By 2025 there will be one million people living the UK with dementia and one person is diagnosed with the condition every three minutes.
By the time today’s 30- and 40- somethings reach the age when they may develop Alzheimher’s disease and dementia, (one in 20 people develop dementia under 65 but above that age a person’s risk doubles roughly every five years) it’s likely we’ll know more about its early signs.
It’s also hoped there will be drugs to treat it before it even shows symptoms.
For Dementia Action Week (May 21-27), Healthista editor Anna Magee has spoken to Britain’s leading authorities about how to prevent it.
In the next ten years it’s expected we’ll know more ever about the specific things that help prevent Alzheimer’s and dementia.
Studies such as the PREVENT trial, which run through various UK universities, are set to confirm this further by looking at the brain and cognitive function of those aged 40-59.
‘We’ll be using brain imaging, blood markers, spinal fluid tests and complex cognitive tests to measure people’s brain function in middle age’, says Craig Ritchie, leader of the trial and professor of the psychiatry of ageing at the University of Edinburgh.
His hope? ‘In the next ten years we’re going to get more and more evidence about the things people can do to prevent Alzheimer’s and dementia,’ he explains.
‘Our aim is to be able to take any given individual and say, “Well your risk is X per cent and here are the things you can personally do to help prevent it.”‘
So, what do we know so far?
1. Mental stimulation, not Sudoku
Brain stimulation, not brain training, is essential in preventing cognitive decline, says Prof. Ritchie.
‘The evidence is now about intellectual activity, rather than brain training,’ says Prof. Ritchie. Key to the former is social interaction.
‘Chatting, being socially interactive with friends and in a work environment is probably what lights up your brain more than anything else.
‘I often get asked “But I do lots of crosswords and Sudoku, will that protect me from dementia”?’
But the evidence now suggests that it’s taking up new hobbies and interests and intellectual challenges that are more beneficial than the things you have done all your life.
‘So, if you’ve done crosswords your whole life, learning to play the piano at 65 is going to have more benefit on your cognitive health than keeping doing things you have always done.’
2. Have you got cognitive reserve?
Cognitive reserve refers to the psychological behaviours you do throughout your life to help maintain your brain health.
‘A high cognitive reserve would be someone with a mixture of high education, a complex lifetime occupation and high levels of social engagement in old age’, says Carol Brayne, professor of public health medicine at Cambridge University.
The more of these factors you have, she says, the more protected you may be if you develop a bit of cognitive impairment without it turning to dementia.
In terms of ‘complex lifetime occupations’, in July this year, occupational scientists at the Alzheimer’s Disease Research Centre, in Wisconsin, graded jobs according to how much intellectual engagement they provide.
They found those less associated with the development of Alzheimer’s in later life were those that worked in complex jobs involving other people.
While lawyers, social workers, teachers and doctors were best protected, those who enjoyed the least protection included shelf-stackers, machine operators and labourers.
3. Aspirin and the brain
Some observational studies have suggested long-term use of aspirin is associated with a reduced risk of Alzheimer’s.
One Swedish study found that women over 70 who took low-dose aspirin because they were at high risk of heart disease were found to have better memory and cognitive function after five years than those who didn’t.
Now, the biggest ever study into the effects of aspirin on the heart and the brain is set to confirm the link.
Funded by the Medical Research Council (MRC), the ASCEND trial involves 15,000 volunteers taking a low-dose aspirin or placebo for seven years.
‘Aspirin acts to reduce the risk of blood clotting, and therefore heart attack and stroke, which are two things associated with measurable effects on cognitive function,’ says Jane Armitage, professor of clinical trials and epidemiology, and honorary consultant in public health medicine at Oxford University who is leading the research.
‘At the end of the trial, expected in 2018, we will look at the volunteers’ cognitive trial and see what affects if any, taking the aspirin had on their risk of developing the signs of dementia and Alzhiemer’s.’
In the mean time, talk to your doctor to see if it will benefit you.
4. The fish oil factor
The ASCEND trial will also look at the effects of taking fish oils – specifically those containing omega-3s, a type of essential fatty acid which the body doesn’t make itself – on cognitive function.
Although small studies such as one, published in 2014 in the Journal of Alzheimer’s Disease, found that supplementation with omega-3 fatty acids helped slow the decline of cognitive function on those with Alzheimer’s Disease, no substantial studies have yet affirmed the link, says Prof. Armitage.
‘Earlier studies have suggested that omega 3 might reduce deaths from heart disease following heart attack, but no large studies as yet,’ she explains.
