Action Plan to Prevent Dementia
BY JEAN CARPER
We are so trapped by our irrational fear of Alzheimer’s and dementia that we typically view them as our fate—a hopeless, genetically determined punishment of living too long that condemns us to an agonizing descent into oblivion. Do not believe it. In truth, much of dementia in old age is self-inflicted and predestined, not by genes, but by the way we live our lives.
Leading researchers worldwide have discovered many ways to help keep dementia from destroying your aging brain. Here are some simple actions you can take now to delay memory loss and dementia, that are supported by current scientific evidence. (in alphabetical order).
Be Smart About Alcohol :
It’s true, moderate drinking (one or two drinks daily) lowered dementia risk by 40 percent in one large study. But a history of heavy drinking (more than 14 drinks a week) doubles your odds of severe memory loss and dementia. Most dangerous: binge drinking--four or more drinks on one occasion. In Americans over age 65, two monthly episodes of binge drinking upped the risk of severe memory loss 250 percent. Best bet for moderate drinkers: wine, especially with food. Among Swedish women, wine drinkers (no other forms of alcohol) had a 70 percent lower rate of dementia. Red wine contains far more brain-protecting antioxidants than white wine.
Be Cautious About Anesthesia:
If possible, avoid general anesthesia. French elderly receiving general anesthesia had a 35 percent higher than normal likelihood of developing dementia several years later. US researchers found that older people exposed to general anesthesia had faster brain shrinkage and more rapid cognitive and functional decline—women, more profoundly than men. Expert advice: Restrict elective surgery. Ask about alternatives to general anesthesia, such as spinal injections.
If you have “mild cognitive impairment, your chances of “converting” to Alzheimer’s soar if you also suffer from anxiety. The risk goes up by 33 percent if the anxiety is mild, by 79 percent if it’s moderate and 135 percent if it’s severe, research shows. Experts suggest getting screened for anxiety if you have memory problems. Some antidotes: exercise and meditation.
Pay Attention to B Vitamins:
Your ability to absorb B12 in food diminishes by age 40, setting the stage for brain degeneration years later. MRIs reveal that people ages 61 to 87 with the lowest vitamin B12 have six times more brain shrinkage than people highest in B12. One solution: supplements of B vitamins. British researchers prevented 90 percent of the usual shrinkage by giving high daily doses of B vitamins (800 mcg folic acid, 20 mg vitamin B6, 500 mcg B12) for two years: Regular shots of B12 can also slow brain shrinkage. Since a B12 deficiency can be mistaken for dementia, any older person with failing memory should get a blood test for B12.
Think Twice About Benadryl, Etc:
So-called “anticholinergic drugs,” are widely used, including sleeping pills, (Benadryl Nytol, Tylenol PM), antihistamines, and tricyclic antidepressants. Research suggests the longer you take them, the higher your chances of dementia. In one large study, people who used anticholinergic drugs for three years had 54 percent higher odds of dementia than non users. Even one year of usage boosted Alzheimer’s risk 30 percent.
Here is a list of common Anticholinergic Drugs: Actifed, Allergy & Congestion Relief, Chlor-Trimeton, Codeprex, Efidac-24 Chlorpheniramine, Thorazine, Anafranil, Clozaril, Amrix, Fexmid, Flexeril, Periactin, Norpramin, Bentyl, Advil PM, Aleve PM, Bayer PM, Benadryl, Excedrin PM, Nytol, Simply Sleep, Sominex, Tylenol PM, Unisom, Adapin, Silenor , Sinequan, Toviaz, Atarax, Vistaril, Anaspaz, Levbid, Levsin, Levsinex, NuLev, Tofranil, Antivert, Bonine, Pamelor, Zyprexa, Norflex, Ditropan, Oxytrol, Brisdelle, Paxil, Trilafon, Compazine, Phenergan, Vavactil, Aprodine, Transderm Scop, Mellaril, Detrol, Stelazine, Surmontil. (Source: Dr. Shelly Gray, JAMA Internal Medicine, Jan. 26, 2015).
