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Why researchers say current brain disorder prevention approaches aren’t adequate.
Healthcare executives are in a key position to help spread the word on brain health and support a prevention approach, according to a new review article.
The review article published in June in the Frontiers of Aging Neuroscience, suggests that applying a precision medicine approach to cognitive disorder treatment and prevention efforts among older adults could improve outcomes. However, researchers and providers will need a more comprehensive understanding of the many risk factors that contribute to cognitive health and brain aging.
The researchers reviewed the extensive literature regarding what is known about the aging brain and age-related cognitive changes. Based on their review, they developed the Precision Aging model that would enhance the current “one-size-fits-all” approach to the cognitive aging population, which “is not adequate to close the gap between cognitive health span and lifespan,” the researchers wrote. The Precision Aging model examines the risk factors for age-related cognitive impairments, as well as potential targets for intervention and prevention efforts.
“Our paper presents a novel model of aging which we call Precision Aging,” says the study lead author Lee Ryan, PhD, professor and head, psychology department, and associate director, Evelyn F. McKnight Brain Institute, College of Science, University of Arizona in Tucson. “The Precision Aging model is meant to capture the incredibly complicated process of aging.”
According to Ryan, there are many different ‘trajectories’ of aging that are dependent on a combination of:
“All of these factors combine to determine brain health and cognitive health in older adults. Alzheimer’s disease is a terrible disease for the individual and their families, but it’s also important to remember that approximately 85% of older adults will never experience dementia,” she says. “They may experience some cognitive impairments, however, and sometimes these can be sufficiently serious to interfere with the quality of their daily lives. To understand these very complicated pathways of aging, we need to take a more nuanced approach to understanding aging.”
Currently, 16 million people in the U.S. are living with cognitive impairment, and more than 1.6 million of these individuals will develop Alzheimer’s disease annually.
“Our ultimate goal is to match cognitive health span with life span,” Ryan says. “The Precision Aging model is meant as a starting point for directing research into the complex ways that the brain ages. By understanding this complexity, we can help each individual understand their specific risk profile and how best to maintain brain health and cognitive health as they age.”
Major risk categories would include cardiovascular insufficiency, immune disruption, and chronic stress, among others.
The complex pathways
To understand these very complicated pathways of aging, Ryan and her colleagues require very large numbers of participants along with ways to reach those individuals who would not necessarily be able to participate in a study in their laboratories.
“The internet is an amazing tool for doing a large-scale study of aging,” she says. “We plan to use the internet to reach large numbers of older adults with various combinations of risk factors.”
With this approach, each individual could be characterized based on a profile of risk categories and genetic variants, leading to more personalized treatments for Alzheimer’s and other age-related cognitive disorders.
Ryan believes that individuals with a family history of Alzheimer’s should not feel doomed to experience Alzheimer’s-"and certainly not simply because your parents or grandparents were diagnosed with the disease,” she says. “There are many examples of people at high risk who live long and healthy lives without dementia. There is currently no cure for Alzheimer’s, or even long-term effective treatment.”
However, there are factors that the researchers noted that are good for the brain and can help reduce the risk of dementia. “They are the things we know we all should be doing already,” Ryan says. “A healthy body equals a better chance at a healthy brain, so things like exercise-aerobic and anaerobic, getting good sleep, eating a well-balanced nutritious diet, socializing, and avoiding risk factors known to negatively impact the cardiovascular system-smoking, heart disease, and diabetes. In our current world, where there is no cure, we need to focus on the things we can control and continue to participate in Alzheimer’s research so we can steadily make our way towards a cure.”