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To stave off dementia, start early

Dementia is now the main cause of death for Australian women, and the message on prevention is to start in middle-age.

While billions have been spent on finding a cure, not only do we not have one, we’re still not sure what causes it. Amyloid plaque, inflammation, herpes or some other virus, genetics?

But it’s useful to recognise that the seeds appear to be sown decades before it shows up — i.e. in our 40s and 50s.

As you probably know, dementia isn’t a single disease. It’s an umbrella term, and Alzheimer’s is the most common form.

There’s also a difference between Alzheimer’s disease and Alzheimer’s dementia. The former refers to changes that take place in the brain over decades; the latter is the endpoint, where a person is confused and loses their memory.

The stepping stones that lead us down this path can include high blood pressure, obesity, later-life smoking, diabetes, inactivity and frailty, and social isolation. 

Depression is often included in this list because it’s common for people diagnosed with dementia to have experienced it. 

But the depression may be in response to realising that we’re losing our cognitive ability. There’s no evidence that being diagnosed with depression in middle-age means we’re going to have dementia. 

The list of possible stepping stones suggests that it’s smart to manage our weight, eat a real-food diet, avoid smoking, stay active and strong, and keep socially and mentally engaged.

There’s an obvious overlap with cardio-disease and other chronic diseases, in that much the same strategies are important in avoiding all of them. 

The issue with obesity seems to be the ratio between muscle and fat. Excess body fat is linked to inflammation, which can damage our brains, among other things.

Alzheimer’s patients are referred to me for exercise because doctors have little else at their disposal. But by the time a brain is damaged it’s too late to improve it with exercise. 

The benefit of exercise is likely to be in prevention — it’s currently regarded as our number one preventive action. We know that it positively changes the structure of the brain, thickening grey matter and increasing neural connectivity. 

This especially seems to be the case for resistance exercise, perhaps because the hormones involved in increasing muscle strength also improve cognitive function. We’ve seen in research that older people who lose muscle tissue also lose brain tissue.

As far as diet is concerned, American psychiatrist and author, Daniel Amen, warns us to avoid excess calories, trans fats, and processed and pesticide-laden foods. 

Mental stimulation is important too, and that’s not just crosswords and sudoku. Spending time with friends and family, volunteering, reading books, and going to the theatre or a museum all tick the box too. 

In addition, we need to get the best sleep we can, try to avoid too much stress, and be moderate with alcohol.

But start in middle-age. 


Photo source: Bigstock

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Thursday, June 28, 2018 | Rhonda Anderson