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Healthy Weight

Obesity is associated with chronic inflammation (a type of healing process that goes haywire). One theory about Alzheimer’s Disease is that the plaques and tangles may be partially made in the brain because of certain proteins that show up when there is constant inflammation. Obesity is contributes to heart and blood vessel disease, which causes vascular dementia.

There are many “diets” out there. The Mediterranean Diet is one route to healthy eating. My personal preference is Whole30. Whole30 is not a diet but a way of eating that helps one to figure out which foods may be contributing to inflammation and feeling yucky. I like Whole30 because I suffer from arthritis and my joint pain disappears when I follow the program.

Keto-diets are gaining popularity.  Keto-diets restrict carbohydrates, even healthy ones found in fresh fruit. Medium-chain fatty acids, like coconut oil, also feature prominently in keto-diets. These diets carry some risk, including dehydration, kidney damage, and elevated cholesterol levels. The jury is still out as to whether or not these diets help people to lower their dementia risk.

Cardiovascular Health

Risk factors associated with heart health makes sense: what’s good for the heart is good for the brain. So cigarette use, excessive alcohol consumption (which causes heart and liver problems all by itself), and a crappy diet improves worsens health and brain health. The solution? Stop smoking, drink alcohol in moderation, and think about changing your eating habits.

Exercise increases blood flow (and oxygen) to the brain, which helps keep brain cells happy and working. Exercise may also help minimize the impact of other bad lifestyle choices. I was reading a report (click here for the layperson version) in which persons who were excessive drinkers, but who exercised almost daily had dementia risk similar to non-drinkers who did not exercise. I carefully present that info as proof for the amazing benefits of physical activity, not as a green light to drink excessively as long as you work out!

Sleep

Insufficient sleep is linked to dementia risk, but I’m unsure if the brain changes seen in dementia are causing the sleep problems or if the sleep issues are related to other risk factors. People who are negative or who experience poorly controlled depression also have higher risks for dementia.

Head Protection

Head protection is another good idea. Persons with TBIs are at extremely high risk for chronic traumatic encephelopathy or pugilistic dementia.

Supplements and “Cures”

To date, no supplements have been found to reduce one’s risk of dementia. Lack of scientific proof has not stopped many companies from advertising that they have a magic pill. Save your money. Likewise, there is a book that is popular on Amazon about “Curing Alzheimer’s.” Again, save your money. The book advertises the “Bredesen protocol,” which includes doing things like eating healthy, getting sufficient sleep, balancing stressors, and making sure the thyroid and other organs are working properly. And, the handful of people who had documented mild dementia “improved” a couple of points on a screening tool (the Montreal Cognitive Assessment Tool, or MoCA). An improvement from 18 points to 20 points on a 30-item instrument is neither clinically nor functionally meaningful.

Cognitive Reserve

Finally, there is cognitive reserve: the more you engage in enjoyable intellectual or mind-challenging pursuits (not just academic activities but things like learning to juggle, learning languages, playing an instrument), the more you build up neuronal connections and increase brain density. Cognitive reserve explains why pathological changes seen at autopsy do not always match clinical findings.  Dr. Snowden’s nun study is a great example.  Some nuns donated brains that were classified by the pathologists as having severe  damage; the memory and functional testing from these same nuns did not match the pathological findings. That is, the nuns were performing at far higher levels than expected based on the pathologists’ findings. On the other hand, other nuns who were diagnosed as having severe dementia before they died had much less damage found in their brains during autopsy.

Categories: Dementia

Dr. Rita Jablonski

Rita Jablonski, PhD, CRNP, FAAN, FGSA is a nurse practitioner, researcher, tenured professor, and former family caregiver. Her research and practice involve all aspects of dementia management; she is best known for non-drug strategies to address dementia-related behaviors.