Brazil joins global network that seeks to prevent Alzheimer’s disease

Two Brazilian institutions, USP and UFMG (Federal University of Minas Gerais), are testing whether preventive measures improve the cognition of the elderly and, ultimately, could prevent dementias, such as Alzheimer’s disease, and whether they could be implemented. in the public health network.

The project lasts for two years and is developed, at the same time, by a worldwide network of countries. The initiative is inspired by a 2015 study from Finland, which showed that a package of actions, such as physical activities, diet rich in fish, nuts, vegetables, control of hypertension, diabetes and cholesterol levels, and memory, can bring important cognitive gains to the elderly.

In Latin America, 12 nations participate in the project. In Brazil, a group of 100 elderly people between 60 and 77 years old, the same age group as the Finnish study, is being monitored at USP and UFMG. Half of them just participate in meetings and are oriented on the benefits of the above topics, and the other half are closely followed by health professionals, such as physical educators, nutritionists and doctors.

Four times a week, for an hour, they do cardio and weight training, as well as cognitive training. They are also instructed to follow a balanced diet, but adapted to the Brazilian reality, and undergo regular clinical consultations to control blood pressure, diabetes and cholesterol levels.

“More than effectiveness, because this has already been demonstrated, we want to verify the executability [do programa] in our SUS population. We have an expectation that, considering the higher prevalence of risk factors in Brazil, the positive impact of controlling them will be even greater. [ao visto na Finlândia]”, says neurologist Paulo Caramelli, professor at UFMG and coordinator of the advisory board of the International Society for the Advancement of Research and Treatment of Alzheimer’s Disease.

Alzheimer’s prevention gained momentum two years ago when a report published by The Lancet magazine showed that 40% of dementias are related to 12 modifiable risk factors, including low education, physical inactivity, smoking, and non-treatment of hearing loss. and the lack of control of cholesterol, blood glucose and blood pressure levels.

There is a projection that in Latin American countries, such as Brazil, up to 56% of risk factors for dementia are preventable. “Precisely because of this profile of poorly controlled risk factors”, explains Caramelli.

The WHO (World Health Organization) estimates that there are 55 million people with dementia, including Alzheimer’s, worldwide. In Brazil, there are 1.2 million cases, most of them without a confirmed diagnosis.

Several countries, such as the Netherlands, France and England, have already implemented national dementia plans that, in addition to prevention, invest in training health teams for diagnosis, in policies to guide family members and caregivers.

“Alzheimer’s prevention measures are what we have most evidence of today. They work much more than any treatment. At least today, September 2022. Some countries have been doing this for many years and have already managed to reduce new diagnoses” , says neurologist Felipe Chaves Barros, from Hospital Israelita Albert Einstein.

According to Paulo Caramelli, the hypothesis is that this occurs because these countries no longer have a significant population aging process and have already controlled the risk factors of their residents for decades.

“In Brazil, in addition to the demographic transition still ongoing, the incidence of dementia in younger elderly people is higher than in European countries and it also starts earlier precisely because risk factors are not controlled.”

Neurologist Ivan Hideyo Okamoto, from Hospital Sírio-Libanês, says that the topic of prevention is the most discussed topic in Alzheimer’s world congresses. “If we can’t interfere with the course of the disease, it’s better not to have it.”

Okamoto recalls that, although it is not possible to prevent all cases of Alzheimer’s with preventive measures alone, in Brazil 400,000 people could be spared the disease if there were public policies aimed at this end. “But here, not even people’s blood pressure can be controlled.”

Neurologist Rodrigo Schultz, president of the Brazilian Alzheimer’s Association, recalls that people’s cognitive reserve, formed throughout their lives by factors such as schooling, reading, socializing, disease control and a healthy lifestyle, is the most important part in Alzheimer’s prevention.

Several studies have analyzed the brains of people, found changes typical of late-stage Alzheimer’s disease, but these individuals did not show any symptoms of the disease.

The explanation would be a large enough cognitive reserve to compensate for the damage and continue to function normally.

“Even if in the future there are very good drugs, prevention will continue to be the best way. It is much less expensive and contributes to the non-development of other diseases, such as cardiovascular diseases”, says Schultz.