Caring Currents

Is This Alzheimer's Prevention Advice Worth Changing Your Life Over?

Last updated: Jul 29, 2009

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Image by jenny downing (few and far between) used under the creative commons attribution license.

Were you among the thousands last week who raised your evening glass of wine in toast to the news that a daily tipple appears to protect older adults from dementia? Or maybe you were tempted to add vitamin D and the spice turmeric to your diet, with the goal of warding off Alzheimer's, a link suggested by a different new study.

Many an informed, health-conscious caregiver is spurred to action by the latest research. But past studies have also sung the praises of things like avoiding aluminum, the omega 3 fatty acid DHA, and ginko biloba in the fight against Alzheimer's, associations that later didn't seem to hold up.

So which lifestyle tweaks to adopt? That's what I asked Gary Small, director of the UCLA Center on Aging, a psychiatrist, neuroscientist, and prolific author (The Memory Bible, iBrain, The Longevity Bible). Small was just back from the International Conference on Alzheimer's Disease in Vienna, where many of the latest Alzheimer's news stories were announced. (But "no breakthroughs," he reports.)

Small says what to tell people eager for actionable advice is a question he struggles with often as an expert in the trenches. Three guidelines to keep in mind:

1. Remember that evidence isn't the same as proof.

"It's easy to overinterpret new results," Small says. A study that finds an association between drinking coffee and a lowered risk of Alzheimer's only means that someone with a past history of this particular behavior seems less likely to have a future outcome. "It doesn't prove cause and effect," he says.

Case in point: Last fall, Small published a study showing that midlifers familiar with searching the Internet triggered more areas of the brain involved in complex reasoning than those who read books. The resulting headlines, he said, read like, "Google Is Making Us Smarter." Some reports mentioned past research showing that using technology to keep the mind active can help stave off Alzheimer's.

"It may make you better able to find a movie but not stave off Alzheimer's at all. People need to separate out what's real and definite from what's possible," Small explains. "Yes, there's evidence suggesting that if you use your brain, you won't get dementia, but there's no proof. There's also evidence that if you learn memory techniques, you will improve your memory."

2. Consider the source, but also consider your own doctor's input.

Anybody can concoct a "study." Hallmarks of reliable research include: * Publication in a creditable medical journal, where it must meet rigorous standards and is reviewed by peers before being released. * Researchers affiliated with major research institutes and universities. * Randomized controlled trials, whose subjects are randomly assigned to a treatment group (who receive the therapy being tested) and a control group (who get a standard treatment or placebo). In a double-blind controlled trial, neither the patients nor the researchers know who's in which group. * Large sample size * Take place over a long period of time

Many of the avoid-Alzheimer's headlines du jour meet standards like these "“ but still may not make sense for you individually. For example, a report in the new [Archives of Internal Medicine] finds that [certain blood pressure medications] (http://www1.wfubmc.edu/News/NewsARticle.htm?ArticleID=2669), the so-called centrally-acting ACE inhibitors, seem to reduce the inflammation that contributes to the development of the disease, while other anti-hypertensives don't. Worth making a switch if you're really worried about dementia? That's a complex choice to make in concert with your doctor--which, of course, is why you're wise to follow all these promising-if-not-perfect studies.

Few findings are black-or-white, Small emphasizes; it's mostly shades of grey.

3. Realize that old news is sometimes the best news.

When it comes to avoiding dementia, worry less about finding a fresh magic bullet in the fine points (e.g. which spices to consume) and direct your best efforts to the bigger picture of what we know fuels good health, including brain health: "Get more physical exercise, lower stress, get mentally active," Small sums. When you hear research pointing to the same outcomes repeatedly, that's worth noting.

Much as we'd all like to hear that headline that will cure or prevent Alzheimer's, it's unlikely to be in tomorrow's paper, which leaves us reading the reports that will be there with both interest and common sense.