Good for the brain
Can a change of lifestyle influence Alzheimer's disease? This is something researchers are aiming to discover in a study involving gym exercise, diet and memory training for people recently diagnosed with Alzheimer's. "It will be exciting to see whether this study will be able to benefit many people," says Ulrika Akenine, research nurse.
The main elements of the new study, which is called MIND-AD, are physical exercise, dietary advice, control of cardiovascular risk factors and cognitive training.
In practical terms, this means that the participants must exercise regularly at the gym twice a week under the guidance of a physiotherapist, meet a dietician and undergo computer-based cognitive training. They are given a schedule to follow and must also keep a food diary and an exercise diary. Memory training is led by a psychologist using a computer program that is adapted to the group and so produces measurable results. Muscle strength, maximal oxygen consumption, blood pressure and blood sugar levels, for example, will also be measured. The study involves people who have not yet developed dementia but are in an early phase of the illness.
The effects of the activities on the cognition of the participants are measured using neuropsychological tests of memory, understanding of context, attention and executive function. These are performed by a neuropsychologist.
"We are taking forward the research already carried out into lifestyle factors and Alzheimer's disease, one step at a time. We want to see if and how influencing lifestyle factors have any impact on the disease. The great thing is that we may be getting closer to offering patients something other than drugs," says Ulrika Akenine, research nurse, Theme Aging.
The research unit's care team within Theme Aging at Karolinska Huddinge who will be implementing the study comprises doctors, nurses, psychologists, a dietician and a physiotherapist.
The unit is engaged in several clinical studies, most of them relating to Alzheimer's drugs, in particular vaccination studies. These studies are often carried out in a collaboration between several countries.
"Now we are launching this study, which focuses on lifestyle factors, in which we will be making rapid use of the academic knowledge gained from the FINGER study to develop patient-based care and help prevent Alzheimer's disease."
FINGER is the world's first major study of multiple factors in combination relating to the impact of lifestyle on Alzheimer's dementia. The results from FINGER are unique in the world and show that a healthy lifestyle has a positive impact on memory problems. In the MIND-AD study, the results from FINGER have been adapted to patients who have already been diagnosed with Alzheimer's, but who do not yet have dementia, in order to see whether a change in lifestyle factors can influence the development of the disease. The idea then is that the results from current studies will be able to influence future recommendations about lifestyle factors provided to patients in the early stages of Alzheimer's.
"We are taking the positive results from FINGER further to this group. To begin with, we will monitor 90 participants in a pilot study in Sweden over a period of six months."
The MIND-AD pilot study will involve a total of 150 patients, with the participation of Finland, Germany and France, among others.
As a research nurse at the unit, Akenine works with both pharmaceutical trials and academic studies.
"With MIND-AD, we are examining lifestyle factors on many levels, medically through monitoring the vascular risk factors, cognitively, physically and with dietary advice. This is an overall approach, which is new and exciting. It is interesting to have the opportunity to conduct both pharmaceutical trials and studies involving lifestyle factors. In this particular study, I will be conducting qualitative research interviews with the participants involving open questions about everything from why they are taking part in the study to what experiences it provides."
MIND-AD is an EU study on the effects of the impact of lifestyle factors in the early stages of Alzheimer's disease (called prodromal AD based on biomarkers). The first phase involves 90 participants in Sweden and is being carried out within Theme Aging at Karolinska University Hospital and in collaboration with Karolinska Institutet. A total of 150 patients from four European countries are taking part. MIND-AD takes the results from the FINGER study further by testing the effects of influencing lifestyle factors such as exercise, diet, cognition and stimulation of social skills. MIND-AD is the name of the Multimodal Preventive Trial for Alzheimer's Disease.
The FINGER study is the first intervention study in the world to show that memory disorders can be prevented. The study shows that diet, physical exercise and cognitive training, as well as the monitoring of vascular risk factors such as high blood pressure, blood sugar and blood lipids, have a positive effect on the brain. The study has been published in The Lancet and is led by Miia Kivipelto, Professor at Karolinska Institutet and Thematic Head of Theme Aging at Karolinska University Hospital. FINGER stands for Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability.
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