Surprisingly Few Steps Tied to Slower Alzheimer's Progression

 Surely your competent? doctor got you recovered enough to do all the walking you need to do! Oh no, your doctors completely fucking failed at that task, and you haven't fired them yet?!

Well, there's all these other numbers for walking that your doctor already told you about, right? Choose one.

Other walking prevention items:

My numbers for steps.

10,000 Steps A Day? How Many You Really Need To Boost Longevity - 4,400

This one suggests 8900 steps a day:

Can Exercise Protect Against Alzheimer's?

 

Exactly How Many Steps You Need to Take a Day to Not Gain Weight - 15,000

Every 2,000 steps a day could help keep premature death at bay

Scientists Reveal the Right Number of Steps to Walk to Stay Healthy (Hint: It's Not 10K)4 min read

World Walking Day: Experts Recommend 30-Minute Daily Walk To Prevent Cancer, Stroke, Others October 2024

The latest here: 

Surprisingly Few Steps Tied to Slower Alzheimer's Progression

Key Takeaways

• Daily step counts aligned with slower Alzheimer's progression in cognitively normal adults with elevated amyloid.
• Moderate levels of physical activity were linked to longer periods without cognitive impairment.
• Physical activity has been identified as a modifiable risk factor for dementia, but its relationship with Alzheimer's pathology is unclear.

The number of daily steps associated with slower Alzheimer's disease progression was a goal many older adults could reach, data from the Harvard Aging Brain Study suggested.

In a group of cognitively unimpaired older adults with elevated levels of amyloid-beta, Alzheimer's-related decline was delayed by an estimated 3 years on average for those who walked 3,000-5,000 steps per day, and by 7 years in people who walked 5,000-7,500 steps per day, reported Wai-Ying Wendy Yau, MD, of Mass General Brigham in Boston, and co-authors.

This relationship emerged only for people with elevated brain amyloid. It was not related to lower amyloid burden at baseline or over time. Instead, higher physical activity was associated with slower amyloid-related inferior temporal tau accumulation, which mediated associations with slower cognitive decline, Yau and colleagues wrote in Nature Medicine

.

"This sheds light on why some people who appear to be on an Alzheimer's disease trajectory don't decline as quickly as others," co-author Jasmeer Chhatwal, MD, PhD, also of Mass General Brigham, said in a statement.

"Lifestyle factors appear to impact the earliest stages of Alzheimer's disease, suggesting that lifestyle changes may slow the emergence of cognitive symptoms if we act early," Chhatwal added.

Elevated brain amyloid is a potential early sign of Alzheimer's disease, even in people who are cognitively normal.

"This research provides strong evidence that moderate levels of physical activity are associated with slower progression of the earliest stages of Alzheimer's disease, and that this is linked to slower accumulation of tau protein, which is an important cause of brain cell loss," wrote Charles Marshall, PhD, of Queen Mary University of London, on the U.K. Science Media Center

web site.

"With this type of observational study, it is always hard to be sure whether the physical activity is actually the thing causing the observed difference," Marshall pointed out.

"The authors do a good job of trying to disentangle this, but we cannot be certain whether the people doing more exercise are healthier in other ways, nor whether the development of Alzheimer's disease changes are influencing activity levels (reverse causality)," Marshall continued. "We also cannot be sure that it is physical activity during this period in later life that makes the difference, or whether those who are more active now have been more active for decades and that the benefits accrue in the much longer term."

Physical activity has been identified as a modifiable risk factor

for dementia, but its relationship with Alzheimer's pathology in humans is unclear, Yau and colleagues noted.

The analysis included data from 296 Harvard Aging Brain Study

participants who were cognitively unimpaired at baseline. Waistband pedometers measured physical activity at baseline, and amyloid and tau were assessed with PET. In a subset of participants, global amyloid and inferior temporal cortex tau burdens were measured longitudinally.

Data were collected between 2010 and 2025. Participants received annual follow-up cognitive and functional evaluations using Preclinical Alzheimer's Cognitive Composite-5 (PACC5) and Clinical Dementia Rating Sum of Boxes (CDR-SB) assessments. The median cognitive follow-up was 9.2 years.

At baseline, participants had an average age of 72 years and 30% had elevated amyloid. Most participants (59%) were women. Mean baseline steps per day were 5,719.

