Dementia, seven rules to prevent it

These are the simple and usual good practices, but remembering them does not hurt. Because they can really, among other things, play a decisive role in preventing the onset of dementia in old age, even in the presence of genetic risk factors. The so-called “Simple 7”, as the American Heart Association defined them, are the seven factors that determine cardiovascular and brain health: being physically active, eating well, maintaining a correct weight, not smoking, maintaining a healthy blood pressure, control cholesterol and reduce blood sugar. This is confirmed today by a research published in Neurology.

Patients monitored for thirty years

The conclusions come from a study that involved 8,823 patients of European ethnicity and 2,738 of African American ethnicity with an average age of 54 years, followed for about thirty years, from 1987-1989 to 2019. To evaluate the degree of compliance of the participants in the Simple 7 were awarded scores on the basis of the reports reported periodically by themselves. On a scale ranging from zero to fourteen, the lowest score was given to less healthy behaviors. Over the whole period, subjects of European origin had an average rating of 8.3, while those of African American origin of 6.6.

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“A working group of the American Heart Association and the American Stroke Association has summarized many years of research to recommend Simple 7s to optimize brain health,” Adrienne Tin, associate professor at the Center for Memory Disorders, told La Repubblica. and neurodegenerative dementias from the University of Mississippi and first author of the study. “However – he continues – it is not clear whether these protective effects can also be observed in subjects with high genetic risk. This prompted us to undertake the current study to evaluate the association between Simple 7 and late-onset dementia across the range. of genetic risks “.

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In the study, genetic risk was assessed on the basis of a gene, Apoe, whose mutations are associated with Alzheimer’s disease. 27.9% of people of European origin had the Apoe e4 variant – the one with the highest risk of developing the disease – while in the African American group this percentage rose to 40.4%. Based on this and other mutations, participants with European ancestry were divided into five groups and those with African ancestry into three groups. At the end of the monitoring period, after thirty years, 1,603 people of European ancestry and 631 of African American ancestry developed dementia.

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Does lifestyle or genetics matter more?

For people of European ancestry, the researchers found that those who scored higher (and therefore better) in Simple 7s had a lower risk of dementia in all five genetic risk groups, including the group with the Apoe e4 mutation. In particular, as the lifestyle score increased by one unit, the risk of developing dementia decreased by 9%. Overall, among those with intermediate and high scores, the risk decreased from 30 to 43%. Among people of African American origin, however, these percentages were 6% and 17%, respectively. These values ​​depend on the one hand on the fact that the latter group was less represented in the study, on the other hand on the fact that the participants all had the same geographical origin.

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“The relative importance of genetics versus Simple 7 lifestyle and other modifiable factors on late-onset dementia is still being researched,” says Tin. “The 2020 Lancet Commission Report estimated that there are 12 health factors, including the Simple 7, responsible for 40% of late-onset dementias worldwide. Other research has estimated that genetics are responsible up to and including 80% of cases of Alzheimer’s, the most common form of dementia. With larger studies on different populations – he concludes – we may be able to reach more accurate estimates. Meanwhile, there is strong evidence to support the use of Simple 7 to greatly reduce the risk of late-onset dementia “.

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