Reducing Your Risk of Dementia
Gary H. Oberlender, MD, FACP
Consultant in Geriatric Medicine
One of the most common fears among seniors and their families is the development of cognitive impairment or dementia. Indeed, dementia is considered by many to be an epidemic: approximately one-third of persons over age 80 have dementia and need some degree of assistance with their activities of daily living.
Cognitive impairment in seniors has many causes and not all of them are due to dementia. These other causes include depression, drug side effects, poorly controlled chronic medical conditions, poor nutrition, and many others. Most of these causes of cognitive impairment can be treated and reversed which is why it is essential to perform a thorough search for one or more of these causes in all cognitively impaired seniors. Dementia is a form of cognitive impairment that is irreversible in most cases, though there are exceptions. In seniors, the most common causes of dementia are Alzheimer’s disease, stroke and other forms of vascular dementia, Parkinson’s disease, Fronto-temporal dementia, and Lewy body dementia.
Despite decades of intensive research, the cause of Alzheimer’s disease remains unknown. However, numerous studies published in high quality medical journals have shown that the risk of a person developing Alzheimer’s disease can be significantly reduced. These studies also suggest common ground between the causes of Alzheimer’s disease and the causes of vascular dementia, suggesting that cerebral atherosclerosis–hardening and narrowing of the blood vessels that feed the brain–may underlie both processes.
A study published in 2002 revealed two remarkable findings: First, that the risk of Alzheimer’s disease in an adult with high blood pressure was 2.6 times higher than someone with normal blood pressure; and second, that the risk of Alzheimer’s disease in an adult with elevated serum cholesterol was 2.8 times higher than someone with normal cholesterol. Prior to that time, high blood pressure and high cholesterol were only associated with atherosclerosis. But here was evidence that the risk of developing Alzheimer’s disease is associated with the same factors that increase one’s risk for developing atherosclerosis (stroke, heart attack).
In a different study published in 2005, researchers performed detailed dietary histories on almost 600 seniors and found that a high dietary intake of folic acid, a naturally occurring vitamin found in fresh fruits and vegetables, resulted in a 66% lower incidence of Alzheimer’s disease. In another study published that same year, French researchers who had carefully studied the diets of almost 8,000 seniors over several years found that people who ate at least one serving of fresh fruits and vegetables each day or who ate fish at least once a week reduced their risk of dementia by 35%. These are remarkable findings: Can you imagine a drug that boasted of reducing your risk of dementia by 35% to 66%? Another study found that adults who ate on average four or more servings of vegetables each day had a 38% reduction in “age related cognitive decline”–the slow steady decline in cognitive function that had been thought to be part of normal aging. This finding has tremendous implications: It suggests that normal aging is not necessarily associated with decline in cognitive function and that diet plays a key role in how the brain ages.
A series of studies published in various medical journals between 2004 through 2008 demonstrated that regular exercise, such as walking, significantly improves cognitive performance and reduces the risk of dementia of all types. Additional lifestyle choices would likewise be expected to reduce your risk of dementia: not smoking; reducing the intake of sugars and carbohydrates; moderating alcohol use; controlling stress; maintaining a good body weight; and having a positive mental attitude towards yourself and others. Finally, research has also shown that maintaining active social networks and practicing activities that keep the mind active improve brain function and reduce the risk of dementia.
Viewed holistically, emerging scientific evidence strongly suggests what many of us have suspected or at least hoped: That diet, exercise, and lifestyle choices play important roles in how our brains function and that intelligent choices in our diets and lifestyle will reduce our risk of developing Alzheimer’s disease and other forms of dementia as we age. There are choices each of us can make right now to improve brain function and reduce our risk of atherosclerosis and dementia. Two old sayings come to mind: “You are what you eat” and “If you don’t use it, you lose it.”
Gary H. Oberlender, MD, FACP is a Roanoke, Virginia based physician with 30+ years of clinical experience in the medical care of seniors. He is Board Certified in Internal Medicine and Geriatric Medicine and provides consultative In-Home Comprehensive Geriatric Evaluations and In-Home Independent Evaluations of Decision-Making Capacity. His services are available for seniors living in central and southwestern Virginia. To learn more about Dr. Oberlender’s services and credentials, visit his website: www.SeniorEvaluations.com or call: 540-529-7566