As Belle Leeds nears her 101st birthday this April, she will celebrate another year of life with her family and the friends she’s made at Brightview Senior Living in Tenafly, New Jersey. Belle lives in a part of the community called Wellspring Village that caters specifically to residents with memory disorders. As one of the first residents at Wellspring Village, Belle began to show signs of dementia in June 2015 when she was around 97 years old. Defined by the Alzheimer’s Association, dementia is a “decline in mental ability severe enough to interfere with daily life.” Genetics, cholesterol and age have all been cited as causes for dementia, but recent studies have identified another possible factor—diet.
Ashley Leeds, Belle’s granddaughter, doesn’t know if dementia runs in their family but described her grandmother as otherwise healthy. “She was a pretty good eater,” she said. “She loved chicken and pasta. She loves bread and chocolate! We joke that that’s what’s keeping her going.” At Wellspring Village, residents are fed healthy options like lean protein, vegetables and fruits. Although these nutritious foods will not reverse memory loss, scientists are researching whether they have promise as a preventive.
One such study is the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, also known as the FINGER study supervised by clinical geriatric epidemiologist Miia Kivipelto in Finland. From 2009 to 2011, over 1,200 recruits between 66 and 77 years old were studied to determine how an improvement in multiple factors, including diet, physical activity and social activities, affected brain health.
Individuals were asked to follow individually-tailored diet plans that emphasized fewer harmful foods like butter and encouraged healthier foods like rapeseed oil. As the first portion of the FINGER study came to a close, researchers wrote, “This is the first large [randomized control trial] showing that it is possible to prevent cognitive decline using a multi-domain intervention among older at-risk individuals.” A combination of regular exercise, increased social activity and a healthy diet was able to slow down memory loss.
But the FINGER study looked only at the Finnish population and focused on multiple factors. In the United States, Dr. Martha Clare Morris, professor of epidemiology at Rush University Medical Center in Chicago, brought the study closer to home.
“At first I was trying to decide whether we should go with something like the Mediterranean diet or the Dash Diet. And then it occurred to me, what am I doing?” Morris explained. “We’ve done all this research. We know what the important nutrients and foods are.” The result was the Mediterranean-DASH Intervention for Neurodegenerative Delay, also known as the MIND Diet. The Mediterranean diet, characterized by nuts, whole grains, breads, vegetables and extra virgin olive oil, is associated with slower cognitive decline and lower chances of developing Alzheimer’s. The DASH diet (Dietary Approaches to Stop Hypertension), emphasizing food like fruits, low-fat dairy products and poultry, has been shown to decrease high blood pressure and cholesterol. /
The results of the nine-year study were published in 2015, based on 960 participants who were already involved in Rush’s Memory and Aging project and had received diet questionnaires about 144 foods. “It has some limitations,” said Morris. “For example, we had no questions on other types of berries,” besides strawberries, “and we didn’t have the best information on whole grains. Still, 144 items is pretty comprehensive.” After collecting the questionnaire sheets and conducting cognitive assessments analyzing any changes, the researchers had what looked like promising number.
“We looked over a 10-year period and found that those people with the highest scores… had a much slower rate of decline in all of their cognitive abilities, whether it was memory or visual spatial skills or more executive functions,” Morris said. The MIND scores were based on how subjects ate over the course of the study and how they performed cognitively. When comparing the highest scoring participants and the lowest scoring participants, the highest scoring group had brain health at least 7.5 years younger. “In the same group of individuals, we looked for the risk of their developing Alzheimer’s disease,” said Dr. Morris. “Those people with the highest scores had a 53% reduction in the risk of developing Alzheimer’s compared to those in the lowest third of scores. And then even people in the intermediate range had a 35% reduction.”/
Dr. Yian Gu of the Columbia University department of neurology found similar results in a 2011 study. Dr. Gu and fellow researcher Nikolaos Scarmeas looked at the three most common ways of studying dietary plans to learn if the approach would alter the results. They found that regardless of approach, dietary plans that enforced a high intake of fruits, vegetables, legumes, fish and nuts saw a reduced risk of Alzheimer’s disease. “So, it can be multiple mechanisms, but more and more evidence have been showing that,” said Dr. Gu.
When asked how important diet was compared to other factors, Morris admitted the research wasn’t conclusive yet. She said, “there’s really not a good way to answer that question or to be able to say with any certainty that one factor is more important than another.”
Gu agreed. “We probably cannot prescribe a healthy diet tool to people now because these are all observational studies,” she said. “We need to replicate or confirm it in intervention studies. We need to find out at what age people need to begin, for how long, all those kinds of things.” Observational studies, as defined by the Medical Research Council Clinical Trials Unit at UCL, are when “the investigator observes individuals without manipulation or intervention.”
Morris still believes that diet can impact brain health. She said, “you get immediate benefits no matter what your age. You feel better, you function better.”
Ashley has begun eating healthier and recognizes the positive impact it could have on her well-being. She said, ” I have started doing so within the past year, but definitely I think doing so will help decrease my dementia risk.”Tags: Alzheimer's, healthy food, memories, Mental Health, nutrition