Tag Archives: dementia

Strategies To Address Dementia Risk

DementiaJacquie Eubanks RN BSNDementia is a general term for the loss of memory and intellectual abilities. Alzheimer’s disease is the 6th leading cause of death in the U.S., and the most common form of age-related dementia, contributing to 70% of the almost 50 million cases worldwide. Alzheimer’s and other forms of dementia are expected to dramatically increase as the population ages, with some estimates predicting 150 million cases by 2050. While there is currently no cure for dementia, a large body of research suggests that modifiable risk factors may hold the most promise for prevention of the progressive decline in mental function due to generalized brain deterioration.

No strategies are guaranteed to protect long term brain health. However, researchers have reviewed a large body of evidence, and have identified nine controllable risk factors, through various stages of life, that affect the likelihood of developing dementia. The study, recently published in The Lancet, brought together 24 international experts to review existing dementia research and determine strategies for prevention and intervention. As well, they looked for ways to improve care for those already living with the disease. While the focus has been on developing medicines for prevention and treatment, non-pharmaceutical preventative approaches that strengthen brain networks early in life may help reduce dementia cases by one-third.

Alzheimer’s causes a gradual decline in memory, thinking, and reasoning skills. There’s no question that many more trials and ongoing research into developing treatments is necessary, yet the researchers considered the scientific evidence strong enough to suggest that preventing dementia and age-related cognitive decline might be possible. Of course, there are no guarantees, and prevention needs to start before there are signs of decline, preferably before middle age.

The nine modifiable risk factors that affect the likelihood of developing dementia are:

  • Hypertension management. Controlled blood pressure levels aid in preserving brain blood vessel health. This is considered most effective when initiated early on in life, but management of blood pressure is advised at every age.
  • Increased physical activity. Aerobic exercise is associated with a reduced risk of cognitive impairment and dementia. Vascular risk factors are well known to be reduced by aerobic exercise. Evidence suggests that physical activity may slow the progression of neurodegenerative processes and age-related loss of synapses in the brain.  
  • Cognitive training. Mental stimulation that challenges the brain helps to strengthen the brain’s networks. Getting a good education in early life, and continuing at least through high school, may have a direct effect on the wiring of the brain. Challenging the brain may increase “cognitive reserve” built through a lifetime of continued learning and curiosity. Research has shown that those with greater cognitive reserve are better able to fend off degenerative brain changes.
  • Lose weight if needed. Being overweight or obese at midlife independently increases the risk of dementia, Alzheimer’s, and vascular dementia in later life.
  • Prevent or control diabetes. Studies suggest that people with type 2 diabetes are at a higher risk of developing Alzheimer’s and vascular dementia. Taking steps to manage diabetes may help to avoid potential cognitive decline.
  • Avoid or address hearing loss. It remains unclear whether hearing loss is the result of changes linked to dementia or whether hearing loss itself contributes to cognitive decline. Research suggests that those who experience hearing loss may be at greater risk of cognitive problems later in life than those without auditory problems.
  • Manage depression. Depression has been proposed as both a risk factor for and an early symptom of dementia. Approximately half of those with late-onset depression have cognitive impairment.
  • Remain socially active. Studies show that social interaction is key to mental health, and that those with larger social networks are 25 percent less likely to develop dementia than those with smaller networks.
  • Quit smoking. Smoking is damaging to cardiovascular and overall health and may lead to cognitive decline. Studies show that smokers have a 40 percent increased risk of Alzheimer’s and vascular dementia. Smoking causes oxidative stress, which appears to promote the formation of the amyloid plaques and neurofibrillary tangles in the brain that are closely associated with Alzheimer’s disease.

