Mediterranean Diet and Walking May Reduce Cognitive Decline
new randomized controlled trial is investigating whether a Mediterranean diet and walking intervention can reduce cognitive decline in older Australians. Learn more about the MedWalk trial and how to participate.
DR TS DIDWAL
10/4/20234 min read
In a recent study published in the Journal of Alzheimer's Disease, researchers discussed the protocol and current progress of a study that investigates the effectiveness of regular walking and adherence to a Mediterranean-style diet in decreasing the risk of dementia and age-related cognitive decline in independently living older adults without existing cognitive impairments. The study, titled "A Mediterranean Diet and Walking Intervention to Reduce Cognitive Decline and Dementia Risk in Independently Living Older Australians: The MedWalk Randomized Controlled Trial Experimental Protocol," sheds light on the potential of lifestyle interventions to combat cognitive decline. In this article, we delve into the details of this groundbreaking study and its implications for cognitive health.
The Growing Concern of Cognitive Decline and Dementia
A decline in cognitive functions, such as spatial working and episodic memory, is a natural consequence of aging. However, a rapid decline in cognitive abilities often signals a neuropathological deterioration that could lead to dementia. Lifestyle factors, including physical activity and diet, play a pivotal role in modifiable risk factors for dementia. Additionally, risk factors related to cardiovascular disease, such as arterial stiffness and high blood pressure, contribute to an increased risk of dementia and cognitive decline. Targeting these risk factors through diet and exercise may hold the key to lowering the risk of dementia.
The Mediterranean Diet and Physical Activity as Protective Measures
The Lancet Commission and the World Health Organization have emphasized the significance of physical activity and adherence to the Mediterranean diet in targeting modifiable risk factors associated with dementia. Studies examining the impact of the Mediterranean diet on health have reported improvements in cardiovascular risk measures, cognitive function, and memory among older individuals. Similar results have been observed for physical activity interventions, though much of the evidence comes from preclinical and prospective cohort studies.
About the MedWalk Randomized Controlled Trial
In the present study, researchers conducted a randomized controlled trial to assess the effectiveness of the MedWalk intervention. This intervention promotes adherence to the Mediterranean diet and regular walking as a form of physical activity. It employs proven psychosocial techniques, such as motivational interviewing and cognitive-behavioral therapy (MI-CBT), to induce behavioral change in participants. The primary hypothesis was that the MedWalk intervention would lead to a slower decline in cognitive function compared to a control group following their habitual lifestyles.
The study also aimed to investigate the impact of the MedWalk intervention on various factors, including quality of life, mood, arterial stiffness, cardiovascular health, and biomarkers like inflammation, glucose regulation, nutrient status, and oxidative stress—all of which are closely linked to cognitive decline. Additionally, the study assessed secondary outcomes, such as health economics and cost-effectiveness.
Conducting the MedWalk Trial
This randomized controlled trial spanned two years and involved older adults residing in retirement villages across Australia. These retirement villages provided a controlled and uniform study environment compared to the more heterogeneous broader community. They also fostered mutual support, making it easier to organize group walk sessions and encourage adherence to dietary plans.
The MedWalk intervention extended over a year, with the initial six months characterized by more frequent group walking sessions and diet consultations. These sessions gradually reduced in frequency over the latter half of the year. Primary and secondary outcomes were assessed at six and twelve months, with adjustments made due to the onset of the COVID-19 pandemic, which led to modifications and abbreviations in the study.
Progress Despite Challenges
Despite the challenges posed by the COVID-19 pandemic, the study made significant progress. Baseline testing was completed for 157 participants who were followed up for a year. Cognitive testing, conducted by blinded testers or researchers, took place at baseline and at six-month and twelve-month follow-ups.
The MI-CBT approach was employed to instill adherence to the Mediterranean-style diet, with dietitians providing instructions, meal planning, and recipes to enhance adherence. Accredited exercise physiologists supervised group walking sessions to increase physical activity levels.
Assessing Cognitive Decline and Related Factors
The study's primary outcome measure for cognitive decline was the Cambridge Neuropsychological Test Automated Battery's Paired Associated Learning task, which evaluates learning and visual memory. Secondary outcomes included motor learning, spatial working memory, rapid visual information processing, and reaction time, all measured using various tests within the automated battery.
To assess mood, questionnaires on anxiety, depression, stress, and general health were administered. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Additionally, arterial stiffness and central and peripheral blood pressures were recorded at baseline and during follow-ups. Various other indices were employed to gauge participants' quality of life and the extent of their social network.
Potential Implications and Future Directions
In summary, the MedWalk intervention has been carefully designed to examine the impact of a combined modified Mediterranean-style diet and increased physical activity through group walks on reducing cognitive decline rates among older adults. Despite the challenges posed by the COVID-19 pandemic, the study is progressing with participants recruited from retirement village communities in Australia and a broader community.
Should the results of this study prove promising, the MedWalk intervention could hold the potential for broader application, aiming to decrease cognitive decline and the risk of dementia among older adults. This would not only benefit the well-being of older individuals but also alleviate the considerable health-related economic burden associated with dementia.
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