The most crucial consideration when devising a comprehensive health intervention is understanding how to prevent or slow the degenerative process best. Without question, dietary factors constitute the single most important preventive focus. In one prospective study, 586 participants without clinical symptoms of dementia, age 55 or older, had their diets assessed at the beginning of the study and were screened for symptoms of dementia an average of two years later.2 After adjusting for other factors, such as age, gender, and education, subjects with the highest total fat intake had a significantly elevated relative risk (RR) of dementia (RR 2.4[1.1-5.2]). Other dietary factors associated with an increased risk of dementia were a high intake of saturated fat (RR 1.9 [0.9-4.0]) and cholesterol (RR 1.7 [0.9-3.2]). An encouraging finding was that a high intake of fish was associated with a significantly lower risk of dementia in general (RR 0.4 [0.2-0.91]) and was particularly associated with a lower risk of the dementia of Alzheimer's disease (RR 0.3 [0.1-0.9]). Several other epidemiologic studies produced similar findings.3,4 Current research supports a free-radical-based theory of cognitive decline that is supported by data suggesting that foods that are rich in antioxidants, such as strawberries and spinach, and supplemental vitamin E, retards the age-related onset of cognitive deficits.5 It is also noteworthy that, in individuals 65 and older (a population facing an ever-increasing risk of dementia), higher beta-carotene and vitamin C levels have been shown to correlate with enhanced memory performance.6 Thus, following a diet rich in whole foods and emphasizing fresh fruits and vegetables provides the low fat and antioxidant abundance protection essential for sustained cognitive function and overall enhanced longevity.
A small randomized, crossover, nonblinded study in patients with Alzheimer's disease examined the effect of increasing the amount of carbohydrates with meals, without changing the protein intake. The results showed poorer memory, and increased aberrant motor behavior with the increased carbohydrate intake.7 Research has also examined the Mediterranean diet and the risk of Alzheimer's disease. The results indicate that higher adherence to the Mediterranean diet was associated with lower risk for Alzheimer's disease, and the association does not seem to be mediated by vascular comorbidity.8 In addition, a literature review showed that high energy intake of monounsaturated fatty acids appeared to be associated with a high level of protection against age-related cognitive decline, fish consumption and cereals are found to reduce the prevalence of Alzheimer's disease, and the relative risk of dementia was lower in subjects who drank three or four glasses of red wine each day compared with total abstainers.9
In both animal and clinical research, a combination of ginseng with ginkgo seems to hold promise.
It should also be noted that some clinicians believe that following a low-calorie diet that provides a wide array of fresh fruits and vegetables can lessen oxidative damage to the central nervous system, thus slowing cognitive decline. This area of research shows some promise; yet, as with all dietary modifications, finding the appropriate balance between therapeutic goals and sustained wellness can be challenging. Calorie restriction has shown to prevent amyloid beta-peptide generation and neuritic plaque deposition in the brain of a mouse model of Alzheimer's disease neuropathology suggesting it may be beneficial in preventative measures aimed at delaying the onset of Alzheimer's disease amyloid neuropathology.10
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