In participants with elevated baseline amyloid, even low levels of physical activity -- 3,001-5,000 steps per day -- were associated with substantially slower rates of tau accumulation, cognitive decline, and functional decline, Yau and colleagues noted. Sedentary individuals had a significantly faster tau buildup and more rapid declines in cognition and daily functioning.

An analysis of PACC5 scores estimated that participants with elevated amyloid would become cognitively impaired at 6.5 years from baseline if they were inactive, at 9.6 years if they had a low level of activity (3,001-5,000 steps), and at 13.6 years if they had a moderate physical activity level (5,001-7,500 steps). Findings were similar for CDR-SB scores.

"Notably, the associations with more favorable tau and cognitive trajectories reached a plateau by moderate levels of physical activity (5,001-7,500 steps per day), which may be a less daunting goal for sedentary older adults than the popular goal of 10,000 steps per day commonly referenced in lay media," Yau and co-authors wrote.

The study had several limitations, the researchers acknowledged. The analysis was observational and reverse causality could not be ruled out. "Future randomized clinical trials are required to establish causal relationships," Yau and colleagues stated.

Physical activity was assessed only once, at baseline. In addition, the sample size was small, and the cohort consisted largely of highly educated, white individuals.

Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Connect:

If You’re Over 70 And Can Still Do These 7 Things, You’re Doing Great

 I'll be 70 in a couple of months, and these are still quite doable.

If You’re Over 70 And Can Still Do These 7 Things, You’re Doing Great

1. Standing up from a chair without using your hands

Standing up from a chair without using your hands shows your legs and core are still strong. It’s a great way to check your muscle strength and balance. If this feels tough, don’t stress. Practicing this move can help you get stronger and make daily life easier.Try it out by sitting and standing without pushing off. If you can do it, your body is working well and you’re less likely to lose your balance.Even small improvements with this skill can make a real difference in your independence.

(I can do this from kitchen chairs, but couches and Adirondack chairs require scooting to the edge to get my feet under me and then still use my right arm to push me up. I consider my efforts in this excellent.)

2. Getting up from the floor without help

Getting up from the floor on your own is a real test of strength and coordination. It means your muscles and balance are working together.

This ability can boost your confidence and help you feel safer at home. If it’s challenging, simple exercises or working with a physical therapist can help you get better.

Practice slowly and safely. Each time you do it, you’re building strength that helps you stay independent.

(Yeah, I've practiced this in my walks in the woods a lot. I can only get up from my right side, so if I end up on my left side I have to roll over to that side.  None of this was worked on with my therapists, I had to figure it all out myself.)

3. Walking a mile comfortably

Walking a mile without stopping is a solid sign your body is in good shape. It shows your heart, lungs, and joints are all working well.

You don’t need to walk fast—just moving at your own pace is enough. Regular walks can lift your mood and help manage stress.

If walking a mile still feels easy, you’re doing a great job staying active. Keep it up and your body will thank you.

(Not a problem and I do this in natural area trails, taking my saws with me to clear branches and trees. The 24 in diameter tree across one of the trails will not be removed since my battery chainsaw is only 14 inches and previous large trees removed bound up the saw causing lots of swearing and implementing plans B, C, and D to get the saw freed. I don't trust myself safely handling my 18-inch gas chainsaw. Used to do 10,000 daily steps very regularly- about 5 miles.)

4. Carrying groceries without strain

When you can carry groceries without feeling wiped out, your muscles and balance are working for you. It may seem like a small thing, but it keeps you independent.

Carrying bags uses your shoulders, core, and grip. If it’s getting harder, try lighter loads or split up your groceries.

Taking care with how you carry things can help you stay active and avoid injury.

(Not a problem, as long as they have carrying handles.)

5. Climbing a flight of stairs without pause

Climbing stairs without stopping is a good sign your heart, muscles, and joints are in sync. It’s a quick way to check your physical health.

Take stairs one step at a time and focus on your breathing. If it’s tough, moving slowly and using the handrail can help.

Even a flight or two each day can support your fitness and confidence.

(Easy. And because I just bought a 4-level condo with 7 steps to each floor I'll have enough practice doing steps, I'll still be doing them at age 100(currently 69). One level living means you didn't plan early enough to keep doing steps. Which means you can't travel to Europe since most bar/restaurant bathrooms are in the basement with no railings.)

6. Balancing on one foot for 30 seconds

Standing on one foot for 30 seconds might seem simple, but it says a lot about your balance. If you can do it, your muscles and nerves are working well together.

