Advertisement

Journal of Neural Transmission

, 114:1187 | Cite as

Non-pharmacologic prevention of Alzheimer’s disease: nutritional and life-style risk factors

  • M. Weih
  • J. Wiltfang
  • J. Kornhuber
Article

Summary

We conducted a review of cohort studies and interventional studies on nutritional and life-style risk factors and primary prevention of Alzheimer’s Disease. Studies were assessed by the Oxford classification. Interventional studies exist for mental training and vitamin supplementation. For alcohol, fat and fish intake, mediterranean diet, homocysteine, overweight/caloric intake, physical and social activity, hypercholesterolemia, diabetes and smoking, currently there is only evidence from cohort studies. Cognitive stimulation by mental training increases mental functions and can be recommended on the basis of positive interventional studies. Vitamin supplementation cannot prevent AD on the basis of interventional studies. Hyperlipidemia, hyperhomocysteinemia, diabetes and typical life-style factors (alcohol, smoking, obesity etc.) modestly increased AD risk, fish, mediterranean diet and unsaturated fat or n-3 fatty acids and social activity are protective in observational cohorts, but interventional studies are lacking.

Keywords: Dementia, cognitive decline, mild cognitive impairment 

References

  1. American Diabetes Association2006Standards of medical care in diabetes — 2006Diabetes Care29S4S42Google Scholar
  2. Anttila, T, Helkala, EL, Viitanen, M, Kareholt, I, Fratiglioni, L, Winblad, B, Soininen, H, Tuomilehto, J, Nissinen, A, Kivipelto, M 2004Alcohol drinking in middle age and subsequent risk of mild cognitive impairment and dementia in old age: a prospective population based studyBMJ329539CrossRefPubMedGoogle Scholar
  3. Arvanitakis, Z, Wilson, RS, Bienias, JL, Evans, DA, Bennett, DA 2004Diabetes mellitus and risk of Alzheimer disease and decline in cognitive functionArch Neurol61661666CrossRefPubMedGoogle Scholar
  4. Barberger-Gateau, P, Letenneur, L, Deschamps, V, Peres, K, Dartigues, JF, Renaud, S 2002Fish, meat, and risk of dementia: cohort studyBMJ325932933CrossRefPubMedGoogle Scholar
  5. Bonaa, KH, Njolstad, I, Ueland, PM, Schirmer, H, Tverdal, A, Steigen, T, Wang, H, Nordrehaug, JE, Arnesen, E, Rasmussen, K 2006Homocysteine lowering and cardiovascular events after acute myocardial infarctionN Engl J Med35415781588CrossRefPubMedGoogle Scholar
  6. Centre for Evidence-Based Medicine (2001) Oxford Centre for Evidence-based medicine levels of evidence. www.cebm.net/levels_of_evidence.asp, Aetiology/Harm level
  7. Engelhart, MJ, Geerlings, MI, Ruitenberg, A, van Swieten, JC, Hofman, A, Witteman, JC, Breteler, MM 2002aDiet and risk of dementia: does fat matter?: the Rotterdam studyNeurology5919151921CrossRefGoogle Scholar
  8. Engelhart, MJ, Geerlings, MI, Ruitenberg, A, van Swieten, JC, Hofman, A, Witteman, JC, Breteler, MM 2002bDietary intake of antioxidants and risk of Alzheimer diseaseJAMA28732233229CrossRefGoogle Scholar
  9. Fabrigoule, C, Letenneur, L, Dartigues, JF, Zarrouk, M, Commenges, D, Barberger-Gateau, P 1995Social and leisure activities and risk of dementia: a prospective longitudinal studyJ Am Geriatr Soc43485490PubMedGoogle Scholar
  10. Ferri, CP, Prince, M, Brayne, C, Brodaty, H, Fratiglioni, L, Ganguli, M, Hall, K, Hasegawa, K, Hendrie, H, Huang, Y, Jorm, A, Mathers, C, Menezes, PR, Rimmer, E, Scazufca, M 2005Global prevalence of dementia: a Delphi consensus studyLancet36621122117CrossRefPubMedGoogle Scholar
