06.01.10
An independent panel convened by the National Institutes of Health (NIH) determined that the value of strategies for delaying the onset and/or reducing the severity of cognitive decline or disease has not been demonstrated in rigorous studies. The panel’s assessment of the available evidence revealed that progress to understand how the onset of these conditions might be delayed or prevented is limited by inconsistent definitions of what constitutes Alzheimer’s disease and cognitive decline. Other factors include incomplete understanding of the natural history of the disease and limited understanding of the aging process in general.
The panel recommended that the research community and clinicians collaborate to develop, test and uniformly adopt objective measures of baseline cognitive function and changes over time. Although many non-modifiable risk factors have been examined, age is the strongest known risk factor for Alzheimer’s disease. Additionally, a genetic variant of a cholesterol-ferrying protein (apolipoprotein E), has strong evidence of association with the risk for developing Alzheimer’s disease.
The panel determined that there is currently no evidence of even moderate scientific quality supporting the association of any modifiable factor—dietary supplement intake, use of prescription or non-prescription drugs, diet, exercise and social engagement—with reduced risk of Alzheimer’s disease. Although there is little evidence that these interventions lessen cognitive decline, some are not necessarily harmful and may confer other benefits. However, the panel also emphasized the need for enhanced public understanding that these proposed prevention strategies are currently, at best, only loosely associated with improved outcomes. Ongoing studies exploring factors including but not limited to physical activity, omega 3 fatty acids, antihypertensive medications and cognitive engagement may provide new insight into Alzheimer’s disease and cognitive decline prevention.
The panel made a variety of recommendations to shape the future research agenda and fill identified gaps. For example, it advocated launching long-term, longitudinal studies to better characterize the natural history and progression of these diseases. They also recommended the establishment of registries for Alzheimer’s disease and cognitive decline, modeled on existing registries for cancer.
The panel recommended that the research community and clinicians collaborate to develop, test and uniformly adopt objective measures of baseline cognitive function and changes over time. Although many non-modifiable risk factors have been examined, age is the strongest known risk factor for Alzheimer’s disease. Additionally, a genetic variant of a cholesterol-ferrying protein (apolipoprotein E), has strong evidence of association with the risk for developing Alzheimer’s disease.
The panel determined that there is currently no evidence of even moderate scientific quality supporting the association of any modifiable factor—dietary supplement intake, use of prescription or non-prescription drugs, diet, exercise and social engagement—with reduced risk of Alzheimer’s disease. Although there is little evidence that these interventions lessen cognitive decline, some are not necessarily harmful and may confer other benefits. However, the panel also emphasized the need for enhanced public understanding that these proposed prevention strategies are currently, at best, only loosely associated with improved outcomes. Ongoing studies exploring factors including but not limited to physical activity, omega 3 fatty acids, antihypertensive medications and cognitive engagement may provide new insight into Alzheimer’s disease and cognitive decline prevention.
The panel made a variety of recommendations to shape the future research agenda and fill identified gaps. For example, it advocated launching long-term, longitudinal studies to better characterize the natural history and progression of these diseases. They also recommended the establishment of registries for Alzheimer’s disease and cognitive decline, modeled on existing registries for cancer.