For anyone over 70, good balance lowers your risk of falling. If you struggle, start with short tries and practice every day.

No special equipment needed—just stand on one foot and add time as you get better. It’s a quick way to keep your balance sharp.

(I have always failed this on my bad leg in the Berg Balance Scale test. 

My therapists failed me by never providing any rehab exercise to fix this when I failed this component in the Berg Balance Scale.

I don't see it ever getting better. I walk unimproved trails with standing water, rocks and roots which is challenging my balance constantly, so I'm not concerned at all about this bogus test.)

7. Cooking a full meal from scratch

There’s something special about preparing a meal from fresh ingredients, especially as we get older. If you’re over 70 and still whipping up dinners from scratch, that’s no small feat.

It takes energy, coordination, and a good memory to follow recipes. Choosing your own ingredients lets you adjust meals to your taste and health needs.Sometimes, simple recipes with just a few fresh items can be surprisingly quick to put together. Batch cooking can also make life easier.

Making several meals at once saves time and effort during the week. Labeling leftovers with dates helps you keep track of what to eat next.

Cooking isn’t just about the food. It’s a creative outlet and a way to stay active.

Trying out new recipes or inviting friends over for dinner brings a sense of connection. Sharing a meal you made yourself is something to feel good about.

(Nope, not occurring. Since my medical team completely failed at recovering my left hand, cutting anything is a recipe for danger. I am currently getting meals from Home Chef with very limited cutting needed. That will allow me to live independently for decades to come.)

Contextual factors associated with walking performance after stroke: a systematic review and meta-analysis

You described something, BUT DID NOTHING THAT GETS SURVIVORS RECOVERED! You're fired. Stroke research is to get survivors recovered, not just for you to get published!

 Contextual factors associated with walking performance after stroke: a systematic review and meta-analysis

Yi ZhangLan Xu^*Xi Pan^*Lei ChenWeiying ZhongJiaxuan Li

• The First Affiliated Hospital of Soochow University, Suzhou, China

Objective: To describe the walking performance of patients with stroke and summarize the contextual factors associated with walking performance.

Methods: PubMed, Web of Science, Embase, and the Cochrane Library were searched from the inception to September 4, 2024. Observational studies on the walking performance of people with stroke and their contextual factors were eligible for inclusion. The relationship between contextual factors and walking performance was evaluated using Fisher’s z-value, which was then converted to correlation values (r).

Results: Thirty studies were included. Walking performance measures included step count, time, distance, and bouts; step count was most common, with pooled results showing a mean 4,296 steps/day after stroke. Guided by the contextual factors classification framework, we stratified the contextual factors of walking performance among subjects with stroke into three dimensions: user context, environmental context, and task context. Meta-analysis showed that walking endurance (r = 0.60; 95% CI, 0.46 to 0.71) was strongly correlated with the number of daily steps. Moderate correlations were found between daily step counts and gait speed (r = 0.41; 95% CI, 0.23 to 0.56), quality of life (r = 0.46; 95% CI, 0.34 to 0.56), self-efficacy (r = 0.30; 95% CI, 0.21 to 0.39), cardiorespiratory fitness (r = 0.36; 95% CI, 0.09 to 0.59), balance (r = 0.37; 95% CI, 0.02 to 0.65), and Rivermead Motor Assessment (r = 0.49; 95% CI, 0.26 to 0.65). Furthermore, age (r = −0.10; 95% CI, −0.18 to −0.02) and area deprivation index (r = −0.15; 95% CI, −0.24 to −0.06) were associated with the number of daily steps after stroke, but effect sizes were small.

Conclusion: Daily step counts among individuals with stroke were not guideline-compliant. Contextual factors can inform the design of context-aware interventions aimed at increasing daily step counts.

