Genetics Might be the Cause of Alzheimer’s in Some Cases

Genetics Might be the Cause of Alzheimer’s

According to new research, having two copies of the APOE4 gene variant may increase the risk of getting Alzheimer’s. The study also discovered that individuals with two copies of APOE4 are more likely to develop the disease earlier in life.

A recent study reveals that some Alzheimer’s cases have a direct hereditary origin [1].

No underlying cause for the majority of Alzheimer’s patients is currently known. Nonetheless, researchers have long understood that having an APOE4 gene variant in your family can increase your risk of being diagnosed. Individuals with two copies, which account for 2–5% of the population overall, are significantly more vulnerable [2].

Researchers have now proposed that possessing two copies of APOE4 may actually cause the condition rather than just increasing the likelihood of developing it.

A New Genetic Disorder

Researchers previously recognized two types of Alzheimer’s disease: familial and sporadic. The familial form results from genetic mutations, as the name implies. Typically, familial types are less common and develop early. Previously, medical practitioners believed less than 5% of cases, or around one in every fifty, were familial [3].

The new study suggests that 1 in 6 cases of Alzheimer’s would be due to the genetic type of the disease. This change occurred because scientists think they now have a better understanding of the role the APOE gene has in Alzheimer’s development. They believe they have discovered that a familial form of Alzheimer’s may be a separate disease rather than an offshoot.

Various forms of APOE that a person can have are:

  • APOE2 protects against developing Alzheimer’s.
  • APOE3 is considered neutral.
  • APOE4 raises the risk of developing Alzheimer’s. Individuals who carry two copies of this gene are at a higher risk.

APOE4 was initially considered to be a risk factor. Scientists now believe that it is an inherited type of Alzheimer’s and a separate disease.

Details About the New Study

Researchers in the United States and Spain contrasted individuals with two copies of APOE4 to those with other forms of the APOE gene [1].

The researchers examined data from 10,000 participants in five clinical trials and data from about 3,297 brains kept at the National Alzheimer’s Coordinating Center. Examining the brains kept at the Coordinating Center, scientists discovered that 273 had two gene copies. About 240 of them had dementia.

Additionally, the researchers discovered that the condition manifested roughly ten years sooner in those with the APOE4 variant with an average onset age of 65. According to their results, those with this inherited form of Alzheimer’s developed the disease at a faster rate than those with other kinds of Alzheimer’s.

The researchers stated that possessing one copy of the gene raises the Alzheimer’s risk. However, having two copies increased the likelihood of developing beta-amyloid and tau buildup in the brain.

These findings led the researchers to hypothesize that individuals who have two copies of APOE4 have a genetic type of Alzheimer’s.

According to a previous study, approximately 30% to 35% of individuals with two copies of the APOE4 gene would get dementia or at least mild cognitive impairment [4].

However, APOE4 has a substantial association with cardiac disease. It is possible that individuals with two gene copies passed away from heart disease rather than dementia since they had died before the researchers started looking for dementia.

Researchers in the current study estimate that 15% of patients with Alzheimer’s disease carry two copies of APOE4. The APOE4 gene is present in two copies in about 2% of the general population, making it one of the most common hereditary disorders.

Future Implications of the Research

The new research highlights whether asymptomatic individuals should undergo genetic testing to know if they carry two copies of APOE4.

Most people who carry two APOE4 genes are those whose parents were both diagnosed with Alzheimer’s disease quite early on—probably in their 60s.

Genetic tests are not currently performed in clinical settings to diagnose or predict Alzheimer’s risk. Many specialists do not recommend it due to the complexity associated with analyzing the results.

According to the study’s authors, this type of testing could be beneficial, and doctors should recommend it to their patients.

Lecanemab is a drug used to treat Alzheimer’s disease by removing amyloid plaques from the brain. Knowing if an individual has two copies could be life-saving. However, people with two copies of APOE4 are more likely to have brain swelling from these medications and since this medicine can cause brain swelling, several treatment centers do not offer it.

