Alzheimer’s disease in brief
This neurodegenerative disease is characterized by a progressive impairment of memory, but also by disorders of language, perception, action, etc., which are at the origin of an ever greater loss of autonomy. It can also manifest itself in the early stages by psychiatric symptoms (anxiety, depression). It would result from the accumulation, in the brain, of toxic proteins (Tau and amyloid plaques), responsible for the progressive destruction of brain cells, connections between neurons and a reduction in brain volume. In Switzerland, around 150,000 people suffer from this disease, which also has a heavy impact on families. A figure probably very underestimated, according to experts. In case of concern for oneself or a loved one, it is recommended to consult as soon as possible.
Would keeping your brain healthy go through the plate? This is indicated by a recent American study published in the Journal of Alzheimer’s Disease. Chicago researchers looked at the diet Mind (read box). The latter takes up the principles of two other well-known and studied diets: the Mediterranean and DASH diets (Dietary Approaches to Stop Hypertension), a dietary approach to prevent high blood pressure.
Previous work had already shown that Mind was associated with slower cognitive decline and a lower risk of developing Alzheimer’s disease in older adults. In this new study, the researchers demonstrated better cognitive functioning in subjects who followed these nutritional precepts, whether or not they suffered from a neurodegenerative disease such as Alzheimer’s. For this, the scientists relied on data from a longitudinal study (Rush Memory and Aging Project). For each of the 560 cases studied, a “Mind” score was calculated on the basis of questionnaires relating to eating habits. This score has been related to the results of cognitive tests as well as to data from brain autopsies. “The strength of this study is that the researchers were able to see the brain damage caused by the disease after the participants died. Nevertheless, this is a retrospective and observational study which highlights an association between factors and not a causal link”, remarks Professor Gilles Allali, director of the Leenaards Memory Center at the Vaud University Hospital Center (CHUV) .
Act on different tables
The system of government Mind is good for the brain, however it cannot be enough on its own to preserve its memory and its cognitive functions, nuances Professor Paul Unschuld, chief physician of the Geriatric Psychiatry Department at the Geneva University Hospitals (HUG): “If we eat healthily, but smoke and otherwise do not engage in physical activity, a strong protective effect cannot be expected. It is essential to adopt a holistic approach that takes into account the different aspects of personal health and well-being.” Indeed, continues Professor Allali: “There is not just one way to counter Alzheimer’s. Today, we are moving towards multidimensional prevention programs, such as for the management of cardiovascular factors. This is all the more important in the context of an aging population, where the same person can suffer from several neurodegenerative diseases.” At a time when the miracle drug to cure or slow the progression of Alzheimer’s disease has not yet been found, prevention is crucial.
Because yes, it is possible to reduce your individual risk by tackling the various risk factors for the disease: diabetes, hypertension, excess cholesterol, overweight and obesity, physical inactivity, smoking, social isolation, anxiety, depression, mental disorders. hearing, low level of education, pollution. “A study of Lancet of 2020 shows that by combining different preventive measures, the risk of later dementia can be reduced by 40%, which is very significant,” says Professor Unschuld. Recent work also shows that a healthy lifestyle can significantly reduce the risk of developing Alzheimer’s disease, even in people with an increased genetic risk. Therefore, “to delay the appearance of the first symptoms, it is necessary to invest the asymptomatic phases of the disease by promoting a healthy and active lifestyle, from the age of 40-50 years”, says Professor Allali. Also, even when a diagnosis is made, the evolution curve of the disease can be modified by preventive behavioral measures.
At the HUG, for example, the Memory Center opens up its research to people over 50 without memory problems in order to screen for genetic, biological and lifestyle risk factors. “People who accumulate several will integrate risk reduction programs comprising different types of interventions”, specifies Professor Giovanni Frisoni, director of the HUG Memory Center.
Pending the implementation of large-scale prevention programs, a healthy lifestyle (without tobacco or excess alcohol), while being physically, socially and intellectually active (reading, memorization, reasoning), is recommended. Without forgetting to treat any diabetes, excess cholesterol, hypertension, overweight, but also his mental health.
The Mind diet consists of favoring certain foods and avoiding certain others as much as possible. “Without being dogmatic, it is a question of removing the main principles”, comments Professor Gilles Allali, director of the Leenaards Center for Memory at the Vaud University Hospital Center (CHUV). Fruits and vegetables are good for the brain, especially those with green leaves (spinach, cabbage, lettuce, etc.). On the fruit side, berries (blueberries, strawberries, raspberries), which promote neurogenesis, should be consumed without moderation. For snacks, instead of chips or pastries, opt for nuts. Instead of red meat, we put chicken and fish on the menu. Legumes (beans, lentils, soybeans) can also fill protein intake. Finally, preferably cook with extra-virgin olive oil (butter and margarine should be avoided). Too much alcohol is bad. A glass of wine with the meal is nevertheless tolerated. As for fatty foods (including cheese), fried or sweet, they are not recommended.
Published in Le Matin Dimanche on 07/10/2022 Dhana K, James BD, Agarwal P, et al. MIND Diet, Common Brain Pathologies, and Cognition in Community-Dwelling Older Adults. J Alzheimers Dis. 2021;83(2):683-692. doi:10.3233/JAD-210107  Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-446. Available at: https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext