In previous blogs, in the spring of 2008 and the fall of 2007, I discussed different behavioral strategies for which there is some support indicating that they may help prevent or delay the mental impairments in Alzheimer’s disease.  Today I would like to briefly review a couple of those and extend the discussion.

I have indicated that physical and mental exercise may help in this regard.  Animal studies and some suggestive studies in people support this.  I have also indicated that diabetes is a disorder that increases the risk for Alzheimer’s disease.  In this blog I will extend this discussion, with a review of some recent research.

Social interaction is one area that appears to be important for decreasing the risk of Alzheimer’s disease.  A study by Krister Håkansson from the Karolinska Institute Alzheimer Research Center, Stockholm, Sweden and Växjö University, Växjö, Sweden assessed whether midlife marital status is related to late-life cognition.  The researches evaluated 1,449 people in midlife and again an average of 21 years later.  Persons in the study who were living with a partner in midlife were significantly less likely to have impairment in cognition (thinking and memory) compared the people who were single, separated, divorced or widowed.  The people with partners had a 50% lower risk for having dementia in late life.  Compared to married people, all life singles had a double risk; people who stayed divorced from midlife on had a triple risk; people who were widowed before midlife and stayed widowed had 6 times greater likelihood of developing dementia.  The researches interpreted this information in the context that social and intellectual stimulation helps protect against dementia.  (Similar to the point I made above that mental exercise appears to help prevent dementia.)

Evaluating people in midlife and reevaluating them two decades later is amazing. It takes great dedication and organization to accomplish such a project.  However, this research study and others like it are important as we try to decrease the impact of this horrible disease on our aging population.

Another research study with a similar approach took place in Israel.  Ramit Ravona-Springer and colleagues from Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel studied “rumination” in midlife and then again 30 years later.  For those of us who are uncertain what Ravona-Springer meant by rumination, I will try to convey that idea. It means the tendency to repeatedly think about one’s problems, such as problems at work or with family. The people were initially evaluated for their tendency to fret or worry about their problems (always forget about them, tend to forget about them, tend to ruminate about them, usually ruminate about them).  After 30 years, those with the strongest history of ruminating were 30-40% less likely to develop dementia.  The researchers did not offer an explanation for this rather astonishing result.  Considering our discussions in the previous paragraphs, we might speculate that rumination is another form of mental exercise.  Another possibility is that there is something about the people who ruminate that causes them to ruminate and at the same time that something causes them to have less of a tendency to have dementia.  This is an important principle in medicine; the association of two things, in this case rumination and tendency to develop Alzheimer’s disease, does not mean that one directly causes the other.