Prevention

We are much better at preventing dementia (at least the Axheimer's and vascular types) then we are at treating it after it developed. This section will review what we know about preventing and slowing down the course of cognitive decline once it starts. We are much better at
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preventing dementia, at least the Alzheimer's Disease (AD) and vascular dementia (VaD)) then we are at treating it after it developed. This section will review what we know about preventing and slowing down the course of cognitive decline. We've been expecting the number of new cases of dementia in the US to increase every year–remember that chart (right) we showed in the section on Growth near the beginning of this website?

As stated before, in the section on Dementia Growth, the average age of death for both men and women in 1900 was 47. We evolved over millions of years to get to age 47, but in just the last 100 years or so we've almost doubled life span. The only way to get these bodies to function past their normal date of obsolescence (around 50) is by maintaining them! The American Psychological Association (APA) reviewed the best prevention methods (often call prophylactic strategies) in their
Monitor in July/August, 2017. Their findings and those of others are presented below:

Exercise
• We've long known that physical exercise alters brain structure and function. In 2011 it was shown that engaging in moderate aerobic exercise three days per week was related in an increase in the brain's hippocampus (where new learning occurs) and memory function.

• Exercise increases neurotrophic factor, a protein created in the brain that is associated with maintaining neuronal health.

• Physical health and exercise are showing benefit to reducing and/or preventing the plaques and tangles that appear to cause AD, according to Dr. Yaakov Stern, a neuropsychologist at the Columbia University's Taub Institute for Research on Alzheimer's Disease and the Aging Brain.

Control Diabetes & High Blood Pressure
• Researchers at Brown University sometimes refer to Alzheimer's Disease as "Diabetes Type 3." Developing diabetes in mid-life and hypertension damage the 30,000 miles of blood vessels in the human body, and especially in the brain as those vessels are tiny. The damage done by diabetes starts with the smallest vessels which is why some diabetics get amputations of the fingers and toes or develop diabetic retinopathy. The damage to the even smaller brain vessels is call "microangiopathic" disease, and you'll see that reported in nearly all brain scans of senior citizens. To reduce this normally occurring damage prevent diabetes type 2 by exercising to control BP and avoid significant weight gain that can trigger diabetes type 2. Losing weight can reverse diabetes type 2 in some cases and with exercise certainly can reduce BP helping prevent tiny strokes, microinfarcts, that cause to VaD. See more about diabetes in
Treatments in this website.

Controlling High Cholesterol
• We've looked at hypercholesterolemia as cholesterol contains fatty material that could feed the plaques that occur in AD. However, large scale studies with the 10+ statin drugs like Lipitor have not shown reduction in Alzheimer's. Still, they appear to reduce vascular disease which is a risk factor for developing both AD and VaD.

Use it or Lose it

• Brain exercise builds cognitive reserve just as exercise builds strength and stamina. Dr. Stern of Columbia and colleagues have reviewed the literature and sound that frequently engaging in leisure activities (like music, knitting, reading, volunteering, etc.) reduces the likelihood of developing dementia.

• People with more than 8 years of education are less likely to develop dementia, possibly because they engage in more complex work and life experiences than those with less education/opportunity.

• Professionally employed people have less dementia than lower skilled workers.

• Dr. Margaret Gatz, a professor of psychology at Univ. of S. California, and her colleagues found lower risk of cognitive impairment associated with participating in leisure activities. Interesting, she found more intellectually demanding activities benefitted women, but not men. So even mundane hobbies or reading seems helpful.

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