Preventing Alzheimers

The Search for AD Prevention Strategies continued...

The NIA is funding several clinical trials to determine whether treating different aspects of diabetes might affect AD development or progression. For example, the NIA is supporting clinical trials to evaluate the effect of a drug called rosiglitazone on changes in cognitive abilities in people with mild cognitive impairment (MCI, a condition in which a person has memory problems but not other AD problems; this condition often progresses to AD). Rosiglitazone makes cells more sensitive to insulin. The NIA is also supporting a study that is evaluating cognitive and brain structure changes using magnetic resonance imaging (MRI). This study, called ACCORD-MIND (Memory in Diabetes) has been added to the ongoing National Heart, Lung, and Blood Institute
ACCORD (Action to Control Cardiovascular Risk in Diabetes) clinical trial. ACCORD is evaluating a variety of approaches for managing glucose, blood pressure, and blood lipids.

Examining social engagement and intellectually stimulating activities. Findings from studies of animals, nursing home residents, and older people living in the community have suggested a link between social engagement and cognitive abilities. Having lots of friends and acquaintances and participating in many social
activities is associated with reduced cognitive decline and decreased risk of dementia in older adults. In the NIA-funded Chicago Health and Aging Project, a high level of social engagement was associated with a significant reduction in cognitive decline.

Studies also have shown that keeping the brain active is associated with reduced AD risk. In the Religious Orders Study, for example, investigators periodically asked more than 700 participants
to describe the amount of time they spent in seven activities that involve significant information processing. These activities included listening to the radio, reading newspapers, playing puzzle
games, and going to museums. After following the participants for 4 years, investigators found that the risk of developing AD was 47 percent lower, on average, for those who did the activities most frequently than for those who did them least frequently. Other studies have shown similar results. In addition, a growing body of research,
including other findings from the Religious Orders Study, suggests that, even in the presence of AD plaques, the more formal education a person has, the better his or her memory and learning ability.

Another NIA-funded study also supports the value of lifelong learning and mentally stimulating activity. In this study of healthy older people and people with possible or probable AD, scientists
found that during their early and middle adulthood, the healthy older people had engaged in more mentally stimulating activities and spent more hours doing them than did those who ultimately
developed AD.

The reasons for these findings aren't entirely clear, but scientists have come up with four possibilities:

• These activities may protect the brain in some way, perhaps by establishing a ¡°cognitive reserve.¡±
• Perhaps these activities help the brain become more adaptable and flexible in some areas of mental function so that it can compensate for declines in other areas.
• Less engagement with other people or in intellectually stimulating activities could be the result of very early effects of the
  disease rather than its cause.
• Perhaps people who engage in these activities have other lifestyle features that may protect them against developing AD.

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