Bret S. Stetka, MD; Gary W. Small, MD


July 03, 2014

In This Article

More Powerful Than a Pill

Medscape: Last year at AAN, you presented some very intriguing data on diet and nutrition. It seems that there is some powerful evidence that lifestyle modifications, including Mediterranean dietary patterns, can benefit patients with AD. Can you speak to these data?

Dr. Small: The strongest data are in the area of physical exercise. People who exercise regularly, and have cardiovascular conditioning, have a lower risk for developing Alzheimer dementia.

In small-scale studies and other epidemiologic studies, there is evidence that nutrition is very important as well. We have programs at the University of California, Los Angeles (UCLA), that we license around the country that help people engage in these healthy lifestyle strategies. They include a nutritional component, a physical exercise component, and a stress management component, because there is some evidence that better stress management is probably better for your brain. We also teach memory techniques to compensate for age-related decline.

Medscape: So you believe a multipronged approach can make a meaningful difference?

Dr. Small: At the University of California, San Francisco, Deborah Barnes and Kristine Yaffe[4] have modeled these and other potentially modifiable risk factors for Alzheimer disease, and they attribute about 50% of cases to some of these risk factors. There is more interest in these risk factors, so while we are waiting for science to catch up and find disease-modifying treatments, we should encourage our patients to live healthy lifestyles.

Medscape: So for the time being, addressing these various risk factors is one of the most important components to Alzheimer disease management?

Dr. Small: It may be as powerful as any medication.


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