June is Alzheimer’s and Brain Awareness Month. It aims to increase public awareness and motivate individuals to donate money or their time to support and research. Besides raising awareness about Alzheimer’s, it aims to provide opportunities to raise funds for research and support services for Alzheimer’s patients and their families. Donate to the Alzheimer’s Research Foundation to help us support the Alzheimer’s family caregivers and provide them with resources.
Donate now: https://www.alzra.org/donate-now/

References

  1. Fortea, J., Pegueroles, J., Alcolea, D., Belbin, O., Dols-Icardo, O., Vaqué-Alcázar, L., Videla, L., Gispert, J.D., Suárez-Calvet, M., Johnson, S.C. and Sperling, R., 2024. APOE4 homozygozity represents a distinct genetic form of Alzheimer’s disease. Nature Medicine, pp.1-8.
  2. Alzheimer’s Disease Genetics Fact Sheet. National Institute on Aging. https://www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/alzheimers-disease-genetics-fact-sheet. Accessed: 7th June, 2024.
  3. Familial Alzheimer’s Disease. UCSF Weill Institute for Neurosciences. https://memory.ucsf.edu/genetics/familial-alzheimer-disease. Accessed: 7th June. 2024.
  4. Qian, J., Wolters, F.J., Beiser, A., Haan, M., Ikram, M.A., Karlawish, J., Langbaum, J.B., Neuhaus, J.M., Reiman, E.M., Roberts, J.S. and Seshadri, S., 2017. APOE-related risk of mild cognitive impairment and dementia for prevention trials: an analysis of four cohorts. PLoS medicine, 14(3), p.e1002254.
  5. Alzheimer’s disease may be inherited more often than previously thought. Medical News Today. https://www.medicalnewstoday.com/articles/alzheimers-disease-may-be-inherited-more-often-than-previously-thought. Published Online: 7th May, 2024. Accessed: 7th June, 2024.
  6. Study Identifies Genetic Variant as a Clear Cause of Alzheimer’s—Does This Mean You Should Get Tested? Health. https://www.health.com/genetics-causes-alzheimer-study-8648326. Published Online: 5th June, 2024. Accessed: 7th June, 2024.

Foods for Healthy Brain and Enhanced Memory

Foods for Healthy Brain and Enhanced Memory

Essential nutrients in oily fish, berries, almonds, and other brain-boosting foods may enhance both short- and long-term brain function.

The brain requires a lot of healthy nourishment to sustain focus throughout the day because it is an energy-intensive organ that uses about 20% of the body’s calories [1]. Eating a diet rich in brain foods is one of the best strategies to keep your mind functioning normally and avoid dementia and cognitive decline.

The brain needs specific nutrients to remain healthy. For instance, antioxidants lower cellular stress and inflammation, which are connected to brain aging and neurodegenerative diseases like Alzheimer’s, while omega-3 fatty acids aid in brain cell synthesis and repair [2].

Besides the calories expended in executing the myriad of brain processes, certain nutrients can enhance our cognitive performance. Based on the scientific evidence, this article explores what you should know about “brain foods.”

Recent Research on Food and Brain Health

A recent research published in Nature Aging has pointed out that particular foods can help slow brain aging [3]. The 100 individuals, ranging from 65 to 75, answered questionnaires, had MRI scans, underwent a battery of physical and mental examinations, and had blood plasma extracted following a fast.

Researchers observed that one group consumed a specific food profile and showed indications of delayed aging. Those with slower aging had higher blood levels of the following nutrients:

  • Fatty acids – found in seafood and some healthy cooking oils
  • Antioxidants – found in berries, garlic, tomatoes, nuts, and other fruits and vegetables
  • Carotenoids – found in spinach, kale, broccoli, and some fruits
  • Vitamin E – found in fruits, vegetables, seafood, seeds, nuts, and more
  • Choline – found in egg yolks, dairy, and some vegetables

The researchers highlighted that many of the foods in the Mediterranean diet are high in these nutrients. While most other studies on diets and brain health have focused on dietary questionnaires, this study is among the first to employ brain scans, blood biomarkers, and cognitive testing.

Foods for Improved Brain Health and Function

1. Fatty Fish

When it comes to brain foods, fatty fish is generally at the top of the list due to its high concentration of omega-3 fatty acids. Fatty fish include salmon, trout, tuna, herring, sardines, and mackerel.

Approximately 60% of your brain comprises fat, with omega-3 fatty acids accounting for slightly more than half of that fat [4]. Omega-3 fatty acids are essential for learning and memory because your brain needs them to form brain and nerve cells. So, meals high in these fats may promote brain health.

According to studies, omega-3 fatty acids may help prevent Alzheimer’s and slow down age-related mental deterioration [5]. Conversely, inadequate consumption of omega-3 fatty acids has been associated with depression and cognitive decline [6].

One study suggests that having one seafood dinner per week lowers the risk of Alzheimer’s and dementia [7]. Some studies also show that people who consume fish regularly have more gray matter in their brains [8]. Gray matter comprises nerve cells that regulate emotion, memory, and decision-making.