1 Introduction

Stroke is the second leading cause of death and the third leading cause of disability worldwide (1). Physical activity (PA) is defined as physical movement in which skeletal muscle contraction induces energy expenditure (2). PA has a robust health-promoting effect and improves the prognosis of patients with stroke. Adequate PA can improve cardiovascular health (3) and promote the functional recovery of patients with stroke (4, 5). In addition, PA can decrease negative emotions (depression, anxiety, etc.) after stroke (6, 7). Walking is the most frequent form of physical activity among individuals with stroke. In contrast to walking capacity (capability of a walking task in a clinical setting), walking performance refers to walking activities (i.e., daily steps, walking distance or duration of walking) in real-world settings (8). However, existing studies suggest that the walking performance of patients with stroke is much less than that recommended by the guidelines (9, 10). Therefore, improving walking performance among patients with stroke remains a priority for rehabilitation after stroke. Recently, mobile health (mHealth) has gradually become a research hotspot in the field of walking performance intervention because it fits the spatial and temporal dynamic characteristics of walking activities. Context-aware intervention is an emerging mobile intervention design that dynamically adjusts interventions based on an individual’s contextual information. Its core lies in the real-time optimization of intervention timing or content according to an individual’s contextual factors, which are defined as all information describing the status of entities, to enhance the accuracy, personalization, and effectiveness of the intervention (11, 12). Understanding and accurately obtaining contextual information can optimize intervention decisions. A systematic review indicated that context-aware interventions can effectively support behavioral changes to improve the health behaviors of users (13). However, the key contextual determinants of walking performance after stroke currently remain unclear.

To date, systematic reviews in this field have predominantly focused on physical activity (PA) among post-stroke individuals and its contextual factors, with no emphasis on walking performance as a distinct outcome. For instance, a systematic review by Thilarajah et al. (14) reported that factors such as age, gender, physical function, depression, fatigue, self-efficacy, and quality of life were significantly associated with PA. Although a number of studies included in this review utilized walking performance as an indicator of PA, their conclusions cannot be directly extrapolated to walking performance. This constraint, specifically, stems from the absence of subgroup analyses stratified by PA assessment methods. In addition, the heterogeneity among the existing studies in the selection of walking performance assessment indicators (e.g., frequency, intensity, etc.) and the measurement of the contextual factors has limited the comparison between studies.

To date, no standardized classification method for contextual factors has been established. A comprehensive classification framework was proposed by Chen (15), which categorizes contextual factors into user context, environmental context, and task context based on the requirements of context-aware technology and a user-centered approach. The user context dimension includes user attributes, living habits, and behavioral habits. The environmental context dimension includes the natural physical environment, comprising time, location, sunlight, and social environment (national customs and religious habits). Task context refers to the attributes and states of the behaviors associated with the user’s completion of the current task. The framework may provide a theoretical basis for the integration of multi-source contextual factors. Therefore, this study aimed to synthesize and categorize the contextual factors influencing walking performance in individuals with stroke, drawing on the contextual factor classification framework proposed by Chen (15) and to identify through quantitative synthesis those contextual factors demonstrating significant associations with walking performance. These efforts seek to provide a theoretical foundation for context-aware intervention development. Additionally, the study aimed to describe walking performance in individuals with stroke using real-world data, thereby updating the current status of walking performance among patients with stroke.

More at link.

15 Minutes of Walking (at This Walking Pace) Adds Years to Your Life, Study Says

 Will your incompetent? doctor have the EXACT protocols to get you recovered enough to do this fast walking? NO? So, YOUR DOCTOR IS FUCKING INCOMPETENT THEN?

If I were to do this fast walking I would destroy my left knee quickly because of hyperextension and the left hip and gluteus medius wouldn't stand the strain.

15 Minutes of Walking (at This Walking Pace) Adds Years to Your Life, Study Says

New research suggests that the pace you walk can lower your risk of early death, improve heart health, and potentially extend your lifespan.

Walking has always been a cornerstone of healthy aging. But new research shows that how you walk may matter more than how long.

Walking has always been the low-hanging fruit of exercise. No equipment, no membership, no excuses, just you and your feet. Research backs it up: logging around 8,000 steps a day can lower your risk of dying from all of the major diseases. Pile on decades of studies showing it lowers blood pressure, steadies blood sugar, and even lifts your mood. No wonder the American Heart Association and World Health Organization keep telling us to “just walk.” It’s the original 

[lon-jev-i-tee] noun

Living a long life; influenced by genetics, environment, and lifestyle.

Learn More

longevity hack.

Now, researchers are suggesting that how you walk may matter more than how long.

A recent study published in Annals of Epidemiology followed nearly 80,000 adults across 12 southern U.S. states for more than 16 years. Researchers wanted to know: does walking pace affect longevity? The findings were striking:

• Fast walking just 15 minutes a day lowered the risk of early death by nearly 20%.
  
• Slow walking for hours showed little benefit, only about a 4% risk reduction.
  
• The greatest protection was against cardiovascular deaths, particularly heart attack and stroke.
  
