What is Dementia?
Dementia is an umbrella term for a set of symptoms that are caused by disorders affecting the brain. Symptoms may include memory loss, and/or difficulties with thinking, problem solving, or language and can lead to changes in mood or behaviour. Alzheimer’s disease is the most common disease that causes dementia but there are other causes, including vascular changes, thyroid gland problems, head trauma, depression, vitamin deficiency, Parkinson’s disease, chronic infections, and medications.1
Dementia can be progressive if the cause is not treatable, which means the symptoms will gradually worsen as more brain cells become damaged. However, some causes are treatable and dementia is reversible, for example if it is caused by vitamin deficiencies, medications, or thyroid problems. If you are seeing signs of dementia it is important to see a health care practitioner to determine and treat the root cause.
Only a part of dementia can be attributed to genetic predisposition. Much more is due to environmental, physiological, and lifestyle factors. If you or a loved one is worried about developing dementia, the good news is that you can do a lot of truly preventative work now to keep your brain healthy.
There are both modifiable and non-modifiable risk factors for dementia. Here we will focus on the ones we can do something about! We have developed 10 strategies for helping prevent the development of dementia by working on most of the following modifiable risk factors:2
- Poor diet & vitamin deficiencies
- Use of medication that contributes to dementia
- Impaired thyroid function
- Cardiovascular risks (high cholesterol, high blood pressure, diabetes)
- Low physical activity
- Alcohol use
- Head injuries
10 Ways to Help Reduce the Risk of Dementia
- Minimize use of anticholinergic medication: Many prescription and over-the-counter sleep aids, heart medication, antidepressants, and allergy medicines (among others) have moderate to strong anticholinergic activity in the body. A recent large, long-term study has shown that cumulative high-dose anticholinergic use is associated with higher risk of developing dementia. Efforts are being made to help health care providers educate patients about which medications have this effect, how much is dangerous, and how to reduce their use. Don’t stop taking these medications right away if you are, but be aware and be sure to have a conversation with your doctor about how to limit their usage or change medications3,4 Follow link to see list of common medications with anticholinergic properties: http://www.virginiageriatrics.org/consult/medications/medsList.html
- Take vitamin D: Both animal and pre-clinical human studies have shown a correlation between low levels of vitamin D and cognitive decline leading to symptoms of dementia. Supplementing animals with Vitamin D is protective against processes that lead to dementia and Alzheimer’s disease. More large-scale human trials are on the way, but all evidence is pointing to the protective benefit of Vitamin D. Getting out in the sun may not be enough, especially in winter months; taking a supplement is the most effective way to get optimum vitamin D levels for the prevention of dementia.5
- Take fish oil: Decosahexaenoic acid (DHA) is one of the main fats in fish oil. Lower DHA levels are associated with increased cognitive impairment and poorer scores on memory tests in older adults. Studies show that supplementing with fish oils is most effective at the early stages of dementia or even before showing any signs to help prevention. To make sure you are getting the brain-boosting effects, take enough fish oil (commonly a combination of EPA and DHA) to get at least 1000mg of DHA per day.6,7 As always, talk with your doctor before starting fish oil as incorrect supplementation can have unwanted effects.
