Skip to main navigation menu Skip to main content Skip to site footer

Review article: Biomedical intelligence

Vol. 147 No. 0910 (2017)

Use it or lose it! Cognitive activity as a protective factor for cognitive decline associated with Alzheimer’s disease

DOI
https://doi.org/10.4414/smw.2017.14407
Cite this as:
Swiss Med Wkly. 2017;147:w14407
Published
01.03.2017

Summary

Because of the worldwide aging of populations, Alzheimer’s disease and other dementias constitute a devastating experience for patients and families as well as a major social and economic burden for both healthcare systems and society. Multiple potentially modifiable cardiovascular and lifestyle risk factors have been associated with this disease. Thus, modifying these risk factors and identifying protective factors represent important strategies to prevent and delay disease onset and to decrease the social burden. Based on the cognitive reserve hypothesis, evidence from epidemiological studies shows that low education and cognitive inactivity constitute major risk factors for dementia. This indicates that a cognitively active lifestyle may protect against cognitive decline or delay the onset of dementia. We describe a newly developed preventive programme, based on this evidence, to stimulate and increase cognitive activity in older adults at risk for cognitive decline. This programme, called “BrainCoach”, includes the technique of “motivational interviewing” to foster behaviour change. If the planned feasibility study is successful, we propose to add BrainCoach as a module to the already existing “Health Coaching” programme, a Swiss preventive programme to address multiple risk factors in primary care.

