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What Keeps Your Heart Strong May Also Keep Your Mind Sharp

‘It is the heart and not the brain That to the highest doth attain,” wrote the poet Longfellow. Yet, when it comes to attaining good health, the heart and the brain are largely one and the same — at least according to new research.

The study concludes that controlling the risk factors for cardiovascular disease, from education through to exercise, can also stave off Alzheimer’s and other forms of dementia.

“Many of the factors that can put our brain health at risk are things we can modify and control,” said Dr. William Thies, vice-president of medical and scientific affairs for the U.S. Alzheimer’s Association. “Healthier living can significantly contribute to reducing the numbers of sick and mentally declining older people, and reduce health-care costs,” he said.

The research, published in today’s edition of the medical journal Alzheimer’s & Dementia is a review of 96 studies already conducted on the link between heart health and brain health. In particular, the researchers focused on 36 long-term epidemiological studies that are following large populations of seniors in Europe and North America.

The scientists found that cardiovascular risk factors that also directly affect the brain include hypertension, smoking, obesity, diabetes and high cholesterol.

Dr. Jack Diamond, scientific director of the Alzheimer Society of Canada, said while there is not a lot of new information in the study, “it’s good to have these things said, if it helps with education.”

Dr. Diamond stressed that most of the risk factors cited in the study contribute to cognitive decline, not necessarily full-blown Alzheimer’s and dementia. “You can have cognitive decline as a normal part of aging and not suffer from dementia,” he said.

Dr. Hugh Hendrie, a professor of psychiatry at Indiana University School of Medicine in Indianapolis, and chair of the committee that conducted the review, said the strongest evidence in the study was the information showing a “link between hypertension and cognitive decline.”

People with hypertension are at much greater risk of heart attack, stroke and dementia. But many Canadians with high blood pressure don’t even know it because they do not necessarily feel unhealthy.

The authors also pointed out that a number of studies that show physical activity can protect against both heart disease and dementia are quite intriguing, but require more study.

Research published last year found that walking between half a kilometer and three kilometres daily can reduce the risk of cognitive decline by between 20 per cent and 50 per cent. “If physical activity were to protect against cognitive deterioration in the elderly, it would be of great public health importance because physical activity is relatively inexpensive, has few negative consequences, and is accessible to most elders,” the report said.

The committee also found that:

The factors most consistently cited as protecting against dementia include higher education level, higher socio-economic status, emotional support, more physical exercise, moderate alcohol use, and use of vitamin supplements, specifically antioxidants such as vitamins C and E;
Psychosocial factors, such as being socially isolated and suffering from depression are strongly associated with Alzheimer’s and dementia;
Increased mental activity throughout life, such as learning new things and regularly doing crossword puzzles and reading newspapers, seems to help the brain remain healthy;
Genetic influences on healthy brains are poorly understood at present.

In the study, the committee urges researchers to shift their focus and study “brain health maintenance” with as much vigour as they currently study brain disease — in other words, that there be a significant shift toward understand how dementia can be prevented.

The panel also recommends that measuring cognitive decline (a precursor to dementia) become an integral part of cardiovascular research.

An estimated 435,000 Canadians over the age of 65 have Alzheimer’s disease or a related dementia, according to the Alzheimer Society of Canada. Women account for two in every three cases of dementia.

In addition to Alzheimer’s, common forms of dementia include vascular dementia (often caused by a stroke), Lewy body disease and Creutzfeldt-Jakob disease.

By ANDRÉ PICARD, Globe and Mail, February 22, 2006.

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