Experts: Lifestyle changes can reduce cases of Alzheimer's, dementia by 40%

Worried about cognitive decline in your later years? Then it’s time to stop smoking and start exercising.

That’s according to Kristine Yaffe, director of the Center for Population Brain Health at the University of California San Francisco. She spoke about her research findings Wednesday as part of a Palm Beach panel of doctors presented by the Alzheimer’s Drug Discovery Foundation.

“At the end of the two years, we found that those people who got this personalized intervention in reducing their risk factors were much, much better in terms of the cognitive testing than the control group, on the order of difference of about 75% better,” Yaffe said.

Risk factors identified in Yaffe’s research included high blood pressure, diabetes, poor sleep schedule, smoking, lack of exercise and diet. In all, she and her team tracked 12 preexisting conditions or less-than-ideal habits among those who took part in the study.

“So, the premise … is that if we could change people’s risk factors … we could really move the needle at a population level,” she said to those in attendance, who numbered about 220.

Hosted at the Society of the Four Arts, Wednesday’s sold-out event was part one of the ADDF's three-part "Tomorrow's Breakthroughs Today: Scientific Symposium Series." Joining Yaffe on stage was moderator Howard Fillit, a geriatrician and ADDF's co-founder and chief science officer.

Palm Beach residents Ronald and Leonard Lauder — along with Fillit — created the Alzheimer’s Drug Discovery Foundation in 1988 following the passing of their mother, Estée Lauder, from Alzheimer's disease. The venture philanthropic organization aims to raise money to fund research into drugs that prevent, treat and cure the degenerative brain disorder.

Though Yaffe's research focused on patients who were about 70 years of age, the doctors highlighted the research's implications when considering the currently accepted science that Alzheimer’s likely develops decades before symptoms arise. 

“So if it takes that long, well, then there are lots of points you can intervene,” Yaffe said. “And I think midlife is a really important time where you can really try and change some of these behaviors.”  

Citing Yaffe's research, Fillit said there could be a 40% reduction in dementia cases, including Alzheimer's, if risk factors are curtailed.

However, they said one challenge in addressing risk factors is that they can often seem unrelated, like sleep.

"Nobody knew why we spend a third of our time asleep," Yaffe said.

She said it wasn't until the last 10 years that researchers started to understand the processes that occur while a person is resting, including the possibility that sleep allows the brain to clear out toxins.

“There’s been some work done in animal models, where if you don’t let the animal sleep or disrupt their sleep, you actually see a greater accumulation of tau and amyloid, the key proteins in Alzheimer’s disease,” Yaffe said.

One of the more surprising findings discussed was the correlation between vision loss and hearing loss and cognitive degeneration.

"There was a big trial that just finished six months ago, where they actually use hearing aids," Yaffe said. "It was a bit of a complicated answer, but at the end of the day, it looked like hearing aids really did decrease cognitive change, compared to having hearing loss and not using the hearing aids."

Yaffe also highlighted what she considered to be one of the most important concepts to understanding brain health: that the brain "continues to grow and change,” which can include change through positive factors such as exercise.

“The hippocampus is a very important part of the brain that’s involved in memory and learning,” she said. “And if you look at people before they exercise, and then after six months of exercising, the hippocampus actually grows, which is fantastic.”

Key to exercise's benefits, according to Yaffe, is the fact that it is believed to elicit the release of brain-derived neurotrophic factor, a protein in the brain and spinal cord. It is vital in the growth and survival of nerve cells in the eyes and brain, and it also helps to make cell-to-cell communication happen within the brain.

Fillit said that continued research into BDNF, which he described as "the most powerful neuroprotective factor in the body," has led the ADDF to fund medicinal research to its application.

“That drug is just starting to move toward the clinic now,” Fillit said.

He said beyond lifestyle changes, further research into the risk factors affecting Alzheimer’s disease can help lead to the creation of new medications.

One example he pointed to was diabetes and the injectable medication Ozempic, which works to lower blood sugar and increase the body's insulin production while also decreasing the amount of sugar made by the liver. It also slows the rate in which food passes through the gastrointestinal tract, leaving the user feeling full for longer periods.

Fillit said that as people get older, their brains lose the ability to process glucose, a major source of their energy.

"Insulin resistance in the brain can lead to neural degeneration, and it's very possible, I think, that Ozempic will turn out to be not only the first drug for obesity, and very effective for diabetes, but also possibly for Alzheimer's," he said.

Considering the wide range of comorbidities the drug may be able to address, Fillit called it possibly "the first FDA-approved anti-aging drug."

Nearing the conclusion of the lecture, both doctors praised the advancements made in biomarker research, including the creation of a blood test that measures a person's susceptibility to Alzheimer's.

"We'll be able to track it and be able to reassure people if it (the biomarker) is low or motivate people to find good treatment if it's high," Yaffe said.

Diego Diaz Lasa is a journalist at the Palm Beach Daily News, part of the USA TODAY Florida Network. You can reach him at dlasa@pbdailynews.com. Help support our journalism. Subscribe today.

This article originally appeared on Palm Beach Daily News: Panel: Lifestyle changes can cut cases of Alzheimer's, dementia by 40%