A meta-analysis (analysis of previous studies) has found that there is not strong evidence of major success for any one approach to preventing or treating mental decline, and specifically, Alzheimer’s dementia. This includes treatments using medicines, diet, exercise, vitamins, and cognitive training (doing a lot of thinking, puzzles, and the like). But, there were some encouraging conclusions too, and some that were less discouraging.
As reported in https://www.medpagetoday.com/neurology/dementia/69970?xid=NL_breakingnews_2017-12-18&eun=g449820d0r&pop=0&ba=1&utm_source=Sailthru&utm_medium=email&utm_campaign=LateShift_121817&utm_term=Late%20Shift , the very scientific Minnesota Evidence-based Practice Center (EPC) concludes that “Overall the results didn’t show much benefit…”.
There were positive results that were not statistically strong enough to meet the standards for recommending a new standard of care. It is possible that treatments were not done soon enough (early enough in life) to bring major benefits. It also is possible that treatments were not done long enough to yield solid gains. And of course, better drugs may be developed in the future.
One of the better results is this:”… the FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) trial showed that of 1,260 adults ages 60 to 77 years with CAIDE (Cardiovascular Risk Factors, Aging and Dementia), those who received an intervention with physical activity, diet, and cognitive training saw a 25% greater 2-year improvement in multi-domain neuropsychological test performance …”
Other than cognitive training, the best results in the studies are from the usual suspects: Diet and Exercise. And, probably for the usual reason: circulation. Lots of studies link mental performance and circulation of the blood to the brain.
An interesting new angle is not yet covered by the kind of studies that the EPC reviewed. Recent research indicates that the “glymphatic system” has “clean-up” cells which may remove or reduce the tangles of beta-amyloid that usually exist in the brains of Alzheimer’s patients. (These tangles are now considered the proximate cause of many symptoms of dementia; their origin and root causes remain under investigation.) The glymphatic system probably performs other maintenance tasks in the brain, as well. The glymphatic system’s activity may be linked to, and enabled by, the shrinkage of other cell types in the brain during sleep, which increases spaces in-between by up to sixty percent. The increased space may be necessary for proper “cleaning” to occur. It is very possible that getting enough sleep is a factor in avoiding dementia.