Keep Blood Sugar Low:
High blood sugar (glucose) hypes likelihood of dementia, even if it’s not bad enough to be called diabetes. And the higher the glucose, the worse the danger. Even high “normal” blood sugar (115 mg/dL) boosted dementia risk significantly in one study. Also, diabetics with glucose levels of 190 mg/dL were 40 percent more apt to have dementia than those with 160 mg/dL. It seems smart to try to maintain blood sugar levels at around 100 mg/dL.
Packed with antioxidants, blueberries may help prevent and even reverse memory loss. A test at the University of Cincinnati showed that people with mild cognitive impairment who ate blueberry powder (equal to a cup of berries) daily for four months, had improved memory and increased brain activity on MRI scans, theoretically lowering their risk of dementia. Frozen blueberries are just as potent as fresh ones.
Add New Brain Cells:
Every day adult brains give birth to around 1000 baby neurons, arising from “stem cells” in the hippocampus or “memory center.” About 50 percent may survive, mature and integrate into the brain’s circuitry. This phenomenon is called “neurogenesis.” Most critical; your lifestyle can stimulate neurogenesis, increasing the size and efficiency of your brain. The strongest “miracle gro” for your brain: exercise, mental stimulation, meditation, novelty, eating omega-3 oils.
Ok, it’s official. The more calories consumed, the more apt you are to develop abnormal memory loss called “mild cognitive impairment,” that can increase your susceptibility to dementia, according to research at the Mayo Clinic. Most memory-protective in over 70-year olds was a daily limit of 1526 calories. In comparison, eating between 2143 and 6,000 daily calories doubled the chances of memory and thinking problems as you age.
Eat “Chocolate” Flavanols:
Cocoa is rich in antioxidant “flavanols” shown to benefit aging brains by increasing blood flow, lowering blood pressure, decreasing inflammation and improving insulin activity. Eat chocolate labeled high in cocoa or cacao. Or avoid fat and sugar in chocolate by taking cocoa supplements. A daily brain-boosting dose is 400-1000 milligrams of cocoa flavanols. The author takes two capsules (750 mg) of chocolate flavanols (CocoaVia) a day.
Reduce “Chronic Stress”:
Long-time psychological stress churns out cortisol, a hormone that kills neurons, shrinking the brain’s hippocampus. In a famous Swedish study, women with the highest stress over 35 years ( from midlife to old age) were 65 percent more apt to develop all forms of dementia, including Alzheimer’s and vascular dementia. Find a way to reduce stress. Powerful proven ways are exercise and meditation.
Say Yes to Coffee and Caffeine:
Surprise: Coffee and caffeine protect aging brains, according to much research. Middle-aged coffee drinkers in Finland who downed three cups a day were 65 percent less apt to have dementia 20 years later. In an elderly group of mild cognitively impaired, those with high blood caffeine were less apt to progress to dementia. So if coffee doesn’t upset you otherwise, or interfere with good sleep, it can be another potential antidote to dementia.
Get on the Computer:
Using a computer at least once a week or more can slash your chances of cognitive problems after age 70 by 42 percent, according to Mayo Clinic researchers. Being computer-smart was more powerful in deterring mild cognitive impairment than reading magazines. Other research shows that the elderly who use a computer less than 51 minutes daily tend to have a smaller hippocampus than those who spend more time at the computer. UCLA researchers also say surfing the internet stimulates brain functioning, improving memory in people over age 65.
Curry’s main secret is the yellow spice, turmeric, packed with brain-boosting curcumin. Regular curry eaters—two or three times a week-- have a lower rate of dementia. In lab animals, curcumin, a potent anti-inflammatory, slashes the build up of Alzheimer’s amyloid plaques. More exciting, researchers recently identified another turmeric compound that incites the birth and growth of stem cells in adult brains. Expert advice: eat turmeric and “yellow” curry. Green and red curries lack curcumin.
