Billions of dollars are being spent on research to find a molecule that could cure Alzheimer’s disease. Yet, as Dr. Louis Bherer explains, adopting certain lifestyle habits could significantly reduce the risk of developing symptoms, in some cases by up to half.
Dr. Bherer is a professor in the Department of Medicine at the University of Montreal and a researcher and director of the EPIC Center, the preventive medicine and physical activity center of the Montreal Heart Institute (Montreal Heart Institute). His work focuses on the impact of lifestyle, physical exercise and cognitive stimulation on the brain health of older adults and patients with cardiovascular diseases.
In his Montreal laboratory, Bherer and his team develop physical and cognitive exercise programs. Their study results support what other research has found about the importance of lifestyle in preventing dementia. This factor has been neglected by public health authorities, explains Dr. Bherer, who is also laboratory director at the University Institute of Geriatrics of Montreal. We recently spoke to Dr. Bherer:
The Canada Conversation: A new study from Statistics Canada indicates a substantial decline in healthy life expectancy in Canada. In 2023, it was 66.9 years, a decrease of 3.5 years from the peak of 70.4 years between 2010 and 2012. Are you surprised?
Dr. Louis Bherer: Yes and no. But what we do know is that the gap between lifespan and health – the gap between life expectancy and healthy life expectancy – is widening. For example, nine out of ten people have at least one risk factor for cardiovascular disease after age 65: excess weight, lack of sleep, inactivity, high blood pressure, etc. As life expectancy increases, this means many years of poor health.
Our lifestyle is not optimal. Stress and anxiety increase. It’s a scourge. Additionally, people are inactive, have sleep problems and neglect their diet. We eat fast, and eat fast food or ultra-processed foods. Even though the information exists and is available, we do not always apply it. We don’t teach this to our children either. Physical education should be part of the daily school curriculum and the basics of nutrition should also be taught.
This article is part of our ongoing series The Gray Revolution. The Conversation Canada and La Conversation explore the impact of the aging baby boomer generation on Canadian society, including housing, work, culture, nutrition, travel and health care. The series explores the upheavals already underway and those to come.
Moreover, people are quickly turning to pharmaceutical solutions. The popularity of Ozempic is an example of this. We want to lose weight, but we don’t address the causes of being overweight. We don’t do much to encourage people to change their lifestyle. It is estimated that almost half of all cases of dementia (45%) could be prevented through a healthy lifestyle. Fourteen modifiable risk factors (MRFs) were identified.
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TCC: A lot of people say to themselves: I’m 65 or 70 years old, so it’s too late for me to change my habits. I should have started earlier.
kg: It’s never too late, even though we know that education (a mitigating factor for dementia) is generally acquired at a young age. This contrasts with hearing loss, which occurs later in life. Many people do not take it seriously or hide it, even though it is a factor associated with an increased risk of major cognitive impairment or dementia. And of course, psychological health plays a major role: a person may be inactive because they feel a little depressed or less motivated, but this increases the risks. We don’t realize that overall health factors are all interrelated. Heart health and brain health go hand in hand. What is good for the heart is good for the brain.
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TCC: Your laboratory, focused on cognitive health, is located at the Montreal Heart Institute. What are you doing here exactly?
kg: We use stimulation programs to assess the impact of exercise on physical and cognitive health. Our participants range in age from 50 to 95 years old, with an average age between 68 and 70 years old. We follow them over periods ranging from three months to a year. They may have mild cognitive deficits that those around them have noticed, and they sometimes suffer from anxiety, a condition that can impact memory and be a predictor of dementia. The other participants do not have cognitive problems, but they are at risk due to high blood pressure, diabetes, etc. Our programs include, for example, memory games on the phone that improve cognitive functions, including psychomotor speed, as well as physical exercises: stationary bikes, treadmills, muscle strengthening, etc. The best approach is a combination of both.
TCC: What did you observe?
kg: We are seeing clinically meaningful improvements. Participants with mild cognitive impairment may see improvements after six months of training, with differences in their attention, alertness and response speed. They are more alert after just a few weeks. There is also an impact on memory, although it takes longer. Using biomarkers, our research attempts to link parameters that change, both physically and cognitively, to effects on the brain. Using brain imaging, we can measure improvements in blood flow and brain structures, such as the hippocampus, which plays a key role in memory.
Physical training, practiced three times a week, stimulates the production of proteins promoting neuroplasticity. When muscles work, they produce and release myokines and other exercises. These molecules play an important role in metabolism, inflammation, bone health and even mood. As is often said, exercise is the miracle pill for overall health.
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TCC: Many people make profound lifestyle changes, but good intentions don’t always last.
kg: Yes, and that’s a shame, because the positive effects of training disappear after a month or a month and a half. And the older you get, the quicker it happens. Ideally, you should choose activities that fit easily into your daily routine. I am thinking, for example, of running, which is a very complete exercise, very simple to perform and inexpensive. Brisk walking is also good, but the idea is to sweat a little. And complement this with certain exercises to increase muscle strength and others to improve posture and mobility. This is an important factor in maintaining independence as we age. The fear of falling worries many elderly people. Balance and posture control exercises, like yoga, can really make a huge difference to the health and lifestyle of older adults.
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