Dietary Patterns, Physical Activity, Sleep, and Risk for Dementia and Cognitive Decline

Abstract

Purpose of Review Diet, physical activity, and sleep are three major modifiable lifestyle factors. This selective review examines the evidence for strong and reliable associations between these three lifestyle factors and risk of dementia and cognitive decline, in an effort to assist clinicians with providing more informed answers to the common questions they face from patients. Recent Findings Certain aspects of nutrition can decrease risk for dementia. Physical activity has also been associated with delayed or slower age-related cognitive decline. In addition, emerging evidence links sleep dysfunction and dementia, with amyloid deposition being a possible mediator. Summary Data from further clinical trials are needed before more definitive conclusions can be drawn regarding the efficacy of these lifestyle interventions for lowering the risk of incident dementia and cognitive decline. Nevertheless, it is reasonable to make recommendations to our patients to adopt certain dietary changes and to engage in regular physical activity to improve cardiovascular risk factors for dementia. It is also reasonable to include questions on sleep during cognitive evaluations of the elderly, given the common co-occurrence of sleep dysfunction and cognitive impairment in the elderly population.

Pour une prise en charge préventive de la maladie d’Alzheimer

“…• en premier lieu, ce sont les mesures d'hygiène de vie, le plus tôt possible dans la vie, dès l'adulte jeune [15] : Q6 contrôle des facteurs de risque vasculaire, notamment hypertension artérielle et diabète ; hygiène alimentaire, inspirée du régime méditerranéen ; activité physique régulière ; et vie sociale, fondée sur l'interaction et les rencontres ; • une intervention multimodale préventive plus directement orientée contre la maladie d'Alzheimer (exercices physiques et cognitifs avec contrôle de santé) doit être proposée chez des sujets à risque [16] ; • dans l'hypothèse où les essais en cours chez des sujets asymptomatiques retardent l'entrée dans la maladie d'Alzheimer (six essais thérapeutiques de phase 3 sont en cours dont nous n'aurons pas de résultats avant 3 ou 4 ans) [17], une prévention pharmacologique est envisageable.…”

“…Leur performance dans les tests cognitifs est normale. Ces « worried well » représentent 20 à 30 % des patients consultants dans une clinique de mémoire de référence [15,16]. Il va falloir composer avec cette nouvelle population de patients présentant des préoccupations, des demandes, des attentes et des espoirs nouveaux.…”

Health benefits induced by adherence to the Mediterranean lifestyle components diet and physical activity

“…In relation to Mediterranean lifestyle components beneficial to cognitive health, next to adherence to the diet, Yannakoulia et al (2015) particularly mention the participation in leisure activities, social interaction, physical activity and the quality of sleep. Each of these factors have been individually demonstrated to effectively maintain better cognitive performance, promote healthy cognitive ageing, reduce depressive symptoms, and delay neurodegeneration (e.g., Polidori, Nelles & Pientka, 2010;Schreiber et al, 2016;Clare et al, 2017;Kivipelto, Mangialasche & Ngandu, 2018;Zhao et al, 2018).…”

Discharge properties of human diaphragm motor units with ageing

“…; Zhao et al . ). ‘Healthy ageing’ is defined as ‘the process of developing and maintaining the functional ability that enables well‐being in older age’ (World Health Organisation, ).…”

“…Accumulation of cellular and molecular damage leads to degradation of tissues, which in turn gradually decreases physiological reserve, increases the risk of disease and decreases functional capacity. Lifestyle factors such as diet, physical activity and sleep are modifiable factors that may impact on the ageing process (Bouzid et al 2018;Zhao et al 2018). 'Healthy ageing' is defined as 'the process of developing and maintaining the functional ability that enables well-being in older age' (World Health Organisation, 2015).…”