10 goals to reduce your risk of Alzheimer’s disease

According to a meta-analysis, 10 risk factors appear to have a major impact on the development of Alzheimer’s disease, many of which may be subject to preventive measures.

An analysis of 395 studies revealed 21 clinical evidence-based proposals to reduce the risk of Alzheimer’s disease, reported by Jin-Tai Yu, MS, PhD and colleagues at Fudan University in Shanghai, China.

The proposal identified 10 risk factors with strong evidence for Class 1 Level A, which Journal of Neurology, Neurosurgery & Psychiatry:

• Diabetes
• Hyperhomocysteinemia
• Inadequate BMI management
• Decrease in education
• High blood pressure in middle age
• Orthostatic hypotension
• Head injury
• Cognitive decline
• stress
• depression

Nine risk factors had weak evidence of class 1 level B: obesity in middle age, weight loss in later life, exercise, smoking, sleep, cerebrovascular disease, weakness, atrial fibrillation, vitamin C, and they Added. Two interventions with class III evidence were not recommended: estrogen replacement therapy and acetylcholinesterase inhibitors.

Evidence about the prevention of Alzheimer’s disease is difficult to interpret, “due to different study designs with different endpoints and credibility,” he said.

“We are working with an international research team that includes several well-known neurologists, geriatricians, psychiatrists, psychologists and epidemiologists to establish the first evidence-based guidelines for Alzheimer’s disease prevention. We have reviewed and analyzed all the current evidence to create,” he said. MedPage today.

“About two-thirds of these proposals address vascular risk factors and lifestyle, and it is important to maintain good vascular status and maintain a healthy lifestyle to prevent Alzheimer’s disease. We are strengthening sex.”

Dr. Keith Fargo, director of science programs, said, “Whether the modifiable risk factors develop cognitive decline or dysfunction with age, regardless of whether they are due to Alzheimer’s disease or other dementias. There is rapidly growing evidence to play an important role in the outreach of the Alzheimer’s Society in Chicago, which was not involved in the study.

“But it can be difficult to separate wheat from rice hulls,” Fargo said. MedPage today.. “The proposed interventions have not been shown to be perfect, but they can mitigate risk, but they cannot eliminate it altogether. Meta-analyses like these are among the most important factors. Avoid things that may not be so influential, as well as helping you become familiar with some.”

The Ultimate Gold Standard is a randomized controlled clinical trial that assesses whether lifestyle interventions targeting many risk factors can protect cognition in older adults who are at ongoing risk of decline. US POINTER Research, Fargo added.

In a review, Yu and co-workers looked at data from 243 observational prospective studies and 152 randomized controlled trials screened from electronic databases and related websites from the start to March 2019. A total of 104 modifiable risk factors and 11 interventions were included in the analysis.

Most studies (82%) recruited people without dementia at baseline, and 17% specifically limited the sample population to those with normal cognition.

The bias in observational studies stemmed primarily from generalizability, exhaustion, and misclassification. The trials were attributed to performance bias, incomplete outcome data, poor allocation hiding, and selective outcome reporting.

Findings are in line with other studies No beneficial effects of menopausal hormone therapy Regarding Alzheimer’s disease, noted Dr. Tomimicola at the University Hospital of Helsinki in Finland, who was not involved in the meta-analysis. “But various papers have shown that menopausal hormone therapy has beneficial effects on vascular diseases, including vascular dementia,” he said.

“In my view, this outlines the difference between Alzheimer’s disease and vascular dementia, but in many studies they were not clearly separated, and at very old age they could probably both. This is a challenge, because there is,” Mikkola said. MedPage today.. “It shows the importance of studying and understanding Alzheimer’s disease in more detail. We may have missed a window of opportunity when diagnosing Alzheimer’s disease.” “

The suggestion emerging from this meta-analysis is that individuals who are not demented but at high risk APOEε4 The researchers wrote who had a high polygenic score, a family history of dementia, or evidence of positive amyloid, and their primary care physician.

“Our research provides a sophisticated and contemporary study of evidence, and we need a higher quality to strengthen our evidence base to reveal more promising approaches to prevent Alzheimer’s disease. It suggests an urgent need for observational prospective studies and randomized controlled trials,” Yu said.

“Well-designed clinical trials are also needed to test the effects of some promising interventions on Alzheimer’s, including sleep improvement, smoking cessation, antidepressant management, and antidiabetic drugs,” he added.