People diagnosed with early Alzheimer’s disease may be highly motivated to protect their memory, but new research suggests that many are still missing everyday steps that could support brain health.
Researchers at the Mass General Brigham Neuroscience Institute found that very few patients followed all of the health recommendations examined in their study.
The findings were published in The Journal of Prevention of Alzheimer’s Disease.
Alzheimer’s disease is the most common cause of dementia.
It slowly damages brain cells and can affect memory, thinking, language, judgment, and eventually the ability to manage daily life. Mild cognitive impairment and mild dementia can represent early stages of the disease, when many people are still living relatively independently.
New medicines have changed the treatment landscape for some people with early Alzheimer’s. One example is lecanemab, an antibody treatment designed to remove amyloid, a protein that builds up abnormally in the brains of people with Alzheimer’s disease.
The medicine requires regular intravenous infusions and also carries risks that need medical monitoring.
Because receiving this treatment involves considerable commitment, the researchers expected patients seeking lecanemab to be especially motivated about protecting their brains in other ways. They wanted to know whether these patients were also following recommendations involving exercise, sleep, diet, blood pressure, blood sugar, social activity, and other potentially changeable factors.
The team studied 150 people with mild cognitive impairment or mild dementia caused by Alzheimer’s disease who were seeking anti-amyloid treatment. They compared them with 117 patients at a similar stage of disease who were not pursuing this treatment. The researchers assessed 15 areas of brain health using an approach called Brain Health Vital Signs.
These recommendations reflect growing evidence that brain health is connected with the health of the rest of the body. Regular physical activity, adequate sleep, healthy eating, good control of blood pressure and blood sugar, and avoiding excessive alcohol may all influence the risk of cognitive decline. Staying socially connected and mentally active, and addressing hearing or vision problems, may also matter.
The results showed a large gap between what is recommended and what patients were actually doing. Fewer than 3% of the people studied were meeting all 15 brain health recommendations. Importantly, patients seeking anti-amyloid treatment were not significantly better at following the recommendations than those who were not seeking the treatment.
Among people pursuing anti-amyloid therapy, more than one-quarter were falling short in 11 of the 15 areas examined. More than half were not meeting the recommended level in four areas. Similar problems were found among patients who were not pursuing anti-amyloid medicines.
Physical activity was the most common challenge. The researchers used a goal of at least 25 minutes of physical activity per day on most days of the week. About 63% of patients seeking anti-amyloid treatment were not reaching that target.
Other difficult areas included stress management and maintaining healthier levels of blood sugar, blood pressure, and body weight. These factors are important because the brain depends on a healthy supply of blood and oxygen. Conditions that damage blood vessels may add to the problems already caused by Alzheimer’s disease.
The findings do not prove that improving all 15 factors will stop Alzheimer’s or restore memory that has already been lost. Alzheimer’s is a complex disease, and lifestyle changes are not a replacement for medical care or appropriate treatment. Instead, the study highlights opportunities to improve overall brain and body health alongside standard Alzheimer’s care.
The researchers believe simply telling patients what they should do may not be enough. Changing exercise, diet, sleep, stress, and other long-established habits can be difficult, especially for someone already experiencing memory or thinking problems. Families and caregivers may also need practical support to help make these changes possible.
Earlier work from the researchers offers some encouragement. Their Brain Health Champion Study found that people who received six months of individualized brain health coaching improved how well they followed recommended behaviors. This suggests that structured coaching may be more effective than handing patients a list of instructions.
The new study has several strengths, including its direct comparison of patients seeking an intensive new Alzheimer’s treatment with similar patients who were not. Looking across 15 changeable health factors also provides a broader picture than studying exercise or diet alone. The findings expose an important gap between scientific recommendations and what happens in everyday life.
There are limitations as well. The study examined adherence to recommendations rather than proving that improving these behaviors would slow Alzheimer’s progression in these particular patients. The participants were also receiving care in a specialized medical setting, so their experiences may not represent every person living with early Alzheimer’s disease.
Overall, the research suggests that advanced medicines and everyday health habits should not be viewed as competing approaches. Even patients willing to undergo regular lecanemab infusions may need much more help with exercise, sleep, stress, and cardiovascular health.
The study’s most practical lesson may be that knowing what protects brain health is only the first step; health systems also need realistic ways to help patients put that knowledge into practice.
If you care about brain health, please read studies about vitamin D deficiency linked to Alzheimer’s and dementia, and strawberries can be good defence against Alzheimer’s.
For more health information, please see recent studies about foods that reduce Alzheimer’s risk, and oral cannabis extract may help reduce Alzheimer’s symptoms.
