Does prevention for Alzheimer's disease exist?

Brucki, Sonia Maria Dozzi

doi:10.1590/S1980-57642009DN30300006

Abstract

The prevention of Alzheimer's disease is a growing public health concern amidst an ageing population. Meanwhile, there is no effective or curative treatment available where prevention could greatly reduce health costs. This review was based on reports of potential preventive factors, including modifiable lifestyle factors, as well as preventive pharmacological strategies. Although the present review was not systematic, the reports selected from PubMed using "Alzheimer's disease" and "prevention" as key-words, allow us to affirm that pursuing a healthy lifestyle; physical, cognitive, leisure activities; good social engagement; a high consumption of fish, low consumption of dietary fat and moderate consumption of wine, and control of vascular risk factors appear to be potential factors for delaying dementia.

Key words:
Alzheimer's disease; prevention; physical exercise; statins; cholinesterase inhibitors; nutrition.

Resumo

A prevenção da doença de Alzheimer é um problema de saúde pública, enquanto a população está envelhecendo. Por enquanto, não há tratamento efetivo ou curativo e prevenção poderia evitar grandes custos financeiros. Esta revisão foi baseada em estudos sobre potenciais fatores preventivos, incluindo fatores modificáveis de estilo de vida, bem como estratégias farmacológicas preventivas. Embora esta revisão não seja sistemática, estudos selecionados do PubMed, com palavras-chave "Alzheimer's disease" e " prevention", permitem afirmar que ter um estilo de vida saudável, atividades físicas, cognitivas e de lazer; bom engajamento social; aumento no consumo de peixes, redução no consumo de gorduras consumo meoderado de vinho; controle dos fatores de risco vasculares parecem ter vantagens potenciais em retardar a demência.

Palavras-chave:
doença de Alzheimer; prevenção; exercício físico; estatinas; inibidores de colinesterases; nutrição.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

