A Mediterranean diet and regular walking could be the key to lowering the risk of dementia

Researchers examined the protocol and current status of a study that examines the efficacy of regular walking and adherence to a Mediterranean-style diet in reducing the risk of dementia and age-related cognitive decline in independently living older adults without pre-existing cognitive impairments in a recent study published in the Journal of Alzheimer’s Disease.

Background

Growing older naturally causes cognitive abilities like episodic memory and spatial working to deteriorate. Nonetheless, a sharp reduction in cognitive function frequently points to a neuropathological deterioration that may result in dementia. Diet and physical activity are two significant modifiable risk factors for dementia in the lifestyle. Moreover, a higher risk of dementia and cognitive decline is associated with cardiovascular disease risk factors such arterial stiffness and high blood pressure. Dementia risk may be reduced by addressing these risk factors with nutrition and exercise.

Physical activity and following a Mediterranean diet are important ways to target the modifiable risk factors of dementia, according to a report by the World Health Organization and the Lancet Commission on dementia prevention, interventions, and care. Studies examining the effects of the Mediterranean diet on health have shown improvements in older people’s memory, cognitive function, and cardiovascular risk measures. Comparable outcomes have also been noted for physical activity interventions; however, preclinical and prospective cohort studies have provided the majority of the evidence for both of these interventions.

About the study

The MedWalk intervention, which encourages walking as a form of physical activity and adherence to the Mediterranean diet, was tested in the current study through a randomized controlled trial. The intervention was implemented using tried-and-true psychosocial strategies like motivational interviewing and cognitive-behavioral therapy (MI-CBT) to induce behavioral change. According to the researchers’ hypothesis, participants in the MedWalk intervention will experience a slower decline in cognitive function than those in the control group, who will carry on with their regular lives.

Additionally, the study sought to determine how the MedWalk intervention affected biomarkers associated with cognitive decline, including inflammation, glucose regulation, oxidative stress, mood, arterial stiffness, and cardiovascular health. One of the study’s secondary objectives was to assess how the intervention affected variables like cost-effectiveness and health economy.

This two-year randomized controlled trial involved senior citizens residing in Australian retirement communities. Compared to the larger community, which would be diverse due to a variety of factors, these retirement communities offered a homogenous and consistent study setup. These residential arrangements promoted camaraderie, which in turn promoted group walks and diet compliance.

Over the course of a year, the MedWalk intervention was put into practice, with more frequent group walks and diet consultations during the first half of the program and fewer during the second half. At six and twelve months following the baseline measurements, primary and secondary outcomes were evaluated. Owing to the coronavirus disease 2019 (COVID-19) pandemic, the research had to be altered and substantially condensed. The main theories and objectives of the study, according to the researchers, did not alter, even though the pandemic forced restrictions on the length of time that the primary and secondary outcomes could be measured.

Progress

Although the study’s sample size and timeline were reduced due to the COVID-19 pandemic, the study’s progress to date showed that baseline testing had been finished for 157 participants, who were being followed up for a year. Researchers or testers who are blinded conduct the cognitive testing at baseline and at the half-yearly and annual follow-ups.

A dietitian provides guidelines, meal plans, and recipes to help improve adherence to the Mediterranean-style diet, which is developed using the MI-CBT approach. To enhance physical activity levels, supervised group walking sessions led by certified exercise physiologists are offered.

The Neuropsychological Test of Cambridge To test the main effect of cognitive decline, the Paired Associated Learning task from Automated Battery is used to assess learning and visual memory. Additional assessments that are part of the automated battery are used to gauge secondary outcomes like response time, motor learning, spatial working memory, and rapid visual information processing.

While mood is being assessed using questionnaires on anxiety, depression, stress, and general health, sleep quality is being assessed using the Pittsburgh Sleep Quality Index. In addition, at baseline and during follow-ups, arterial stiffness and central and peripheral blood pressure readings are recorded. The participant’s quality of life and the size of their social network are evaluated using a variety of other indices.

Conclusions

In summary, the goal of the MedWalk intervention is to investigate how a modified Mediterranean-style diet combined with more physical activity—such as group walks—can reduce the rates of cognitive decline in older adults. The study is currently underway, with participants being recruited from retirement village communities in Australia as well as the broader community, due to the onset of the COVID-19 pandemic and associated social restrictions.

If this study’s findings hold up, the MedWalk intervention may be implemented in larger settings to slow down older adults’ cognitive aging and dementia risk, which would also greatly lessen the financial burden associated with their medical care.