Can we avoid dementia or Alzheimer’s?
It is unbelievably expensive and yet research indicates that some little known actions can help postpone the onset, delaying trouble and expense.
1. What is it?
“Dementia” is the word for a collection of symptoms that occur when your brain permanently stops working as well as it used to. It’s not just a memory problem. You lose judgement and other life skills like driving, and handling money.
2. What is the difference between dementia and Alzheimer's disease?
Dementia is the symptom, and Alzheimer’s disease is one cause. Journalists use the words interchangeably, but they’re wrong. A few diseases cause dementia but the commonest is Alzheimer’s, and vascular disease comes second.
3. Can you inherit it?
Usually not, because dementia is related to ageing. A tiny number of people get it long before retirement, and this “early onset” dementia may be inherited. If your grandparents developed it in their eighties or nineties that does not mean you’ll get it. If your parent was affected early in their sixties, you could ask your doctor about genetic counseling.
4. Can you avoid it?
The strongest research evidence is for exercise, though diet also makes a difference. Some studies show folate and vitamin B reduces the risk of Alzheimer’s. Red fruits, which have lots of antioxidants, are also good. Fish oils, which contain omega fatty acids, found in cold-water fish, dramatically slowed down the progress of Alzheimer’s in some studies in mice. This isn’t conclusive, but we were always told that fish is brain food so this might be right. The Mediterranean diet that is good for blood pressure and weight has the strongest support. Smoking is very, very bad. Head injuries, such as the repeated concussion from boxing or other contact sports are unhelpful. Avoid or control diabetes, depression and high blood pressure.
5. What effect does alcohol have?
Avoiding getting drunk is really important. The number of younger people with dementia caused by heavy drinking is increasing. Alcohol related brain damage is the only truly avoidable form of dementia. The worst pattern is binge drinking, or saving up all your units for a big session. It is said that drinking some wine may reduce the risk of dementia. Wine drinkers may eat better than other drinkers, so more research is needed about the cause, but a daily glass of wine has benefits as far as we know.
6. What is it about exercise?
Physical activity can reduce the chance of developing dementia. It’s never too late to benefit, even if the underlying changes that cause the disease have already been laid down. What’s good for the heart is good for the head. Your brain uses oxygen for fuel, and if you have damaged your blood vessels through smoking, a fatty diet, or lack of exercise, they are less able to keep your brain healthy. Exercise reverses that and also improves mood, which is good for delaying dementia symptoms.
7. What about brain training?
A rich and stimulating environment helps. Do things that challenge your mind, whether it’s Sudoku or discussing politics with your children. Whatever the reason, don’t let your brain vegetate. It needs to work out just like your body. There is no strong evidence that doing a particular brain exercise gives a global improvement in brain health, but keeping mentally busy is good. If you don’t use it, you are more likely to lose it. Advanced education seems to offer some protection against dementia, offering spare capacity that delays disability if part of your brain starts to fade.
8. Should I be doing something in case?
Sort out a Power of Attorney for yourself long before you need it. Do it on your 50th birthday or when your children reach 18. The trouble and expense of making sure you have what you want and need if you are affected will be huge if you have not taken that precaution.
9. What does dementia cost?
In the UK as a whole, it is more than cancer, heart disease and stroke put together. For a family, a diagnosis of cancer is devastating, but you may recover. With dementia you don’t recover and you may have to sell your house to pay for care. People don’t realise you need to prepare in case. If you plan to live till past 90 years, you’ve got a 50% chance of being affected.
10. Where can I find out more now?
There is more on this in the book Dementia The One-stop Guide; practical advice for families, professionals and people living with dementia and Alzheimer’s disease published by Profile books. Buying it helps the Dementia Services Development Trust and it might save you a lot of money.
Professor June Andrews FRCN Dementia The One-stop Guide
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