References

¹
Ferri CP, Prince M, Brayne C, et al. Global prevalence of dementia: a Delphi consensus study. Lancet 2005;366:2112-2117.
²
Nitrini R, Bottino CMC, Albala C, et al. Prevalence of dementia in Latin America: a collaborative study of population-based cohorts. Int Psychogeriatrics 2009;21:622-630.
³
Barnes DE, Cauley JA, Lui LY, et al. Women who maintain optimal cognitive function into old age. J Am Geriatr Soc 2007;55:259-264.
⁴
Yaffe K, Fiocco AJ, Vittinghoff E, et al. Predictors of maintaining cognitive function in older adults. The Health ABC Study. Neurology 2009;72:2029-2035.
⁵
Erten-Lyons D, Woltjer RL, Dodge H, et al. Factors associated with resistance to dementia despite high Alzheimer disease pathology. Neurology 2009;72:354-360.
⁶
Scarmeas N, Levy G, Tang MX, Manly J, Stern Y. Influence of leisure activity on the incidence of Alzheimer's disease. Neurology 2001;57:2236-2242.
⁷
Wilson RS, Mendes De Leon CF, Barnes LL, et al. Participation in cognitive stimulating activities and risk of incident Alzheimer's disease. JAMA 2002;287:742-748.
⁸
Verghese J, Lipton RB, Katz MJ, et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med 2003;348:2508-2516.
⁹
Verghese J, LeValley A, Derby C, et al. Leisure activities and the risk of Amnestic Mild Cognitive Impairment in the elderly. Neurology 2006;66:821-827.
¹⁰
Carlson MC, Helms MJ, Steffens DC, Burke JR, Potter GG, Plassman BL. Midlife activity predicts risk of dementia in older male twin pairs. Alzheimer's & Dementia 2008;4: 324-331.
¹¹
Bennett DA, Schneider JA, Tang Y, Arnold SE, Wilson RS. The effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal cohort study. Lancet Neurol 2006;5:406-412.
¹²
Podewills LJ, Guallar E, Kuller LH, et al. Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. Am J Epidemiol 2005;161:639-651.
¹³
Saczynski JS, Pfeifer LA, Masaki K et al. The effect of social engagement on incident dementia: the Honolulu-Asia Aging Study. Am J Epidemiol 2006;163:433-440.
¹⁴
Wang HX, Karp A, Winblad B, Fratiglioni L. Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen project. Am J Epidemiol 2002;155:65-73.
¹⁵
Lautenschlager NT, Cox KL, Flicker L, et al. Effect of physical activity on cognitive function in older adults at risk for Alzheimer's disease. A randomized trial. JAMA 2008;300:1027-1037.
¹⁶
Uda M, Ishido M, Kami K, Musuhara M. Effects of chronic treadmill running on neurogenesis in the dentate gyrus of the hippocampus of adult rat. Brain Res 2006;1104:64-72.
¹⁷
Ruitenberg A, van Sweiten JC, Witteman JCM, et al. Alcohol consumption and risk of dementia: the Rotterdam study. Lancet 2002;359:281-286.
¹⁸
Mukamal KJ, Kuller LH, Fitzpatrick AL, et al. Prospective study of alcohol consumption and risk of dementia in older adults. JAMA 2003;289:1405-1413.
¹⁸
Espeland MA, Gu L, Masaki KH, et al. Association between reported alcohol intake and cognition: results from the Women's Health Initiative Memory Study. Am J Epidemiol 2005; 161:228-238.
¹⁹
Collins MA, Neafsey EJ, Mukamal KJ, et al. Alcohol in moderation, cardioprotection, and neuroprotection: epidemiological considerations and mechanistic studies. Alcohol Clin Exp Res 2009:33:206-219.
²⁰
Mehlig K, Skoog I, Guo X, et al. Alcoholic beverages and incidence of dementia:34-year follow-up of the prospective population study of women in Göteborg. Am J Epidemiol 2008;167:684-691.
²¹
Marambaud P, Zhao H, Davies P. Resveratrol promotes clearance of Alzheimer's disease amyloid-b peptides. J Biol Chem 2005;280:37377-37382.
²²
Vingtdeux V, Dreses-Werringloer U, Zhao H, Davies P, Marambaud P. Therapeutic potential of resveratrol in Alzheimer's disease. BMC Neuroscience 2008;9(Suppl 2):S6.
²³
Scarmeas N, Stern Y, Mayeux R, Luchsinger JA. Mediterranean diet, Alzheimer disease, and vascular mediation. Arch Neurol 2006;63:739-747.
²⁴
Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA. Mediterranean diet and risk for Alzheimer's disease. Ann Neurol 2006;59:922-927.
²⁵
Scarmeas N, Sterm Y, Mayeux R, Manly JJ, Schupf N, Luchsinger JA. Mediterranean diet and Mild Cognitive Impairment. Arch Neurol 2009;66:216-225.
²⁶
DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginkgo Biloba for prevention of dementia: a randomized controlled trial. JAMA 2008;300:2253-2262.
²⁷
Green RC, McNagny SE, Jayakumar P, et al. Statin use and the risk of Alzheimer's disease: the MIRAGE Study. Alzheimer's & Dementia 2006:2:96-103.
²⁸
Cramer C, Haan MN, Galea S, et al. Use of statin and incidence of dementia and cognitive impairment without dementia in a cohort study. Neurology 2008;71:344-350.
²⁹
Sparks DL, Kryscio RJ, Sabbagh MN, et al. Reduced risk of incident AD with elective statin use in a clinical trial cohort. Curr Alzheimer Res 2008;5:416-421.
³⁰
Haag MDM, Hofman A, Koudstaal PJ, Stricker BHC, Breteler MMB. Statins are associated with a reduced risk of Alzheimer disease regardless of lipophilicity. The Rotterdam Study. J Neurol Neurosurg Psychiatry 2009;80:13-17.
³¹
Hoffman LB, Schmeidler J, Lesser GT, et al. Less Alzheimer disease neuropathology in medicated hypertensive than non-hypertensive persons. Neurology 2009;72:1720-1726.
³²
Haag MDM, Hofman A, Koudstaal PJ, Breteler MMB,Stricker BHC. Duration of antihypertensive drug use and risk of dementia: a prospective cohort study. Neurology 2009;72:1727-1734
³³
Hanon O, Forette F. Treatment of hypertension and prevention of dementia. Alzheimer Dement J Alzheimer Assoc 2005;1:30-37.
³⁴
Forette F, Seux ML, Staessen JA, et al. Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial. Lancet 1998;352:1347-1351.
³⁵
Tzourio C, Anderson C, Chapman N, et al. Effects of blood pressure lowering with perindopril and indapamide therapy on dementia and cognitive decline in patients with cerebrovascular disease. Arch Intern Med 2003;163:1069-1075.
³⁶
Petersen RC, Thomas RG, Grundman M, et al. Vitamin E and donepezil for the treatment of mild cognitive impairment: Alzheimer's Disease Cooperative Study Group. N Engl J Med 2005;352:2379-2388
³⁷
Lu PH, Edland SD, Teng E, et al. Donepezil delays progression to AD in MCI subjects with depressive symptoms. Neurology 2009;72:2115-2121.
³⁸
Doody RS, Ferris SH, Salloway S, et al. Donepezil treatment of patients with MCI - A 48-week randomized, placebo-controlled trial. Neurology 2009;72:1555-1561.
³⁹
Salloway S, Ferris S, Kluger A, et al. Efficacy of donepezil in mild cognitive impairment. A randomized placebo-controlled trial. Neurology 2004;63:651-657.
⁴⁰
Feldman HF, Ferris S, Winblad B, et al. Effect of rivastigmine on delay to diagnosis of Alzheimer's disease from mild cognitive impairment: the InDDEx study. Lancet Neurol 2007;6:501-512.
⁴¹
Winblad B, Gauthier S, Scinto L, et al. Safety and efficacy of galantamine in subjects with mild cognitive impairment. Neurology 2008;70:2024-2035.