References

  1. Alzheimer’s Disease International. World Alzheimer Report 2015. The Global Impact of Dementia. [Internet]. 2015. Available from: http://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf
  2. Satizabal CL Beiser AS Chouraki V Chêne G Dufouil C Seshadri S. Incidence of Dementia over Three Decades in the Framingham Heart Study. N Engl J Med. 2016;374(6):523–32. doi:.https://doi.org/10.1056/NEJMoa1504327
  3. Matthews FE Stephan BCM Robinson L Jagger C Barnes LE Arthur A Cognitive Function and Ageing Studies (CFAS) Collaboration. A two decade dementia incidence comparison from the Cognitive Function and Ageing Studies I and II. Nat Commun. 2016;7:11398. doi:.https://doi.org/10.1038/ncomms11398
  4. Alzheimervereinigung S. Zahlen und Fakten zur Demenz [Internet]. 2015. Available from: http://www.alz.ch/index.php/zahlen-zur-demenz.html
  5. Kraft E Marti M Werner S Sommer H. Cost of dementia in Switzerland. Swiss Med Wkly. 2010;140:w13093.
  6. McKhann GM Knopman DS Chertkow H Hyman BT Jack CR Jr Kawas CH The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011;7(3):263–9. doi:.https://doi.org/10.1016/j.jalz.2011.03.005
  7. Salmon DP. Neuropsychological features of mild cognitive impairment and preclinical Alzheimer’s disease. Curr Top Behav Neurosci. 2012;10:187–212.
  8. Braak H Braak E. Neuropathological stageing of Alzheimer-related changes. Acta Neuropathol. 1991;82(4):239–59. doi:.https://doi.org/10.1007/BF00308809
  9. Tiraboschi P Hansen LA Thal LJ Corey-Bloom J. The importance of neuritic plaques and tangles to the development and evolution of AD. Neurology. 2004;62(11):1984–9. doi:.https://doi.org/10.1212/01.WNL.0000129697.01779.0A
  10. Barnes DE Yaffe K. The projected effect of risk factor reduction on Alzheimer’s disease prevalence. Lancet Neurol. 2011;10(9):819–28. doi:.https://doi.org/10.1016/S1474-4422(11)70072-2
  11. Norton S Matthews FE Barnes DE Yaffe K Brayne C. Potential for primary prevention of Alzheimer’s disease: an analysis of population-based data. Lancet Neurol. 2014;13(8):788–94. doi:.https://doi.org/10.1016/S1474-4422(14)70136-X
  12. Reitz C Brayne C Mayeux R. Epidemiology of Alzheimer disease. Nat Rev Neurol. 2011;7(3):137–52. doi:.https://doi.org/10.1038/nrneurol.2011.2
  13. Xu W Tan L Wang H-F Jiang T Tan M-S Tan L Meta-analysis of modifiable risk factors for Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2015;86(12):1299–306.
  14. Braak H Braak E. Frequency of stages of Alzheimer-related lesions in different age categories. Neurobiol Aging. 1997;18(4):351–7. doi:.https://doi.org/10.1016/S0197-4580(97)00056-0
  15. Corder EH Saunders AM Strittmatter WJ Schmechel DE Gaskell PC Small GW Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer’s disease in late onset families. Science. 1993;261(5123):921–3. doi:.https://doi.org/10.1126/science.8346443
  16. Farrer LA Cupples LA Haines JL Hyman B Kukull WA Mayeux R APOE and Alzheimer Disease Meta Analysis Consortium. Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype and Alzheimer disease. A meta-analysis. JAMA. 1997;278(16):1349–56. doi:.https://doi.org/10.1001/jama.1997.03550160069041
  17. Fratiglioni L Paillard-Borg S Winblad B. An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurol. 2004;3(6):343–53. doi:.https://doi.org/10.1016/S1474-4422(04)00767-7
  18. Fratiglioni L Winblad B von Strauss E. Prevention of Alzheimer’s disease and dementia. Major findings from the Kungsholmen Project. Physiol Behav. 2007;92(1-2):98–104. doi:.https://doi.org/10.1016/j.physbeh.2007.05.059
  19. Mangialasche F, Xu W, Kivipelto M. Prevention of Alzheimer’s Disease: Intervention Studies. In: Zerr I, editor. Understanding Alzheimer’s Disease [Internet]. InTech; 2013 [cited 2015 Dec 21]. Available from: http://www.intechopen.com/books/understanding-alzheimer-s-disease/prevention-of-alzheimer-s-disease-intervention-studies
  20. Andrieu S Coley N Lovestone S Aisen PS Vellas B. Prevention of sporadic Alzheimer’s disease: lessons learned from clinical trials and future directions. Lancet Neurol. 2015;14(9):926–44. doi:.https://doi.org/10.1016/S1474-4422(15)00153-2
