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To Your Health: NLM update Transcript

Lifestyle and senior cognitive health: 11/02/2015

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D., senior staff, U.S. National Library of Medicine (NLM).

Here is what's new this week in To Your Health, a consumer health oriented podcast from NLM, that helps you use MedlinePlus to follow up on weekly topics.

While two comprehensive studies suggest moderate exercise and recommended diet supplements do not impact cognitive levels for seniors, lifestyle decisions remain important for older Americans, suggests an interesting editorial recently published in the Journal of the American Medical Association (JAMA).

The editorial accompanies two, new, comprehensive research studies published in the same JAMA issue, which suggest: first — cognitive benefits for seniors are not derived from structured exercise and second — an array of dietary supplements do not result in significant differences in cognitive outcomes among older study participants.

The editorial's two authors explain both studies were based on secondary analyses of randomized clinical trials of older adults. One trial recruited 1635 men and women ages 70-89. One group of seniors participated in moderate physical activities (including walking, resistance training, and flexibility exercises) compared to a peer group that did not participate in these activities. After two years, no differences in cognitive outcomes were found between the groups.

The second trial enrolled 4023 older adults at a high risk of progressing to late age-related macular degeneration. Some participants took an array of diet supplements (such as omega 3 fatty acids, vitamins C and E, beta carotene, and zinc) for as long as five years. Overall, the editorial's authors note none of the dietary supplements were associated with significant differences in cognitive outcomes between the participant groups.

The editorial's authors explain (and we quote): 'there is great interest in new evidence of lifestyle modifications that might improve cognitive aging and prevent the onset of dementia' (end of quote). The editorial's authors explain dementia is expected to increase significantly in the U.S. from about 36 million adults in 2010 to 66 million in 2030.

As a result, the editorial's authors note it is a challenge to reconcile the trial results (and we quote) 'with existing literature on exercise and diet interventions to prevent cognitive decline and dementia...' (end of quote).

Still, the authors note the overall weight of existing evidence suggests (and we quote): 'it is still likely that lifestyle factors such as diet and physical activity have important roles in the prevention of cognitive decline, dementia, and performance of the activities of daily living' (end of quote).

The editorial's authors acknowledge while the new research suggests the direct cognitive benefits of lifestyle interventions require more scrutiny, the authors counter (and we quote) 'there is clear evidence that physical activity and a healthy diet contribute to improvements in a wide variety of health outcomes' (end of quote).

Moreover, the editorial's authors conclude: (and we quote): 'it is likely the biggest gains in reducing the overall burden of dementia will be achieved through policy and public health initiatives promoting primary prevention of cognitive decline rather than efforts directed towards individuals who have already developed significant cognitive deficits' (end of quote).

Meanwhile, links to prevention information for seniors and adults abound in MedlinePlus.gov's dementia and mild cognitive impairment health topic pages. For example, the Alzheimer's Association has a link to a helpful website on brain health within the 'prevention/screening' section of MedlinePlus.gov's dementia health topic page. The U.S. Preventive Services Task Force also provides a good overview of screening for cognitive impairment in older adults, also within the 'prevention/screening' section of MedlinePlus.gov's dementia health topic page.

With prevention in mind, the American Academy of Family Physicians, provides information on nourishing your brain in the 'prevention/screening' section of MedlinePlus.gov's mild cognitive impairment health topic page.

MedlinePlus.gov's dementia and mild cognitive impairment health topic pages additionally provide links to the latest pertinent journal research articles, which are available in the 'journal articles' section. Links to clinical trials that may be occurring in your area are available in the 'clinical trials' section of both health topic pages. You also can sign up to receive updates about dementia or mild cognitive impairment as they become available on MedlinePlus.gov.

To find MedlinePlus.gov's dementia health topic page type 'dementia' in the search box on MedlinePlus.gov's home page, then, click on 'dementia (National Library of Medicine).' To find MedlinePlus.gov's mild cognitive impairment health topic page type 'MCI' in the search box on MedlinePlus.gov's home page, then, click on 'mild cognitive impairment (National Library of Medicine).'

MedlinePlus.gov also has health topic pages devoted to the treatment and care of Alzheimer's Disease.

Finally, the research addressed within the JAMA editorial represents a rare example where important medical research is published based on no significant findings. Usually, the published research in major journals focuses on significant (not non-significant) results. So, it is refreshing to see one of the world's leading medical journals publish (as well as contextualize) research where no significant differences are operant.

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It was nice to be with you. Please join us here next week and here's to your health!