CAN I PREVENT DEMENTIA AS I GET OLDER?
Medically Reviewed by Dr. Sony Sherpa (MBBS) and Updated on November 21, 2023
Dementia is not a specific disease but rather a general term to describe the loss of cognitive functioning, like the ability to remember, think, and reason, as you get older.
The condition dementia is often incorrectly referred to as “senile dementia” or “senility”. This reflects a widespread and incorrect belief that serious mental decline is part of normal aging.
It is natural to experience some amount of deterioration in cognitive function due to the consequences of biological aging. However, in dementia, the decline is beyond what might be normally expected.
According to the World Health Organization (WHO), globally, around 55 million people suffer from dementia. With the increasing proportion of the older population, this figure is expected to reach 78 million in 2030 and a staggering 139 million in 2050.
This article will talk about dementia prevention, what the symptoms look like, and the risk factors behind it. We will also answer some of your most frequently asked questions.
Let’s begin by getting to the root of the problem: why do people suffer from dementia?
What Causes Dementia?
Dementia results when the once-healthy brain cells or neurons in the brain stop functioning. Owing to the senile degeneration of the brain, these neurons may also lose connection with the other cells of the brain and die off. While age-related neuronal loss is experienced by everyone, the degree is far greater in people with dementia.
Brain damage in dementia can be caused by:
Alzheimer’s Disease
This is by far the most common cause of dementia and accounts for 60-80% of the cases. Alzheimer’s is a brain disorder that gradually destroys memory and thinking skills, which eventually leads to the inability to carry out simple daily tasks.
In Alzheimer’s disease, there is an abnormal buildup of proteins. These protein clumps (called amyloid plaques) and tangled bundles of fibers (known as neurofibrillary or tau tangles) deposit many years before the symptoms appear. It is not currently known why and what causes this process to begin.
As the neurons get affected, the chemical messengers involved in sending messages across the brain begin to decrease. Over time, the areas of the brain shrink, and the ones responsible for memories usually get affected first.
For most people, symptoms first appear in their mid-60s, which is referred to as the late-onset type of symptoms. Very rarely, the disease manifests between the early 30s and mid-60s in what is known as early-onset Alzheimer’s.
Vascular Dementia
Damage to the vessels that supply blood to the brain results in vascular dementia.
This is the second most common cause of dementia and can be caused by many conditions that interrupt or limit the blood flow to the brain. It could be microscopic bleeding in the brain or a blockage of the blood vessels.
To function properly and remain healthy, the brain cells need a constant supply of blood and nutrients. When there is a block or reduction in the blood flow to the various parts of the brain, the blood cannot reach the brain cells and will eventually die.
The cells of the brain are very vulnerable to an inadequate supply of blood. When the cells die, it can cause problems with memory, reasoning, and thinking. When these cognitive issues start impairing daily functioning, then it is called vascular dementia.
You can develop vascular dementia as a result of a stroke, brain hemorrhage, and chronically damaged or narrow blood vessels due to diabetes, high blood pressure, and aging.
Frontotemporal Dementia
Frontotemporal dementia (FTD), also known as Pick’s disease, is a group of disorders that causes dementia due to the loss of brain cells from the front and side lobes (frontal and temporal) of the brain.
Unlike other causes of dementia, these can affect younger people. While the exact cause of FTD is unknown, it has been associated with abnormal mutations and protein deposition in the brain.
Lewy body Dementia
Lewy body dementia (LBD) is caused by the abnormal deposition of clumps of proteins in the brain. These proteins are thought to interfere with the signals between the neurons, affecting the normal functioning of the brain.
In LBD, protein builds up in the areas of the brain responsible for functions like vision, thinking, and muscle movement. This leads to seeing things that are not present and unpredictable changes in attention, alertness, and concentration. Eventually, loss of memory sets in.
Mixed Dementia
Mixed dementia is a condition in which a person has more than one type of dementia. The most common is a combination of Alzheimer’s and vascular dementia.
Risk Factors for Dementia
Many factors can contribute to dementia eventually. Some risk factors can be changed, while there is nothing you can do about the others. Let’s take a look at each of them.