  21. Barnett J Bahar-Fuchs A Cherbuin N Herath P Anstey K. Interventions to prevent cognitive decline and dementia in adults without cognitive impairment: a systematic review. J Prev Alzheimers Dis. 2015;2:38–45. doi:.https://doi.org/10.14283/jpad.2015.36
  22. Dubois B Hampel H Feldman HH Scheltens P Aisen P Andrieu S Proceedings of the Meeting of the International Working Group (IWG) and the American Alzheimer’s Association on “The Preclinical State of AD”; July 23, 2015; Washington DC, USA. Preclinical Alzheimer’s disease: Definition, natural history, and diagnostic criteria. Alzheimers Dement. 2016;12(3):292–323. doi:.https://doi.org/10.1016/j.jalz.2016.02.002
  23. Alzheimer’s Disease International. World Alzheimer Report 2014. Dementia and risk reduction - An analysis of protective and modifiable factors. London: Alzheimer’s Disease International; 2014.
  24. Richard E Andrieu S Solomon A Mangialasche F Ahtiluoto S van Charante EPM Methodological challenges in designing dementia prevention trials - the European Dementia Prevention Initiative (EDPI). J Neurol Sci. 2012;322(1-2):64–70. doi:.https://doi.org/10.1016/j.jns.2012.06.012
  25. Solomon A Mangialasche F Richard E Andrieu S Bennett DA Breteler M Advances in the prevention of Alzheimer’s disease and dementia. J Intern Med. 2014;275(3):229–50. doi:.https://doi.org/10.1111/joim.12178
  26. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, DC: American Psychiatric Association Press; 2013.
  27. Biessels GJ. Capitalising on modifiable risk factors for Alzheimer’s disease. Lancet Neurol. 2014;13(8):752–3. doi:.https://doi.org/10.1016/S1474-4422(14)70154-1
  28. Morris MC Tangney CC Wang Y Sacks FM Bennett DA Aggarwal NT. MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimers Dement. 2015;11(9):1007–14. doi:.https://doi.org/10.1016/j.jalz.2014.11.009
  29. Scarmeas N Luchsinger JA Schupf N Brickman AM Cosentino S Tang MX Physical activity, diet, and risk of Alzheimer disease. JAMA. 2009;302(6):627–37. doi:.https://doi.org/10.1001/jama.2009.1144
  30. Scarmeas N Stern Y Tang M-X Mayeux R Luchsinger JA. Mediterranean diet and risk for Alzheimer’s disease. Ann Neurol. 2006;59(6):912–21. doi:.https://doi.org/10.1002/ana.20854
  31. Gillette-Guyonnet S Secher M Vellas B. Nutrition and neurodegeneration: epidemiological evidence and challenges for future research. Br J Clin Pharmacol. 2013;75(3):738–55. doi:.https://doi.org/10.1111/bcp.12058
  32. Canevelli M Lucchini F Quarata F Bruno G Cesari M. Nutrition and Dementia: Evidence for Preventive Approaches? Nutrients. 2016;8(3):144. doi:.https://doi.org/10.3390/nu8030144
  33. Hayes SM Alosco ML Hayes JP Cadden M Peterson KM Allsup K Physical Activity Is Positively Associated with Episodic Memory in Aging. J Int Neuropsychol Soc. 2015;21(10):780–90. doi:.https://doi.org/10.1017/S1355617715000910
  34. Lautenschlager NT Cox KL Flicker L Foster JK van Bockxmeer FM Xiao J Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. JAMA. 2008;300(9):1027–37. doi:.https://doi.org/10.1001/jama.300.9.1027
  35. Rockwood K Middleton L. Physical activity and the maintenance of cognitive function. Alzheimers Dement. 2007;3(2, Suppl):S38–44. doi:.https://doi.org/10.1016/j.jalz.2007.01.003
  36. Rovio S Kåreholt I Helkala E-L Viitanen M Winblad B Tuomilehto J Leisure-time physical activity at midlife and the risk of dementia and Alzheimer’s disease. Lancet Neurol. 2005;4(11):705–11. doi:.https://doi.org/10.1016/S1474-4422(05)70198-8
  37. Best JR Chiu BK Liang Hsu C Nagamatsu LS Liu-Ambrose T. Long-Term Effects of Resistance Exercise Training on Cognition and Brain Volume in Older Women: Results from a Randomized Controlled Trial. J Int Neuropsychol Soc. 2015;21(10):745–56. doi:.https://doi.org/10.1017/S1355617715000673
  38. Erickson KI Voss MW Prakash RS Basak C Szabo A Chaddock L Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci USA. 2011;108(7):3017–22. doi:.https://doi.org/10.1073/pnas.1015950108
  39. Neuner-Jehle S Schmid M Grüninger U. The “Health Coaching” programme: a new patient-centred and visually supported approach for health behaviour change in primary care. BMC Fam Pract. 2013;14(1):100. doi:.https://doi.org/10.1186/1471-2296-14-100
