Preventing cognitive decline: a question (also) of lifestyle

Marta Cristofanini

The cognitive decline that accompanies the onset of dementia most often affects older people; however, this does not exclude the possibility of earlier manifestations of a condition that, at the moment, we must learn to live with. Prevention through a healthy and active lifestyle remains the most effective tool in the fight.

An old couple cycling together

Data at hand

Preventing cognitive decline is an important health goal. The WHO estimates that there are about 55 million people in the world affected by dementia, predicting that in the next thirty years this number will triple. This is expected to rise to 78 million in 2030, and by 2050 139 million people are predicted to be affected. About 60-70% of cases are affected by the most common form of dementia, Alzheimer’s disease.

In Italy, the Istituto Superiore di Sanità or ISS speaks of 1 million people affected, plus 900 thousand who are diagnosed with a risk condition, known as isolated cognitive impairment.

This is a global health emergency; it represents one of the primary causes of loss of independence in the elderly population, with highly disabling characteristics and attributable to a general cognitive impairment.

Symptoms of cognitive impairment

Dementia is basically a neurocognitive disorder, which can lead to various diseases, depending on the clinical picture of the individual. Early diagnosis is an effective tool to counteract and slow down its effects.

The causes that lead to the development of these different declinations of the disease are multiple while its manifestations are generally well recognizable.

All of them, in fact, concern memory and learning disorders. People who suffer from this disease show a disoriented and altered attitude compared to normal, so that the most basic activities can be compromised, depending on the severity. Language skills, judgment and abstract reasoning abilities are often altered; mood swings and personality changes may also occur.

The loss of autonomy disrupts the life not only of the affected person, but also that of all those who are part of it; continuous assistance in fact, as the symptoms worsen over time, becomes increasingly necessary.

What experts say on preventing cognitive disease

Unfortunately, with the knowledge we currently have, there is no definitive cure for cognitive decline. There are pharmacological treatments that can slow down the progression of the disease and alleviate its symptoms; in addition, there are non-pharmacological treatments that can provide valuable support.

In fact, there is an increasingly widespread culture of prevention with respect to the onset of the disease, culminating in 2019 with the publication by the WHO of some guidelines to decrease the risk of cognitive decline in the older population.

Eliminated some endogenous factors such as genetic predisposition and the co-presence of other diseases (such as diabetes and hypertension), there are some strategies related to a healthy lifestyle that can help reduce the risk of its onset, and not by little. Let’s look at some of them together!

“Prevention is Cure”: from words to actions

Safeguard yourself through a healthy lifestyle and mindful diet: how to put it into practice?

Here are the areas of intervention for effective prevention.

Two seniors spending time together

Cognitive stimulation

A trained brain is a healthier and more combative brain on average. Although there is no overwhelming evidence that cognitive stimulation protects against decline, some studies show an undeniable increase in neuronal density thanks to it; moreover, those who have spent many years studying or keeping their mind trained turn out to be more protected from the risk of developing dementia.

Physical exercise

Mens sana in corpore sano: you can’t have one without the other, so all that remains is to eradicate laziness; movement has undoubted neuroprotective effects and even just 30 minutes a day of exercise can make all the difference!

Aerobic exercise remains the most indicated, since it keeps in check other diseases that may be associated with or even promote the onset of neurocognitive disorders, such as hypertension, cardiovascular disease and diabetes.

In addition, exercise has a beneficial impact on mental health, reducing stress and helping to control any depressive states. The causes are not yet clear, but there seems to be a strong relationship between the two conditions. Indeed, those who suffer from depression are more likely to develop dementia.

Social activity

Loneliness has strong repercussions on all those aspects that should instead be kept under control, being risk factors; the prolonged lack of socialization is in fact correlated to depression, obesity, diabetes, hypertension, cancer and alcohol abuse.

Also for this reason, the recreational activities of day centers and clubs for the elderly are valuable: through a solid social and family network it is easier to resist cognitive decline.

Mediterranean diet and caloric restriction

Several researches carried out on the binomial diet/prevention confirm it: the Mediterranean diet has always been considered the healthiest one, since it includes the use of foods considered essential to counteract cognitive decline.

To be highlighted also the validity of the Asian diet, thanks to the use of substances such as green tea, curcumin and ginko-biloba, known for their anti-inflammatory and antioxidant effects.

The excellence of the Umberto Veronesi Foundation has always supported the importance of adopting a healthy lifestyle and a careful diet.

In fact, a diet low in simple sugars, salt, fat and animal protein protects the neuronal network. Moreover a half glass of red wine can only do good, since moderate consumption has been associated with increased longevity. So, long live toasts, but in moderation!

A diet against Alzheimer’s?

A concrete example is about the most common neurodegenerative disease, Alzheimer’s disease: in the past years have been done in-depth studies about which foods are more effective to fight it.

Important researches in this field have shown that the beta-amyloid protein seems to be one of the main responsible for the onset of the disease, being generally associated with memory problems. Aggregates of this protein constitute the senile plaques, whose presence has been found in the brains of people with Alzheimer’s disease.

To reduce the rate in the blood, experts recommend foods rich in polyunsaturated fatty acids such as omega-3. They are contained in fish, chicken meat, nuts (walnuts, almonds, hazelnuts) and, of course, in fruits and vegetables, especially salad.

However, a recent study has updated the research, showing that subjects diagnosed with mild cognitive disorder (a disorder that often precedes the actual onset of the disease) accumulate the typical amyloid plaques later, partially reversing the cause-effect relationship. These developments could lead to new treatment strategies.

An old couple relaxing and drinking wine

Practical help from AI

The use of advanced Artificial Intelligence techniques for diagnostic purposes can help in strengthening preventive activities.

Thanks to the use of Machine and Deep Learning algorithms trained on the vast amounts of data made available by fMRI scans, it is possible to make early, timely and effective diagnoses.

Beating the onset of symptoms (from mild to severe) is the best shield against cognitive decline. Knowing in time means drawing up a targeted and reasoned prevention plan; knowing in advance the type and speed of dementia development means proceeding with appropriate treatment right from the start, and this can make a decisive difference.

But digital and intelligent technology can help us not only for diagnostic purposes; the home as the primary place of care, especially in the post-covid era, is becoming the primary reference model.

The use of environmental devices, for example, can make the home and remote care safer: by monitoring a person’s behaviour, it is possible to signal risk situations or significant changes in his or her habits (of movement, rest, hydration, in terms of both time and space).

In short, investing in research can significantly improve the living and care conditions of those affected.

Taking care

The debate is wide and still ongoing, but in this context we were interested above all in highlighting the responsibility that each of us has towards ourselves and towards those we care about.

With a greater awareness of the advantages of a healthy and prevention-oriented lifestyle, we will be able to take better care of ourselves and others, especially in view of advancing age.

Prevention is the best cure, accompanied by constant observation of one’s state of health, to promptly notice any suspicious symptoms, and intervene. In time.

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