Publication Dates

Publication in this collection
Jul-Sep 2009

History

Received
08 July 2009
Accepted
12 Aug 2009

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] ¹
Ferri CP, Prince M, Brayne C, et al. Global prevalence of dementia: a Delphi consensus study. Lancet 2005;366:2112-2117.

[2] ²
Nitrini R, Bottino CMC, Albala C, et al. Prevalence of dementia in Latin America: a collaborative study of population-based cohorts. Int Psychogeriatrics 2009;21:622-630.

[3] ³
Barnes DE, Cauley JA, Lui LY, et al. Women who maintain optimal cognitive function into old age. J Am Geriatr Soc 2007;55:259-264.

[4] ⁴
Yaffe K, Fiocco AJ, Vittinghoff E, et al. Predictors of maintaining cognitive function in older adults. The Health ABC Study. Neurology 2009;72:2029-2035.

[5] ⁵
Erten-Lyons D, Woltjer RL, Dodge H, et al. Factors associated with resistance to dementia despite high Alzheimer disease pathology. Neurology 2009;72:354-360.

[6] ⁶
Scarmeas N, Levy G, Tang MX, Manly J, Stern Y. Influence of leisure activity on the incidence of Alzheimer's disease. Neurology 2001;57:2236-2242.

[7] ⁷
Wilson RS, Mendes De Leon CF, Barnes LL, et al. Participation in cognitive stimulating activities and risk of incident Alzheimer's disease. JAMA 2002;287:742-748.

[8] ⁸
Verghese J, Lipton RB, Katz MJ, et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med 2003;348:2508-2516.

[9] ⁹
Verghese J, LeValley A, Derby C, et al. Leisure activities and the risk of Amnestic Mild Cognitive Impairment in the elderly. Neurology 2006;66:821-827.

[10] ¹⁰
Carlson MC, Helms MJ, Steffens DC, Burke JR, Potter GG, Plassman BL. Midlife activity predicts risk of dementia in older male twin pairs. Alzheimer's & Dementia 2008;4: 324-331.

[11] ¹¹
Bennett DA, Schneider JA, Tang Y, Arnold SE, Wilson RS. The effect of social networks on the relation between Alzheimer's disease pathology and level of cognitive function in old people: a longitudinal cohort study. Lancet Neurol 2006;5:406-412.

[12] ¹²
Podewills LJ, Guallar E, Kuller LH, et al. Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. Am J Epidemiol 2005;161:639-651.

[13] ¹³
Saczynski JS, Pfeifer LA, Masaki K et al. The effect of social engagement on incident dementia: the Honolulu-Asia Aging Study. Am J Epidemiol 2006;163:433-440.

[14] ¹⁴
Wang HX, Karp A, Winblad B, Fratiglioni L. Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen project. Am J Epidemiol 2002;155:65-73.

[15] ¹⁵
Lautenschlager NT, Cox KL, Flicker L, et al. Effect of physical activity on cognitive function in older adults at risk for Alzheimer's disease. A randomized trial. JAMA 2008;300:1027-1037.

[16] ¹⁶
Uda M, Ishido M, Kami K, Musuhara M. Effects of chronic treadmill running on neurogenesis in the dentate gyrus of the hippocampus of adult rat. Brain Res 2006;1104:64-72.

[17] ¹⁷
Ruitenberg A, van Sweiten JC, Witteman JCM, et al. Alcohol consumption and risk of dementia: the Rotterdam study. Lancet 2002;359:281-286.

[18] ¹⁸
Mukamal KJ, Kuller LH, Fitzpatrick AL, et al. Prospective study of alcohol consumption and risk of dementia in older adults. JAMA 2003;289:1405-1413.

[19] ¹⁸
Espeland MA, Gu L, Masaki KH, et al. Association between reported alcohol intake and cognition: results from the Women's Health Initiative Memory Study. Am J Epidemiol 2005; 161:228-238.

[20] ¹⁹
Collins MA, Neafsey EJ, Mukamal KJ, et al. Alcohol in moderation, cardioprotection, and neuroprotection: epidemiological considerations and mechanistic studies. Alcohol Clin Exp Res 2009:33:206-219.

