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Lifestyle interventions for dementia: Ways to boost cognition by 25%
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Maintaining your mental capacity as you grow older is desired by everyone. The brain is an intricate organ that can be nourished and trained to maintain mental agility and memory. With 55 million people suffering from dementia globally [1] and one person developing dementia every 3 minutes in the UK [2], it is vital to work towards measures to prevent cognitive decline. In 2009, experts in Finland started a revolutionary study that is still ongoing. It is called the FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) trial and has led to impressive discoveries about lifestyle interventions that can preserve your brain health in old age.
The FINGER trial and why you should know about it.
Professor Miia Kivipelto, MD, PhD, who is an award-winning Professor in Clinical Geriatrics. She also serves as the Director for Research & Development of Theme Aging, Sweden. With over 300 publications under her name, she is the front lead of the FINGER trial [3]. This high-quality study was designed to learn about how improving different lifestyle areas can help prevent cognitive impairment. 10 years on, the study continues to provide results on the big impact everyday changes can have long term. The study focused on nutrition, physical activity, cognitive stimulation, and vascular and metabolic health [3]. The social aspect of health was emphasised by incorporation of group activities. Over a 1000 people aged 60-77 years, stayed throughout the 2-years trial, providing strong evidence about how you can protect and promote brain health through simple changes in your power. Compared to the control group, which received general health advice, those who adhered to lifestyle improvement had:
Here is how you can gain similar benefits by following 3 of the FINGER trial interventions: eating better, moving more and keeping your brain active.
Eat your way to a smarter brain.
The FINGER trial participants were recommended dietary guidelines based on Finnish recommendations that propose increased fruits and vegetables intake, substituting refined grains with whole grains products and opting for low-fat options in milk and meat products. They also recommended decreasing sugar intake to less than 50g/day, using unsaturated fats like vegetable oils instead of butter and increasing fish intake to at least 2 portions/week. Here are the detailed recommendations of the best foods to prevent dementia [4]:
|
Food components |
Recommendations |
|
Unhealthy fats (saturated and trans fats) |
<10% of total calories intake. Low fat options of animal fats |
|
Healthy fats (Polyunsaturated fats) |
5-15% of total calories intake (Rapeseed oil and fatty fish) |
|
High fibre intake |
Wholegrains, fruits and vegetables |
|
Sugar |
<10% of total calories |
|
Protein |
10-20% of total calories to ensure adequate intake |
|
Alcohol |
<5% of total calories to limit alcohol intake |
|
Fish and shellfish |
At least 2 portions/week |
|
Fruits and berries |
>200g/day |
|
Vegetables |
>200g/day |
A deeper look at these recommendations reflect that they form the basis of other diets like the Mediterranean diet and MIND diet which have been shown to improve brain function. For example, eating fish weekly and limiting meat intake to <100g/day is protective against brain ageing for 5 years [5]. High intake of berries helps boost intake of plant nutrients called flavonoids, which are known to improve memory by increasing blood flow to the brain [6]. The recommendations to decrease sugar and alcohol intake are due to their detrimental effects on brain health. Those who had more than 7 sugary drinks / week had almost 3 times higher chance of getting Alzheimer's [7]. Having 8 or more alcoholic drinks each week leads to faster decline in cognitive skills than non-drinkers [8], but the good news is once you stop alcohol intake, your brain can spring back into restoration mode within 2 weeks [9].
Exercise your body for a well-built brain.
Exercise is regarded as a form of therapy proven to provide cognitive benefits. Exercise increases blood flow and oxygen to the brain, producing more brain cells, strengthening the connections between different brain areas and the size of brain structures [10]. This is one area that the FINGER trial focused on. This was rightly done due to the massive amount of evidence supporting exercise’s brain benefits. The intervention comprised of the following training program [11]:
- Muscle strength training (1–3 times per week)
- Aerobic exercise (2–5 times per week), and
- Exercises to improve postural balance.
Exercises that build muscles help to release proteins called myokines. These help to protect brain cells and increase brain cells production [12][13]. A review of 29 studies found that aerobic exercise helps improve memory, attention, and processing speed [14]. The best part about exercising is that even if you start small, you can still reap benefits. Walking only 3800 steps per day can offer you a 25% lower dementia risk [15]. Most forms of exercise offer brain benefits, including just 10-60 minutes of cycling or running on the treadmill to boost your attention and memory [16].
Best cognitive exercises for a resilient brain.
