Effectiveness of Lifestyle Interventions in Preventing Dementia

Research Overview

Researchers have explored whether lifestyle interventions can effectively prevent dementia in individuals genetically predisposed to Alzheimer’s disease. The study focuses on the apolipoprotein E (APOE) gene, particularly the APOE ε4 allele, which has been associated with increased risk of cardiovascular and neurological diseases, including dementia. Carriers of the APOE ε4 allele often exhibit reduced cortical gray matter in areas affected by Alzheimer’s and are more vulnerable to environmental risk factors.

The Role of Lifestyle Changes

Given the belief that overall health improvements can positively impact Alzheimer’s conditions, lifestyle modifications are considered a viable strategy to mitigate the effects of genetic susceptibility to dementia.

The FINGER Trial for Dementia

Study Design

The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) assessed the effectiveness of lifestyle modifications for individuals at risk of Alzheimer’s disease, comparing those with and without the APOE ε4 gene. This clinical trial involved participants aged 60 to 77 from the general population in Finland, specifically targeting those at risk for cardiovascular diseases and dementia. The findings were published in JAMA Neurology.

Intervention Process

Conducted over two years, the trial included 1,260 participants who demonstrated average or below-average cognitive levels and were able to safely engage in intervention practices. The intervention group received specialized cognitive training, dietary guidance, exercise regimens, and vascular management, while the control group only received general health advice. All participants were provided with written and oral information regarding healthy lifestyle choices, emphasizing the benefits of diet, physical activity, cognitive engagement, and social interactions for managing vascular risks and preventing disability. Genomic DNA tests were performed to identify the presence of APOE ε4, along with neuropsychological assessments to evaluate cognitive outcomes over the 24-month study period.

Findings of the Study

Impact of Lifestyle Interventions

The results indicated that cognitive levels improved among participants in the intervention groups, demonstrating that lifestyle modifications were effective for individuals both with and without the APOE ε4 gene. This suggests that even those genetically predisposed to dementia can experience benefits from targeted lifestyle changes. Notably, individuals with genetic susceptibility may have gained additional advantages, although further research is needed to validate these findings.

Significance of Early Interventions

The outcomes of this clinical trial highlight the potential for healthy lifestyle changes to positively influence cognition in older adults at risk of Alzheimer’s disease. The findings indicate promising effects even in individuals with APOE-related genetic susceptibility to dementia. However, additional studies are necessary to ascertain whether the benefits of lifestyle changes are more pronounced in APOE ε4 carriers. This investigation underscores the importance of early preventative strategies targeting multiple modifiable risk factors for those at risk of dementia.

Author and References

Written by Viola Lanier, PhD MSc.
Reference: Alina Solomon, MD, PhD; Heidi Turunen, BM; Tiia Ngandu, MD, PhD; Markku Peltonen, PhD; Esko Levälahti, MSc; Seppo Helisalmi, PhD; Riitta Antikainen, MD, PhD; Lars Bäckman, PhD; Tuomo Hänninen, PhD; Antti Jula, MD, PhD; Tiina Laatikainen, MD, PhD; Jenni Lehtisalo, MSc; Jaana Lindström, PhD; Teemu Paajanen, MA, Psy; Satu Pajala, PhD; Anna Stigsdotter-Neely, PhD; Tim. Effect of the Apolipoprotein E Genotype on Cognitive Change During a Multidomain Lifestyle Intervention: A Subgroup Analysis of a Randomized Clinical Trial. JAMA Neurology. January 2018.