• The benefits were strongest among those with existing health conditions, though everyone gained.
  

Why Walking Pace Matters for Longevity

Brisk walking challenges the cardiovascular system in ways casual strolling does not. It improves blood flow, strengthens the heart’s efficiency, and regulates blood pressure and glucose. Even if you never set foot in a gym, moving at a faster clip rewires your physiology toward 

[ri-zil-yuhns] noun

The ability to recover quickly from stress or setbacks.

Learn More

resilience.

Even more compelling: the benefits of fast walking worked independently of other exercise. Whether or not participants lifted weights or went jogging, the daily brisk walk still delivered protection.

Why Accessibility Matters

What makes these findings remarkable is who was studied. More than half of the people reported incomes below $15,000 a year, and nearly two-thirds were Black. These are communities often left out of longevity research and often facing the steepest health risks.

“Brisk walking offers a convenient, accessible, and low-impact activity that individuals of all ages and fitness levels can use to improve general health and cardiovascular health specifically,” says study author Wei Zheng, MD, PhD, MPH, the Anne Potter Wilson Professor of Medicine and director of the Vanderbilt Epidemiology Center. 

The fact that something as simple as brisk walking can meaningfully extend life is powerful. It shows that longevity science isn’t just for the few with resources. It’s for everyone with a sidewalk, a safe block, or even a hallway to walk through.

Here’s How to Walk at the Pace That Extends Healthspan

• Find your “brisk” pace: It’s the pace that makes conversation a little harder but still possible. If you’re tracking, aim for 50–70% of your max heart rate.
  
• Start with 15 minutes. The study showed benefits at that threshold. Work toward 30 minutes if you can.
  
• Layer it into your day. Power walk between meetings, take stairs two at a time, or speed up evening strolls.
  
• If fast isn’t possible, go long. Slow walking for an hour or more still showed benefits for heart health, especially ischemic heart disease.
  

Longevity isn’t reserved for those with access to cutting-edge treatments or boutique fitness studios. Sometimes it’s as simple as how you move through your day. Fast walking, even for 15 minutes, can shift your physiology toward resilience and longevity.

Your assignment for the week? Choose one walk and speed it up. Not a marathon, not even a mile. Just a daily practice of moving with intention. Your heart, and your future self, will thank you.

Walking and Diet Boost Cognition in At-Risk Adults

 Is your doctor competent enough to get you recovered enough to do this walking? NO? So, you DON'T have a functioning stroke doctor, do you? RUN AWAY!

Walking and Diet Boost Cognition in At-Risk Adults

Growing evidence suggests that lifestyle interventions such as walking may help slow cognitive decline in individuals with the apolipoprotein E (APOE) ε4 allele, who have a genetically higher risk of developing Alzheimer’s disease (AD) — and may even provide greater benefits than in noncarriers.

Preliminary findings from a new study show that while men and women APOE ε4 carriers experienced steeper declines in cognition over a 10-year period, regular walking appeared to mitigate these effects by preserving global cognition and executive function.

The results underscore the value of accessible physical activity programs for individuals genetically at risk for AD, study investigator Cindy Barha, PhD, Canada Research Chair in Neuroscience, Brain Health, and Exercise, and assistant professor, Faculty of Kinesiology, University of Calgary, Alberta, Canada, told Medscape Medical News.

“We can start telling people that if you’re at risk, we know this one thing — walking — will be beneficial for you,” Barha said, adding this is part of an overall effort to “start personalizing our interventions so we can maximize benefit.”

The findings were presented on July 29 at the Alzheimer’s Association International Conference (AAIC) 2025.

Risk Variation by Sex

APOE ε4 accounts for almost 50% of the genetic risk for late-onset AD, but evidence suggests the risk is more pronounced in women than men. One copy of this allele is associated with a twofold increased risk in men and an eightfold greater risk in women, while two copies are associated with a fourfold increased risk in men and a 12-fold increased risk in women, Barha said.

“We know exercise and walking are good for the brain, and we wondered whether they would be even more beneficial for ε4 carriers and if they’re sex-dependent.”

Meanwhile, research showed that the ε2 version of APOE may protect against cognitive decline compared with the ε3 allele, which is the most common and neutral variant.

“We also wondered if exercise would provide a kind of ‘double hit’ in ε2 carriers,” Barha said. “If you’re an ε2 carrier and you’re walking a lot, maybe you’re going to be super protected.”

