Without getting any further caught up in technical definitions, what is clear is that all forms of dementia have a heart-breaking effect on both sufferers and their loved ones. It is, for many, an absolutely terrifying affliction. Sufferers can experience extreme confusion and frustration at not being able to perform the simplest of tasks, while their loved ones often have to watch as the person they knew slowly fades away before their eyes.
One of the most worrying things about all this is that rates of dementia are by no means slowing or stabilising, and in fact it is very much the opposite. A new sufferer is diagnosed every 3.2 seconds around the world, and the estimated number of people with the condition is expected to surpass 100 million by 2020. Here in the Middle East, the World Health Organisation (WHO) expects to see a 125% increase in Alzheimer’s cases by 2050.
The only bright spot in this rather grim scenario is that while Alzheimer’s and dementia are often found in elderly patients, it is by no means an inevitable part of growing old. There are in fact several things we can do, starting from a young age, to help protect ourselves from Alzheimer’s and dementia.
Diet
As with most things health-related, our diet has its part to play in helping to keep dementia at bay – a very large part in fact. A paper recently published in the Journal of Diabetes Science and Technology reported that “Alzheimer’s represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both type 1 and type 2 diabetes.”
The paper goes on to refer to Alzheimer’s as ‘type 3 diabetes’, a more and more used term among medical professionals. The connection is that in the very same way type 2 diabetes results from insulin resistance in the muscle, liver, and fat cells, so too is Alzheimer’s, in part, due to insulin resistance in the brain.
As for what foods to avoid to help protect against insulin resistance, I think we all know the answer – sugar and grains and all those foods that have too much of an impact on our blood sugar levels. Not only have low to medium levels of sugar been shown to disrupt brain function, but according to the American journal Neurology, one long-term effect of sugar is to shrink the brain’s hippocampus – and a smaller hippocampus is often found in Alzheimer’s patients.
On the other side of the coin there are plenty of great foods to get into your diet to help protect the brain from the effect of Alzheimer’s and dementia. The Alzheimer’s Association recommends plenty of fresh fruits and vegetables, including spinach, beetroot, peppers, blackberries, strawberries, red grapes and oranges, while there is also evidence to suggest that eating plenty of fish high in omega-3 fatty acids may be beneficial for cognitive health.
Stay Active
One of the best ways to lower your risk of Alzheimer’s is to get moving. According to King’s College London, physical inactivity is thought to account for 21.8% of the total risk of developing Alzheimer’s, while researchers at the University of Illinois found evidence to suggest that regular aerobic activity – such as running, cycling or walking – helps to protect brain function by supplying it with regular blasts of oxygen-rich blood. What’s more, this exercise does not need to be of a high intensity. In fact, the United Kingdom Alzheimer’s Association advises that just 30 minutes of light to medium exercise per day is enough to have an effect.
Watch your weight
There’s another reason why eating healthy and staying active can help reduce your chances of dementia: the heavier you are, the more likely you are to develop Alzheimer’s. At least that’s according to research published by the University of California Los Angeles (UCLA) School of Medicine, whose researchers found that the brains of older people who were obese (with a BMI over 30) had around 8% less brain volume that individuals of a normal weight. The study goes on to suggest that where brain volume reaches approximately 10%, symptoms such as memory loss and confusion begin to appear.
Previous studies have also presented evidence that those with a BMI of between 25 and 30 have a two-fold increase in risk of Alzheimer’s, while those who are obese in middle-age increase their risk by three-fold. As for what causes this increased risk, the UCLA report hypothesises that the heavier we are, the more fat gets deposited in our brain, while the blood vessels which deliver its fuel become narrower. This over time causes brain cells to die and vital connections to be lost.
In the Middle East, the World Health Organisation (WHO) expects to see a 125% increase in Alzheimer’s cases by 2050
Researchers at Rush University Medical Center in Chicago also point to the fact that the proteins responsible for breaking down fats in our livers are also found in the memory and learning centres of our brains, and people with excess abdominal fat have a lower count of these proteins. Therefore, the more we carry around the midriff, the less of these vital proteins we have to carry out important brain function.
Keep the brain busy
The brain in fact has the ability to generate new brain cells, and when we keep the brain busy by feeding it with new information and experiences, it is constantly having to change and recognise new neural pathways to process its new learnings – think of it as a “brain workout”. Where am I going with this? According to America’s National Institute on Aging, regularly engaging in a mental activity that challenges the brain can help lower your risk of dementia symptoms.
There is no hard and fast advice as to what specific activities to undertake, however several studies have suggested that learning another language is one of the most effective things you can do in this respect. Once again referencing the American journal Neurology, a study from the publication concluded that bilingualism plays a clear role in delaying “age at onset of dementia”.
Stay social
There are a number of studies which suggest that while establishing and maintaining strong and varied social connections may not hold off the onset of Alzheimer’s, it can in fact protect us against its symptoms of cognitive decline. In the biggest study of its kind, researchers at Rush University Alzheimer’s Disease Center followed 89 elderly people with Alzheimer’s, monitoring the effects of their social relationships in relation to the development of the disease.
The research involved monitoring the subjects’ social activity and documenting their overall level of brain function, and then looking at their brains after death. The findings are thought provoking, because while the more social of the Alzheimer’s sufferers were noted to have considerably higher levels of brain function even in the later stages of the disease, when their brains were examined after death they were found to be just as equally riddled with diseased plaques and tangles (classic hallmarks of Alzheimer’s disease) as those participants who socialised less.
It is thought that this is because social interaction helps to stimulate the brain into making new connections that may compensate for its decline in other areas. Or to put it another way, having an active social life can provide a protective reserve in the brain as the degenerative nature of the disease continues to progress elsewhere. Worth a mention here is that dancing, in particular, has been shown to be an exceptionally good social interaction for the brain.
Treat your body like a temple
Unfortunately there are a couple of risk factors for Alzheimer’s that are simply out of our hands, the first being genetics and the other being old age (the likelihood of developing Alzheimer’s doubles every five years from the age 65). However, the suggestions listed above have been shown to reduce risk factors even in those with a family history of the disease, and we know that the best defense against diseases that come with ageing – and against most of the more serious non-communicable diseases (NCDs) – is living well and treating your body with the highest level of respect.
Also note that the research shows it is a combination of the above that has the greatest effect. That is, a combination of physical and mental activity, social engagement and a healthy diet, is far more effective than any of these factors on their own in protecting us against Alzheimer’s and other illnesses.
Whether you stay healthy or not as you grow older – or really at any stage in your life – is mainly down to two factors: knowing what a good lifestyle is and isn’t (educating yourself); and having the discipline to live accordingly. The latter is very difficult, but anything worth having (and health certainly is worth having) is worth putting in the effort for.
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The opinions in the column are by Dr Graham Simpson, and are not necessarily those held by Esquire or Hearst International. Dr Simpson is Chief Medical Officer and Founder of Intelligent Health, a preventive medical centre located in Jumeirah, Dubai. He graduated from the University of the Witwatersrand Medical School in Johannesburg, South Africa, and is board certified in Internal Medicine and Emergency Medicine. As a founding member of the American Holistic Medical Association (AHMA) Dr Simpson is also a licensed homeopath.