By Sara Lindquist, MD, Internal Medicine and Geriatrics

Not a normal part of aging

Dementia is not a normal part of aging. Although it is normal to occasionally misplace the car keys, struggle to find a word, or forget the name of a casual acquaintance, confusion or changes in memory and thinking that interferes with daily life are symptoms that should be assessed by a medical professional. Other possible symptoms of dementia are:

• Getting lost in a familiar neighborhood
• Not being able to complete tasks independently
• Repeating questions
• Difficulty naming items or family members
• Forgetting the function of items
• Misplacing items frequently

Types of dementia

Dementia can be caused by a number of different diseases. The most common types of dementia are:

• Alzheimer’s disease. Alzheimer’s disease is a progressive loss of memory and the ability to complete tasks independently. The symptoms of Alzheimer’s disease usually don’t start until after age 60. The most typical initial symptom is the inability to remember recent events. As time passes, symptoms become more severe and pronounced. Age is the biggest risk factor for the development of Alzheimer’s disease, but also having a first-degree relative with the disease increases one’s risk by 10-30%.¹
• Vascular dementia. Some types of dementia are linked to strokes or having problems with blood flow to the brain. Risk factors for vascular dementia are diabetes, high blood pressure, and high cholesterol. In vascular dementia, memory impairment and loss of function occur in a step-wise fashion, meaning symptoms suddenly occur or get worse in the event of a stroke or mini-stroke.
• Lewy body dementia. This type of dementia is frequently associated with a diagnosis of Parkinson’s disease. In addition to memory loss, there are often problems with muscle stiffness, tremors or balance. People with Lewy body dementia may also experience trouble with visual hallucinations, such as seeing people or objects that are not there.
• Fronto-temporal dementia. This type of dementia affects the frontal lobes of the brain more than the memory center. As a result, people suffering from fronto-temporal dementia may have changes in their personality and behavior more so than their memory. Fronto-temporal dementia symptoms can also start at younger ages than Alzheimer’s disease.

Prevention of dementia

Unfortunately, there is currently no cure for dementia, and no known way to absolutely prevent the development of dementia. A number of studies have been and are currently being done, however, in an effort to prevent and slow the progression of this disease. Because brain changes in Alzheimer’s disease start 10-20 years before symptoms appear, the hypothesis is that with intervention, memory loss and other progressive symptoms may be able to be prevented or delayed.

A study published in the Journal of the American Medical Association (JAMA) this year looked at whether a healthy lifestyle could offset an increased genetic risk for dementia.² This study found that those with an unfavorable lifestyle and a high genetic risk had a higher dementia risk and that those with a healthier lifestyle had a lower risk of dementia, even if they had a higher genetic risk. The determination of a healthy lifestyle was based on smoking status, level of physical activity, healthy diet, and level of alcohol consumption. Likewise, another study reported in the British Medical Journal (BMJ) in August suggested that those with a better cardiovascular status at age 50 may have a lower risk of dementia later in life.³ Like the study reported in JAMA, the BMJ study used lifestyle measures of smoking, diet, and physical activity to help determine health status, as well as the added measures of body mass index, blood sugar level, cholesterol level, and blood pressure.

In an effort to reduce your risk for developing dementia, consider taking these preventive measures⁴:

• If you are a smoker, stop smoking.
• Maintain healthy blood pressure.
• Manage cholesterol levels.
• Keep blood sugar within a healthy range.
• Maintain a healthy weight.
• If you drink alcohol, do so in moderation—up to one drink per day for women and up to two drinks per day for men.
• Eat a diet of whole foods with plenty of nutrients and vitamins. This means eating the rainbow of colors for fruits and vegetables and limiting the intake of added sugar and saturated fats such as from fatty cuts of meat, fried take-away foods, and pastries.
• Exercise regularly. Aim for 150 minutes of moderate-intensity exercise (such as walking) per week.
• Get good quality sleep.
• Reduce environmental hazards that could lead to falls or head injury.
• Keep your mind active and stimulated with challenging tasks such as learning a new activity.
• Maintain social contacts.

If you are concerned about your own memory or that of a loved one, talk with your medical provider. Early intervention in memory loss can help slow disease progression.

Juniper programs can be a part of dementia prevention

Although there are no 100% proven ways to prevent dementia, living a healthy lifestyle is a great way to start in terms of both reducing dementia risk and the risk of other illnesses. Consider attending a Juniper program to learn more about the prevention and management of chronic disease. Juniper offers classes on fall prevention such as Tai Ji Quan: Moving for Better Balance, A Matter of Balance, and Stepping On; chronic disease self-management programs such as Living Well with Diabetes and Living Well with Chronic Conditions; and exercise programs such as SAIL—Stay Active and Independent for Life. Partnering with Juniper can be a part of a healthy lifestyle that could positively impact your risk of disease development later in life.

References:

¹https://www.cdc.gov/aging/dementia/index.html

²JAMA. 2019;322(5):430-437

³BMJ. 2019;366:14414

⁴https://www.cdc.gov/aging/publications/features/dementia-not-normal-aging.html