The BBC’s recent story headed ‘Dementia: Brain check-up tool aims to cut risk at any age’ is a step in the right direction since early prevention is the key to reducing risk. However, the online brain health check, hosted by the Alzheimer’s Research Trust, is very basic, with only a dozen questions, and ignores the key evidence-based and common nutritional risk factors for Alzheimer’s disease. It covers ‘stay sharp’ which is about mental stimulation, ‘stay connected’ which is about social interaction and ‘love your heart’.
It ignores the two strongest nutritional risk factors, namely homocysteine lowering B vitamins and omega-3 intake from seafood. The US National Institute for Health’s research [1] attributes 22% of Alzheimer’s risk to each of these.
‘Love your heart’ gives advice to keep your cholesterol and blood pressure in check and manage diabetes. This refers an individual to their GP who is likely to prescribe statins to lower cholesterol and hypertensive drugs to lower blood pressure. Neither reduce Alzheimer’s risk. A recent major review [2] of the evidence concludes ‘prospective, randomized, placebo‐controlled clinical trials that have failed to provide evidence for the benefit of statin therapy’ and there is ‘insufficient [evidence] to tell us whether reducing BP for dementia risk reduction is effective.’
The same review recommends omega-3 supplementation is start early and maintained and B vitamin supplementation to lower homocysteine, which is cited as the most evidence-based prevention approach considered. This report says “In view of the high population attributable risk, it is important that raised homocysteine can readily be lowered by the oral administration of three B vitamins (folate, B6, and B12). The doses of these vitamins that are required to lower homocysteine are considerably larger than can readily be obtained from the diet.” This is based on evidence of the VITACOG trial [3] which was part funded by the Alzheimer’s Research Trust.
A GP could lower a person’s risk much more effectively by measuring homocysteine in the blood and recommending B vitamin supplements, as well as upping omega-3 intake by eating fish and/or supplementing. This combination has reduced the rate of brain shrinkage by up to 73% in those with pre-dementia [4] but only few GPs do.
The Think Brain Health check does not assess diet, or make specific recommendations, and there’s no mention of protective supplements, but refers people to the NHS’s ‘eight tips for healthy eating’. These recommend ensuring starchy carbohydrates make up over a third of what you eat, reducing saturated fat and salt. There is no evidence that these reduce risk for Alzheimer’s. Too many carbs may actually be a promoter of cognitive decline. They also recommend eating less sugar, lots of fruit and veg and having at least 2 portions of fish a week, including at least 1 portion of oily fish. There is evidence that these recommendations may reduce dementia risk.
In sharp contrast foodforthebrain.org’s validated Cognitive Function Test and Dementia Risk Index questionnaire (139 questions) both objectively measure a person’s cognitive function and calculates their risk, then gives specific and actionable instructions as to how a person can reduce their risk, inviting them back every six months to track their progress.
The Cognitive Function Test is free and for those who wish to improve, we have launched COGNITION, a new way to Upgrade your Brain at a low cost of just £5 per month. You can access both tests once logged into your account.
1. Beydoun MA, Beydoun HA, Gamaldo AA, Teel A, Zonderman AB, Wang Y. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health. 2014 Jun 24;14:643. doi: 10.1186/1471-2458-14-643. PMID: 24962204; PMCID: PMC4099157.
2. Peters R, Breitner J, James S, Jicha GA, Meyer PF, Richards M, Smith AD, Yassine HN, Abner E, Hainsworth AH, Kehoe PG, Beckett N, Weber C, Anderson C, Anstey KJ, Dodge HH. Dementia risk reduction: why haven’t the pharmacological risk reduction trials worked? An in-depth exploration of seven established risk factors. Alzheimers Dement (N Y). 2021 Dec 8;7(1):e12202. doi: 10.1002/trc2.12202. PMID: 34934803; PMCID: PMC8655351.
3. Smith AD, Smith SM, de Jager CA, Whitbread P, Johnston C, Agacinski G, Oulhaj A, Bradley KM, Jacoby R, Refsum H. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One. 2010 Sep 8;5(9):e12244. doi: 10.1371/journal.pone.0012244. PMID: 20838622; PMCID: PMC2935890.
4. Oulhaj A, Jernerén F, Refsum H, Smith AD, de Jager CA. Omega-3 Fatty Acid Status Enhances the Prevention of Cognitive Decline by B Vitamins in Mild Cognitive Impairment. J Alzheimers Dis. 2016;50(2):547-57. doi: 10.3233/JAD-150777. PMID: 26757190; PMCID: PMC4927899.