Worry About DDT:
Evidence of DDT in the blood and brains of old people with Alzheimer’s is alarming. One study found that 86 percent of Alzheimer’s patients had four times higher blood levels of DDT residue than people without Alzheimer’s. In a study of identical twins, the one exposed to DDT developed Alzheimer’s; the other did not.
Deal with Depression:
Depression is toxic to your brain. People with late-life depression show a greater shrinkage of their hippocampus and more white matter vascular damage, both predictive of dementia. British research documented that depression in people over age 50 hiked chances of Alzheimer’s by 65 percent and more than doubled chances of vascular dementia.
Be Afraid of Dirty Air:
Breathing polluted air accelerates cognitive decline. A large study of 20,000 American women, ages 70 to 81, revealed that long- term exposure to common levels of air pollution --from cars and trucks, diesel fuel, coal burning etc.—hastened cognitive impairment by the equivalent of two years of aging. In Boston, stroke rates went up 35 percent on days of higher air pollution.
Take DHA Supplements:
Fish oil or omega-3 supplements typically include two fatty acids EPA and DHA. The one your brain craves is DHA, (docosahexanoic acid), a strong anti-inflammatory. Cognitively impaired and Alzheimer’s brains are low in DHA. People with a large hippocampus have high DHA. In the Framingham heart study, those with the highest DHA had a 47 percent lower risk of all forms of dementia. You get DHA in fatty fish, notably salmon, but it’s smart to take at least 240 mg DHA daily. (The author takes 800 mg daily of vegetarian Life’s DHA from Martek.)
Having type 2 diabetes ups your odds of dementia by 50 to 100 percent. Nobody is sure why diabetes promotes dementia. Most likely, it involves brain blood vessel damage due to obesity, high blood pressure, high blood sugar, dysfunctional insulin and invisible micro-strokes. In any case—with or without diabetes—controlling blood sugar and normalizing insulin seem to discourage dementia. Ways to accomplish that: eat a low saturated fat, low sugar diet, increase exercise and lose weight.
Get a Long Education:
For every extra year of education, your odds of dementia fall. A high school drop- out has a 16 percent risk. It sinks to 10 percent for high school graduates and to 6 percent if you enter college. Each year of college depresses the risk further. The theory is that learning somehow strengthens your brain’s resistance to damage from aging.
Don’t Get Fat at Forty:
If you are obese in your forties and fifties, you are twice as apt to get dementia in your seventies. Tons of research finds that midlife obesity, not necessarily obesity in old age, is a major culprit in dementia. Some theorize that fat in the blood releases proteins that travel to the brain, causing progressive long-term damage. Regardless, the best time to prevent weight gain to save your brain is during mid-life, not late-life.
Undeniably, fish is brain food. Fish eaters have bigger brains and lower odds of dementia. One reason: fish’s anti inflammatory omega-3 fat,--higher in salmon, tuna, sardines, swordfish and herring. However, all fish may be brain boosters if baked or broiled—not fried. UCLA researchers report that people who eat non-fried fish once a week have a 14 percent larger hippocampus. In other studies, eating fish once a week slashes your odds of dementia by 50 percent. Fish is especially protective for carriers of the Alzheimer’s APOE4 gene.
Surround Yourself with Friends:
Social engagement is one of the absolute requirements for saving your brain from dementia. Research shows older people who socialize frequently test higher on memory and cognition tests. Being socially isolated and lonely brings on dementia. Older people with the highest loneliness scores have double the risk of Alzheimer’s. Also having a “soul mate, alter ego, sounding board, best friend--somebody to whom secrets are told.”—in short, a confidant—is a strong force against dementia. In one study, people over sixty, who did NOT have a confidant were FIVE times more apt to develop Alzheimer’s!
Guard Against Gum Disease:
Surprisingly, people with periodontal disease (severely inflamed gums and tooth loss) are more prone to cognitive impairment and dementia. In one study, having periodontal disease before age 35 hiked Alzheimer’s chances by 400 percent. Research suggests that periodontal inflammation spurs the build up of amyloid beta in the brain, thought to trigger Alzheimer’s. Get prompt treatment for gingivitis (inflamed or bleeding gums).