Risk Factors That Cannot Be Changed
Genetics
The genes you inherit from your parents can contribute to your risk of developing dementia. For instance, if several members of your family have developed dementia over generations, it is more likely that the condition is passed on to you as well.
Down’s Syndrome
People with Down’s syndrome are at a higher risk of developing Alzheimer’s disease. The genetic changes in Down’s syndrome can lead to abnormal protein buildup, causing Alzheimer’s and dementia in some people.
Age
The risk of dementia increases as you age, but it is not an inevitable part of aging. Although extremely rare, dementia can sometimes affect people as young as 30 years.
Risk Factors That Can Be Modified
Alcohol
Excessive and long-term consumption of alcohol and dementia have been interlinked. According to research, heavy drinking can increase the risk of dementia by threefold.
Drinking alcohol causes brain damage, and those who drink heavily and over prolonged periods have a reduced volume of white matter. This is the region responsible for transmitting signals across the brain and can lead to an issue with normal functioning.
The brain damage from alcohol may be reversed when alcohol stays out of your body for long periods.
Stress
Stress affects our immune system, which is known to play a key role in the development of dementia. The stress hormone, cortisol, has been linked with memory problems. Studies have even found that chronic stress may even trigger the onset of Alzheimer’s.
Smoking
Cigarette smoking increases the risk of Alzheimer’s, vascular problems like stroke, and other causes of dementia. It is estimated that smokers have a 30-50% increased risk of developing dementia.
Other Risk Factors
Head Injury
Some studies have linked the risk of developing Alzheimer’s in people who have had a history of head injury. However, more research is needed.
Hearing Loss
Hearing loss has been associated with a risk of developing Alzheimer’s, although the inability to hear may not directly cause dementia.
Depression
People with symptoms of depression tend to suffer a rapid decline in memory and thinking skills. Researchers have found that depression can increase the risk of dementia by 70%.
Kidney Disease
A poorly functioning kidney is thought to be associated with an increased risk of dementia. However, more studies exploring the link between kidney disease and dementia are required.
Diabetes
The exact relationship between diabetes and dementia has not been well understood, but it is believed that high blood sugar can harm the brain. Diabetes damages the blood vessels and increases the risk of stroke and heart disease, both of which may contribute to dementia.
The Signs and Symptoms of Dementia
Some people with dementia cannot control their emotions, while others may experience a change in their personalities. Sometimes dementia is so severe that it interferes with a person’s ability to carry out daily activities.
Because the condition ranges from mild to severe, people may have varying symptoms.
Early Stages of Dementia
One of the first signs of dementia is forgetfulness. Other early signs of dementia are becoming lost in familiar places and losing track of time. Because the onset of symptoms is gradual during the early stage, it may often be overlooked.
When dementia progresses, so do the symptoms.
Middle Stages of Dementia
Forgetting people’s names or recent events, needing help with personal care, becoming confused even while at home, difficulty in communicating, and behavior changes like repeated questioning and wandering are some symptoms of dementia in the middle stages.
Late Stages of Dementia
In the late stage of dementia, memory disturbances are serious. There is near total dependency and physical symptoms become more obvious.
People with late-stage dementia are unaware of the time and place and experience difficulty in walking or carrying out daily activities. They have a hard time recognizing their spouse, children, friends, and other family members.
Sometimes, behavior changes may escalate and lead to aggression.
Can Dementia Be Prevented?
Researchers are still investigating how dementia develops, so there are no certain ways it can be prevented completely.
However, experts do believe what’s good for the heart is also good for the brain. So, here’s some insight on how to prevent dementia, to the best that we can:
Exercise
Being overweight or obese can increase the risk of several diseases like diabetes and high blood pressure, which are linked to both Alzheimer’s disease and vascular dementia.
Exercising will help reduce stress, make your heart healthy, control your weight, and keep your learning, thinking, and judgment skills sharp as you age.
Scientists have explored the direct link between exercise and dementia, with some studies suggesting that regular exercise may reduce the risk of developing dementia by 30%.
Get at least 150 minutes of moderate-intensity physical activity (such as aerobics, fast walking, or cycling)
Diet
While there is no dementia prevention diet as such, eating a healthy and balanced diet may help. Avoid foods that are high in salt, sugar, and saturated fats, and low in fiber.