The analysis included 2981 participants with a mean age of 74 years, from the Health, Aging, and Body Composition (Health ABC) study. It began in 1997 with a cohort of cognitively unimpaired community-dwelling older adults in Memphis, Tennessee, and Pittsburgh.

Walking was self-reported and assessed annually. Participants were queried about their walking habits, and walkers were asked about the total number of minutes they engaged in this activity over the past 7 days.

To assess cognition, researchers used the Digit Symbol Substitution Test (DSST), which measures a range of cognitive functions such as attention, working memory, and information processing, and the Modified Mini-Mental State Exam (3MS), a tool for evaluating global cognition. Both tests were administered at baseline and approximately every 2 years over a 10-year period. Researchers categorized APOE genotypes into ε2, ε3, and ε4 groups.

Study results showed that APOE ε4 carriers — both men and women — experienced steeper declines on both cognitive tests than ε3 carriers. Among women, the decline was significant on the DSST (β = -0.10; P < .001) and the 3MS (β = -0.13; P < .001). In men, the decline was also significant on the DSST (β = -0.07; P = .005) and more pronounced on the 3MS (β = -0.22; P < .001).

The APOE ε2 allele appeared protective against cognitive decline, but only in women on the 3MS (β = 0.15; P = .002).

Simple Activity, Strong Impact

Walking showed the strongest protective effect on both cognitive measures in APOE ε4 carriers of both sexes. A 10% increase in walking was associated with a 4.7% improvement in complex thinking performance over time in women and a 2.6% improvement in men. For global cognitive performance, the same increase in walking was linked to an 8.5% improvement in women and a 12.0% improvement in men.

Regular walking may help preserve cognition through several potential mechanisms, the authors noted. These include enhancing cerebral blood flow — improving the delivery of oxygen and nutrients to the brain — increasing levels of brain-derived neurotrophic factor, which supports neurogenesis and synaptic plasticity, promoting angiogenesis, and reducing neuroinflammation and oxidative stress.

Barha speculated that because APOE ε4 carriers begin with lower cognitive performance and decline more rapidly, they may have more room to improve and therefore stand to gain more from walking interventions. The findings highlight a key takeaway for people at elevated risk for dementia: Doctors should promote regular walking for their patients, especially as they age and if they have an elevated risk for dementia, she said.

Still to be determined are the optimal intensity and frequency of walking — and whether other forms of exercise may offer similar benefits for ε4 carriers.

Looking ahead, the research team plans to study the impact of physical activity earlier in life. “A lot of Alzheimer’s disease biomarkers start to accumulate in the brain during midlife — not when you’re 70 years old or already showing signs of cognitive decline, but 20 years before that,” Barha noted.

One limitation of the study is that walking was self-reported; however, Barha noted that data collected through actigraphy closely correlates with self-reported activity levels.

Another limitation of the study was its focus solely on walking. The authors noted that if data on more vigorous activities like running and weight training had been included, the observed impact on slowing cognitive decline in this high-risk group might have been even greater. Additionally, the study did not account for other factors known to affect cognition, such as diet, stress, and sleep.

Greater Cognitive Gains for APOE ε4 Carriers

Building on these findings, results from another study presented on July 28, 2025, at the AAIC suggested that the benefits of physical activity and other lifestyle interventions may be even greater for APOE ε4 carriers than noncarriers.

The meta-analysis pooled data from three randomized clinical trials involving older adults at risk for dementia or with mild cognitive impairment (MCI) who had known APOE status: the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER; n = 1109), the Multidomain Alzheimer Preventive Trial (MAPT; n = 934), and the Japan-Multimodal Intervention Trial for Prevention of Dementia (J-MINT; n = 426).

FINGER and J-MINT randomly assigned participants to lifestyle interventions — including physical activity, healthy diet, cognitive training, and risk monitoring — or control groups. 

The MAPT combined lifestyle interventions with omega-3 supplements; for this analysis, participants receiving only supplements were excluded, and those receiving lifestyle interventions with or without supplements were combined.

Researchers estimated cognitive change using each trial’s original primary outcome: A composite cognition score based on multiple neurocognitive tests. The analysis compared carriers of one or two APOE ε4 alleles with noncarriers.

