Why Let a Tiny Two Letter Word Deter You (Cinch Cast)

By Bob DeMarco Alzheimer's Front Row

Dotty is complaining to me that her knees are hurting. This happens every day. I don't remember her ever complaining about her knees back in the days when we were going to the gym.

Combination of Mediterranean Diet and Exercise Cuts the Risk of Alzheimer's by 60 Percent

My name is Bob DeMarco, I am an Alzheimer's caregiver. My mother Dorothy, now 93 years old, suffers from Alzheimer's disease.

I wrote previously about how exercise in a gym has an immediate positive effect on my mother's behavior and attitude. There are many articles here on the Alzheimer's Reading Room about the importance of a healthy diet, and how it could lower the risk of Alzheimer's in older age. I also wrote a few times about how a Mediterranean-type diet can help slow cognitive decline.

Now for the first time, a new research study has studied the combination of exercise and the Mediterranean diet -- the results are encouraging.

The study found that

• those subjects who were very physically active had a 33 percent risk reduction of Alzheimer’s,
• those who adhered more strongly to a Mediterranean-type diet had a 40 percent risk reduction.
• found that there was a gradual decreasing risk for Alzheimer’s in study participants who were reporting that they were both exercising a lot, and following a diet closer to the Mediterranean-type: those subjects had a 60 percent reduction in their risk for developing Alzheimer’s disease.

Subscribe to The Alzheimer's Reading Room

Go here to read -- What is a Mediterranean Style Diet
Exercise and Mediterranean-type Diet Combined Appear to be Associated with Lower Risk for Alzheimer’s Disease
Findings of Observational Study Warrant Further Research in Controlled Clinical Trial to Clarify the Role of These and Other Possible Factors Contributing to AD Risk

Both being more physically active and adhering to a Mediterranean-type diet appears to be associated with reduced Alzheimer’s risk, according to a new report in the August 12, 2009 issue of the Journal of the American Medical Association (JAMA).

While previous studies have only investigated the association between either physical activity or diet and Alzheimer’s disease risk separately, this new research explored their combined association.

“Often times people who exercise also follow a healthy diet and vice versa. We wanted to tease out which of these two behaviors may be associated with lower risk for AD, or if the combination of the two is associated with decreased risk even further,” said Nikos Scarmeas, M.D., lead author of the study and associate professor of clinical neurology in the Department of Neurology, in the Sergievsky Center and in the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain at Columbia University Medical Center.

This population-based study in a multi-ethnic community living in Northern Manhattan, observed 1880 elderly subjects, with an average age of 77. The participants were interviewed about their level of physical activity and dietary habits, and their responses were then summarized into two single scores. The study subjects were then followed to observe which subjects went on to develop Alzheimer’s over the course of approximately five and a half years.

To learn about their physical exercise routine, participants were queried about their activity during a two week period prior to the interview. The subjects were asked to quantify how many times they engaged in physical activity and for how long. Participants were queried regarding three categories of activities: vigorous activity (i.e., jogging etc), moderate activity (i.e., hiking, bicycling, etc), and light activity (i.e., golfing, gardening, etc).

For the dietary portion of the study, subjects were asked regarding their food consumption over the course of the previous year. Their responses were then grouped into nine food categories, the sum of which represented the Mediterranean-type diet score. A Mediterranean-type diet is typically characterized by high intake of fish, vegetables, legumes, fruits, cereals and monounsaturated fatty acids; relatively low intake of dairy products, meats and saturated fats; and moderate alcohol consumption.

The study found that those subjects who were very physically active had a 33 percent risk reduction of Alzheimer’s; those who adhered more strongly to a Mediterranean-type diet had a 40 percent risk reduction. In addition, Dr. Scarmeas and his colleagues found that there was a gradual decreasing risk for Alzheimer’s in study participants who were reporting that they were both exercising a lot and following a diet closer to the Mediterranean-type: those subjects had a 60 percent reduction in their risk for developing Alzheimer’s disease.

“So it seemed that the more that they were doing in terms of both diet and exercise, the lower was their risk for the disease,” said Dr. Scarmeas.

Dr. Scarmeas further noted that even low degrees of physical activity reported by these elderly study subjects seemed to be associated with having a protective effect against Alzheimer’s.

“This study is important because it shows that people may be able to alter their risk of developing Alzheimer’s by modifying their lifestyles through diet and exercise,” said Dr. Scarmeas.

