From the Guidelines
Lifestyle interventions are a crucial component in the management of Alzheimer's dementia, and they should be implemented early and consistently to delay symptom onset or slow progression. The most recent and highest quality study, published in 2022 in the Journal of BioScience Trends 1, suggests that non-pharmacologic interventions, including cognitive training, physical exercise, and a Mediterranean diet, may have a positive impact on cognition and physical function.
Key Interventions
- Regular physical exercise, particularly aerobic exercise for 150 minutes weekly
- A Mediterranean or MIND diet rich in fruits, vegetables, whole grains, fish, and olive oil
- Cognitive stimulation through activities like puzzles and learning new skills
- Quality sleep (7-8 hours nightly)
- Stress management
- Social engagement
These interventions work by improving cardiovascular health, reducing inflammation, enhancing neuroplasticity, and promoting brain-derived neurotrophic factor production, as noted in a 2021 study published in the Journal of Internal Medicine 1. While lifestyle changes cannot cure or reverse established Alzheimer's, they may delay symptom onset by 2-5 years when implemented early and consistently.
Implementation
They are most effective as preventive measures or in early stages of cognitive decline, and should complement (not replace) medical treatments. For best results, these interventions should be implemented consistently as part of a comprehensive approach that includes proper medical management and regular cognitive assessments, as recommended in a 2022 review on policy practices, clinical guidelines, end-of-life care, and challenges along with an aging population 1.
From the Research
Effectiveness of Lifestyle Interventions for Alzheimer's Dementia
- Lifestyle interventions, including education, social engagement, cognitive stimulation, exercise, and healthy diet, have been shown to have significant effects in delaying and/or preventing Alzheimer's disease 2.
- A systematic review found that combination of early lifestyle interventions can decrease the risk of developing Alzheimer's disease 2.
- A digital application-supported intervention, which combines training in compensatory and healthy lifestyle behaviors, has been developed to promote healthy aging in persons at risk for Alzheimer's disease 3.
- The intervention aims to improve global cognition and everyday function, and will be evaluated through a randomized controlled trial 3.
Components of Lifestyle Interventions
- Physical activity interventions have been shown to improve functional abilities and quality of life among community-dwelling people living with dementia 4.
- Healthy eating and nutrition interventions may also improve nutritional status or quality of life among community-dwelling people living with dementia 4.
- The effectiveness of interventions may vary depending on the components, setting, program structure, mode of delivery, dosage, and participant characteristics 4.
Comparison with Pharmacological Interventions
- Memantine, a pharmacotherapeutic option for Alzheimer's disease, has been shown to improve cognitive functions and behavioral disturbances, both as monotherapy and in combination with donepezil 5, 6.
- However, lifestyle interventions may be a useful alternative or complement to pharmacological treatments, particularly in the early stages of the disease 2, 3.