Preliminary results showed greater benefits of the intervention among APOE ε4 carriers than noncarriers at 24 months for both global cognition and executive function. The overall effect size for the composite score among carriers was 0.282 (95% CI, 0.111-0.454; P = .001), with the largest effect observed in J-MINT, followed by FINGER and MAPT.

Multiple Mechanisms at Play

Healthy eating and exercise likely affect brain health through multiple mechanisms — possibly those related to cholesterol metabolism and vascular mechanisms, study investigator Jenni Lehtisalo, PhD, researcher at the Finnish Institute for Health and Welfare, Helsinki, Finland, told Medscape Medical News.

Lehtisalo noted that cognitive benefits among APOE ε4 carriers appeared consistent across diverse populations — Asian and European — and cognitive groups, including at-risk individuals and those with MCI. The research team plans to examine additional studies to see if these findings hold in more geographically and ethnically diverse populations.

These findings offer hope for patients with a family history of AD who may feel powerless to reduce their risk. Individuals can still act and benefit from lifestyle changes, Lehtisalo said. While carriers may derive greater benefit from lifestyle interventions, she emphasized that everyone gains from healthy habits.

The analysis could not determine which specific components of the intervention — physical activity, healthy diet, cognitive training, or risk factor monitoring — most benefited APOE ε4 carriers. Lehtisalo noted that healthy habits often cluster; for example, physically active individuals tend to eat healthier diets. The study also did not assess sex differences.

Commenting on the two studies for Medscape Medical News, Rebecca M. Edelmayer, PhD, vice president of Scientific Engagement at the Alzheimer’s Association, noted the importance of understanding what puts people at risk for AD, including genetics.

“That’s why looking at these associations between genetic risk and some type of lifestyle intervention is critical,” she said.

The Health ABC study was supported by the National Institutes of Health’s National Institute on Aging (NIA) and the National Institute of Nursing Research. The current analysis was funded in part by the Intramural Research Program of the NIA.

Biomechanical approaches in correction of gait in post-stroke hemiparesis

 Is this similar? No clue how this shift is accomplished.

Gait Enhancing Mobile Shoe (2 posts to December2017)

Biomechanical approaches in correction of gait in post-stroke hemiparesis

[Article in Russian]

V A Gurevich 1 2, S V Prokopenko 1 2, V S Ondar 1 2, N R Kozlov 1 2

Affiliations 

• PMID: 40767752
 
• DOI: 10.17116/kurort202510203124

Abstract 

in English, Russian

Neurorehabilitation of post-stroke motor disorders is a relevant and rapidly developing area in modern medicine. Timely correction of the developing pathological gait stereotype is an important task for a physician of physical and rehabilitation medicine. Identification of the central defect in the biomechanics of gait and targeted impact on it using various rehabilitation methods makes it possible to restore the gait function in a patient with post-stroke hemiparesis more effectively.

Objective: To evaluate the effects of rehabilitation using author's technique of shifting the center of gravity of the foot on gait biomechanics in patients with post-stroke hemiparesis.

Material and methods: This article studies a variant of rehabilitation effect on the pathological gait stereotype caused by the violation of the forward outreach of the paretic leg using author's technique of shifting the center of gravity of the foot developed on the basis of the Department of Nervous Diseases of the Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University. A pilot study was carried out with participation of 15 patients undergoing rehabilitation at the 2nd stage in the medical rehabilitation departments No. 2 and 3 of the Federal Siberian Research Clinical Centre under FMBA of Russia (FSRCC FMBA of Russia) in Krasnoyarsk. The patients underwent gait training sessions using technique of shifting the center of gravity of the foot according to the scheme of 10 daily sessions with the duration of 20-40 minutes per day. The function of gait was assessed using the ichnography method.

Results: A comparison of gait function before and after rehabilitation was conducted using the Wilcoxon p-test. The median of the step length of the paretic leg before sessions was 34.31 cm, after sessions 44.84 cm (p<0.01), the median of the step asymmetry, that is, the difference in the step length of the paretic and intact leg, before sessions, was 11.77 cm, after sessions 6.35 cm (p<0.01). Significant improvements in the main spatial parameters of step were obtained against the background of rehabilitation using technique of shifting the center of gravity of the foot.

Conclusion: Training using technique of shifting the center of gravity of the foot improves the function of gait and may be used as a method of motor rehabilitation for patients with post-stroke hemiparesis.

Keywords: Neurorehabilitation; pathological gait stereotype; post-stroke hemiparesis; technique of shifting the center of gravity of the foot.