Dr. Scarmeas cautions, however, that this was an observational, epidemiological study – based on interviews with study subjects on their physical activity routines and dietary habits. Therefore, the associations were based on what subjects reported and no randomized interventions were done. Only a clinical trial type of design would offer additional information to help clarify the role of these behaviors and reveal other potential contributing factors.

“We know that some part of Alzheimer’s is related to genetic changes and as time goes on we discover more and more of these changes. But it is also possible that non-genetic changes, including lifestyle and behavior, may also be affecting our brain health and our risk of developing brain diseases, like Alzheimer’s, maybe in combination with our genetic predisposition,” said Dr. Scarmeas. “We need to understand and learn more about the exact biological mechanisms that may connect physical activity and diet with the biological changes of Alzheimer’s disease.”

“Since the benefits of following a healthy diet and remaining active have already been suggested as beneficial in other disease prevention and since based on the present and other similar studies we have some preliminary hints that this may also be helpful for brain health, it seems advisable that we emphasize not only to patients, but to healthy individuals, too, the importance of these lifestyle behaviors in affecting our overall health,” said Dr. Scarmeas.

Authors of the JAMA study include: Nikolaos Scarmeas, M.D.; Jose A. Luchsinger, M.D.; Nicole Schupf, Ph.D.; Adam M. Brickman, Ph.D.; Stephanie Cosentino, Ph.D.; Ming X. Tang, Ph.D.; and Yaakov Stern, Ph.D.

This study was supported by the National Institute on Aging.

Note: In the same issue of JAMA, Dr. Scarmeas co-authored with researchers from the Université Victor Ségalen Bordeaux 2 in France, a separate study titled, “Adherence to Mediterranean Diet, Cognitive Decline, and Risk of Dementia.” Dr. Scarmeas expressed his encouragement about the study, which helps to validate findings by Dr. Scarmeas and his colleagues on the association between the Mediterranean diet and a reduced risk for Alzheimer’s disease. More specifically, the French study found an association between higher adherence to this diet and slower rates of cognitive decline. No associations with risk for developing Alzheimer’s disease were noted in this study, but this was clearly due to methodological limitations including the relatively small number of study subjects who developed Alzheimer’s disease according to Dr. Scarmeas. Dr. Scarmeas also noted the significance of the fact that the French study looked at a different population, and in particular, a Mediterranean one.

Here is the link to the article in the Journal of the American Medical Association (JAMA).
Physical Activity, Diet, and Risk of Alzheimer Disease

The Taub Institute for Research on Alzheimer's Disease and the Aging Brain at Columbia University Medical Center is a multidisciplinary group that has forged links between researchers and clinicians to uncover the causes of Alzheimer’s, Parkinson’s and other age-related brain diseases and discover ways to prevent and cure these diseases. It functions in close cooperation with the Department of Pathology and Cell Biology, the Department of Neurology and the Gertrude H. Sergievsky Center.

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia's College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. For more information, please visit www.cumc.columbia.edu.

Contact:

Karin Eskenazi
ket2116@columbia.edu
212-305-3900

Elizabeth Streich
eas2125@columbia.edu
(212) 305-3900

More from the Alzheimer's Reading Room

• The Alzheimer's Reading Room--Press Release
• Test Your Memory (TYM) for Alzheimer's or Dementia in Five Minutes
• Questions About Test Your Memory (TYM) for Alzheimers and Dementia
• Dimebon Clinical Trial?
• The Thyroid and Alzheimer's
• Are Alzheimer's Caregivers the Forgotten?
• Flavanol-rich Cocoa Consumption Improves Blood Flow to the Brain
  
• A Simple Three Minute Test Can Detect the Earliest Stage of Alzheimer's Disease
• Eli Lilly Launches Two Late Stage Clinical Trials for Alzheimer's (LY2062430)
• Is it Really Alzheimer's or Something Else?
• Wii a Useful Tool for Alzheimer's Caregivers
• Five Ways to Keep Alzheimer's Away
• 2009 Alzheimer's Disease Facts and Figures
• The Mini-Cog Test for Alzheimer's and Dementia
• What is Dementia?
• A Real Solution to the Health Care Crisis
• 80 Percent of Medical Bills Contain Errors -- Fighting Mistakes

My name is Bob DeMarco, I am an Alzheimer's caregiver. My mother Dorothy, now 93 years old, suffers from Alzheimer's disease.

I wrote previously about how exercise in a gym has an immediate positive effect on my mother's behavior and attitude. There are many articles here on the Alzheimer's Reading Room about the importance of a healthy diet, and how it could lower the risk of Alzheimer's in older age. I also wrote a few times about how a Mediterranean-type diet can help slow cognitive decline.