Soybeans, almonds, flaxseed, and other seeds are also good sources of omega-3s.

2. Coffee

Caffeine and antioxidants, two of coffee’s primary components, can promote brain health. Coffee caffeine has several beneficial impacts on the brain, including increased alertness, improved mood, and enhanced focus [9].

In addition to increasing alertness, a 2018 study found that caffeine may improve the brain’s ability to process information [10]. The researchers discovered that caffeine increases brain entropy, which refers to intricate and variable brain activity. A high level of entropy allows the brain to process more information.

Long-term coffee use has also been associated with a lower risk of neurological conditions, including stroke, cognitive decline, Parkinson’s, and Alzheimer’s. Adults who consumed 3-4 cups daily showed the highest risk reduction [11]. It may be due to coffee’s high concentration of antioxidants [12].

However, consuming caffeine close to bedtime or in excess might have a detrimental effect on your sleep. It can adversely affect your brain and memory.

3. Dark Chocolate

Dark chocolate comprises 70% or greater cocoa and is high in brain-boosting substances such as flavonoids, caffeine, and antioxidants. Since oxidative stress, linked to age-related cognitive decline and brain illnesses, can severely harm the brain, flavonoids, a form of antioxidant, are particularly crucial for maintaining brain health.

Flavonoids from cacao appear to be beneficial to the brain. A study suggests they might promote blood vessel and neuron growth in brain regions related to memory and learning. They might also increase the brain’s blood flow [13].

Another study also validates dark chocolate’s brain-boosting effects. The researchers employed imaging tools to examine brain activity after subjects consumed chocolate containing at least 70% cacao [14]. The researchers found that eating this type of dark chocolate may boost brain plasticity, which is essential for learning and may provide other cognitive benefits.

4. Berries

Similar to dark chocolate, many berries contain flavonoid antioxidants. Research suggests that these properties may make the berries beneficial to the brain since antioxidants lessen oxidative stress and inflammation. Berries are rich in antioxidants like quercetin, catechin, anthocyanin, and caffeic acid.

According to a review, berries’ antioxidant components have a variety of advantageous effects on the brain, such as [15]:

  • Enhancing communication between neurons
  • Reducing inflammation all over the body
  • Increasing plasticity, which helps brain cells make new connections, enhancing learning and memory
  • Preventing or delaying age-related neurodegenerative illnesses and cognitive decline

Berries high in antioxidants that promote brain health include strawberries, blackberries, blueberries, blackcurrants, and mulberries.

5. Nuts and Seeds

Since nuts and seeds are high in antioxidants and omega-3 fatty acids, eating more of them may benefit the brain. Research has shown that consuming nuts can enhance heart health markers, and having a healthy heart is associated with having a healthy brain and a lower chance of neurological problems [16].

According to one study, older persons who regularly eat nuts may be at a lower risk of experiencing cognitive decline [17].

Vitamin E, an antioxidant that shields cells from free radical-induced oxidative stress, is abundant in nuts and seeds. Vitamin E helps delay the onset of mental decline by protecting cells from the damaging effects of free radicals [18].

While all nuts benefit the brain, walnuts may have more advantages since they also contain omega-3 fatty acids, which have anti-inflammatory properties [19].

6. Broccoli

Broccoli is a low-calorie, high-fiber food that may also benefit the brain. It contains a high concentration of glucosinolates. When the body degrades them, it produces isothiocyanates. Isothiocyanates may lessen the risk of neurodegenerative illnesses and oxidative stress [20].

It is also high in vitamin K, a fat-soluble vitamin required for sphingolipids formation, a type of fat found densely packed in brain cells [21].

Some studies in older persons suggest that a higher vitamin K intake correlates with improved memory and cognitive status [22].

Additionally, broccoli includes substances like sulforaphane, which have antioxidant and anti-inflammatory properties and may help shield the brain from damage. Broccoli sprouts have a high concentration of sulforaphane [23].

7. Eggs

Eggs are an excellent source of nutrients linked to brain function, such as choline, folate, and vitamins B6 and B12.

Choline is a vital nutrient your body needs to produce acetylcholine, a neurotransmitter that regulates mood and memory. You must obtain choline from food to meet your needs since the liver can only create a limited quantity. Higher intakes may be associated with improved memory and mental function [24].

Eggs contain B vitamins, which are also good for the brain. They may assist in slowing the progression of cognitive decline by reducing levels of homocysteine, an amino acid that may be connected to dementia and Alzheimer’s [25].