  11. Fratiglioni, L, Ahlbom, A, Viitanen, M, Winblad, B 1993Risk factors for late-onset Alzheimer’s disease: a population-based, case-control studyAnn Neurol33258266CrossRefPubMedGoogle Scholar
  12. Fratiglioni, L, Paillard-Borg, S, Winblad, B 2004An active and socially integrated lifestyle in late life might protect against dementiaLancet Neurol3343353CrossRefPubMedGoogle Scholar
  13. Fratiglioni, L, Wang, HX, Ericsson, K, Maytan, M, Winblad, B 2000Influence of social network on occurrence of dementia: a community-based longitudinal studyLancet35513151319CrossRefPubMedGoogle Scholar
  14. Gustafson, D, Rothenberg, E, Blennow, K, Steen, B, Skoog, I 2003An 18-year follow-up of overweight and risk of Alzheimer diseaseArch Intern Med16315241528CrossRefPubMedGoogle Scholar
  15. Hebert, LE, Scherr, PA, Bienias, JL, Bennett, DA, Evans, DA 2003Alzheimer disease in the US population: prevalence estimates using the 2000 censusArch Neurol6011191122CrossRefPubMedGoogle Scholar
  16. Kalmijn, S, Foley, D, White, L, Burchfiel, CM, Curb, JD, Petrovitch, H, Ross, GW, Havlik, RJ, Launer, LJ 2000Metabolic cardiovascular syndrome and risk of dementia in Japanese-American elderly men. The Honolulu-Asia aging studyArterioscler Thromb Vasc Biol2022552260PubMedGoogle Scholar
  17. Kalmijn, S, Launer, LJ, Ott, A, Witteman, JC, Hofman, A, Breteler, MM 1997Dietary fat intake and the risk of incident dementia in the Rotterdam studyAnn Neurol42776782CrossRefPubMedGoogle Scholar
  18. Kivipelto, M, Helkala, EL, Laakso, MP, Hanninen, T, Hallikainen, M, Alhainen, K, Iivonen, S, Mannermaa, A, Tuomilehto, J, Nissinen, A, Soininen, H 2002Apolipoprotein E epsilon4 allele, elevated midlife total cholesterol level, and high midlife systolic blood pressure are independent risk factors for late-life Alzheimer diseaseAnn Intern Med137149155PubMedGoogle Scholar
  19. Larson, EB, Wang, L, Bowen, JD, McCormick, WC, Teri, L, Crane, P, Kukull, W 2006Exercise is associated with reduced risk for incident dementia among persons 65 years of age and olderAnn Intern Med1447381PubMedGoogle Scholar
  20. Launer, LJ, Andersen, K, Dewey, ME, Letenneur, L, Ott, A, Amaducci, LA, Brayne, C, Copeland, JR, Dartigues, JF, Kragh-Sorensen, P, Lobo, A, Martinez-Lage, JM, Stijnen, T, Hofman, A 1999Rates and risk factors for dementia and Alzheimer’s disease: results from EURODEM pooled analyses. EURODEM Incidence Research Group and Work Groups. European Studies of DementiaNeurology527884PubMedGoogle Scholar
  21. Laurin, D, Verreault, R, Lindsay, J, MacPherson, K, Rockwood, K 2001Physical activity and risk of cognitive impairment and dementia in elderly personsArch Neurol58498504CrossRefPubMedGoogle Scholar
  22. Lee, PN 1994Smoking and Alzheimer’s disease: a review of the epidemiological evidenceNeuroepidemiology13131144CrossRefPubMedGoogle Scholar
  23. Leibson, CL, Rocca, WA, Hanson, VA, Cha, R, Kokmen, E, O’Brien, PC, Palumbo, PJ 1997Risk of dementia among persons with diabetes mellitus: a population-based cohort studyAm J Epidemiol145301308PubMedGoogle Scholar
  24. Lindsay, J, Laurin, D, Verreault, R, Hebert, R, Helliwell, B, Hill, GB, McDowell, I 2002Risk factors for Alzheimer’s disease: a prospective analysis from the Canadian Study of Health and AgingAm J Epidemiol156445453CrossRefPubMedGoogle Scholar