  40. Katzman R Terry R DeTeresa R Brown T Davies P Fuld P Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques. Ann Neurol. 1988;23(2):138–44. doi:.https://doi.org/10.1002/ana.410230206
  41. Andel R Vigen C Mack WJ Clark LJ Gatz M. The effect of education and occupational complexity on rate of cognitive decline in Alzheimer’s patients. J Int Neuropsychol Soc. 2006;12(1):147–52. doi:.https://doi.org/10.1017/S1355617706060206
  42. Scarmeas N Albert SM Manly JJ Stern Y. Education and rates of cognitive decline in incident Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2006;77(3):308–16. doi:.https://doi.org/10.1136/jnnp.2005.072306
  43. Stern Y. Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol. 2012;11(11):1006–12. doi:.https://doi.org/10.1016/S1474-4422(12)70191-6
  44. Langa KM Larson EB Crimmins EM Faul JD Levine DA Kabeto MU A comparison of the prevalence of dementia in the United States in 2000 and 2012. JAMA Intern Med. 2016 Nov 21. [Epub ahead of print] doi:10.1001/jamainternmed.2016.6807.https://doi.org/http://dx.doi.org.
  45. Stern Y. Cognitive reserve. Neuropsychologia. 2009;47(10):2015–28. doi:.https://doi.org/10.1016/j.neuropsychologia.2009.03.004
  46. Sattler C Toro P Schönknecht P Schröder J. Cognitive activity, education and socioeconomic status as preventive factors for mild cognitive impairment and Alzheimer’s disease. Psychiatry Res. 2012;196(1):90–5. doi:.https://doi.org/10.1016/j.psychres.2011.11.012
  47. Akbaraly TN Portet F Fustinoni S Dartigues J-F Artero S Rouaud O Leisure activities and the risk of dementia in the elderly: results from the Three-City Study. Neurology. 2009;73(11):854–61. doi:.https://doi.org/10.1212/WNL.0b013e3181b7849b
  48. Verghese J Lipton RB Katz MJ Hall CB Derby CA Kuslansky G Leisure activities and the risk of dementia in the elderly. N Engl J Med. 2003;348(25):2508–16. doi:.https://doi.org/10.1056/NEJMoa022252
  49. Lachman ME Agrigoroaei S Murphy C Tun PA. Frequent cognitive activity compensates for education differences in episodic memory. Am J Geriatr Psychiatry. 2010;18(1):4–10. doi:.https://doi.org/10.1097/JGP.0b013e3181ab8b62
  50. Reed BR Dowling M Tomaszewski Farias S Sonnen J Strauss M Schneider JA Cognitive activities during adulthood are more important than education in building reserve. J Int Neuropsychol Soc. 2011;17(4):615–24. doi:.https://doi.org/10.1017/S1355617711000014
  51. Brown J Cooper-Kuhn CM Kempermann G Van Praag H Winkler J Gage FH Enriched environment and physical activity stimulate hippocampal but not olfactory bulb neurogenesis. Eur J Neurosci. 2003;17(10):2042–6. doi:.https://doi.org/10.1046/j.1460-9568.2003.02647.x
  52. Kempermann G Kuhn HG Gage FH. More hippocampal neurons in adult mice living in an enriched environment. Nature. 1997;386(6624):493–5. doi:.https://doi.org/10.1038/386493a0
  53. Valenzuela MJ Sachdev P Wen W Chen X Brodaty H. Lifespan mental activity predicts diminished rate of hippocampal atrophy. PLoS One. 2008;3(7):e2598. doi:.https://doi.org/10.1371/journal.pone.0002598
  54. Belleville S Mellah S de Boysson C Demonet JF Bier B. The pattern and loci of training-induced brain changes in healthy older adults are predicted by the nature of the intervention. PLoS One. 2014;9(8):e102710. doi:.https://doi.org/10.1371/journal.pone.0102710
  55. Barrett KC Ashley R Strait DL Kraus N. Art and science: how musical training shapes the brain. Front Psychol. 2013;4:713. doi:.https://doi.org/10.3389/fpsyg.2013.00713
  56. Lazarov O Robinson J Tang Y-P Hairston IS Korade-Mirnics Z Lee VM-Y Environmental enrichment reduces Abeta levels and amyloid deposition in transgenic mice. Cell. 2005;120(5):701–13. doi:.https://doi.org/10.1016/j.cell.2005.01.015
  57. Martin M Clare L Altgassen AM Cameron MH Zehnder F. Cognition-based interventions for healthy older people and people with mild cognitive impairment. Cochrane Database Syst Rev. 2011;(1):CD006220.
  58. Bugos JA Perlstein WM McCrae CS Brophy TS Bedenbaugh PH. Individualized piano instruction enhances executive functioning and working memory in older adults. Aging Ment Health. 2007;11(4):464–71. doi:.https://doi.org/10.1080/13607860601086504
