Review Article

Prevention of Dementia: Focus on Lifestyle

Table 1

RCT and prospective cohort studies on the effects of physical activity, cognitive and social activity, and natural nutrition on cognition and or dementia risk in healthy or demented patients aged 70 years and older.

DiagnosisDesignNumberOutcomeIntervention/MeasureResults

PHYSICAL ACTIVITY

Baum et al. [24]Mild Dementia (mean MMSE 21/30)RCT20CognitionStrength training or recreational therapy 6 monthsImproved MMSE with physical activity
Van de Winkel et al. [25]Severe Dementia (mean MMSE 13/30)RCT15CognitionPhysical activity + music or conversation 3 monthsImproved MMSE with physical activity
Weuve et al. [33]Healthy womenProspective cohort Nerses’ Health Study766CognitionPhysical activity and walkingBetter cognitive function/less cognitive decline with physical activity and walking
Stevens and Killeen [26]Mild and Severe Dementia (MMSE 9-23/30)RCT75Clock drawing testPhysical activity or social visit or noneSlower cognitive decline with physical activity
Lautenschlager et al. [27]Subjective memory impairmentRCT308DementiaEducation and usual care versus physical activity for 6 mos(Modest) Cognitive improvement at 18 mos
Brown et al. [28]Healthy subjectsRCT134CognitionBalance versus general trainingCognitive improvement at 6 months
Verghese et al. [29]Healthy subjectsProspective Cohort469DementiaPhysical activity versus Leisure/Cognitive ActivityDecreased risk for dementia
Abbott et al. [30]Healthy subjectsProspective cohort Honolulu Asia Aging2257DementiaPhysical activity, walkingDecreased risk for dementia
Larson et al. [31]Healthy subjectsProspective cohort1740DementiaPhysical exerciseDecreased risk for dementia
Cassilhas et al. [32]Healthy subjectsRCT62CognitionModerate or High-level resistance trainingImprovement of cognition with both levels of resistance training

SOCIAL, COGNITIVE AND LEISURE ACTIVITY

Scarmeas et al. [36]Healthy subjectsProspective cohort1772DementiaLeisure activitiesDecreased risk for dementia
Wang et al. [37]Healthy subjects Kungsholmen projectProspective cohort152DementiaIntellectual and social stimulationDecreased risk for dementia
Verghese et al. [29]Healthy subjectsProspective cohort469DementiaLeisure activitiesDecreased risk for dementia
Karp et al. [38]Healthy subjects Kungsholmen projectProspective cohort776DementiaMental, physical or social activity versus two or moreDecreased risk for dementia with increasing number of activities
Verghese et al. [35]Healthy subjects of the Bronx Aging StudyProspective cohort437Amnestic MCILeisure activitiesDecreased risk for MCI with increasing number of activities
Willis et al. [39]Healthy subjectsRCT2832CognitionVerbal episodic memory training versus Inductive reasoning training versus visual search and identification training versus no trainingImproved cognition with any training type
Helzner et al. [40]ADProspective cohort287CognitionLeisure activitiesNo association
Wilson et al. [41]Healthy subjects from Rush Memory and Aging ProjectProspective cohort770MCICognitive activitiesDecreased risk for MCI with increased cognitive activity
Karp et al. [42]Healthy subjects Kungsholmen projectProspective cohort931DementiaWork complexityDecreased risk for dementia with increasing work complexity
Healthy subjects Kungsholmen projectProspective cohort506DementiaNeuroticism and extraversionDecreased risk for dementia with low neuroticism and high extraversion

NUTRITION

Barberger-Gateau et al. [43]Healthy subjectsProspective Cohort8085DementiaFruit and vegetable intake versus fish and omega-3 fatDecreased risk for dementia with high fruit, vegetable, fish and omega-3 fat intake
Luchsinger et al. [44]Healthy subjectsProspective Cohort980ADDaily intake of calories, carbohydrates, fats and proteinsIncreased risk for AD with increased caloric and fat intake
Morris et al. [45]Healthy subjectsProspective Cohort1718CognitionHigh versus low fruit and vegetable intakeSlower cognitive decline with high vegetable intake
Scarmeas et al. [46, 47]Healthy subjectsProspective Cohort2258ADAdherence to Mediterranean diet versus no adherenceDecreased risk for AD with increased adherence to Mediterranean diet
Morris et al. [45]Healthy subjectsProspective Cohort1041ADNutritional folate, B12, B6 vitaminsNo association