  25. Livingston, G, Johnston, K, Katona, C, Paton, J, Lyketsos, CG 2005Systematic review of psychological approaches to the management of neuropsychiatric symptoms of dementiaAm J Psychiatry16219962021CrossRefPubMedGoogle Scholar
  26. Lobo, A, Launer, LJ, Fratiglioni, L, Andersen, K, Di Carlo, A, Breteler, MM, Copeland, JR, Dartigues, JF, Jagger, C, Martinez-Lage, J, Soininen, H, Hofman, A 2000Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research GroupNeurology54S4S9PubMedGoogle Scholar
  27. Lonn, E, Yusuf, S, Arnold, MJ, Sheridan, P, Pogue, J, Micks, M, McQueen, MJ, Probstfield, J, Fodor, G, Held, C, Genest, J,Jr 2006Homocysteine lowering with folic acid and B vitamins in vascular diseaseN Engl J Med35415671577CrossRefPubMedGoogle Scholar
  28. Luchsinger, JA, Mayeux, R 2004Dietary factors and Alzheimer’s diseaseLancet Neurol3579587CrossRefPubMedGoogle Scholar
  29. Luchsinger, JA, Tang, MX, Shea, S, Mayeux, R 2002Caloric intake and the risk of Alzheimer diseaseArch Neurol5912581263CrossRefPubMedGoogle Scholar
  30. Luchsinger, JA, Tang, MX, Stern, Y, Shea, S, Mayeux, R 2001Diabetes mellitus and risk of Alzheimer’s disease and dementia with stroke in a multiethnic cohortAm J Epidemiol154635641CrossRefPubMedGoogle Scholar
  31. Luchsinger, JA, Tang, MX, Siddiqui, M, Shea, S, Mayeux, R 2004Alcohol intake and risk of dementiaJ Am Geriatr Soc52540546CrossRefPubMedGoogle Scholar
  32. MacKnight, C, Rockwood, K, Awalt, E, McDowell, I 2002Diabetes mellitus and the risk of dementia, Alzheimer’s disease and vascular cognitive impairment in the Canadian Study of Health and AgingDement Geriatr Cogn Disord147783CrossRefPubMedGoogle Scholar
  33. Malouf R, Areosa SA (2003) Vitamin B12 for cognition. Cochrane Database Syst Rev CD004326Google Scholar
  34. Malouf R, Grimley EJ (2003) The effect of vitamin B6 on cognition. Cochrane Database Syst Rev CD004393Google Scholar
  35. Malouf M, Grimley EJ, Areosa SA (2003) Folic acid with or without vitamin B12 for cognition and dementia. Cochrane Database Syst Rev CD004514Google Scholar
  36. Masaki, KH, Losonczy, KG, Izmirlian, G, Foley, DJ, Ross, GW, Petrovitch, H, Havlik, R, White, LR 2000Association of vitamin E and C supplement use with cognitive function and dementia in elderly menNeurology5412651272PubMedGoogle Scholar
  37. Merchant, C, Tang, MX, Albert, S, Manly, J, Stern, Y, Mayeux, R 1999The influence of smoking on the risk of Alzheimer’s diseaseNeurology5214081412PubMedGoogle Scholar
  38. Mielke, MM, Zandi, PP, Sjogren, M, Gustafson, D, Ostling, S, Steen, B, Skoog, I 2005High total cholesterol levels in late life associated with a reduced risk of dementiaNeurology6416891695CrossRefPubMedGoogle Scholar
  39. Moroney, JT, Tang, MX, Berglund, L, Small, S, Merchant, C, Bell, K, Stern, Y, Mayeux, R 1999Low-density lipoprotein cholesterol and the risk of dementia with strokeJAMA282254260CrossRefPubMedGoogle Scholar
  40. Morris, MC, Evans, DA, Bienias, JL, Tangney, CC, Bennett, DA, Aggarwal, N, Wilson, RS, Scherr, PA 2002Dietary intake of antioxidant nutrients and the risk of incident Alzheimer disease in a biracial community studyJAMA28732303237CrossRefPubMedGoogle Scholar
  41. Morris, MC, Evans, DA, Bienias, JL, Tangney, CC, Bennett, DA, Aggarwal, N, Schneider, J, Wilson, RS 2003aDietary fats and the risk of incident Alzheimer diseaseArch Neurol60194200CrossRefGoogle Scholar
  42. Morris, MC, Evans, DA, Bienias, JL, Tangney, CC, Bennett, DA, Wilson, RS, Aggarwal, N, Schneider, J 2003bConsumption of fish and n-3 fatty acids and risk of incident Alzheimer diseaseArch Neurol60940946CrossRefGoogle Scholar
  43. Mukamal, KJ, Kuller, LH, Fitzpatrick, AL, Longstreth, WT,Jr, Mittleman, MA, Siscovick, DS 2003Prospective study of alcohol consumption and risk of dementia in older adultsJAMA1914051413CrossRefGoogle Scholar
  44. Notkola, IL, Sulkava, R, Pekkanen, J, Erkinjuntti, T, Ehnholm, C, Kivinen, P, Tuomilehto, J, Nissinen, A 1998Serum total cholesterol, apolipoprotein E epsilon 4 allele, and Alzheimer’s diseaseNeuroepidemiology171420CrossRefPubMedGoogle Scholar
  45. Orgogozo, JM, Dartigues, JF, Lafont, S, Letenneur, L, Commenges, D, Salamon, R, Renaud, S, Breteler, MB 1997Wine consumption and dementia in the elderly: a prospective community study in the Bordeaux areaRev Neurol (Paris)153185192Google Scholar
  46. Oswald, WD, Rupprecht, R, Gunzelmann, T, Tritt, K 1996The SIMA-project: effects of 1 year cognitive and psychomotor training on cognitive abilities of the elderlyBehav Brain Res786772CrossRefPubMedGoogle Scholar
  47. Ott, A, Slooter, AJ, Hofman, A, van Harskamp, F, Witteman, JC, van Broeckhoven, C, van Duijn, CM, Breteler, MM 1998Smoking and risk of dementia and Alzheimer’s disease in a population-based cohort study: The Rotterdam StudyLancet35118401843CrossRefPubMedGoogle Scholar
  48. Ott, A, Stolk, RP, van Harskamp, F, Pols, HA, Hofman, A, Breteler, MM 1999Diabetes mellitus and the risk of dementia: the Rotterdam studyNeurology5319371942PubMedGoogle Scholar
  49. Peila, R, Rodriguez, BL, Launer, LJ 2002Type 2 diabetes, APOE gene, and the risk for dementia and related pathologies: The Honolulu-Asia Aging StudyDiabetes5112561262CrossRefPubMedGoogle Scholar
  50. Petersen, RC, Stevens, JC, Ganguli, M, Tangalos, EG, Cummings, JL, DeKosky, ST 2001Practice parameter: early detection of dementia: mild cognitive impairment. Report of the Quality standards subcommittee of the American academy of neurologyNeurology5611331142PubMedGoogle Scholar
  51. Petersen, RC, Thomas, RG, Grundman, M, Bennett, D, Doody, R, Ferris, S, Galasko, D, Jin, S, Kaye, J, Levey, A, Pfeiffer, E, Sano, M, van Dyck, CH, Thal, LJ 2005Vitamin E and donepezil for the treatment of mild cognitive impairmentN Engl J Med35223792388CrossRefPubMedGoogle Scholar
  52. Podewils, LJ, Guallar, E, Kuller, LH, Fried, LP, Lopez, OL, Carlson, M, Lyketsos, CG 2005Physical activity, APOE Genotype, and dementia risk: findings from the cardiovascular health cognition studyAm J Epidemiol161639651CrossRefPubMedGoogle Scholar
  53. Reitz, C, Tang, MX, Luchsinger, J, Mayeux, R 2004Relation of plasma lipids to Alzheimer disease and vascular dementiaArch Neurol61705714CrossRefPubMedGoogle Scholar
  54. Romas, SN, Tang, MX, Berglund, L, Mayeux, R 1999APOE genotype, plasma lipids, lipoproteins, and AD in community elderlyNeurology53517521PubMedGoogle Scholar
  55. Ruitenberg, A, van Swieten, JC, Witteman, JC, Mehta, KM, van Duijn, CM, Hofman, A, Breteler, MM 2002Alcohol consumption and risk of dementia: the Rotterdam studyLancet359281286CrossRefPubMedGoogle Scholar
  56. Sano, M, Ernesto, C, Thomas, RG, Klauber, MR, Schafer, K, Grundman, M, Woodbury, P, Growdon, J, Cotman, CW, Pfeiffer, E, Schneider, LS, Thal, LJ 1997A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer’s disease. The Alzheimer’s disease cooperative studyN Engl J Med33612161222CrossRefPubMedGoogle Scholar
  57. Saunders, PA, Copeland, JR, Dewey, ME, Davidson, IA, McWilliam, C, Sharma, V, Sullivan, C 1991Heavy drinking as a risk factor for depression and dementia in elderly men. Findings from the Liverpool longitudinal community studyBr J Psychiatry159213216CrossRefPubMedGoogle Scholar