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References:
Defeating Alzheimer’s disease and other dementias. http://www.thelancet.com/commissions/dementia
One-third of dementia cases could be prevented, report says. http://www.cbsnews.com/news/one-third-of-dementia-cases-could-be-prevented-alzheimers-report/
10 Early Signs and Symptoms of Alzheimer’s. http://www.alz.org/10-signs-symptoms-alzheimers-dementia.asp
2016 Alzheimer’s Statistics. http://www.alzheimers.net/resources/alzheimers-statistics/
Can Dementia Be Prevented? Education May Bolster Brain Against Risk. http://www.npr.org/sections/health-shots/2016/02/11/466403316/can-dementia-be-prevented-education-may-bolster-brain-against-risk
What is cognitive reserve? http://www.health.harvard.edu/mind-and-mood/what-is-cognitive-reserve
Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3258000/
Midlife overweight and obesity increase late-life dementia risk. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100125/
Diabetes and Alzheimer’s linked. http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/diabetes-and-alzheimers/art-20046987?pg=2
The complex relationship between depression and dementia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3039168/
Friends Make You Smart. http://www.aarp.org/health/brain-health/info-11-2008/friends-are-good-for-your-brain.html
Smoking and Dementia: What to Know. https://www.healthafter50.com/memory/article/smoking-and-dementia-what-to-know

 

Blood Sugar and Dementia Risk

dementiaBy Jacquie Eubanks BSN, RN

If you needed one more good reason to cut back on sugar in your diet, here it is.  A study published in the New England Journal of Medicine shows that above normal blood sugar levels increase the risk factor for developing dementia even among those who do not have diabetes.  Researchers tracked the blood glucose levels of 2,067 members of Group Health, a nonprofit HMO, for seven years.  Some of the patients had type 2 diabetes when the study began, but most did not.  None had dementia.  Over the course of the study, about 25% of the participants developed dementia of some kind, primarily Alzheimer’s disease or vascular dementia.

“We found a steadily increasing risk associated with ever-higher blood glucose levels, even in people who didn’t have diabetes,” Dr. Crane said. Of particular interest: “There’s no threshold, no place where the risk doesn’t go up any further or down any further.” The association with dementia kept climbing with higher blood sugar levels and, at the other end of the spectrum, continued to decrease with lower levels.  This held true even with glucose levels considered relatively normal.  The normal range for blood glucose levels measured after an 8 hour fast is between 70 – 99 mg/dl.

The study showed that for people without diabetes whose average blood glucose level was 115 mg/dl the risk of developing dementia was 18% higher as compared to those with an average glucose level of 100 mg/dl.  For people with diabetes, whose blood sugar levels are generally higher, dementia risk was 40% higher for those with an average reading of 190 mg/dl compared to those with an average level of 160 mg/dl.  This study establishes for the first time a link between dementia and elevated blood sugars in the non-diabetic range.  Researchers concluded that any incremental increase in blood sugar levels is associated with a higher risk for developing dementia and that the brain is a target organ for damage by high blood sugar.

The study stopped short of proving that high blood sugar “causes” dementia, only that there is an association between the two.  That being said, it is still worth keeping your blood sugar within normal levels to try to avoid developing type 2 diabetes and a variety of health problems including heart, eye, kidney and nerve disease.  The good news is that blood sugar levels can be lowered by exercising and, if necessary losing weight.

 While a healthy diet would contain a significant amount of naturally occurring sugar, such as the amount found in fruits and grains, chronic consumption of sugary drinks, candy and sweets and processed foods is wreaking havoc with our health. Cutting back on processed foods, soda, bakery goods and highly refined grains can help, as can shifting to a healthier diet with lots of vegetables, fruits and whole grains.  If the recommended 150 minutes per week of moderate intensity exercise, such as brisk walking, is too daunting, even a little activity each day can make a big difference in lowering blood glucose levels.  Exercise allows your muscles to used stored glucose and use insulin more effectively.

Our brains need sugar every day to function.  In fact, the brain is totally dependent on blood glucose for its energy supply, as glucose is virtually the only fuel the brain uses.  Sugar is not the brain’s enemy, added sugar is.  Research shows that diets high in added sugar reduce the production of the brain chemical called brain-derived neurotrophic factor or BDNF.  Low levels of BDNF impairs memory formation and learning.  Diabetics and pre-diabetics have particularly low levels of BDNF, and as the amount of BDNF decreases, sugar metabolism worsens, setting up a destructive cycle that’s difficult to reverse.  Research has also linked low levels of BDNF to depression and dementia.

