s disease is linked to excess high glycaemic load carbohydrates in the diet. This provokes an elevated insulin response and it’s why many people are now coining the phrase of Type 111 diabetes for Alzheimer’s. 

Researchers tend to what to know “the” factor that causes problems. “If I eat a banana will I become a banana”. “ If I eat eggs will I get high cholesterol”

In life it is not that simple. 

Epigenetics (functionally relevant changes to the genome) are helping to understand that our lifestyle can switch on and switch off certain genes and make us susceptible to different disease processes.

Realising that some exercise (not necessarily going to the gym), keeping the brain active and adopting a balanced varied diet (whatever that means to you) will minimize your risk of developing dementia. That’s the general stuff if you want to know more detail look through my website.