The main finding announced in the press release is:
“The panel determined that there is currently no evidence of even moderate scientific quality supporting the association of any modifiable factor—dietary supplement intake, use of prescription or non-prescription drugs, diet, exercise, and social engagement—with reduced risk of Alzheimer's disease. The evidence surrounding risk reduction for cognitive decline is similarly limited. Low-grade evidence shows weak associations between many lifestyle choices and reduced risk of Alzheimer's disease and cognitive decline.”
Prevention research is limited by lack of agreement on how to define both Alzheimer’s disease and cognitive decline, the release said.
Reporters on the call asked the panel what they expected doctors and the public to do with such negative findings. “I think that physicians can actually benefit from the information contained in this report,” replied Dr. Evelyn Granieri , a panel member from Columbia University. “It provides them with factual information to provide to patients and caregivers. This is informational, and the public should have the information we have… the state-of-the-science is that we don’t know how to prevent Alzheimer’s or cognitive decline.”
“…we’re not trying to take anyone’s hope away, not trying to make people feel helpless,” added Dr. Carl Bell from the University of Illinois at Chicago. “We have to go with the hard science, but we’re not trying to take away from people’s personal choices.” At 63, he says he’s “scared to death” of cognitive decline himself.
The panel did recommend further research into measures that have shown some promise, including some dietary measures, “cognitive engagement” (mostly brain training) and tightly controlling blood pressure.
This telebriefing turned out to have more discussion of healthcare economics than the actual conference did. “We hope this will dissuade folks from spending extraordinary amounts of money on stuff that doesn’t work,” said Dr. Bell. We found no evidence, and people should know that so they can make informed choices about how they spend their money,” said Dr. Dinesh Patel from George Washington University.
The idea of assessing how effective various treatments are and advising the public and physicians is not new – the Agency for Healthcare Research and Quality has conducted many similar reviews, including one prepared for this conference. Given current efforts to reduce the cost of healthcare, I’m sure we’ll see many more such reviews.
But new research might cost more than consumers save. Dr. Martha Daviglus of Northwestern University, Chair of the panel, acknowledged that the recommended research, where people will be monitored for 60, 70 or even 80 years, would cost “millions and millions” of dollars.