Definition of Dementia

Dementia describes a group of symptoms affecting memory, thinking, and social abilities severely enough to interfere with one’s daily life.  There are several different diseases may cause dementia. Globally dementia affected more than 45 million people in 2015. Alzheimer’s disease is the most common cause of progressive dementia accounting for 50 to 70% of cases in older adults. The other common cause is vascular (related to blood vessels) dementia, accounting for to 20-25%.

Symptoms of Dementia

. Memory loss, which is noticed by a spouse or someone else

.Getting lost

.Difficulty in finding words

.Difficulty in reasoning, organizing and problem solving

. Confusion and disorientation

Causes of Dementia (memory loss)

There are many causes of memory loss:

.Aging

.Mild cognitive impairment (MCI)

.Medical conditions like Alzheimer, stroke, and head injuries

.Emotional problems like depression

Age Related Memory Loss

Forgetfulness can be a normal part of getting old. As people get older, changes occur in all parts of the body, including the brain. As a result, they do not remember information like names, place, as well as they did, or they lose things like their glasses or keys. These are usually signs of mild forgetfulness due to aging and not signs of serious dementia like Alzheimer’s disease.

Mild Cognitive Impairment (MCI)

The earliest stage of dementia is called mild cognitive impairment. 70% of those diagnosed with mild cognitive impairment, later progress to full dementia. It is the stage between the expected decline of normal aging and the serious decline of dementia.

Memory Loss Related to Medical Conditions

Medical conditions that may cause memory problems include:

.Alzheimer’s disease and vascular dementia

.Tumors, blood clots, or infections of the brain

.Head injuries such as concussion

. Drinking too much alcohol

.Some thyroid, kidney, or liver disorder

.Medications side effects

Alzheimer’s diseaseis the most common cause of dementia in older adults. It is a progressive brain disorder that slowly destroys memory and thinking skills. It is not a normal part of aging. It appears first in mid 60s. It is the most common cause of dementia in older people. Scientists do not yet fully understand what causes Alzheimer’s disease in most people. In early –onset Alzheimer which occurs in a person between 30s and mid-60s, there may be a genetic component.

Vascular dementia is the second most common form of dementia in older adults after Alzheimer’s disease. It results from injuries to vessels that supply blood to the brain, often after a stroke or series of strokes. Risk factors for vascular dementia are: high blood pressure, smoking, obesity, diabetes, high cholesterol, and sedentary life style. The symptoms of vascular dementia can be similar to those of Alzheimer’s and both conditions can occur at the same time (mixed dementia).

What science says about reducing the risks of dementia?

When it comes to dementia, the unfortunate news is this: medications so far have proven ineffective at curing or stopping the disease, and its most common form, Alzheimer’s disease. But according to a recent wave of scientific studies, we have more control over our cognitive health than commonly known. According to the Lancet, the British medical journal, around 35% of dementia might be prevented if people make certain life style changes. They are:

• Blood pressure control

In 2017 and 2018, researchers have found that lowering the high blood pressure to normal range can reduce dementia rate by 20%. A blood pressure of 120/80 is considered normal.

• Exercise

Exercise increases the flow of blood to the brain, improves the health of the blood vessels and raises the level of the good cholesterol (HDL) and protects against heart disease and dementia. It also lowers blood pressure and reduces the risk of diabetes and arthritis and depression. Exercise can also lead to the formation of new brain synapses (connection) and protects brain cells from dying. A minimum of 60 minutes of aerobic exercise (walking, running, playing games, bicycling, swimming etc.) a week will give you the benefits. 150 minutes a week is even better.

• Diet

Several population studies have shown that people with a Mediterranean diet, which is high in fish, fruits, nuts, and vegetables, have lower rates of dementia. Researchers found the Mind diet (Mediterranean diet + more berries and leafy vegetables) even more beneficial, leading to 30% reduction in Alzheimer’s disease. A diet consisting of whole grains, a variety of fruits and vegetables, some nuts, fish and poultry and unsaturated fat is appropriate for everyday consumption.

• Cognitive Training

Many population studies suggest that education increases cognitive reserve, a term for brain’s ability to compensate for neurological damage. People with high- School or higher education have lower dementia rate. Researchers have found that older people 65 and older, who engaged in more than six activities a month- including pursuing their hobbies, reading, visiting their friends, walking, volunteering and attending religious services- had a 38% lower rate of developing dementia, than people who did fewer activities.

• Sleep

No one knows for sure why we sleep. One theory is that sleep helps us remember important information. Another theory is that sleep washes “toxic substance out of our brains that should not be there,” including beta amyloid and tau proteins that are implicated in Alzheimer’s disease. Researchers believe that poor sleep may be a risk factor for dementia. Treating sleep problems may prevent dementia. Depending on the age, 7-8 hours of sleep a night is recommended for most people.

• Combination

There is a growing consensus that when it comes brain health, the more healthy habits you adopt, the better. Many points to a recent clinical trial in Finland of 1,250 adults ages 60-77 as proof that a multi–pronged approach can work in reducing the rate of dementia.

Conclusion

There is a growing consensus among scientists that when it comes to brain health, the more healthy habits you adopt, the better. Lowering your high blood pressure, exercising at least 60-150 minutes a week, eating a healthy diet, getting a good night sleep and staying engaged ( working on hobbies, reading, visiting friends, volunteering) will improve your brain health and lower your  chance of getting dementia. GET STARTED!

Sources

1- National Institute of Aging- www. nia.nih.gov

2-The Wall Street Journal- Nov, 18, 2019, R-3

Dr Saheb Sahu, FA.A.P. MPH.