Prevent Head Injury:
It’s well known that repeated concussions can bring on dementia in football players years later. But even a single blow to the head from a severe fall or vehicle accident can result in loss of consciousness and traumatic brain injury, possibly leading to late life Alzheimer’s. Shielding your brain from serious injury is a first line defense against dementia. Surprising fact: the number one cause of concussions--bicycle accidents. Wear helmets for head-threatening activities. Always wear your seat belt. Think twice about exposing your brain to concussion-prone sports.
Reconsider Heartburn Drugs:
Drugs like Prilosec, Prevacid and Nexium (proton pump inhibitors) are linked to increased dementia risk. In a large German study, regular users over age 75 were 44 percent more apt to develop dementia, including Alzheimer’s and vascular dementia, than non users. Such drugs are overprescribed, so be sure you really need them. Try instead to identify and cut back on your personal dietary triggers. Common are alcohol, fatty foods, chocolate, tomatoes, onions, garlic, citrus, hot spices and peppermint. Wait at least three hours after eating to lie down.
Try to Avoid Infections:
It seemed whacky at first, but research increasingly implicates common infections in Alzheimer’s—such as herpes cold sores, gastric ulcers, pneumonia, fungal infections and even the flu. The herpes simplex virus and fungi are abnormally present in Alzheimer’s brains. One theory is that infections stimulate amyloid plaque that destroys neurons. In some cases, antibiotics and antivirals have relieved dementia, and elderly Canadians who received vaccinations against a variety of common infections were 60 percent less apt to develop Alzheimer’s.
Learn to Meditate Regularly:
Science has demonstrated that meditation can enlarge the hippocampus, increase brain blood flow, lower blood pressure and reduce stress—all factors that enhance memory and deter dementia. One type of meditation called Kirtan Kriya, when practiced for 12 minutes a day for eight weeks, actually reversed memory loss and improved brain structure in people ages 52 to 77. For simple instructions on learning Kirtan Kriya, see http://www.alzheimersprevention.org/research/12-minute-memory-exercise
Try the “MIND” Diet:
This combination of the Mediterranean and Dash diet can cut your dementia odds by 50 percent. Here are the servings of food the diet calls for each week: green leafy vegetables 6+; other veggies 1+; nuts 5; berries 2+; beans 3+; whole grains 3+; fish 1; poultry 2; sweets less than 5; red meat less than 4; cheese, fried and fast food less than 1. Butter or margarine, less than 1 tablespoon daily; wine 1 glass daily. Always cook with olive oil.
Get Physically Active:
Any kind of aerobic physical activity gives you a bigger brain and discourages dementia. That includes dancing, bicycling, gardening, walking, and riding an exercise cycle at the gym. Research at UCLA and University of Pittsburgh showed that older people (average age 78) who stepped up their physical activity had enlarged frontal, temporal and parietal brain lobes, including the hippocampus. The more calories they expended, the more additional gray matter. Their risk of Alzheimer’s also sank a stunning 50 percent. Moving your body is considered the best proven way to ward off memory decline as you age.
Know Your True Dementia Risk:
Statistics on your odds of dementia are often grossly exaggerated by self-serving interests. For example, the commonly used figure that half (50 percent) of all people over age 80 or 85 have Alzheimer’s or dementia is simply wrong. Here are the real facts from unbiased sources on older Americans’ likelihood of dementia:
Age 71-74 3 %
Age 75-79 5%
Age 80-84 13%
Age 85-89 20%
Age over 90 39%
(Kenneth Langa, New England Journal of Medicine, April, 4, 2013.)
Take a Partner:
Being married or living with a significant other in midlife—slashes your risk of cognitive decline in old age by half. Biggest hazard: divorce, which hiked dementia risk 50 percent, in a recent large study. Being single in old age upped dementia odds 20-30 percent. Being widowed increased odds 10 percent.