Folate deficiency is widespread in dementia patients, and research indicates that folic acid supplementation can help reduce age-related cognitive loss [26]. In addition, vitamin B12 has a role in controlling blood sugar levels and synthesizing brain chemicals.

There is limited direct evidence on the relationship between eating eggs and brain health. However, studies confirm the brain-boosting properties of particular nutrients found in eggs.

8. Green Tea

Caffeine in green tea may enhance mental health by promoting focus, memory, performance, and alertness. Green tea also has additional components that boost brain function.

An amino acid called L-theanine has the ability to pass across the blood-brain barrier and raise GABA neurotransmitter activity, which relieves anxiety and induces relaxation [27].

According to a review, green tea’s L-theanine counteracts the stimulating effects of caffeine, promoting relaxation [28].

Antioxidants and polyphenols found in high concentrations in green tea may shield the brain against mental deterioration and lower the risk of neurodegenerative illnesses. Additionally, green tea might aid with memory improvement [29].

The Bottom Line

Certain foods, like fruits and vegetables, tea, and coffee, include minerals and antioxidants that help safeguard your brain from damage, enhance memory, elevate mood, and promote brain development. You may promote brain health by strategically incorporating these nutrients into your diet.

June is Alzheimer’s and Brain Awareness Month. It aims to increase public awareness and motivate individuals to donate money or their time to support and research. Besides raising awareness about Alzheimer’s, it aims to provide opportunities to raise funds for research and support services for Alzheimer’s patients and their families. Donate to the Alzheimer’s Research Foundation to help us support the Alzheimer’s family caregivers and provide them with resources.