  59. Gaser C Schlaug G. Brain structures differ between musicians and non-musicians. J Neurosci. 2003;23(27):9240–5.
  60. Fotuhi M Do D Jack C. Modifiable factors that alter the size of the hippocampus with ageing. Nat Rev Neurol. 2012;8(4):189–202.
  61. Kivipelto M Ngandu T Laatikainen T Winblad B Soininen H Tuomilehto J. Risk score for the prediction of dementia risk in 20 years among middle aged people: a longitudinal, population-based study. Lancet Neurol. 2006;5(9):735–41. doi:.https://doi.org/10.1016/S1474-4422(06)70537-3
  62. Ngandu T Lehtisalo J Solomon A Levälahti E Ahtiluoto S Antikainen R A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385(9984):2255–63. doi:.https://doi.org/10.1016/S0140-6736(15)60461-5
  63. Ligthart SA van den Eerenbeemt KD Pols J van Bussel EF Richard E van Charante EPM. Perspectives of older people engaging in nurse-led cardiovascular prevention programmes: a qualitative study in primary care in the Netherlands. Br J Gen Pract. 2015;65(630):e41–8. doi:.https://doi.org/10.3399/bjgp15X683149
  64. Richard E Van den Heuvel E van Charante EPM Achthoven L Vermeulen M Bindels PJ Prevention of dementia by intensive vascular care (PreDIVA): a cluster-randomized trial in progress. Alzheimer Dis Assoc Disord. 2009;23(3):198–204. doi:.https://doi.org/10.1097/WAD.0b013e31819783a4
  65. Gillette-Guyonnet S Andrieu S Dantoine T Dartigues J-F Touchon J Vellas B MAPT Study Group. Commentary on “A roadmap for the prevention of dementia II. Leon Thal Symposium 2008.” The Multidomain Alzheimer Preventive Trial (MAPT): a new approach to the prevention of Alzheimer’s disease. Alzheimers Dement. 2009;5(2):114–21. doi:.https://doi.org/10.1016/j.jalz.2009.01.008
  66. Lilamand M Cesari M del Campo N Cantet C Soto M Ousset P-J MAPT Study Group. Brain Amyloid Deposition Is Associated With Lower Instrumental Activities of Daily Living Abilities in Older Adults. Results From the MAPT Study. J Gerontol A Biol Sci Med Sci. 2016;71(3):391–7. doi:.https://doi.org/10.1093/gerona/glv155
  67. Vellas B Carrie I Gillette-Guyonnet S Touchon J Dantoine T Dartigues JF MAPT Study: a multidomain approach for preventing Alzheimer’s disease: design and baseline data. J Prev Alzheimers Dis. 2014;1(1):13–22.
  68. Cornuz J Rodondi N Ospelt R Zoller M Durrer D Tschirky E EviPrev, ein Programm zu Prävention und Gesundheitsförderung in der Hausarztpraxis. Schweiz Ärztezeitung. 2010;91:60–3. Article in German.
  69. Cornuz J Auer R Neuner-Jehle S Humair J-P Jacot-Sadowski I Cardinaux R Schweizer Empfehlungen für den Check-up in der Arztpraxis. Swiss Med Forum. 2015;15(43):974–80. Article in German.
  70. Neuner-Jehle S Schmid M Grüninger U. Kurzberatung in der Arztpraxis zur Verbesserung des Gesundheitsverhaltens: Probleme und Lösungen. Praxis (Bern). 2014;103(5):271–7. Article in German. doi:.https://doi.org/10.1024/1661-8157/a001572
  71. Neuner-Jehle S Grüninger U Schmid M. Efficacy of a communication skill training fostering health promotion in primary care: a mixed method analysis. J Community Med Health Educ. 2016;6(2):1000413.
  72. Rollnick S, Miller W, Butler C. Motivational Interviewing in Health Care. New York: The Guilford Press; 2008.
  73. Söderlund LL Madson MB Rubak S Nilsen P. A systematic review of motivational interviewing training for general health care practitioners. Patient Educ Couns. 2011;84(1):16–26. doi:.https://doi.org/10.1016/j.pec.2010.06.025
  74. Ng JYY Ntoumanis N Thøgersen-Ntoumani C Deci EL Ryan RM Duda JL Self-Determination Theory Applied to Health Contexts: A Meta-Analysis. Perspect Psychol Sci. 2012;7(4):325–40. doi:.https://doi.org/10.1177/1745691612447309
  75. Patrick H, Resnicow K, Teixeira PJ, Williams GC. Communication skills to elicit physical activity behavior change: How to talk to the client. In Nigg CR (editor). ACSM’s Behavioral Aspects of Physical Activity and Exercise. Philadelphia: Lippincott Williams & Wilkins; 2013. pp 129–52).
  76. Teixeira PJ Silva MN Mata J Palmeira AL Markland D. Motivation, self-determination, and long-term weight control. Int J Behav Nutr Phys Act. 2012;9(1):22. doi:.https://doi.org/10.1186/1479-5868-9-22

Most read articles by the same author(s)