- Take a B complex vitamin: B vitamins are cofactors in many cellular processes. In this context, they are very helpful in lowering levels of a molecule called homocysteine (HC)- especially vitamin B12, B6 and folate. HC is known to damage the vascular system and having a high level can contribute to risk of heart disease, stroke, or other vascular problems leading to age-related cognitive decline. Something as simple as taking a B complex that includes 500mcg of B12 (methylcobalamin) can effectively lower HC and reduce its damaging effect on the body.8
- Be physically active: Regularly getting your blood moving and your heart pumping is one of the most effective ways to strengthen your vascular system. This is preventative medicine for nearly all chronic health concerns! It doesn’t need to be an intense workout regime; thirty minutes a day of moderate activity like walking, biking, or gardening is enough to see the health benefits of exercise. Increase the benefits even more by doing your exercise outside. Connecting with nature is inherently healing and has been shown to reduce blood pressure and weight faster than exercise indoors.8,9
- Challenge your brain by trying something new, doing crosswords, word puzzles, or learning a new language: Sound incredible? This really is preventative. Studies show that being bilingual, for example, delays the onset of symptoms of dementia by almost 5 years compared to elderly adults who speak only one language10. Another study has shown that doing regular crossword puzzles can delay the onset of memory decline by 2.5 years.11
- Control alcohol intake and quit smoking: The oxidative damage done by smoking and excessive alcohol intake is almost unparalleled, and is what leads to many chronic disease processes. The evidence is strong that current daily smokers are at a 45% higher risk of developing Alzheimer’s disease when compared to non-smokers or former smokers. When looking at risk due to alcohol consumption, people who drink moderate amounts of alcohol have the lowest risk of developing dementia. Those who don’t drink any alcohol at all have a slightly higher risk, and those who drink excessively have the highest risk. These results can be explained by the slight antioxidant power of moderate alcohol intake, mostly from red wine. Moderate drinking is generally considered no more than one drink per day.2
- Protect against head injuries for your whole life: Wear a helmet on a bike, no ifs, ands, or buts about it. If you ever suffer a concussion, ensure to not further damage your brain while it is in an already-aggravated state. Be extra careful to protect it and avoid successive concussions.2
- Stay connected socially and interact with others regularly: Having a social network that is reliable is one of the best defenders against many health conditions. Regularly interacting with others can protect against the adverse effects of isolation and loneliness. Combine this with physical activity or nature and get extra benefit!2
- Track your numbers: keep your blood pressure, cholesterol, fasting blood glucose, and weight within recommended ranges : All of these measures of cardiovascular and metabolic health are some of the most important predictors of dementia. These are big categories that affect your risk of not just dementia, but heart disease, stroke, and other diseases, so it really is in your best interest to control these parameters of your health. Your metabolism is a part of this too- adults who develop type-2 diabetes in mid life are twice as likely to develop Alzheimer’s as those who don’t. Tackle these with the help of your health care provider and natural approaches.2
These are some, but not all, of the ways you can help protect yourself and your brain from age-related decline and dementia. Be sure to rule out other health concerns like thyroid dysfunction or depression with a health care provider. While you should consider these suggestions, don’t forget that just having a regular healthy diet with fish, nuts, seeds and leafy greens is very helpful for preventing dementia and for so much more. What’s stopping you from taking care of yourself now so you and your beloved brain can live to a healthy old age? Give yourself some self-care and pick up these habits.
- Alzheimer’s Society of Canada. Risk factors for Dementia. http://www.alzheimer.ca/en/About-dementia/Alzheimer-s-disease/Risk-factors
- Alzheimer’s Society of Canada. What is Dementia? http://www.alzheimer.ca/en/About-dementia/What-is-dementia
- Gray et. al., 2015. Cumulative Use of Strong Anticholinergics and Incident Dementia, A Prospective Cohort Study. JAMA Internal Medicine, 2015 175:(3) http://archinte.jamanetwork.com/article.aspx?articleid=2091745
- CNN online. April 18, 2016. Author Ben Tinker. Common over-the-counter drugs can hurt your brainhttp://www.cnn.com/2016/04/18/health/otc-anticholinergic-drugs-dementia/
- Landel et. al., 2016. Vitamin D, Cognition, and Alzheimer’s Disease: The Therapeutic Benefit is in the D-Tails.J Alzheimers Dis. 2016 May 11. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/27176073
- Yurko-Mauro, 2010. Cognitive and cardiovascular benefits of docosahexaenoic acid in aging and cognitive decline. Curr Alzheimer Res. 2010 May;7(3):190-6.http://www.ncbi.nlm.nih.gov/pubmed/20088810
- Hashimoto et. al., 2016. Beneficial effects of dietary docosahexaenoic acid intervention on cognitive function and mental health of the oldest elderly in Japanese care facilities and nursing homes. Geriatr Gerontol Int. 2016 Jan 28. doi: 10.1111/ggi.12691. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/26822516
- Food For the Brain, Action Plan for Dementia and Alzheimer’s, http://www.foodforthebrain.org/nutrition-solutions/dementia-and-alzheimer%E2%80%99s-disease/action-plan-for-dementia-alzheimer%E2%80%99s.aspx
- Logan and Selhub 2012.Your Brain on Nature. https://www.amazon.ca/Your-Brain-Nature-Eva-Selhub/dp/1443428086
- Alladi et. al., 2013. Bilingualism delays age at onset of dementia, independent of education and immigration status.Journal of Neurology 2013 vol. 81 no.22
- Pillai et.al., 2011. Association of crossword puzzle participation with memory decline in persons who develop dementia.J Int Neuropsychol Soc.2011 Nov;17(6):1006-13. http://www.ncbi.nlm.nih.gov/pubmed/22040899