  58. Scarmeas, N, Levy, G, Tang, MX, Manly, J, Stern, Y 2001Influence of leisure activity on the incidence of Alzheimer’s diseaseNeurology5722362242PubMedGoogle Scholar
  59. Scarmeas, N, Stern, Y, Tang, MX, Mayeux, R, Luchsinger, JA 2006Mediterranean diet and risk for Alzheimer’s diseaseAnn Neurol59912921CrossRefPubMedGoogle Scholar
  60. Seshadri, S, Beiser, A, Selhub, J, Jacques, PF, Rosenberg, IH, D’Agostino, RB, Wilson, PW, Wolf, PA 2002Plasma homocysteine as a risk factor for dementia and Alzheimer’s diseaseN Engl J Med346476483CrossRefPubMedGoogle Scholar
  61. Tan, ZS, Seshadri, S, Beiser, A, Wilson, PW, Kiel, DP, Tocco, M, D’Agostino, RB, Wolf, PA 2003Plasma total cholesterol level as a risk factor for Alzheimer disease: the Framingham StudyArch Intern Med16310531057CrossRefPubMedGoogle Scholar
  62. Toole, JF, Malinow, MR, Chambless, LE, Spence, JD, Pettigrew, LC, Howard, VJ, Sides, EG, Wang, CH, Stampfer, M 2004Lowering homocysteine in patients with ischemic stroke to prevent recurrent stroke, myocardial infarction, and death: the Vitamin Intervention for Stroke Prevention (VISP) randomized controlled trialJAMA291565575CrossRefPubMedGoogle Scholar
  63. Truelsen, T, Thudium, D, Gronbaek, M 2002Amount and type of alcohol and risk of dementia: the Copenhagen City Heart StudyNeurology5913131319PubMedGoogle Scholar
  64. Verghese, J, Lipton, RB, Katz, MJ, Hall, CB, Derby, CA, Kuslansky, G, Ambrose, AF, Sliwinski, M, Buschke, H 2003Leisure activities and the risk of dementia in the elderlyN Engl J Med1925082516CrossRefGoogle Scholar
  65. Verhaeghen, P, Marcoen, A, Goossens, L 1992Improving memory performance in the aged through mnemonic training: a meta-analytic studyPsychol Aging7242251CrossRefPubMedGoogle Scholar
  66. Wang, HX, Wahlin, A, Basun, H, Fastbom, J, Winblad, B, Fratiglioni, L 2001Vitamin B(12) and folate in relation to the development of Alzheimer’s diseaseNeurology5611881194PubMedGoogle Scholar
  67. Whitmer, RA, Gunderson, EP, Barrett-Connor, E, Quesenberry, CP,Jr, Yaffe, K 2005Obesity in middle age and future risk of dementia: a 27 year longitudinal population based studyBMJ3301360CrossRefPubMedGoogle Scholar
  68. Wilson, RS, Bennett, DA, Bienias, JL, Aggarwal, NT, Mendes De Leon, CF, Morris, MC, Schneider, JA, Evans, DA 2002aCognitive activity and incident AD in a population-based sample of older personsNeurology5919101914Google Scholar
  69. Wilson, RS, Mendes De Leon, CF, Barnes, LL, Schneider, JA, Bienias, JL, Evans, DA, Bennett, DA 2002bParticipation in cognitively stimulating activities and risk of incident Alzheimer diseaseJAMA287742748CrossRefGoogle Scholar
  70. Xu, WL, Qiu, CX, Wahlin, A, Winblad, B, Fratiglioni, L 2004Diabetes mellitus and risk of dementia in the Kungsholmen project: a 6-year follow-up studyNeurology6311811186PubMedGoogle Scholar
  71. Yoshitake, T, Kiyohara, Y, Kato, I, Ohmura, T, Iwamoto, H, Nakayama, K, Ohmori, S, Nomiyama, K, Kawano, H, Ueda, K 1995Incidence and risk factors of vascular dementia and Alzheimer’s disease in a defined elderly Japanese population: the Hisayama studyNeurology4511611168PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • M. Weih
    • 1
  • J. Wiltfang
    • 1
  • J. Kornhuber
    • 1
  1. 1.Department of Psychiatry and PsychotherapyFriedrich-Alexander UniversityErlangenGermany

Personalised recommendations