Now for the first time, a new research study has studied the combination of exercise and the Mediterranean diet -- the results are encouraging.

The study found that

• those subjects who were very physically active had a 33 percent risk reduction of Alzheimer’s,
• those who adhered more strongly to a Mediterranean-type diet had a 40 percent risk reduction.
• found that there was a gradual decreasing risk for Alzheimer’s in study participants who were reporting that they were both exercising a lot, and following a diet closer to the Mediterranean-type: those subjects had a 60 percent reduction in their risk for developing Alzheimer’s disease.

Subscribe to The Alzheimer's Reading Room

Go here to read -- What is a Mediterranean Style Diet
Exercise and Mediterranean-type Diet Combined Appear to be Associated with Lower Risk for Alzheimer’s Disease
Findings of Observational Study Warrant Further Research in Controlled Clinical Trial to Clarify the Role of These and Other Possible Factors Contributing to AD Risk

Both being more physically active and adhering to a Mediterranean-type diet appears to be associated with reduced Alzheimer’s risk, according to a new report in the August 12, 2009 issue of the Journal of the American Medical Association (JAMA).

While previous studies have only investigated the association between either physical activity or diet and Alzheimer’s disease risk separately, this new research explored their combined association.

“Often times people who exercise also follow a healthy diet and vice versa. We wanted to tease out which of these two behaviors may be associated with lower risk for AD, or if the combination of the two is associated with decreased risk even further,” said Nikos Scarmeas, M.D., lead author of the study and associate professor of clinical neurology in the Department of Neurology, in the Sergievsky Center and in the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain at Columbia University Medical Center.

This population-based study in a multi-ethnic community living in Northern Manhattan, observed 1880 elderly subjects, with an average age of 77. The participants were interviewed about their level of physical activity and dietary habits, and their responses were then summarized into two single scores. The study subjects were then followed to observe which subjects went on to develop Alzheimer’s over the course of approximately five and a half years.

To learn about their physical exercise routine, participants were queried about their activity during a two week period prior to the interview. The subjects were asked to quantify how many times they engaged in physical activity and for how long. Participants were queried regarding three categories of activities: vigorous activity (i.e., jogging etc), moderate activity (i.e., hiking, bicycling, etc), and light activity (i.e., golfing, gardening, etc).

For the dietary portion of the study, subjects were asked regarding their food consumption over the course of the previous year. Their responses were then grouped into nine food categories, the sum of which represented the Mediterranean-type diet score. A Mediterranean-type diet is typically characterized by high intake of fish, vegetables, legumes, fruits, cereals and monounsaturated fatty acids; relatively low intake of dairy products, meats and saturated fats; and moderate alcohol consumption.

The study found that those subjects who were very physically active had a 33 percent risk reduction of Alzheimer’s; those who adhered more strongly to a Mediterranean-type diet had a 40 percent risk reduction. In addition, Dr. Scarmeas and his colleagues found that there was a gradual decreasing risk for Alzheimer’s in study participants who were reporting that they were both exercising a lot and following a diet closer to the Mediterranean-type: those subjects had a 60 percent reduction in their risk for developing Alzheimer’s disease.

“So it seemed that the more that they were doing in terms of both diet and exercise, the lower was their risk for the disease,” said Dr. Scarmeas.

Dr. Scarmeas further noted that even low degrees of physical activity reported by these elderly study subjects seemed to be associated with having a protective effect against Alzheimer’s.

“This study is important because it shows that people may be able to alter their risk of developing Alzheimer’s by modifying their lifestyles through diet and exercise,” said Dr. Scarmeas.

Dr. Scarmeas cautions, however, that this was an observational, epidemiological study – based on interviews with study subjects on their physical activity routines and dietary habits. Therefore, the associations were based on what subjects reported and no randomized interventions were done. Only a clinical trial type of design would offer additional information to help clarify the role of these behaviors and reveal other potential contributing factors.

“We know that some part of Alzheimer’s is related to genetic changes and as time goes on we discover more and more of these changes. But it is also possible that non-genetic changes, including lifestyle and behavior, may also be affecting our brain health and our risk of developing brain diseases, like Alzheimer’s, maybe in combination with our genetic predisposition,” said Dr. Scarmeas. “We need to understand and learn more about the exact biological mechanisms that may connect physical activity and diet with the biological changes of Alzheimer’s disease.”

“Since the benefits of following a healthy diet and remaining active have already been suggested as beneficial in other disease prevention and since based on the present and other similar studies we have some preliminary hints that this may also be helpful for brain health, it seems advisable that we emphasize not only to patients, but to healthy individuals, too, the importance of these lifestyle behaviors in affecting our overall health,” said Dr. Scarmeas.

