The landmark Nun Study on aging and Alzheimer's disease will be extended for another five years, says the lead researcher.

        Dr. David Snowdon, a neurologist and epidemiologist at the University of Kentucky College of Medicine, says researchers and the School Sisters of Notre Dame are still working to determine the parameters of the new research.

        “It won't just be about the brain. We'll look more at the whole-body approach,” he says.

        Dr. Snowdon will be in town April 27 to speak at the Health Alliance geriatrics convention, Aging America 2002. The convention is geared toward health and medical professionals and social workers who work with geriatric patients.

        The Nun Study, which began in 1986 at the School Sisters of Notre Dame in Mankato, Minn., followed more than 600 nuns to determine what factors in early, middle and late life contribute to Alzheimer's and other brain diseases, including stroke. When the study began, the nuns ranged in age from 75 to 103 years.

        Researchers collected medical data and looked atconvent archives, school records and sisters' writings to guage their intellectual abilities. .

        “The thing that surprised us the most is how these early life factors like education and language ability would be such a strong predictor, six decades later, of Alzheimer's disease symptoms,” Dr. Snowdon says. “Basically, those who had packed more ideas into their senses as young 20-year-olds 60 years later had fewer symptoms. (Yet) when we looked at their brains, they had significant signs of Alzheimer's disease.”

        The findings, coupled with other research, suggest that lifestyle factors — such as education — can help prevent Alzheimer's, much in the same way diet, exercise and stress management are used to prevent and control heart disease and diabetes, Dr. Snowdon says.

        Alzheimer's disease is “a lifelong process,” and physical signs of the disease can be found in the brain as early as the 20s.

        “It's really not going to be that different from stroke or heart disease or diabetes,” Dr. Snowdon says. “It's going to take a lifelong effort to prevent it. Even if you can just postpone it by four years, you can reduce by half the number of people who develop it, because it happens at such a late age.”

        Stroke seems to be a trigger factor for Alzheimer's symptoms, he says. Nuns who remained stroke-free were also free of dementia symptoms, even though post-mortem exams showed they had Alzheimer's. Head injuries are also associated with a greater risk of Alzheimer's.

        “The brain can handle a certain amount of damage up to a point and compensate and adapt to that damage,” he says.

        The findings of the Nun Study helped spawn interest in “brain fitness” as a way to ward off Alzheimer's disease.

        Researchers were “almost a little depressed” to learn how early physical signs of the disease appear, Dr. Snowdon says.

        But many elderly nuns in the study whose brains exhibited “major presence” of the disease showed none of the classic symptoms of dementia, “like people who are in bad car accidents and walk away without a scratch,” he says.

        Dr. Stephen Mueller, a geriatrician at Christ Hospital, says the study suggests it's important for caregivers and patients to remain active. “I guess the bottom line is to keep yourself stimulated intellectually,” he says.

        Dr. Snowdon says it's important to keep active intellectually, but physical activity may have more of an effect. Regular exercise helps prevent stroke and heart disease and also seems to help prevent the symptoms of Alzheimer's disease.

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