There is no question that cognition declines with age. Mild cognitive impairment (MCI) is a feature of an increasing number of people as they age past their mid-seventies on into their eighties. A proportion of these, not all, will head into the terrible world of dementia.
A variety of interventions is required
Some recent studies have suggested that slowing cognition can be reversed by:
- a programme of physical exercise
- improved diet
- medical reviews
- some generous use of sophisticated brain-training techniques.
Is this feasible?
A wide range of scientific studies over the past 20 years has emphasised that mental function declines more rapidly in people who are careless about their basic health management. The indolent, those who find brain activity an unwelcome diversion from TV watching, the obese, particularly those with heart disease and high blood pressure, all have been shown to have a more rapid decline in cognitive function. It is not just one factor like exercise or diet. It’s the whole shooting match: healthy habits, and minimising the risk of disease, particularly those associated with blood vessels which can predispose to mini strokes and even dementia.
An important study of mild cognitive decline in elderly people was conducted in Finland and published in 2015 as the FINGER study. The investigation included 1260 subjects aged 60 to 77 with some evidence of cognitive impairment. The intervention group adopted a regime of diet, exercise, cognitive training by computer, and cardiovascular risk-factors management. They followed a weight-loss programme for the overweight participants, adopted a Finnish nutrition diet (similar to the Mediterranean diet), a programme of planned aerobic activity with progressive muscle-strength training and exercises, psychologist-supervised mental exercises, using computer programs to investigate memory, shape recognition, thought processing, executive functioning and verbal testing.
A regular medical review ensured that the participants had optimal management of any underlying conditions. Participants were followed for over two years and compared with a control population.
Those following the active intervention showed cognitive performance 25 per cent higher than controls, and some mental functions were 100 per cent ahead of the non-intervention participants. This carefully managed and controlled investigation established firm evidence that a variety of interventions can slow down cognitive loss. The study is continuing for another seven years to answer the vexed question: does controlling cognition result in a delay of dementia?
Since the FINGER study was published in 2015 a number of academic groups around the world have planned or have initiated comparable programmes, to reinforce the message that mild cognitive impairment might be reversed to some extent. A Lancet-sponsored Commission on Dementia concluded that up to 30 per cent of dementia cases worldwide can be attributed to seven modifiable risk factors (diabetes, high blood pressure, obesity, physical inactivity, smoking, lower education, and depression).
From Ageing Well: How to Navigate Life’s Journey in Your Later Years by Dr Doug Wilson, published with permission of Calico Publishing.