(Editor’s note: SharpBrains Summit attendee Steve Zanon wrote a very insightful comment to our previous post regarding the NIH independent panel on Alzheimer’s/ cognitive decline prevention. We republish comment here for easier access.)
In the introductions on day one of the NIH conference Jenifer Croswell from OMAR outlined three different frames of reference and decision making in this context. She mentioned (1) the individual and family based on personal values, (2) community doctors affecting their patients, and (3) recommendations for an entire population of people which should only contain strong evidentiary based information. She indicated that this conference would produce a statement based on the third context and in that respect the panel has done a great job in highlighting the gaps that government, industry & research need to focus on in order to most effectively move forward.
However some good news for individuals did come out of the conference. Pages 7 & 8 of the “Systematic Evidence Review” (link opens new window where you can download report as PDF) provides a great snapshot of all the associated factors considered at the conference and their current status in terms of level of evidence. This document summarises the research from 25 systematic reviews and 250 primary research studies which were filtered from searches that located 6907 citations. The studies were evaluated for eligibility and quality, and data were abstracted on study design, demographics, intervention or predictor factor, and cognitive outcomes. The final report was peer reviewed. In terms of independence and weight of evidence this document is likely to provide the strongest position on the subject that we have today.
If we understand that all this evidence is still building but clearly has strong direction then I believe it is a good baseline (as of today) from which individuals may begin to make lifestyle choices. Of course as research progresses the baseline will change but for now I think it is a solid foundation from which to work. Personal preferences would guide choices but where the direction of association is categorised as …..
- “no evidence” we should probably consider ignoring
- “inadequate evidence” we should probably consider treating as suspicious
- “increasing or decreasing risk” we should probably consider to be strongly associated (but not definitive) and therefore offering promising (but not certain) lifestyle choices
So with any good risk management strategy our best bet is to diversify risk across several of the most likely factors. The “Systematic Evidence Review” clearly identifies the most likely risk factors. We don’t have certainty but we do have direction and I think that is an encouraging message for the public.
The good news for those interested in brain training is that in the findings for cognitive decline (page 8), cognitive training has the highest level of evidence.
Recommended reading: “Systematic Evidence Review” of factors that can decrease or increase risk of Alzheimer’s Disease and cognitive decline, by NIH independent panel