Authors of the JAMA study include: Nikolaos Scarmeas, M.D.; Jose A. Luchsinger, M.D.; Nicole Schupf, Ph.D.; Adam M. Brickman, Ph.D.; Stephanie Cosentino, Ph.D.; Ming X. Tang, Ph.D.; and Yaakov Stern, Ph.D.

This study was supported by the National Institute on Aging.

Note: In the same issue of JAMA, Dr. Scarmeas co-authored with researchers from the Université Victor Ségalen Bordeaux 2 in France, a separate study titled, “Adherence to Mediterranean Diet, Cognitive Decline, and Risk of Dementia.” Dr. Scarmeas expressed his encouragement about the study, which helps to validate findings by Dr. Scarmeas and his colleagues on the association between the Mediterranean diet and a reduced risk for Alzheimer’s disease. More specifically, the French study found an association between higher adherence to this diet and slower rates of cognitive decline. No associations with risk for developing Alzheimer’s disease were noted in this study, but this was clearly due to methodological limitations including the relatively small number of study subjects who developed Alzheimer’s disease according to Dr. Scarmeas. Dr. Scarmeas also noted the significance of the fact that the French study looked at a different population, and in particular, a Mediterranean one.

Here is the link to the article in the Journal of the American Medical Association (JAMA).
Physical Activity, Diet, and Risk of Alzheimer Disease

The Taub Institute for Research on Alzheimer's Disease and the Aging Brain at Columbia University Medical Center is a multidisciplinary group that has forged links between researchers and clinicians to uncover the causes of Alzheimer’s, Parkinson’s and other age-related brain diseases and discover ways to prevent and cure these diseases. It functions in close cooperation with the Department of Pathology and Cell Biology, the Department of Neurology and the Gertrude H. Sergievsky Center.

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia's College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. For more information, please visit www.cumc.columbia.edu.

Contact:

Karin Eskenazi
ket2116@columbia.edu
212-305-3900

Elizabeth Streich
eas2125@columbia.edu
(212) 305-3900

More from the Alzheimer's Reading Room

• The Alzheimer's Reading Room--Press Release
• Test Your Memory (TYM) for Alzheimer's or Dementia in Five Minutes
• Questions About Test Your Memory (TYM) for Alzheimers and Dementia
• Dimebon Clinical Trial?
• The Thyroid and Alzheimer's
• Are Alzheimer's Caregivers the Forgotten?
• Flavanol-rich Cocoa Consumption Improves Blood Flow to the Brain
  
• A Simple Three Minute Test Can Detect the Earliest Stage of Alzheimer's Disease
• Eli Lilly Launches Two Late Stage Clinical Trials for Alzheimer's (LY2062430)
• Is it Really Alzheimer's or Something Else?
• Wii a Useful Tool for Alzheimer's Caregivers
• Five Ways to Keep Alzheimer's Away
• 2009 Alzheimer's Disease Facts and Figures
• The Mini-Cog Test for Alzheimer's and Dementia
• What is Dementia?
• A Real Solution to the Health Care Crisis
• 80 Percent of Medical Bills Contain Errors -- Fighting Mistakes

The Alzheimer's Action Plan: The Experts' Guide to the Best Diagnosis and Treatment for Memory Problems

Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for advice and insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 700 articles with more than 18,000 links on the Internet. Bob resides in Delray Beach, FL.

The Alzheimer's Action Plan: The Experts' Guide to the Best Diagnosis and Treatment for Memory Problems

Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for advice and insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 700 articles with more than 18,000 links on the Internet. Bob resides in Delray Beach, FL.

Original content the Alzheimer's Reading Room

Walmart and this Alzheimer's Caregiver

Subscribe to Alzheimer's Front Row--via Email

My name is Bob DeMarco, I am an Alzheimer's caregiver. My mother Dorothy, now 93 years old, suffers from Alzheimer's disease.

I learned in my role as an Alzheimer's caregiver that exercise, bright light, socialization, and simple tasks that allow my mother to use her brain have a positive effect on my mother's quality of life and behavior.

I am always searching for new ways to keep her active and in the world.

About a year ago, I came up with a new idea and decided to give it a try.

I took my mother to Super Walmart for an outing. If you have a super Walmart near you, you already know the parking lot is usually jammed.

When we arrive at Walmart, I look around for a parking space. We do not use the handicapped spot. Reason? Exercise (mission accomplished).

