Dementia prevention – predisposition and solutions
Dementia encompasses a wide range of neuro-psychiatric and medical conditions characterised by cognitive deficits that interfere with everyday life. It is important to note that pathological brain processes underlying dementia begin long before clinical manifestation and progress slowlywhich creates the prospect of developing interventions aimed at early identification and treatment of the preclinical stages of the disease.
However, studies to date suggest that a multifactorial intervention that includes regular exercise and healthy diet, along with amelioration of vascular risk factors, psychosocial stress and major depressive episodes may hold the most promise for preventing cognitive decline.
Epidemiological studies have highlighted the concept of “cognitive reserve”: individuals with a higher number of years of education and cognitive functioning show symptoms of dementia later than those with a lower level of education. However, once individuals with higher cognitive reserve show symptoms of dementia, they show more rapid disease progression than individuals at the other end of the spectrum.
In dementia prevention, we discuss in particular strategies targeting modifiable risk factors that have the potential to act before the onset of the disease, increasing the cognitive reserve of healthy individuals and delaying the development of neuropathological changes characteristic of dementia.
Early prevention strategies include lifestyle factors such as nutrition, exercise, stress reduction, improving vascular risk factors (such as high blood pressure and diabetes), treatment of major depressive disorder and cognitive stimulation.
Existing literature, including the World Alzheimer’s Report, advocates a multi-pronged approach to dementia prevention, given the role played by multiple risk factors for the disease. A total of 48.4% of dementia cases can be attributed to to Modifiable lifestyle risk factors: smoking, obesity, physical inactivity, low education, diabetes, high blood pressure and major depressive disorder. The report also summarized, benefits of cognitive stimulation on improvement in several cognitive domains, including executive function, attention and processing speed, and memory.
What can we do?
In addition to lifestyle factors – which can be adjusted – the risk of dementia is also influenced by genetic inheritance. This means that the presence in the family of a parent, uncle or grandparent diagnosed with this disease should raise questions about the preventive measures that need to be applied. In our clinic, this predisposition can be determined using genetic testing, so that – once the risk is known – we can immediately start the prevention plan to avoid the condition.
Adequate nutrition
Evidence suggests that dietary interventions may hold promise for preventing cognitive decline. It has been found that the Mediterranean diet, a nutritional style based on fruit, vegetables and fish can delay cognitive decline. The beneficial impact of the Mediterranean diet on cognition can be particularly enhanced when this dietary style is combined with the DASH (Dietary Approach to Systolic Hypertension) diet.
Physical activity
In dementia-prone patients, recently synthesised evidence has shown that aerobic exercise alone or in combination with other types of exercise can improve cognitive function.
Brisk walks in the fresh air, aerobic exercise, dancing – these are activities that get the blood moving and have a proven beneficial effect on the heart and brain as well as general well-being.
Reducing vascular risk factors
Diseases of the heart and circulatory system can predispose to the development of dementia syndromes, including vascular dementia and Alzheimer’s.
Therefore, reducing the occurrence of these conditions or keeping them under control (if they have already occurred), improving predisposing conditions for vascular pathology, such as hypertension, dyslipidaemia and diabetes, can be an important target for dementia prevention.
Stress relief
Numerous studies have demonstrated the negative effect of stress on different areas of cognition – attention, memory, concentration – especially when stress is a constant long-term presence.
The negative impact of chronic stress on cognition suggests that interventions aimed at stress control may be beneficial for dementia prevention.
Social engagement
People with low social engagement may be more likely to develop dementia compared to those with multiple social activities. Interaction with other people, dialogue – actively solicits more cortical areas, resulting in a more active brain.
Some studies have discussed that social activity, similar to cognitive and physical activity, may reduce the risk of dementia.
Reducing depression
So far findings suggest that early identification and treatment of major depressive disorder, a widespread disorder affecting all ages and populations, can substantially influence cognitive functioning in later life. Effective treatment of depression can lead to improvements in several cognitive areas, including attention, psychomotor speed and executive function. Untreated depression has also been shown to increase the risk of cognitive decline, so psychiatric assessment and psychotherapy are recommended for the management of depression.
Cognitive exercises
Several studies have reported that people who engage in activities that stimulate cognitive function, such as learning, reading or playing games are less likely to develop dementia compared to those who do not engage in these activities. Cognitive interventions for dementia encompass a wide range of modalities, cognitive stimulation targeting multiple domains, with a focus on social interaction and cognitive rehabilitation adapted to improve activities of daily living.Computerised cognitive stimulation – innovative solution
In response to patients’ need for prevention of Alzheimer’s dementia, but also as a proven means of intervention when the disease has already taken hold, our clinic continues to develop its line of high-tech, innovative services by bringing computer-assisted cognitive stimulation services to Romania for the first timeas an optimal support in the prevention of various cognitive deficits.
By solving tasks in computer-assisted cognitive stimulation, brain processes are activated and important brain functions are improved. The success of this treatment means that the user will be better able to cope with the challenges of everyday life. Computer-assisted cognitive stimulation therapy is available to help patients improve their cognitive functions such as attention, memory, executive functions and visual field. You can find out more by clicking on the button below.
Contact us for an Alzheimer’s dementia screening appointment or for any other information you need:
Bibliography:
- Rakesh G, Szabo ST, Alexopoulos GS, Zannas AS. Strategies for dementia prevention: latest evidence and implications. Therapeutic Advances in Chronic Disease. August 2017:121-136. doi:10.1177/2040622317712442
- Andrade, C., & Radhakrishnan, R. (2009). The prevention and treatment of cognitive decline and dementia: An overview of recent research on experimental treatments. Indian journal of psychiatry, 51(1), 12-25. https://doi.org/10.4103/0019-5545.44900
- Middleton LE, Yaffe K. Promising Strategies for the Prevention of Dementia. Arch Neurol.2009;66(10):1210–1215. doi:10.1001/archneurol.2009.201
- Christopher Patterson, John W. Feightner, Angeles Garcia, G.-Y. Robin Hsiung, Christopher MacKnight and A. Dessa Sadovnick
- CMAJ February 26, 2008 178 (5) 548-556; DOI: https://doi.org/10.1503/cmaj.070796
Author: Mădălina Grosu – Resident Physician in Psychiatry
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