With an Alzheimer's epidemic looming, scientists, health officials, policymakers and the public are asking if anything can slow down this disease. Some prevention trials in the U.S. will test drug interventions but what about lifestyle modifications, such as eating better or exercising more? Some data suggest that tweaks in our routine could help, but in 2010 a panel from the National Institutes of Health deemed that evidence insufficient to justify formal recommendations. Now, three large, randomized controlled trials in Europe are for the first time testing prospectively whether multifaceted lifestyle changes can prevent dementia in healthy, non-demented people. Key researchers from these initiatives have come together under the European Dementia Prevention Initiative (EDPI), a collaboration established to help them share data and design new studies.
Retrospective analyses of large populations suggest that mental stimulation, diet, exercise, and other healthy behaviors can benefit cognition. "We have quite a lot of epidemiological studies showing that these modifiable risk factors are related to dementia," said Miia Kivipelto, University of Eastern Finland, Kuopio. "Now we need to move from observation to action, and to show in a clinical trial that these lifestyle changes really can modify or postpone the cognitive impairments,"
One ongoing trial is PreDIVA (Prevention of Dementia by Intensive Vascular Care). Overseen by Willen van Gool from the University of Amsterdam, the Netherlands, it tests if intense treatment of cardiovascular risk factors, above and beyond standard care, prevents dementia or brain changes as seen by structural magnetic resonance imaging (MRI).