[21] ²⁰
Mehlig K, Skoog I, Guo X, et al. Alcoholic beverages and incidence of dementia:34-year follow-up of the prospective population study of women in Göteborg. Am J Epidemiol 2008;167:684-691.

[22] ²¹
Marambaud P, Zhao H, Davies P. Resveratrol promotes clearance of Alzheimer's disease amyloid-b peptides. J Biol Chem 2005;280:37377-37382.

[23] ²²
Vingtdeux V, Dreses-Werringloer U, Zhao H, Davies P, Marambaud P. Therapeutic potential of resveratrol in Alzheimer's disease. BMC Neuroscience 2008;9(Suppl 2):S6.

[24] ²³
Scarmeas N, Stern Y, Mayeux R, Luchsinger JA. Mediterranean diet, Alzheimer disease, and vascular mediation. Arch Neurol 2006;63:739-747.

[25] ²⁴
Scarmeas N, Stern Y, Tang MX, Mayeux R, Luchsinger JA. Mediterranean diet and risk for Alzheimer's disease. Ann Neurol 2006;59:922-927.

[26] ²⁵
Scarmeas N, Sterm Y, Mayeux R, Manly JJ, Schupf N, Luchsinger JA. Mediterranean diet and Mild Cognitive Impairment. Arch Neurol 2009;66:216-225.

[27] ²⁶
DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginkgo Biloba for prevention of dementia: a randomized controlled trial. JAMA 2008;300:2253-2262.

[28] ²⁷
Green RC, McNagny SE, Jayakumar P, et al. Statin use and the risk of Alzheimer's disease: the MIRAGE Study. Alzheimer's & Dementia 2006:2:96-103.

[29] ²⁸
Cramer C, Haan MN, Galea S, et al. Use of statin and incidence of dementia and cognitive impairment without dementia in a cohort study. Neurology 2008;71:344-350.

[30] ²⁹
Sparks DL, Kryscio RJ, Sabbagh MN, et al. Reduced risk of incident AD with elective statin use in a clinical trial cohort. Curr Alzheimer Res 2008;5:416-421.

[31] ³⁰
Haag MDM, Hofman A, Koudstaal PJ, Stricker BHC, Breteler MMB. Statins are associated with a reduced risk of Alzheimer disease regardless of lipophilicity. The Rotterdam Study. J Neurol Neurosurg Psychiatry 2009;80:13-17.

[32] ³¹
Hoffman LB, Schmeidler J, Lesser GT, et al. Less Alzheimer disease neuropathology in medicated hypertensive than non-hypertensive persons. Neurology 2009;72:1720-1726.

[33] ³²
Haag MDM, Hofman A, Koudstaal PJ, Breteler MMB,Stricker BHC. Duration of antihypertensive drug use and risk of dementia: a prospective cohort study. Neurology 2009;72:1727-1734

[34] ³³
Hanon O, Forette F. Treatment of hypertension and prevention of dementia. Alzheimer Dement J Alzheimer Assoc 2005;1:30-37.

[35] ³⁴
Forette F, Seux ML, Staessen JA, et al. Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial. Lancet 1998;352:1347-1351.

[36] ³⁵
Tzourio C, Anderson C, Chapman N, et al. Effects of blood pressure lowering with perindopril and indapamide therapy on dementia and cognitive decline in patients with cerebrovascular disease. Arch Intern Med 2003;163:1069-1075.

[37] ³⁶
Petersen RC, Thomas RG, Grundman M, et al. Vitamin E and donepezil for the treatment of mild cognitive impairment: Alzheimer's Disease Cooperative Study Group. N Engl J Med 2005;352:2379-2388

[38] ³⁷
Lu PH, Edland SD, Teng E, et al. Donepezil delays progression to AD in MCI subjects with depressive symptoms. Neurology 2009;72:2115-2121.

[39] ³⁸
Doody RS, Ferris SH, Salloway S, et al. Donepezil treatment of patients with MCI - A 48-week randomized, placebo-controlled trial. Neurology 2009;72:1555-1561.

[40] ³⁹
Salloway S, Ferris S, Kluger A, et al. Efficacy of donepezil in mild cognitive impairment. A randomized placebo-controlled trial. Neurology 2004;63:651-657.

[41] ⁴⁰
Feldman HF, Ferris S, Winblad B, et al. Effect of rivastigmine on delay to diagnosis of Alzheimer's disease from mild cognitive impairment: the InDDEx study. Lancet Neurol 2007;6:501-512.

[42] ⁴¹
Winblad B, Gauthier S, Scinto L, et al. Safety and efficacy of galantamine in subjects with mild cognitive impairment. Neurology 2008;70:2024-2035.

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