Donate now: https://www.alzra.org/donate-now/

References

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  5. Bakre, A.T., Chen, R., Khutan, R., Wei, L., Smith, T., Qin, G., Danat, I.M., Zhou, W., Schofield, P., Clifford, A. and Wang, J., 2018. Association between fish consumption and risk of dementia: a new study from China and a systematic literature review and meta-analysis. Public health nutrition, 21(10), pp.1921-1932.
  6. Liao, Y., Xie, B., Zhang, H., He, Q., Guo, L., Subramanieapillai, M., Fan, B., Lu, C. and McIntyre, R.S., 2019. Efficacy of omega-3 PUFAs in depression: a meta-analysis. Translational psychiatry, 9(1), p.190.
  7. Zhang, Y., Chen, J., Qiu, J., Li, Y., Wang, J. and Jiao, J., 2016. Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose-response meta-analysis of 21 cohort studies. The American journal of clinical nutrition, 103(2), pp.330-340.
  8. Kokubun, K., Nemoto, K. and Yamakawa, Y., 2020. Fish intake may affect brain structure and improve cognitive ability in healthy people. Frontiers in aging neuroscience, 12, p.76.
  9. Ikram, M., Park, T.J., Ali, T. and Kim, M.O., 2020. Antioxidant and neuroprotective effects of caffeine against Alzheimer’s and Parkinson’s disease: Insight into the role of Nrf-2 and A2AR signaling. Antioxidants, 9(9), p.902.
  10. Chang, D., Song, D., Zhang, J., Shang, Y., Ge, Q. and Wang, Z., 2018. Caffeine caused a widespread increase of resting brain entropy. Scientific reports, 8(1), p.2700.
  11. Nehlig, A., 2016. Effects of coffee/caffeine on brain health and disease: What should I tell my patients?. Practical neurology, 16(2), pp.89-95.
  12. Poole, R., Kennedy, O.J., Roderick, P., Fallowfield, J.A., Hayes, P.C. and Parkes, J., 2017. Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. bmj, 359.
  13. Nehlig, A., 2013. The neuroprotective effects of cocoa flavanol and its influence on cognitive performance. British journal of clinical pharmacology, 75(3), pp.716-727
  14. Berk, L., Miller, J., Bruhjell, K., Dhuri, S.A.Y.A.L.I., Patel, K., Lohman, E., Bains, G. and Berk, R., 2018. Dark chocolate (70% organic cacao) increases acute and chronic EEG power spectral density (μV2) response of gamma frequency (25–40 Hz) for brain health: enhancement of neuroplasticity, neural synchrony, cognitive processing, learning, memory, recall, and mindfulness meditation. The FASEB Journal, 32, pp.878-10..
  15. Subash, S., Essa, M.M., Al-Adawi, S., Memon, M.A., Manivasagam, T. and Akbar, M., 2014. Neuroprotective effects of berry fruits on neurodegenerative diseases. Neural regeneration research, 9(16), pp.1557-1566.
  16. Nishi, S.K., Sala-Vila, A., Julvez, J., Sabaté, J. and Ros, E., 2023. Impact of nut consumption on cognition across the lifespan. Nutrients, 15(4), p.1000.
  17. Li, F., Jiang, W., Wang, J., Zhang, T., Gu, X., Zhai, Y., Wu, M., Xu, L. and Lin, J., 2022. Beneficial effects of nut consumption on cognitive function among elderly: findings from a 6-year cohort study. Frontiers in Aging Neuroscience, 14, p.816443.
  18. Zhao, R., Han, X., Zhang, H., Liu, J., Zhang, M., Zhao, W., Jiang, S., Li, R., Cai, H. and You, H., 2022. Association of vitamin E intake in diet and supplements with risk of dementia: A meta-analysis. Frontiers in Aging Neuroscience, 14, p.955878.
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  22. Alisi, L., Cafolla, C., Gentili, A., Tartaglione, S., Curini, R. and Cafolla, A., 2020. Vitamin K concentration and cognitive status in elderly patients on anticoagulant therapy: a pilot study. Journal of Aging Research, 2020.
  23. Klomparens, E.A. and Ding, Y., 2019. The neuroprotective mechanisms and effects of sulforaphane. Brain Circulation, 5(2), pp.74-83.
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  26. Puga, A.M., Ruperto, M., Samaniego-Vaesken, M.D.L., Montero-Bravo, A., Partearroyo, T. and Varela-Moreiras, G., 2021. Effects of supplementation with folic acid and its combinations with other nutrients on cognitive impairment and Alzheimer’s disease: a narrative review. Nutrients, 13(9), p.2966.
  27. Williams, J.L., Everett, J.M., D’Cunha, N.M., Sergi, D., Georgousopoulou, E.N., Keegan, R.J., McKune, A.J., Mellor, D.D., Anstice, N. and Naumovski, N., 2020. The effects of green tea amino acid L-theanine consumption on the ability to manage stress and anxiety levels: a systematic review. Plant foods for human nutrition, 75(1), pp.12-23.
  28. Dietz, C. and Dekker, M., 2017. Effect of green tea phytochemicals on mood and cognition. Current pharmaceutical design, 23(19), pp.2876-2905.
  29. Baba, Y., Inagaki, S., Nakagawa, S., Kaneko, T., Kobayashi, M. and Takihara, T., 2020. Effect of daily intake of green tea catechins on cognitive function in middle-aged and older subjects: A randomized, placebo-controlled study. Molecules, 25(18), p.4265.
  30. Best Foods for A Healthy Brain and Improved Memory. Healthline. https://www.healthline.com/nutrition/11-brain-foods. Published Online: 13th March, 2024. Accessed: 3rd June, 2024.
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  32. These 5 foods can slow aging in your brain, new study finds. Today. https://www.today.com/health/diet-fitness/brain-foods-rcna152259. Published Online: 28th May, 2024. Accessed: 3rd June, 2024.

Healthy Lifestyle May Help Offset Cognitive Decline Even in Dementia Patients

According to a recent study, eating healthily, exercising, and abstaining from alcohol and tobacco can all help prevent or slow mental decline. The study revealed that by adopting these healthy practices, even individuals with dementia experienced less decline.

A healthy lifestyle is known to have a tremendous positive impact on our mental and physical well-being, and a recent study suggests that it may also maintain our cognitive abilities as we age.

The study, published in JAMA Neurology, discovered that living a healthy lifestyle — being physically active, eating healthily, quitting smoking, and reducing alcohol intake — can decrease cognitive loss, even in persons with neuropathologies like dementia [1].

Although more research is required to fully understand the role of lifestyle factors, scientists believe that healthy activities improve vascular function, reduce inflammation in the brain, and support brain cell growth and plasticity.

People With Healthier Lifestyle Exhibited Better Brain Function

The researchers examined the health records of 586 people who participated in the Rush Memory and Aging Project, a longitudinal study from 1997 to 2022 [2].

The subjects were dead and autopsied. The study contained information regarding the person’s cognition, lifestyle characteristics, and neuropathologic evaluation results.

Every person was given a lifestyle score, which went from 0 to 5, based on factors such as their diet, level of regular physical activity, use of alcohol or tobacco, and participation in cognitive activities.