Find a Purpose in Life:
“I have a sense of direction and purpose in life.” If that describes you, your chances of escaping Alzheimer’s are two and a half times higher than older people who don’t have a purpose in life. Also, you’re less apt to develop mild cognitive impairment as well as other disabilities, and to have a longer happier life, according to studies at Chicago’s Rush University.
Love to Sleep:
Insomnia, short sleep (less than seven to eight hours a night) and waking up repeatedly can harm your brain. People who wake up frequently tend to have more amyloid plaque, a sign of “preclinical Alzheimer’s.” Poor quality sleep also robs your brain of oxygen, increases brain shrinkage and blocks the consolidation of new memories. One reason sleep is good for your brain: during sleep, the brain sweeps away toxins, including Alzheimer’s plaque. Fact: sleeping on your side gets rid of toxins better than sleeping on your belly or back. Also see stop snoring.
Stay away from Smoking:
MRI scans show that smoking doubles brain shrinkage as you age and your risk of dementia. Stopping helps stop the damage. But even after 25 years of quitting, smokers in a Harvard study still had more brain shrinkage at age 70 than nonsmokers. Second hand smoke boosts cognitive decline risk by 40 percent.
Snoring is a form of sleep apnea, where breathing is disrupted, depriving the brain of oxygen. In a recent study, older people with obstructive sleep apnea showed mild mental and memory impairment 13 years earlier --at age 77 compared with age 90 --for sleepers without apnea. Important: those with apnea who used a CPAP machine that prevented snoring and oxygen deprivation, did not experience earlier memory decline that typically precedes dementia.
Learn a New Sport:
Instead of always engaging in sports you’ve already mastered, taking up a new one can expand your brain. For example, juggling. In one study, Germans ages 55 to 67 who learned to juggle three balls after three months of practice showed increased gray matter on MRI brain scans, both in their cortex and hippocampus. However, three months after they quit juggling, their gray matter shrank back to pre-juggling days. Experts explain the brain likes both familiar and novel types of exercise to maintain optimal size and function.
Don’t Count on Statins:
It’s been suggested that lowering cholesterol with statins may delay cognitive decline and dementia. But a recent large European study finds no evidence for it. Among nearly 7,000 elderly, those with lower cholesterol due to Lipitor and other drugs were at the same risk of cognitive decline and dementia as those not on cholesterol lowering drugs.
Be Wary of Low Testosterone:
Low testosterone in men may raise the risk of cognitive deficits and Alzheimer’s. Notably, men getting androgen deprivation therapy (ADP) for prostate cancer, are about twice as apt to develop Alzheimer’s as men not undergoing the testosterone-lowering therapy, say University of Pennsylvania and Stanford researchers. The longer the ADP therapy the higher the Azheimer’s risk.
Get On the Treadmill:
A mere 10 minutes a day walking briskly on a treadmill (or using an elliptical machine) can improve memory in older brains. However, 30 daily minutes of exercise did not boost cognition further, although it did improve fitness, report researchers at the University of Kansas. They recommend at least 75 minutes a week on the treadmill, spread across three or four days, for aging people who want a better memory.
Take Vitamin D:
A vitamin D deficiency doubles your odds of various dementias, including Alzheimer’s. People low in vitamin D also tend to have a smaller hippocampus and poorer processing speed and other neuropsychological functions. One theory: you need vitamin D to help clear Alzheimer’s plaque from your brain. To avoid a vitamin D deficiency in late age, take 600 to 2,000 IU of vitamin D3 daily.
Beware Weight Loss:
Keeping pounds ON in old age is far more beneficial than unintended weight loss. After age 70, gradually losing 10 pounds per decade boosted odds of cognitive impairment by 24 percent, say Mayo studies. Becoming frail commonly precedes Alzheimer’s. An elderly body mass index of under 18.5 is a strong predictor of dementia. If you become thin and frail in old age, seek medical attention to regain normal weight.