Positive Health Online

Is it Possible to Avoid Developing Dementia?

Well perhaps – if we knew what caused dementia in the first place. The simple truth is that we still do not know the cause, nor is there a cure for those who do develop a dementia disease.

The word dementia describes a cluster of symptoms that are caused by a number of different conditions. People outside the health profession often incorrectly use the terms Alzheimer’s Disease and Dementia interchangeably. Alzheimers’ disease is the most common condition to cause symptoms, but it is just one of the conditions. Other common forms of dementia are Vascular Dementia and Dementia with Lewey Bodies.

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Research has, so far, not revealed a single cause for dementia but it has pinpointed that there are various ‘risk factors’ which might make your chances of developing dementia much higher. My book Dodging Dementia – Understanding MCI and Other Risk Factors examines these risk factors and the research which highlights them and it guides the reader through a self-assessment, taking into account past personal history and current lifestyle choices.

Whilst I have considered the research throughout the book, I have also taken into account  the experiences and history of the clients I have helped through my support and advisory service. These are, of course, subjective rather than objective. Yet on taking the history of those I’ve advised, I noticed there are many common factors in the lead up to  a diagnosis of dementia and this aroused my interest and curiosity. There are a large number of suggested risk factors connected with lifestyle, such as smoking, drinking, sedentary habits,  alcohol, air pollution, poor nutrition and electromagnetic smog. There are also more nebulous suggested risk factors such as brain plasticity and social integration. When looking at risk factors, we can choose to address all the postulated risk factors or just concentrate on a selection. There were certain factors that particularly  stood out to me and I chose to focus on them, because they seem to be connected and  as a result, can be addressed together.

It is well known that taking more physical exercise can lower your risk of developing dementia.[1] Sometimes this surprises people as they are inclined to believe that ‘brain exercise’ in the form of crosswords and puzzles is required, but keeping physically active has many benefits to brain health. Physical exercise has a beneficial effect on the cardio-vascular system and a healthy cardio-vascular system helps protect against Vascular Dementia. Sometimes people almost groan at the term ‘exercise’ bringing as it does visions of energetic lycra-clad enthusiasts but really exercise simply equates to movement. Walking, gardening, housework and shopping are all forms of exercise which may be helpful in lowering the dementia risk.

In addition to the straightforward health benefits I’d argue that physical exercise is in itself cognitively stimulating. For example, taking part in physical exercise such as Pilates, dancing, swimming, yoga classes or even dog walking increases your number of social contacts and allows you to experience different social situations. Whilst it is true that one can ‘go for a run’ alone and benefit from the physical movement, many more people opt to take part in ‘park runs’ or marathons rather than lone running. Alternatively, they might join a gym or class where they can exercise in the company of others.

This leads us on to consider our levels of social interaction. I wrote Dodging Dementia shortly after the restrictions experienced during the Covid crisis and it made me very aware of the detrimental effect that feelings of loneliness and isolation had on the elderly.  It may well be that this partly accounts for the recent increase  in dementia cases. Social interaction is a difficult area to research, relying as it often does on self-reporting and on the fact that each person’s consideration of what constitutes a ‘good’ social life is different. There was a tendency during the time of Covid for the media and authority groups to imply that remote interaction in the form of  electronic meetings and social media was adequate stimulation. Some people even predicted that working from home and online social groups would become the new ‘norm’.

My clients told me that remote contact in the form of electronic meetings, telephone calls and social media were not as satisfying and stimulating as face to face meetings.  Certainly, after the strongest Covid restrictions were lifted and I was once more able to run Cognitive Stimulation Therapy Groups, clients returned to the groups with alacrity. It is interesting to note that one of the first symptoms regularly reported by those close to someone with dementia is a reluctance to go out and take part in previously enjoyed social events and meeting. Carers have frequently told me that if the individual they’re caring for does not mix with others, their symptoms tend to get worse.

Mixing with other people, making conversation, attending social events and taking an active part in the local community can help to lower the risk of developing dementia. But as the carers explained to me the less their cared-for sees others and mixes with them, the less they seem to want to do so. This does not only apply to people with a diagnosis of dementia. I found it quite frightening to hear so many people saying and writing that they preferred not having to mix with other people during 2020/21. This was not due to fear of infection but rather to a wish not to have to interact with others or to make the effort to be involved with them.

There are steps we can take to lower this risk factor. It isn’t always easy to extend our social circle or to make new friends, especially as we get older. Many of our friends and acquaintances are made through work or our children. We don’t all feel confident enough to ‘join a club’ or take up a new hobby in later life. Not everyone wants to be part of a large social circle or to be constantly involved in meetings and parties but we can all take steps to be more sociable in small ways. There are many paths to sociability.

For example, even improving the level of simple social contact – increasing your network of familiar faces is a great help. For example,  recognizing and greeting local people in the street, or the assistant who serves you in the local shop or knowing who your mail delivery person is or who your neighbours are can all be helpful. How pleasant to think that by taking a daily walk and exchanging greetings with those we meet on the way might have the effect of reducing two of the known dementia risk factors.

Social interaction may also have an indirect effect on brain plasticity. This interesting term refers not to basic levels  of intelligence nor to the ability to do ‘brain puzzles’ or play intricate card games (such as Bridge). It refers to changes in the neural pathways and synapses of the brain which develop due to changes in behaviour, environment or experiences. Education and exposure to a range of activities and experiences (especially new experiences) seem to be important factors when considering brain plasticity. The research seems to indicate that learning a new language or new skill can mitigate against developing dementia.[2] But it would appear that it is not necessarily the actual learning of the new skill or art that is important but the willingness to be open to new ideas and experiences and to listen and consider, without lightly dismissing opinions other than your own and falling into habitual routines, excluding trying anything different.

When considering this aspect of social integration it is tempting to wonder if the present tendency to build ‘senior living’ villages and blocks of apartments is really a good idea. Can it really help our brain plasticity to live solely amongst others in the same age group, in an environment (however safe and free from maintenance worries) which is relatively unchanging and unchallenging? It is true that many of these facilities provide activities and events to enhance the everyday living experience but these facilities are all aimed at the same age group with similar interests in common. Frequently they are provided at the living facility meaning that the opportunities to meet the wider community are limited and it does not involve the physical exercise involved in attending an external venue. It may be that continuing to live in a wider community, with contact with a wide range of activities and age groups, and with proper support provided within that community might be more conducive to lowering one risk factors leading to dementia. We all have this choice to make.

The links between brain plasticity, physical activity and social integration became very obvious to me as I researched Dodging Dementia and it is heartening to consider that by simply  making some simple lifestyle changes, which in themselves can be very pleasant and not at all onerous, we could all take steps to reduce the risk of developing dementia.

References

1. Stanley J. Colcombe, et alKirk I. Erickson, Paige E. Scalf, Jenny S. Kim, Ruchika Prakash, Edward McAuley, Steriani Elavsky, David X. Marquez, Liang Hu, Arthur F. Kramer, Aerobic Exercise Training Increases Brain Volume in Aging Humans, The Journals of Gerontology: Series A, November 2006. Volume 61 (11): 1166–1170, https://doi.org/10.1093/gerona/61.11.1166
2. Costumero V, Marin-Marin L, Calabria M, Belloch V, Escudero J, Baquero M, Hernandez M, Ruiz de Miras J, Costa A, Parcet MA, Ávila C. A cross-sectional and longitudinal study on the protective effect of bilingualism against dementia using brain atrophy and cognitive measures. Alzheimers Res Ther. Jan 10 2020;12(1):11. doi: 10.1186/s13195-020-0581-1. PMID: 31924269; PMCID: PMC6954576.