The researchers discovered that a healthier lifestyle was associated with improved cognitive function, irrespective of whether the patients had brain diseases like Alzheimer’s. Reduced levels of beta-amyloid plaque, a protein that builds up in the brains of Alzheimer’s patients, were also linked to higher lifestyle scores.

It implies that lifestyle factors may maintain brain function in older adults, even in those who are actively undergoing cognitive decline.

How to Protect Your Cognitive Function

Research continuously demonstrates that leading a healthy lifestyle has several positive effects on cognition and may even lower the risk of dementia in individuals who are genetically susceptible to the illness [3].

According to a recent study, modifying 12 risk factors, many of which are associated with a healthy lifestyle, could delay or avert up to 40% of dementia diagnoses [4].

Although further investigation is required, scientists have a few theories about how and why lifestyle factors affect cognition.

According to some experts, adopting healthy lifestyle practices that support brain health, like physical activity and cognitive stimulation, can assist in improving heart health, boosting brain activity, and increasing brain volumes, besides increasing blood flow to the brain [5].

For instance, research has shown that a healthy lifestyle improves vascular function in the body, lowering the incidence of diabetes, hypertension, and, eventually, dementia [6].

Furthermore, lifestyle variables may support neuroplasticity—the brain’s capacity to create new connections between brain cells—and neurogenesis, or the growth of brain cells. Maintaining a healthy lifestyle may also shield the brain against oxidative stress and neuroinflammation [7].

Investing in Your Health Today Can Pay Off in the Future

According to research, engaging in 150 minutes of physical activity each week, eating a well-rounded diet, spending time with friends and family, and engaging in cognitively demanding activities are all recommended.

The effects of lifestyle on cognitive performance are most prominent in older persons without dementia.

According to research, engaging in 150 minutes of physical activity each week [8], eating a well-rounded diet, spending time with friends and family, and engaging in cognitively demanding activities are all recommended.

The effects of lifestyle on cognitive performance are most prominent in older persons without dementia. However, engaging in social, mental, and physical activities may be beneficial even for people who already have brain disorders.

June is Alzheimer’s and Brain Awareness Month. It aims to increase public awareness and motivate individuals to donate money or their time to support and research. Besides raising awareness about Alzheimer’s, it aims to provide opportunities to raise funds for research and support services for Alzheimer’s patients and their families. Donate to the Alzheimer’s Research Foundation to help us support the Alzheimer’s family caregivers and provide them with resources.

Donate now: https://www.alzra.org/donate-now/

References

  1. Dhana, K., Agarwal, P., James, B.D., Leurgans, S.E., Rajan, K.B., Aggarwal, N.T., Barnes, L.L., Bennett, D.A. and Schneider, J.A., 2024. Healthy Lifestyle and Cognition in Older Adults With Common Neuropathologies of Dementia. JAMA neurology.
  2. Memory and Aging Project. Rush University. https://www.rushu.rush.edu/research/departmental-research/rush-alzheimers-disease-center/rush-alzheimers-disease-center-research/epidemologic-research/memory-and-aging-project. Accessed: 30th May, 2024.
  3. Lourida, I., Hannon, E., Littlejohns, T.J., Langa, K.M., Hyppönen, E., Kuźma, E. and Llewellyn, D.J., 2019. Association of lifestyle and genetic risk with incidence of dementia. Jama, 322(5), pp.430-437.
  4. Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C. and Costafreda, S.G., 2020. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), pp.413-446.
  5. Healthy Lifestyle May Offset Cognitive Decline Even in People With Dementia. Healthline. https://www.healthline.com/health-news/healthy-lifestyle-may-offset-cognitive-decline-even-in-people-with-dementia. Published Online: 6th February, 2024. Accessed: 30th May, 2024.
  6. Elwood, P., Galante, J., Pickering, J., Palmer, S., Bayer, A., Ben-Shlomo, Y., Longley, M. and Gallacher, J., 2013. Healthy lifestyles reduce the incidence of chronic diseases and dementia: evidence from the Caerphilly cohort study. PloS one, 8(12), p.e81877.
  7. Kip, E. and Parr-Brownlie, L.C., 2023. Healthy lifestyles and wellbeing reduce neuroinflammation and prevent neurodegenerative and psychiatric disorders. Frontiers in Neuroscience, 17, p.1092537.
  8. Wang, S., Liu, H.Y., Cheng, Y.C. and Su, C.H., 2021. Exercise dosage in reducing the risk of dementia development: Mode, duration, and intensity—A narrative review. International journal of environmental research and public health, 18(24), p.13331.