Cognitive decline may be prevented using interventions but may be inadequate says report

New research shows that there are several interventions that could help prevent cognitive decline. According to the latest report entitled “Preventing Cognitive Decline and Dementia: A Way Forward,” from the National Academies of Sciences, Engineering, and Medicine (NASEM), cognitive training, increase in physical activity, control of blood pressure adequately among those with a high blood pressure are all fruitful measures to reduce cognitive decline. However evidence to support these three interventions is encouraging but insufficient to justify a public health campaign focused on their adoption.

Alan I. Leshner, chair of the committee and CEO emeritus, American Association for the Advancement of Science, says that as of now the evidence that these measures work when applied to a wider community is sparse. With time more clinical trials would bring in more information. However general public should have access to these interventions and be made aware of them he said. This is so that they can make informed choices about which lifestyle changes to adapt in order to maintain health of the brain with age.

The National Institute on Aging (NIA) in association with AHRQ conducted another systematic review in 2015 to look at fresh evidence. National Academies was also asked to pitch in. The results were supposed to be used to make public health recommendations. The evidence was gathered from randomized controlled trials. These are considered the best forms of trials that can give most robust and unbiased results. From these trials three interventions stood out as effective in reducing cognitive decline and dementia. These were as follows;A similar report was published in 2010 by the Agency for Healthcare Research and Quality (AHRQ) which concluded that the recommendations regarding interventions to stop cognitive decline or dementia could not be made due to insufficient evidence. Over the last few years several other studies have also surfaced.

  • Cognitive training – this includes training programs that can help improve logic, problem solving skills, reasoning, processing speed, memory etc. these training modules help to slow the age related cognitive decline and dementia. These programs may or may not be administered using the computers.
  • Control of blood pressure among those who have high blood pressure or hypertension. This can help slow the progress of Alzheimer’s dementia and its clinical manifestations.
  • Increased physical activity – this can provide several health benefits including delay or slowing of age related cognitive decline.

Cognitive training for example, has been found to be effective in reducing cognitive decline in the short term only. Only one trial showed long term benefit of these training programs on memory and other parameters of cognitive functioning. The results from other trials were mixed and inconclusive the reviewers found.

Control of high blood pressure benefits the public in terms of preventing cardiovascular events such as heart attacks and stroke. This may be reason enough to justify control of blood pressure. As such the evidence regarding control of blood pressure and prevention of progress of Alzheimer’s related decline is mixed. However considering other benefits, the public may be made aware of this other brain health benefit says the report.

Physical activity too has been seen to show multiple benefits. It also leads to stroke prevention and maintains brain health. Although the evidence that physical activity directly prevents cognitive decline is inconclusive, increase in physical activity may be advised to the public the report says.

Further research to test if any of these interventions could do the public any good is necessary feel the experts at the committee. To check for actual efficacy, those persons who are at a greater risk of cognitive decline and underrepresented populations could be chosen for the studies. Long term interventions need to be studied where they have begun at younger ages. More trials could be included to provide an in depth knowledge. Public and community based studies are warranted feel the experts.

This study was funded by National Institute on Aging.

Comments

  1. George Kafantaris George Kafantaris United States says:

    Use it or lose it -- both body and mind.  Not complicated.

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