Prevention of dementia

Prevention of dementia is the attempt to avoid developing dementia.Although no cure for dementia is available, there are many ways to decrease the risk of acquiring dementia in the first place, including both lifestyle changes and medication.

Lifestyle

Mental activity

"Use it or Lose it" might be applied to the brain when it comes to dementia. Intellectual activities help keep the mind in shape in the older days.Activities, such as reading, playing cards and board games and playing a musical instrument prevents dementia of both Alzheimer's and vascular dementia [http://www.wvdhhr.org/bph/oehp/hsc/dementia/prevent.htm West Virginia Department of Health and Human Resources (with further links to experiments respectively)] ] . The risk decreases proportionally to the frequency of activity.

Not only activities during spare time seem to prevent dementia. What kind of occupation also matters, especially during the thirties, forties and fifties. A good job in this case is any mentally demanding one.

Why activity contributes to prevent dementia could be explained by a "brain reserve" built up by the brain; Additional connections between neurons are created, connections more resistant to the deterioration seen in dementia.

Physical activity

Since vascular dementia is the second most common form of dementia (after Alzheimer's disease), decreasing risk factors for Cerebrovascular disease also decreases the risk factors for dementia. Thus, physical exercise, having good blood cholesterol, healthy Body weight and Blood pressure lowers the risk of developing dementia. An active lifestyle can almost halve the risk compared to a sedentary one.

The effect of physical activity is not limited to vascular effects. For instance, it can give rise to new neurons in the brain, as well as releasing a substance that can protect them.

Some studies say Alzheimer's and other dementias may be caused by high blood pressure, since it can cause blood vessel damage by constricting them. [http://news.bbc.co.uk/1/hi/health/7528539.stm] [http://www.washingtonpost.com/wp-dyn/content/article/2008/07/27/AR2008072701213.html]

Furthermore, physical activity has many other Exercise benefits.

Diet

Obesity increases the risk of any dementia, but Alzheimer's in particular.

However, what kind of food eaten also matters. Fish consumption reduces the risk of Alzheimer's. Fish is high in Docosahexaenoic acid, an omega-3 fatty acid, especially in cold water fish such as salmon, tuna and halibut.

Vegetables and nuts also benefit, because of their high content of polyunsaturated fats. Non-fish meat, on the other hand, increases the risk of Alzhemer's, by its high content of Saturated fat. The moderate consumption of alcohol may reduce risk through improving vascular health and other mechanisms. [ Mulkamal, K.J., et al. Prospective study of alcohol consumption and risk of dementia in older adults. Journal of the American Medical Association, 2003 (March 19), 289, 1405-1413; Ganguli, M., et al. Alcohol consumption and cognitive function in late life: A longitudinal community study. Neurology, 2005, 65, 1210-12-17; Huang, W., et al. Alcohol consumption and incidence of dementia in a community sample aged 75 years and older. Journal of Clinical Epidemiology, 2002, 55(10), 959-964; Rodgers, B., et al. Non-linear relationships between cognitive function and alcohol consumption in young, middle-aged and older adults: The PATH Through Life Project. Addiction, 2005, 100(9), 1280-1290; Anstey, K. J., et al. Lower cognitive test scores observed in alcohol are associated with demographic, personality, and biological factors: The PATH Through Life Project. Addiction, 2005, 100(9), 1291-1301; Espeland, M., et al. Association between alcohol intake and domain-specific cognitive function in older women. Neuroepidemiology, 2006, 1(27), 1-12; Stampfer, M.J., et al'. Effects of moderate alcohol consumption on cognitive function in women. New England Journal of Medicine, 2005, 352, 245-253; Ruitenberg, A., et al. Alcohol consumption and risk of dementia: the Rotterdam Study. Lancet, 2002, 359(9303), 281-286; Scarmeas, N., et al. Mediterranean diet and risk for Alzheimer’s disease. Annals of Neurology, 2006 (published online April 18, 2006). ]

Drinking alcohoic beverages in moderation reduces the risk of dementia. It also delays and slows down the progression of the disease once it begins. [ ]

Medication

Hypertension medications

The etiology of Vascular dementia includes hypertension, and thus, lowering blood pressure with Antihypertensives has a positive effect in the prevention of dementia, just as physical activity.

A study has shown a link between high blood pressure and developing dementia. The study, published in the Lancet Neurology journal July 2008, found that blood pressure lowering medication reduced dementia by 13%. [cite web| title= Reduce high blood pressure to reduce dementia risk| url= http://www.my-blood-pressure.com/dementia-risk.html]

Furthermore, antihypertensives lowers the risk of not only vascular dementia, but also of developing Alzheimer's disease, especially when using Potassium-sparing diuretics.

Anti-diabetic drugs

Diabetes mellitus is a risk factor for vascular dementia, and is thus lowered with Anti-diabetic drugs [http://www.mayoclinic.com/health/diabetes-and-alzheimers/AZ00050 MayoClinic] ] .

Besides, Rosiglitazone (Avandia) improves memory and thinking ability to people with mild Alzheimer's disease. The mechanism of the effect might be due to the ability of the drug to reduce insulin resistance. Thus, less insulin needs to be released to achieve its metabolic effects. Insulin in the bloodstream is a trigger of Amyloid beta-production, so decreased insulin levels decrease the level of amyloid beta. This leads to less formation of amyloid plaques seen in Alzheimer's disease.

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) decreases the risk of developing Alzheimer's. However, the period of use has to be of a certain length before any effect can be seen. It should be longer than 2 years to have any effect .

Alzheimer's disease causes inflammation in the neurons by its deposits of amyloid beta peptides and Neurofibrillary tangles. These deposits irritate the body by causing a release of e.g. cytokines and Acute phase proteins, leading to inflammation. When these substances accumulate over years they contribute to the effects of Alzheimer's [ [http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=10858586 Inflammation and Alzheimer's disease, Neurobiol Aging. 2000 May-Jun;21(3):383-421] ] . NSAIDs inhibit the formation of such inflammatory substances, and prevent the deteriorating effects.

Vaccine

There is yet no vaccine against dementia. Such a vaccine could activate the body's own immune system to combat the beta amyloid plaques in Alzheimer's disease. One problem to overcome is overreaction from the immune system, leading to Encephalitis.

ee also

* Dementia
* Alzheimer's disease
* Preventive medicine

References