A Thorough Review of the Research
Before the conference, a Systematic Evidence Review (Meta-Study) of all the leading scientific publications on (1) Alzheimer’s Disease and (2) Cognitive Decline was performed by one of the Agencies for Healthcare Research and Quality Evidence-based Practice Centres (EPC’s). The EPC’s develop scientific evidence reports and technology assessments based on a rigorous analysis of the scientific literature, emphasising explicit documentation of methods, rationale, and assumptions.
The Meta-Study produced summarises the research from 25 systematic reviews and 250 primary research reports which were filtered from a total of 6,907 scientific studies. These 4% of studies were evaluated based on passing strict quality selection criteria including study design, demographics, intervention or prediction factor, and cognitive outcomes. Both observational and intervention studies were evaluated. The final 700 page Meta-Study was independently peer reviewed. In terms of independence and weight of evidence this report provides the strongest position on the subject of Dementia and Cognitive Ageing that we have today.
The National Institutes of Health Conference
The State of the Science Conference panel comprised of 12 industry experts. Their task was to review all of the evidence presented, give balanced, objective, and informed attention to the topic and prepare a formal report. The conference itself featured an additional 20 speakers: 4 analysts presented the historical information assessed in the EPC’s Meta-Study of the literature; the other 17 speakers were published experts and presented an overview of the scientific research in progress. Where multiple viewpoints existed on important topics, speakers were included that addressed all sides of the issue.
The Conference assessed whether the research on purported risk or protective factors for Alzheimer's Disease and Cognitive Decline is of sufficient strength to warrant specific recommendations for behavioural, lifestyle, or pharmaceutical interventions. The statement produced reflects the independent panel’s assessment of medical knowledge available at the time it is written. Thus, it provides a “snapshot in time” (April 2010) of the state of knowledge on the two topics examined - (1) Alzheimer’s Disease and (2) Cognitive Decline.
The Health Factors Reviewed
Health factors were grouped into the following categories and analysed: nutritional factors, medical conditions and medications, social/economic/behavioural factors, toxic environmental factors, and genetics. In summary, factors associated with increased risk were: diabetes, the APOE e4 gene, smoking, and depression. Factors showing a fairly consistent association with decreased risk were: cognitive engagement and physical activity. The good news for those interested in brain training exercises is that in the findings for Cognitive Decline, cognitive training has the highest level of evidence. For greater detail pages 7 & 8 of the “Systematic Evidence Review” ( http://www.ahrq.gov/clinic/tp/alzcogtp.htm ) provides a good snapshot of all the associated factors and their current status in terms of level of evidence.
Scientific research on Alzheimer's Disease and Cognitive Decline is progressing well but currently is not in a position to make definitive medical conclusions. Further long term research is still needed. However the current research does allow us to make some well informed decisions. Like cardiovascular health there will never be any guarantees but by acting on what we know now we will gain both immediate and long term benefits.
The weight of evidence does have clear trends and this is a good baseline from which individuals can make educated lifestyle choices. Certainty will continue to improve as research progresses, but for now this report provides the most solid foundation from which to work. Personal preferences should always guide individual choices but in this Meta-Study where the direction of association for each risk factor is categorised as:
1. “no evidence” we should probably consider ignoring
2. “inadequate evidence” we should probably consider treating as suspicious
3. “increasing or decreasing risk” we should probably consider as offering promising (but not certain) lifestyle choices
With any good risk management strategy our best bet is to diversify our risk across several of the most likely factors. The “Systematic Evidence Review” clearly identifies the most likely risk and protective factors. Like most of life we will never have complete certainty but we do have some very good direction provided by an independent panel of world experts. That is probably the most encouraging and truthful message for the public to hear.
A Warning about Media Headlines
Headline reporting of single studies that appear in the media from time to time do not carry the same scientific weight as the conference’s Systematic Evidence Review and whilst often containing useful and newly emerging information the study parameters should be rigorously weighed against the Meta-Study’s evaluation criteria. In reviewing the evidence for the Meta-Study the researchers found many poorly designed studies and conflicting results amongst the nearly 7,000 scientific publications they reviewed. Therefore it is the quality of evidence across the entire research community that is most important. Any person or organisation promoting a single study as being definitive should be regarded with suspicion.
PubMed ( www.ncbi.nlm.nih.gov/entrez/ ) is a service of the U.S. National Library of Medicine ( www.nlm.nih.gov ) that includes millions of citations from science journals. Scientific claims that cannot be supported by published research that appears in that library should also be regarded with suspicion.
Proactive Ageing Policy
Proactive Ageing believes that the NIH's State of the Science Conference on “Preventing Alzheimer’s Disease and Cognitive Decline”, it's Statement and Systematic Evidence Review (Meta-Study) provide the strongest medical and scientific position on the subject of Dementia and Cognitive Ageing that we have today. Although we remain up to date with new research as it becomes available the foundation of our prevention policies, education and fitness services is based on this research. Proactive Ageing believes that the NIH conference documents provide the most trustworthy source to help you understand how the science is truly progressing. From that perspective you will be able to better assess the value of emerging research and clarify what the future may hold.
Our training classes provide you with an overview of the conference, its meta-study and offer a realistic perspective on how the science is truly progressing. We will make it easy for you to translate the jargon, navigate the media headlines and understand what it all might mean for you. Our goal is to give you enough knowledge to comfortably make the lifestyle choices that are right for you.
Proactive Ageing’s Commentary
Proactive Ageing’s perspectives on the NIH's State of the Science Conference on Age Related Cognitive Decline has been published on an international market research firm’s website. Read here ..... SharpBrains-Report Author : Steve Zanon, Proactive Ageing Company Director.
Video on Australian Research
The Brain and Mind Research Institute at Sydney University is investigating whether early intervention programs promoting mind health can reduce cognitive decline. Click on the following link to view the ABC’s “730 Report” on developments. (Dec 2011)
The World’s Leading Health Research Organisation
The National Institutes of Health (NIH) in the USA is the largest medical research institution in the world ( www.nih.gov/about ). Its Consensus Development Program was established as a formal mechanism to systematically review and report on important topics in medicine and public health in an unbiased, impartial manner. Over 33 years the NIH has conducted 156 scientific conferences under this program, addressing a wide range of health issues. In April 2010, the NIH conducted its conference on “Preventing Alzheimer’s Disease and Cognitive Decline” and produced a comprehensive report reviewing virtually all of the scientific evidence available today.