Include at least 5 portions of vegetables and fruits every day. It may also be helpful if you cut back, if not quit, smoking and consuming alcohol.
Meditation
Meditation calms your mind and improves physical health. It also helps enhance your mental ability. Practicing meditation daily for at least 15 to 30 minutes may help lower your risk of dementia.
Manage Health Problems
Health problems like diabetes, high blood pressure, depression, and hearing loss are known to increase the risk of dementia. Consult with your GP regularly to stay on top of your treatment.
Stay Mentally and Socially Active
Stay mentally alert by picking up new hobbies, solving crossword puzzles, playing chess, or simply reading a book. You may also put together a jigsaw puzzle, build your vocabulary or listen to music.
Involve yourself in social activities. Attend community programs and support groups. Listen to and communicate with other people.
Understanding the Causes of the Unanticipated Drop in Dementia Rates
The unexpected decline in dementia incidence in the developed world has generated significant interest among researchers. While the exact reasons for this decline are not fully understood, several factors have been suggested based on new research:
- Improved Cardiovascular Health: One of the leading theories for the decline in dementia incidence is the emphasis on improving cardiovascular health over the past few decades. Cardiovascular diseases, such as heart attacks and strokes, have been a major focus in North America and Western Europe. Efforts to control high blood pressure and reduce cholesterol levels through medications like statins have become widespread. This focus on heart health is believed to have contributed to the reduction in dementia cases, as there is a known link between cardiovascular health and brain health.
- Gender Differences: Research has shown that the reduction in dementia incidence rates has been greater in men. Historically, efforts to reduce cardiovascular risk factors were primarily targeted at men in the 1970s and 1980s, at a time when it was erroneously believed that women were less susceptible. This may have played a role in the observed decline.
- Cognitive Reserve and Education: Those with active and nimble brains appear to be better equipped to tolerate the cognitive deterioration associated with dementia. The concept of "cognitive reserve" suggests that individuals with higher levels of education (measured in terms of years of exposure) and mental engagement may have better cognitive resilience, potentially delaying the onset of dementia or allowing individuals to cope with its effects for longer. However, there is ongoing debate among scientists regarding the exact nature of this relationship.
- Vascular Health and Alzheimer's Disease: There is growing recognition that vascular health is not only important in preventing vascular dementia but may also play a role in protecting against Alzheimer's disease. Research indicates that vascular pathology can contribute to Alzheimer's dementia. Better cardiovascular health might enhance resilience to factors contributing to Alzheimer's disease, such as amyloid plaque and tau protein accumulation.
While the decline in dementia incidence has been observed in the developed world, researchers are hopeful that similar trends may emerge in other regions. Population studies are being conducted in countries like Brazil, Nigeria, and South Africa, raising hopes that the decline in dementia cases may become a more widespread phenomenon. However, it is important to acknowledge that these improvements may not be universal, as factors like lifestyle, education, and healthcare access can vary significantly between regions.
FAQs
Can Dementia be Brought on by Emotional Trauma?
Studies have determined that a traumatic event or those associated with repeated and persistent stress could enhance the risk of dementia.
Some diseases have features similar to dementia but are instead caused by vitamin deficiencies or a reaction to certain medications. These respond well to treatments. Even dementia induced by alcohol may be reversed. However, dementia caused by progressive diseases such as Alzheimer's is irreversible.
Dementia, by itself, will not cause death. Progressive brain damage as a result of dementia may eventually be fatal. For instance, people with Alzheimer’s disease may live, on average, 4 to 8 years after diagnosis. Depending upon other factors, some people may live up to 20 years.
Conclusion: Can You Prevent Dementia?
While the biggest risk factor for dementia is getting old, there are certain things that you can do to prevent the condition. Doing regular physical activity is one of the best ways, and so is following a healthy diet that is good for your mind and heart. Staying away from alcohol and cigarettes can also help.
Take control of your health from the start and manage health problems that may lead to dementia. Engage in mental and social activities that may help build the brain’s ability to cope with such conditions.
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