Puzzles and brain games are great, but the key to reducing the risk for dementia appears to be "stimulating your brain in ways it isn't accustomed to, such as learning a new language or learning to play an instrument," says UCI Health neuropsychologist Hayley B. Kristinsson, PsyD.

While there is as yet no cure for Alzheimer’s disease, new research shows that healthy lifestyle actions taken now can add years to your life and decrease the risk of developing the progressive neurological disorder.

Age is the No. 1 risk factor for getting AD and symptoms such as dementia usually first appear after age 60. A new study published in the British Medical Journal evaluated more than 2,400 men and women ages 65 and older who participated in the Chicago Health and Aging Project (CHAP). It found that those who lived longer without developing AD had the following lifestyle factors in common:

• Ate a Mediterranean-style diet high in nutritious vegetables and fruits and lean protein
• Got at least 2 ½ hours of moderate to vigorous physical activity each week
• Engaged in brain-stimulating activities
• Did not smoke
• Consumed little or no alcohol

Not only were these factors associated with longer life expectancy in study participants, they lived a larger proportion of their remaining years without Alzheimer’s, a degenerative brain disorder that causes a gradual loss of memory, judgment and the ability to function.

With nearly 6 million Americans now living with AD, a number projected to triple by 2060, the study’s findings may help healthcare professionals and policy makers better plan for future health services, costs and needs.

Live Well asked UCI Health neuropsychologist Hayley B. Kristinsson, PsyD, who specializes in neurodegenerative disorders and the cognitive markers used to predict dementia, to discuss the groundbreaking study, the risk factors associated with AD and the best ways to prevent it.

How should we view this study?

This research is critically important. Many studies have explored increasingly longevity, but few have looked at the quality of those extra years and whether they include increased time living with AD.

This type of research is challenging in that it is observational and cannot establish causation. It does, however, further support using lifestyle interventions to try to prevent and treat Alzheimer’s disease.  

What are the risk factors for AD?

Age is the single greatest risk factor for developing Alzheimer’s disease and the risk of developing Alzheimer’s doubles about every five years after age 65. There are genetic risk factors including Down syndrome and a version of the APOE gene involved in how the body processes cholesterol and other fats. Other risk factors include cardiovascular disease, a prior history of traumatic brain injury, diabetes, obesity, smoking and hypertension.

But it is important to remember that these risk factors may increase or decrease risk by mechanisms other than by directly influencing the neurological changes associated with AD.

For example, smoking may increase the risk of cardiovascular disease, which leads to an increased risk of dementia. This does not mean that smoking directly impacts the plaques and tangles in the brain that are associated with AD.

Increased risk of developing AD also is associated with having fewer years of formal education and some researchers believe that education builds up “cognitive reserve” in the brain. Having fewer years of education is also associated with lower socioeconomic status, which affects access to nutritional food and healthcare.

Having a parent who has AD also increases a person’s risk for developing the disease. Other factors being studied include alcohol abuse, inadequate or poor-quality sleep, depression, environment toxins (i.e., air pollution) and the presence of severe illness.

Can regular exercise help reduce the risk of AD? 

Regular physical activity promotes healthy brain aging and can help with the management of cardiovascular risk factors, which may lower one’s risk of developing AD. Brain health also is strongly linked to heart health, so exercise that is good for the heart is also good for the brain. 

Can diet stave off or prevent AD? 

Diet alone cannot prevent the development of AD. However, a combination of the Mediterranean and DASH diets shows promise in managing certain risk factors that can contribute to the development of AD.

To improve brain health, it’s important to incorporate green, leafy vegetables, whole grains, berries, fish and nuts while cutting down on red meat. 

It is important to remember that reducing risk does not necessarily mean preventing AD. You can reduce your risk but still develop AD, but you may develop it later in life or be less likely to develop it with certain lifestyle modifications.  

Can cognitive activities help?

Cognitive exercise is important for maintaining good cognitive functioning throughout the lifespan, but research is mixed on the effectiveness of brain games in actually preventing dementias such as AD.

There are numerous workbooks, apps and websites that offer brain training exercises. I often tell patients that the key is choosing an activity you enjoy that is also mentally challenging, but not so challenging that it is discouraging. If the game or activity is too easy, you’re not really getting the benefit.

The key appears to be stimulating your brain in ways it isn't accustomed to, such as learning a new language or learning to play an instrument. 

The most important thing you can do is challenge your brain to work in new ways.