Little changes can all add up

Most experts in the field would agree that when it comes to optimising brain health, the earlier the better.

Another perhaps less optimistic way of framing this is that there are diminishing returns as brain health deteriorates.

This has led historically to a widely held view that when dementia – a syndrome of poor brain health – has set in, there is little you can do to help yourself.

Over the past decade, however, this nihilism has been challenged as more research is conducted.

A case in point is a recent study from the US conducted by well-respected physician and researcher Dean Ornish  as well as colleagues, and the findings are very encouraging.

The study involved 51 patients with mild cognitive impairment or early dementia, whose mean age was about 73.

They were split into two groups: one undergoing a fairly intensive lifestyle intervention and one having ‘usual care’ (a so-called control group which was asked not to change lifestyle) – both over a 20-week period.

The elements of the lifestyle intervention included a specific diet that focused on minimally processed  plant-based wholefoods, high in  complex carbohydrates (fruit, vegetables, whole grains, legumes, soy products, seeds and nuts) and low in harmful fats, sweeteners and refined carbs (white bread, pasta, pastries).

The meals and snacks were provided by the researchers so everyone was getting the same food. They were told not to consume other foods.

Exercise was another important ingredient, and participants were asked to do aerobic exercise (such as walking) for  at least 30 minutes per day, as well as  mild strength training exercises three times a week.

Then there was stress management, which involved relaxation techniques such as meditation, yoga and breathing exercise, as well as promotion of sleep.

Group support was also offered to participants and their spouses by way of an hour session three times a week, and they were given a handbook on memory exercises, which was used periodically during these sessions.

Finally, a number of supplements were used, including omega-3 fatty acids, curcumin, multivitamins and minerals, coenzyme Q10, vitamin C, vitamin B12, magnesium threonate, lion’s mane and  a probiotic.

So, what did the study show?

Well, those who had the active lifestyle interventions showed a statistically significant improvement in cognitive and daily function, as well as improvement in several so-called ‘biomarkers’ that are relevant to the severity of the  Alzheimer’s disease, including levels of amyloid in the blood.

The study is not without limitations, including that it involved only a small number of people and the fact that multiple different interventions were being studied at the same time – making it hard to know whether certain changes were better than others.

Nonetheless, the results provide  hope that even in the early stages of dementia, changes to lifestyle can make a positive difference.

Despite the recent development of medications that may modify  Alzheimer’s disease, we still do not have a cure, and the best we can do in general is slow the rate of decline.

Therefore, it is important and empowering to consider that paying more attention to how we live our lives may influence our experience of dementia.

I hope that further research is conducted to build upon this study.

Until then, there is little harm in incorporating the interventions used (though I would discuss the supplements with your doctor before committing to using them) whatever the state of your brain health.

I suspect the more of them you practise, the better off you’ll be.

 Kailas Roberts is a psychogeriatrician and author of Mind Your Brain: The Essential Australian Guide to Dementia, now available at all good bookstores  and online. Visit yourbraininmind.com  or uqp.com.au