Q.  My mother had dementia, and I have heard that it can run in families. Is there anything I can do to prevent dementia?  – Judy

A.  Thank you, Judy, for the question. Dementia is a very popular topic lately, especially as cases of dementia continue to rise at a startling rate.  One aspect of the Physical Therapy Advisor web site is to provide “how to” advice on successful aging as well as how to manage your health and well-being.  Preventing dementia is definitely a critical component in successful aging and a healthy lifestyle.

Let’s first define exactly what dementia is, and then we will address the symptoms and risk factors.  Dementia is not actually a specific disease.  It’s a term used to describe a group of symptoms affecting a person’s memory or ability to perform activities of daily living (ADLs). There are six basic ADLs: eating, bathing, dressing, toileting, transferring (walking), and continence.

At least two brain functions, such as memory loss and impaired judgement, need to be affected for a person to be diagnosed with dementia.  A person may experience memory loss along with difficulty of performing ADL tasks, such as how to cook or drive.  Loss of memory only would not necessarily mean that a person has dementia.  Although there are many potential causes of dementia, Alzheimer’s disease is the most common form of dementia.  Other possible causes include:

• Vascular dementia
• Lewy Bodies dementia
• Frontotemporal dementia
• Parkinson’s dementia
• Huntington’s dementia
• Hydrocephalous
• Dementia like symptoms caused by nutrient deficiencies or reactions to medications

Dementia is a serious health problem facing many industrialized nations including the United States.  Actual numbers of people diagnosed with dementia vary between 2 and 5 million people.  Even more troubling is that 5-8% of people over the age of 65 have some form of dementia and that number doubles every 5 years after the age 65.

Symptoms of Dementia may include the following:

• Memory loss
• Difficulty communicating
• Difficulty with complex tasks, such as driving or math
• Difficulty with motor programming or coordination
• Easily disoriented or getting lost easily
• Personality changes
• Difficulty with logic or reason
• Loss of safety awareness or judgement
• Paranoia
• Agitation
• Hallucinations

Dementia like symptoms should be evaluated by a medical physician and should be openly discussed with all parties involved.  Many forms of dementia are progressive.  Early diagnosis allows for proper planning and time to make crucial decisions.  Depending on the type of dementia, there may be medical options to slow down the progression.  In addition, some causes of dementia like symptoms are reversible if caught early.  Your physician can assist you in determining your specific diagnosis and prognosis.

Risk Factors for Dementia:

• Age – Dementia can occur at any age, but the risk significantly increases after the age of 65. Dementia is not considered a normal aging process.

• Family History – Genetics play a role. A family history of dementia and certain specific genetic mutations increase your risk.

• Down syndrome – Down syndrome increases your risk of developing dementia.

• Alcohol Abuse – Heavy drinking and alcohol abuse increases your risk. Mild to moderate alcohol consumption may help to prevent dementia (particularly when consumed in the form of red wine).

• Microvascular diseases such as diabetes or atherosclerosis, which is the fatty build up in the arteries. Any disease process that has an inflammatory effect on the small blood vessels of the body increases your risk.

• High Blood Pressure

• Depression

• Hearing Loss

• Obesity

• Smoking

Now that we have identified exactly what dementia is and many of the risk factors that increase your risk for developing dementia, let’s address Judy’s question regarding prevention.

10 Tips to Prevent Dementia:

1. Eliminate known risk factors. This includes eliminating smoking and avoiding heavy alcohol consumption.
2. Stay social. To experience purpose in your life, it’s key to maintain your social outlets and friendships. It also helps to decrease your risk of developing depression, which is a risk factor for dementia. Be active in your community by interacting with family, friends, church, civic organizations or volunteer projects.
3. Maintain sharp mental health. Regardless of age, it’s important to remain engaged and mentally sharp through constant and varied mental stimulation. Read, play engaging games, and avoid excessive TV watching.
4. Get hearing aids. Poor hearing is associated with an increased risk of dementia. When a person loses his/her hearing, he/she tends to disengage with the environment. He/she becomes less social, more depressed, and no longer participates in stimulating activities. Stay engaged by quickly addressing hearing loss.
5. Exercise. Walk daily or take a yoga or Tai Chi class. Participate in a strength training and high intensity training (HIT) program. Exercise can help you to maintain a suitable weight by insuring your metabolism stays elevated and your hormone levels remain balanced. It also insures good blood flow to the smaller vessels in the brain and helps to regulate insulin levels, which prevents diabetes (a risk factor for dementia).
6. Do not eat anything that comes in a package. Most of our food should be from low sugar fruits and vegetables as well as protein and healthy fats (primarily from plant sources such as avocados and coconut or olive oil). Any animal fat should be from organic and grass fed animals. Your brain and body tissue need nutrients to be able to perform at a high level. Avoid processed food as much as possible. Limit sugary food and add more protein and healthy fat in your diet. Maintaining a diet with adequate healthy fats is essential in providing the nutrients to support all hormone function in the body as well as support the brain and nervous system. Adequate protein intake is necessary to support muscle health and development.
7. Stay hydrated. The human body is primarily made of water, which is critical for all body functions. Dehydrated tissues are prone to injury as they struggle to gain needed nutrients to heal and repair. Dehydrated tissues are less flexible and tend to accumulate waste products. Water intake supports proper brain, muscle, and hormone function as well as lubrication of the joints and skin appearance. Stay hydrated by drinking water. Try to avoid beverages that contain artificial sweeteners or chemicals with names that you can’t spell or pronounce.
8. Manage your weight. Obesity places additional strain on your cardiovascular system and increases your risk of diabetes—thus increasing your risk of stroke, heart disease, and dementia. When attempting to lose weight, aim for 1-2 pounds per week.
9. Sleep more. While sleeping, your brain clears out metabolic waste, known as neurofibrillary tangles, which are associated with dementia. Your body must rest in order to grow and develop. Most people are not getting adequate sleep and rest. Sleep is critical to maintaining your growth hormone and testosterone production as well as stabilizing your metabolism.
10. Supplements. There is some evidence that certain vitamins, minerals, and/or herbal supplements may help to reduce your risk of dementia. Folic acid, vitamin B12, vitamin D, magnesium, and fish oil are believed to preserve and improve brain health. Although results are less conclusive, vitamin E, ginkgo biloba, coenzyme Q10, and turmeric may also be beneficial in the prevention of or delay the onset of dementia like symptoms. Please consult with your healthcare practitioner to determine if these supplements are ideal for you.

Dementia is quickly becoming a major public health crisis.  The risk for developing dementia rapidly increases as baby boomers (and others in the western world) age.  Although the exact cause of the spike in dementia cases is unknown, it’s pertinent that we live a healthy lifestyle and avoid known risk factors.  To learn more about how to age successfully, please refer to My Top 10 Anti-Aging Tips.  For inspiration regarding the aging process, I also recommend reading Ken Dychtwald’s Age Power: How the 21st Century Will Be Ruled by the New Old.  Thank you, Judy, for this question!

Do you have a loved one or friend who is experiencing dementia?  Which tip will you implement in order to prevent dementia?  Please leave your comments below.

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Disclaimer:  The Physical Therapy Advisor blog is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice.  No health care provider/patient relationship is formed.  The use of information on this blog or materials linked from this blog is at your own risk.  The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Do not disregard, or delay in obtaining, medical advice for any medical condition you may have.  Please seek the assistance of your health care professionals for any such conditions.