The FINGER trail also included interventions to keep the brain active. The training sessions were designed to be for 10-15 mins, 3 times a week [11]. These sessions were aimed at exercising memory, mental speed, letters and number exercises on an individual and group basis. Keeping your brain active through cognitive exercises can increase the size of brain areas involved in memory and learning [17]. Keeping your brain active can be fun if you incorporate hobbies that are intellectually stimulating. Older adults who frequently enjoyed activities like knitting, socialising, reading, learning a new language, volunteering, playing board games, taking classes etc had an 8% lower risk of dementia for each activity performed [18]. When you pick up brain sharpening exercises that require mental effort, it can help build extensive brain connections [19] due to regular practice of those skills. Stronger brain connections are more resilient and help in old age.
The FINGER trial provides a growing wealth of evidence that making small changes in your lifestyle can massively improve your cognitive health in old age. Help your brain help you, by eating right, moving more and cognitively stimulating the brain. Give it the best chance to stay strong throughout life.
References
- Alzheimer's Disease International (2020). Dementia Statistics. [online] Alzheimer’s Disease International
- www.alzheimers.org.uk. (2023). Facts for the media about dementia | Alzheimer’s Society. [online]
- FINGERS Brain Health Institute. (n.d.). Our journey. [online]
- Lehtisalo, J. et al. (2017). Nutrient intake and dietary changes during a 2-year multi-domain lifestyle intervention among older adults: Secondary analysis of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) randomised controlled trial. British Journal of Nutrition, 118(4), 291-302.
- Gu, Y. et al. (2015). Mediterranean diet and brain structure in a multiethnic elderly cohort. Neurology, 85(20), 1744–1751.
- Medina dos Santos, N. et al. (2019). Current evidence on cognitive improvement and neuroprotection promoted by anthocyanins. Current Opinion in Food Science, [online] 26, pp.71–78.
- Miao, H. et al. (2021). Sugar in Beverage and the Risk of Incident Dementia, Alzheimer's Disease and Stroke: A Prospective Cohort Study. The journal of prevention of Alzheimer's disease, 8(2), 188–193.
- Heymann, D. et al. (2016). The Association Between Alcohol Use and the Progression of Alzheimer’s Disease. Current Alzheimer research, [online] 13(12), pp.1356–1362.
- van Eijk, J. et al. (2012). Rapid Partial Regeneration of Brain Volume During the First 14 Days of Abstinence from Alcohol. Alcoholism: Clinical and Experimental Research, 37(1), pp.67–74.
- Mahalakshmi, B., Maurya, N., Lee, S. D., & Bharath Kumar, V. (2020). Possible Neuroprotective Mechanisms of Physical Exercise in Neurodegeneration. International journal of molecular sciences, 21(16), 5895.
- Ngandu, T. et al. (2015). A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet (London, England), 385(9984), 2255–2263
- Scisciola, L. et al. (2021). Sarcopenia and Cognitive Function: Role of Myokines in Muscle Brain Cross-Talk. Life (Basel, Switzerland), 11(2), 173.
- Lee, B., Shin, M., Park, Y., Won, S. Y., & Cho, K. S. (2021). Physical Exercise-Induced Myokines in Neurodegenerative Diseases. International journal of molecular sciences, 22(11), 5795.
- Smith, P. J., Blumenthal, J. A., Hoffman, B. M., Cooper, H., Strauman, T. A., Welsh-Bohmer, K., Browndyke, J. N., & Sherwood, A. (2010). Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosomatic medicine, 72(3), 239–252.
- del Pozo Cruz, B. et al. (2022). Association of Daily Step Count and Intensity With Incident Dementia in 78 430 Adults Living in the UK. JAMA Neurology.
- Blomstrand, P. et al. (2020). Effects of a Single Exercise Workout on Memory and Learning Functions in Young Adults – a Systematic Review. Translational Sports Medicine.
- Cheng, S.-T. (2016). Cognitive Reserve and the Prevention of Dementia: the Role of Physical and Cognitive Activities. Current Psychiatry Reports, 18(9).
- Scarmeas, N. et al. (2001). Influence of leisure activity on the incidence of Alzheimer’s Disease. Neurology, 57(12), pp.2236–2242.
- Sigmundsson, H. et al. (2022). Motion, Relation, and Passion in Brain Physiological and Cognitive Aging. Brain Sciences, 12(9), p.1122.
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