What this study and other research strongly suggest is that we are seriously damaging ourselves with processed foods high in added sugar, and the damage begins in our brains.  Chronic added sugar consumption can be seen in the same damaging light as smoking and alcoholism.  It would be wise to limit sugar consumption to less than 25 grams per day, especially for people showing signs of metabolic syndrome and insulin resistance, such as those with obesity, high blood pressure and high cholesterol.  Remember, what’s good for the brain is also good for the heart.  Keeping blood glucose, blood pressure, and cholesterol levels in check, maintaining a healthy weight, and keeping tabs on added sugar, can keep the brain, the heart and their vessels in good working order. 

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Everyday Brain Fitness

brainBy Jacquie Eubanks BSN, RN

” A strong body makes the mind strong.” ~ Thomas Jefferson

Neuroscience tells us that physical exercise is good for the brain as well as the body.  Physical activity plays an essential role in maintaining a sharp mind.  According to Laura L. Carstensen, author of A long Bright Future and director of the Stanford Center on Longevity, “The latest research shows that cognitive decline is not inevitable.  Although the brain does shrink slightly, it continues to make new neurons and fine-tune neural connections as we age. ”  If you want to reduce your lifetime risk of developing alzheimer’s disease and general dementia, aerobic exercise can help keep cognitive abilities sharp.  Exercise boosts the flow of blood to the brain, resulting in the release of brain chemicals that stimulate the formation of new neurons, work to repair cell damage and strengthen the synapses that connect brain cells.  

Exercise and physical activity are primary components of a healthy lifestyle.  Studies show that everyone, no matter their age or health condition, can increase their brain power by exercising regularly.  Exercise does not have to be strenuous to reap the benefits.  Brisk walking, cycling or other activities that get the body moving and the heart pumping for 150 minutes a week will stimulate the same brain activity.  According to a study done by the Department of Exercise and Science at the University of Georgia, even briefly exercising for 20 minutes at a time facilitates information processing and memory functions.  Regular exercise can result in an increase in brain size, which may be the best memory aid of all. 

Engage in novel and complex activities.  Mental stimulation translates to neurophysiological growth much the same way as aerobic exercise stimulates cardiovascular health.  Learning challenging new skills helps to keep your brain strong by promoting synaptic density and decreasing risk of developing neurogenerative disease.  Physical exercise in conjunction with brain training increases the chances of increasing cognitive skills.  Ballroom dancing or tennis are activities that include both physical and mental demands, which can have a greater impact on cognitive functioning.  It appears that the best brain workouts are those that include coordination, rhythm and strategy.  If you always walk the same route, change up by reversing the route or try a new one altogether. 

Find an exercise partner.  Exercising with a friend not only provides support to keep you on track and motivated, socializing during exercise also helps to exercise the mind.  Studies show that people who engage in social interactions display higher levels of cognitive performance and that these cognitive benefit boosts may occur almost immediately.  Communicating and interacting with others helps maintain strong connections that can have significant health-promoting benefits such as stress reduction and emotional bonding. 

If it’s good for the heart, it’s good for the brain.  The brain and the heart act in harmony to support life.  Nearly 25% of the oxygen and blood from every heartbeat is destined for the brain.  Lifestyle behaviors that benefit brain health have a similar benefit for the cardiovascular system.  Contrarily, brain function may decline as heart disease risk factors increase.  Risk factors that accelerate the brain function degenerative process, such as smoking, obesity and a sedentary lifestyle, are the same risk factors that promote heart disease, which can affect blood supply to the brain and other brain-heart interactions. 

Keep your brain and your heart healthy by making exercise a part of your daily routine.  Exercise boosts the production of proteins that stimulate brain cell growth, brings glucose and oxygen to the brain and helps neurons work optimally.  Adopting a brain healthy diet, limiting your intake of foods high in fat, dietary cholesterol and sugar, and managing your body weight are most effective at reducing risk factors when combined with physical and mental activity and social interaction. 

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