Prevent Dementia

My 87 year old mother was just diagnosed with dementia; she is in the early stages and is still able to live independently. My grandmother also had dementia, but I don’t think it was ever diagnosed; she passed away in her early nineties. Is there anything I or my siblings can do to prevent dementia?

Hoping to prevent dementia…

Dear Preventing Dementia,

Thank you so much for your letter and I hope I can alleviate some of your concerns. A diagnosis of dementia is made based on clinical symptoms and can be confirmed only by a brain biopsy after death. For this reason, it is difficult to study ways to diagnose, treat, or for that matter prevent dementia. Female gender, Caucasian race, family history, low socioeconomic status, history of brain injury, and age are all risk factors for developing dementia.

Unfortunately, there is not much room for change in this list. In your situation, both your mother and grandmother were fairly up in age before they developed symptoms, so their diagnosis may not be related to family history, but age. However, there are some additional factors that lead to dementia that can be controlled.

The two most common dementias are Alzheimer’s dementia and vascular dementia. They are difficult to differentiate, often co-exist in the same patient, and are treated with the same medications. The biggest risk factor for vascular dementia is cardiovascular disease; so anything that maintains cardiovascular health will help prevent dementia. This includes controlling blood pressure, maintaining cholesterol levels, and preventing arrhythmias. Maintaining good glucose control in a diabetic patient will improve his or her cardiovascular status and indirectly help prevent dementia. Refraining from heavy alcohol use also helps improve cardiovascular and health and indirectly helps prevent dementia.

The studies connecting smoking and dementia are mixed. There are a few small studies that show that people with depression are more likely to develop dementia and treating depression may prevent dementia from developing. Sleeping well may help prevent dementia; poor sleep is linked with higher levels of beta-amyloid development, a protein found in increasing amounts in patients with dementia. Lastly, multiple small studies have shown that aerobic exercise can help prevent dementia; aerobic exercise can also increase the hippocampal size which often shrinks in patients with dementia; aerobic exercise is also beneficial for cardiovascular health.

While doing crossword puzzles and other mentally stimulating activities are beneficial for your brain, there have been no studies that show these activities definitely prevent dementia. Similarly, there are no good studies that show ginko bilboa or other herbal medications can prevent dementia. There are some small studies that show that a person who has a diagnosis of dementia and has a decrease in social activity or poor hearing has a faster cognitive decline than someone who does not have these issues; the same may hold true for preventing dementia, but has not been proven in any studies. I hope I was able to provide some guidance for you.

The Doctor

Prevent Dementia