Recent Press on Preventing Alzheimer's

 Contributed by: Dennis Fortier, President, Medical Care Corporation



There is no hope? 

Eating well, staying fit, and using your brain have no effect on your risk for Alzheimer's?  Many headlines have implied this dire message over the past 24 hours.

The source of these headlines is an article published in the Archives of Neurology, online edition.  The article reviewed the evidence that actively managing modifiable factors could reduce the risk of AD, and concluded that only a low level of evidence suggests a relationship between the risks and the disease.

Let's be sure not to misunderstand this.

What is a "Low Level" of Evidence?
The authors classified the level of evidence for each risk factor in accordance with accepted scientific standards.  These standards allow for three levels of evidence: low, medium, and high. 

Importantly, a "low" level of evidence means that real research, conducted with sound methods, that was published in peer-reviewed medical journals, showed an association between the risk factor being studied and the incidence of AD.  Perhaps the association was not overly strong, perhaps the sample size was small, perhaps similar studies have not been completed to verify the result, but even a "low" level of evidence is a pretty good start in finding a meaningful association.

The panel authoring this paper, on behalf of the National Institutes of Health, found a low level of evidence that diabetes, high cholesterol, and tobacco use all confer a higher risk of Alzheimer's disease.  Sure we want more evidence and a higher level of confidence, but all work so far suggests that these are real risks that need to be managed.

The panel also found a low level of evidence that a Mediterranean diet, folic acid intake, light alcohol consumption, cognitive activity, and physical activity all reduced risks of Alzheimer's.  That's more good news.

This review constitutes unbiased, expert confirmation that many modifiable risk factors should in fact be managed to reduce the risk of AD.  The evidence is not as strong as we would all like, but it has reached a minimum threshold of scientific scrutiny to establish a likely association.

The problem here is the massive and consistent misinterpretation of these findings by the press.  In every day jargon, a "low level of evidence" is a negative testimonial as to the likelihood of an association.  But in the scientific world, where facts are closely scrutinized before they qualify as "evidence", a low level of evidence connotes a pretty good start toward proving a point.  It is a shame that this is not understood by the major media outlets and is not more clearly represented in their publications.