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Sunday
Jul302017

Warding off dementia

As we age, all kinds of diseases can start to crop up. This isn’t to say young people can’t get afflicted with horrible diseases like cancer, diabetes, heart disease and so on but many of these things do tend to crop up when we grow older.

Dementia is another affliction that’s commonly associated with age. Research tells us that a lot of it has to do with genetics and other factors that are beyond our control. But a recent report by The Lancet Commission on Dementia Prevention, Intervention and Care says that at least 35 per cent of dementia cases can be traced to lifestyle factors that we have the power to modify.

This study had brought together 24 international experts to review existing dementia research in order to provide recommendations for treating and preventing dementia.

According to a survey in 2015, there were about 47 million people around the world living with dementia (including Alzheimer’s which is a form of dementia). With better healthcare people are now living longer than ever and as the population ages, that figure will only increase. It’s estimated that the number of people afflicted with dementia will rise to 115 million by 2050.

Besides the huge healthcare costs — the global estimate in 2015 was US$818 billion — there are tremendous social costs incurred by family members of dementia patients. It’s a common enough disease that most of us know someone who has dementia — it could be a parent, a relative, a friend — and we can clearly see how difficult and heart-breaking this situation can be. For sure, we don’t want to be afflicted with dementia ourselves.

While dementia is not entirely preventable and there’s currently no drug treatment to cure it, the good news is that there are behavioural and lifestyle changes that can significantly improve our chances of warding off dementia.

Preventive measures

According to the Lancet report, about one-third of dementia cases can be reduced by taking heed of nine modifiable risk factors through various stages of life that can affect the potential for developing the disease.

These factors are staying in school until over the age of 15; exercising; reducing depression and social isolation later in life; avoiding hearing loss in mid-life, not smoking; and reducing high blood pressure, obesity and diabetes.

In short, it’s good to increase education, physical activity and social contact; and minimise (or if possible, eliminate) hearing loss, smoking, depression, hypertension, obesity and diabetes.

It’s worth mentioning that these factors do not carry equal weight. Some are more impactful than others.

For example, one of the most impactful factors is one that researchers had not identified before, which is hearing loss. They now estimate that reducing hearing loss in mid-life would also reduce the number of dementia cases by as much as 9 per cent. You might be wondering what hearing loss has to do with dementia. While there’s no certainty on it yet, the researchers believe that it may have something to do with the social isolation that those with hearing loss go through when they lose their ability to hear well. As such, people should take care not to listen to music too loudly on their headphones. It could haunt us later in life in ways that most of us won’t expect.

The second biggest factor is education. The researchers say that increasing education in early life (defined as studying until over the age of 15) can help reduce dementia by 8 per cent. It’s believed that education and other mentally stimulating tasks help the brain to build up its neural networks (or “cognitive reserve” as the researchers put it) which will be useful for allowing the brain to continue to function well even when it starts to decline due to age.

The third preventable major factor that can help reduce dementia has to do with smoking. We all know smoking is bad for health physically. Now we know it affects negatively mentally as well. Dementia can be reduced by as much as 5 per cent if all people stopped smoking, the researchers believe. Smoking negatively affects heart health and this in returns affects brain health. The healthier your body is, the healthier your brain will be. It’s as simple as that.

It’s important to point out that even if we take heed of all nine factors, it doesn’t mean we can definitely stave off dementia. In fact, some 65 per cent of dementia cases are not preventable no matter what precautions are taken. But we should take heart in the fact that we now have a better understanding of what to do more off and what to reduce or cut out.

For those who think it’s too troublesome to remember all nine factors, let me reduce it to three simple things: stay physically and mentally active and watch what you eat.

Other considerations

Why physical exercise is important is quite straightforward. According to Gary Small, director of UCLA’s Longevity Centre and author of The Alzheimer’s Prevention Programme, when your heart is really pumping, more nutrients and oxygen get delivered to your brain. The body also secretes protective chemicals during physical activity, including a protein called brain-derived neurotrophic factor, which is believed to spark the growth of neurons. “Exercise can’t guarantee that you won’t get Alzheimer’s, of course,” he says. “But the hope is to delay the disease long enough so that you never experience symptoms in your lifetime.”

The importance of mental exercise is very obvious too. The more we work out our brain, the fitter it stays. But mental exercise doesn’t have to mean doing puzzles and brain quizzes. It can be as simple as trying out new things such as trying out new routes to get home, according to UCLA’s Small. Generally, anything that gets your brain working is good, he says. Repetitive mental exercises aren’t that helpful though. Once a task becomes repetitive, the brain work involved becomes more rote, which means there’s less neural activity going on.

Food plays a big role in health so it makes sense to eat the right things and avoid too much junk food. What you drink can make a difference too. It’s best to avoid alcohol. Although red wine has some anti-oxidants that can be good for your heart, there’s too much bad that comes with the good. No doctor will recommend consuming alcohol on health grounds as alcohol contributes to dozens of negative medical conditions including various cancers, high blood pressure, liver cirrhosis and not to mention depression.

There’s good news if you like coffee and tea though. Both these beverages seem to be good for warding off dementia. A 2009 study done in Finland found that subjects who regularly drank coffee had a 65 per cent lower risk of dementia and Alzheimer’s. The researchers for that study followed the drinking habits of 1,400 coffee drinkers for more than two decades and found one group that seemed to benefit the most: those who’d been drinking three to five cups of coffee a day in their 40s and 50s.

More recent research from Singapore has found that drinking black, green or oolong tea can help reduce the risk of dementia in older people by 50 per cent. And for those who were genetically at risk of Alzheimer’s disease (those who carry the gene APOE e4) the risk was reduced even further by 86 per cent. The study involved 957 Chinese seniors aged at least 55 years old who regularly drank tea.

“Tea is one of the most widely consumed beverages in the world,” said Feng Lei, the study’s lead author from the National University of Singapore. “The data from our study suggests that a simple and inexpensive lifestyle measure such as daily tea drinking can reduce a person’s risk of developing neurocognitive disorders in late life.”

So, stay active physically and mentally, eat sensible meals and drink your coffee or tea. Such habits will go a long way towards reducing the risk of dementia, a disease that greatly impairs the quality of life not just for those who are afflicted but also their family members and loved ones.

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