We park, and I walk my mother up to the entrance to the store. Next, I get her into one of those electric shopping carts that allow you to drive around the store. This forces my mother to use her brain (mission accomplished).

When I take her into Walmart we drive around through all the departments. This allows my mother to use her brain for an extended period of time, and to be exposed to the bright lighting (mission accomplished).

My mother usually gets nervous when she is around large groups of people. The experience in Walmart exposes her to lots of people, and sometimes when she is stopped people actually say 'hi' or start talking to her (mission accomplished).

The trip to Walmart satisfies a need to keep her in and attached to the outside world. (mission accomplished).

If I let my mother sit around (actually lay around at home), she often falls into a dark mood. Sometimes she will just stop talking, or worse utter words like " I would be better off dead", or, "I am living on overtime".

I noticed years ago, when I take her out into the world her behavior improves, she starts smiling, and often starts interacting with others (this really makes me feel good--mission accomplished).

To be honest, we both benefit from the trip to Walmart.

My mother gets out, gets some exercise, gets exposed to bright light: while riding in the car, walking up to the store, and in the store. She gets to see people and do one one of her favorite things--shop. She likes the cloths section almost as much as she likes grabbing a box of Cheez-it off the shelf.

For me? I get out in the world and stay attached to other human beings. This beats staying at home day after day--all alone.

The trip to Walmart is like a respite to me. Even though I am a man, I can now tell you the price of everything we buy. I can tell you we save lots of bucks while shopping in Walmart--another benefit.

We now go to super Walmart weekly.

My advice to you? Get out in the real world and smell the Cheez-it(s).

Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for advice and insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 700 articles with more than 18,000 links on the Internet. Bob resides in Delray Beach, FL.

From the Alzheimer's Reading Room

• The Alzheimer's Reading Room--Press Release
• Test Your Memory (TYM) for Alzheimer's or Dementia in Five Minutes
• Questions About Test Your Memory (TYM) for Alzheimers and Dementia
• Medivation Dimebon Connection Study Complete, Additional Phase 3 Trials Still Open
• The Thyroid and Alzheimer's
• Are Alzheimer's Caregivers the Forgotten?
• Flavanol-rich Cocoa Consumption Improves Blood Flow to the Brain
  
• A Simple Three Minute Test Can Detect the Earliest Stage of Alzheimer's Disease
• Eli Lilly Launches Two Late Stage Clinical Trials for Alzheimer's (LY2062430)
• Is it Really Alzheimer's or Something Else?
• Wii a Useful Tool for Alzheimer's Caregivers
• Five Ways to Keep Alzheimer's Away
• 2009 Alzheimer's Disease Facts and Figures
• The Mini-Cog Test for Alzheimer's and Dementia
• What is Dementia?
• A Real Solution to the Health Care Crisis
• 80 Percent of Medical Bills Contain Errors -- Fighting Mistakes

The Alzheimer's Action Plan: The Experts' Guide to the Best Diagnosis and Treatment for Memory Problems

Should Women Be Worried about Alzheimer's ?

Current statistical studies indicate that at age 80, there is a one in five chance of suffering from Alzheimer's disease (20 out of 100).

At age 85, the odds rise to one out of every two (50 out of 100). I call this the Alzheimer's danger zone.

It is well known that women live longer than men. But, I don't think it is well known that healthy women live much longer than healthy men, and live into the Alzheimer's danger zone.

Women who reach the age of fifty without suffering from cancer or heart disease can expect to live nearly ninety-two years (92).**

Men who live to age sixty-five without suffering from cancer or heart disease, can expect to live to eighty-one (81).

Does Walking Help Ward Off Alzheimer's

Here is a little known fact that might get your attention.

In a study published in the Journal of the American Medical Association, researchers asked 2,257 men (ages 71–93 and with no signs of dementia) how far they walked each day.

Cognitive assessments performed four to eight years later showed that the men who walked less than a quarter mile a day were nearly twice as likely to have developed dementia as those who walked two miles or more each day.

Source: John Hopkins, Guarding Your Memory

Subscribe to The Alzheimer's Reading Room--via Email

Bob DeMarco is an Alzheimer's caregiver and editor of the Alzheimer's Reading Room. The Alzheimer's Reading Room is the number one website on the Internet for insight into Alzheimer's disease. Bob taught at the University of Georgia, was an executive at Bear Stearns, the CEO of IP Group, and is a mentor. He has written more than 600 articles with more than 11,000 links on the Internet. Bob resides in Delray Beach, FL.

More from the Alzheimer's Reading Room

• Are Alzheimer's Caregivers the Forgotten? (Opinion)
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