It’s this heart benefit connection that hold a great prevention key, she says.
5. Want brain benefits? Be good to your heart
‘The same processes that cause heart attacks and strokes are also in some way associated with the development of dementia,’ says Prof. Armitage.
‘There is quite a lot of indirect evidence that if you can reduce your vascular risk factors, you may also protect yourself from future cognitive problems’.
Indeed, Professor Brayne points out that of the seven key risk factors for the development of Alzheimer’s: high blood pressure and obesity in mid-life, diabetes, smoking, low levels of physical activity, low education and lifetime depression – five are associated with a higher risk of heart disease.
In fact, where in the past doctors saw Alzheimer’s and dementia as being caused either by amyloid plaques (abnormal deposits of protein), neurofibrillary tangles (containing tau) and imbalances in a chemical called acetylcholine or vascular damage in the brain, latest research suggests that most people with Alzheimer’s or dementia will develop some vascular factors.
Ultimately, this means that the lifestyle factors that help the heart, can also maintain cognitive function, says Prof. Brayne.
6. Alcohol, exercise and the Med diet
News to pop a cork over came out earlier this month when scientists at the University of Reading found that consuming one to three glasses of bubbly a week might help prevent Alzheimer’s and dementia.
They claimed the phenolic compounds present in both pinot noir and pinot meuniere – two of the grapes used to make champagne – had the ability to increase spatial memory, improve cognitive function and promote learning and memory retention.
Although the Champagne study was done on rats, Prof. Ritchie says that while high levels of drinking are undoubtedly damaging to the brain, there is some evidence suggesting small amounts of red wine in particular may help.
Meanwhile, of the diets associated with helping prevent dementia, the bulk of the evidence points to the high polyunsaturated fat, fish, vegetable, fruit, grain and indeed conservative red wine content of the Mediterranean diet, he says.
A 2013 systematic review published in the journal Epidemiology pulled together 11 papers looking at the effects of a Mediterranean diet on brain function and found that it was associated with slower cognitive and a lower risk of developing Alzheimer’s.
Meanwhile, it’s worth noting that all of the scientists spoken to for this story cited regular, moderate exercise as the number one risk factor that could help prevent the onset of dementia.
And it doesn’t even have to be very hard, says Prof. Brayne.
‘Just try and move more, from taking a 20 minute walk on most days to having a swim,’ she says. ‘Doing a sport is particularly helpful as it also involves social engagement, which is hugely important.’
The future of Alzheimer’s disease
In August last year, a landmark study was launched at the University of Oxford and funded by the Medical Research Council which plans to identify the measurable characteristics, known as biomarkers, which can detect the occurrence of Alzheimer’s Disease very early on in the progression of the disease – when a person has no obvious symptoms.
‘We know that Alzheimer’s disease starts long before it is noticed by those with the disease or their doctor,’ says Simon Lovestone, professor of translational neuroscience at the University of Oxford.
‘Previous studies have shown changes to the brain as early as 10 to 20 years before symptoms arise.
‘If we can identify the biomarkers present in this very early stage, we have the chance of developing drugs that treat the disease early, thus preventing damage to people’s memory and thinking.’
This article originally appeared on Healthista and has been reproduced with their permission.
WHAT IS DEMENTIA? THE KILLER DISEASE THAT ROBS SUFFERERS OF THEIR MEMORIES
A GLOBAL CONCERN
Dementia is an umbrella term used to describe a range of progressive neurological disorders, that is, conditions affecting the brain.
There are many different types of dementia, of which Alzheimer’s disease is the most common.
Some people may have a combination of types of dementia.
Regardless of which type is diagnosed, each person will experience their dementia in their own unique way.
Dementia is a global concern but it is most often seen in wealthier countries, where people are likely to live into very old age.
HOW MANY PEOPLE ARE AFFECTED?
The Alzheimer’s Society reports there are more than 850,000 people living with dementia in the UK today, of which more than 500,000 have Alzheimer’s.
It is estimated that the number of people living with dementia in the UK by 2025 will rise to over 1 million.
In the US, it’s estimated there are 5.5 million Alzheimer’s sufferers. A similar percentage rise is expected in the coming years.
As a person’s age increases, so does the risk of them developing dementia.
Rates of diagnosis are improving but many people with dementia are thought to still be undiagnosed.
IS THERE A CURE?
Currently there is no cure for dementia.
But new drugs can slow down its progression and the earlier it is spotted the more effective treatments are.
All Rights Reserved for Anna Magee