Short version

-Eat well, exercise your brain and your body, avoid harm and sleep.

-The focus: Blood flow, oxygen, nutrients and toxins

-Using your brain is your best defense.

Long version

There are many types of Dementia, Alzheimer’s is the most common type but the words are not interchangeable. There are also versions of dementia that are due to poor blood flow from vascular disease, from head trauma, from alcohol and other toxins and some from rare infections.

Dementia is currently incurable, we have treatments but as all things in health, prevention is better. Here’s how,

1-Eat well. There aren’t any good studies that back supplements, which doesn’t mean they don’t help you. Except Prevagen-that doesn’t help anyone. Save your money on that one, use it to buy good fish to eat. I remain a big fan of vitamin B12 as a supplement. When low B12 can interfere with memory, energy and even cause neuropathy- tingling and numbness. We absorb less B12 with age and due to some common medications (like metformin) B12 is found in animal products so if you are Vegan you need to supplement. Yet there isn’t any good data that this vitamin alone prevents dementia. Same for fish oil, there is good data that eating fish is great for your brain (avoiding mercury) but when we tried to distill the benefits into a tiny package as a pill we have mostly achieved gross burps and not the same brain benefit.

2– Use your brain. While physical exercise is probably the most important thing you can do to improve your brain, Brain exercises are important too.

What does that mean? Use your brain to be social, call a friend or meet up at Dunkin Donuts with a group, join a card game at your library or join a volunteer group. Use your brain individually too, crosswords, word search and sudoku are good but so is reading.

One of my favorite recommendations is cribbage but if you play bridge or chess you have a head start there. Why? Any game where you have to plan 2-3 steps ahead or recall 2-3 steps behind is great brain exercise. Hate crosswords or cards, don’t. There are other ways. Learn something new – anything new.

Do you like wood working or building, knitting or sewing, painting or gardening? Great. If you like those things but aren’t currently doing them. Please get back to it, it is a benefit for your mood now and your memory later.

3- Physical exercise helps get blood flowing and oxygen to the brain and removing toxins away from the brain. Add 10-15 minutes of some exercise after a meal. A walk or yoga/ tai chi for your balance? Those PT exercises we really keep meaning to do….make it a habit rather than an occasion. If you can do it outside the benefit seems to be even better.

If you join an exercise class you knock off two things socializing and physical exercise. Go out for coffee after? order the salmon salad for lunch and you have met all 3! That sounds like a good day, who wants to go with me? 🙂

4- Avoid toxins- it gets less exciting here. Alcohol is the most common brain toxin that leads to dementia risk. For many reasons, one being that the body will absorb and process alcohol sugars first, and nutrients second. You will compete for absorption of things like thiamine (B1) and B12. so even though you are eating well you won’t see all the benefits. Alcohol can also be directly toxic to neurons. the next concern is smoking – tobacco and marijuana if it’s a frequent daily habit.

5- Sleep– There are myriad health consequences of poor sleep but not just limited hours of sleep but also quality of sleep. Treat any sleep apnea and you will find it easier to remember what you went into the room for or find your words quicker. If you don’t have a sleep disorder, don’t be afraid to nap, especially if you can in that natural 3pm slump of energy flow in our day. Your sleep doesn’t have to be a perfect 8 hours, that’s actually rare with age. Instead just allow it to be a priority that you protect. Sleep in 2 shifts and read or journal between enjoying the quiet rather than being anxious about not sleeping. CBT helps if you need a guide to your own brain.

6-Take your meds, think small. If you have a medical condition like high blood pressure or diabetes, take your medications regularly. Get a pill planner and a routine around taking them regularly. It makes a difference.

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Dementia is premature aging of the brain, your brain age is older than your age. All brains shrink in time, almost all organs in the body shrink with aging. We aren’t worried about size, we are looking for performance.

I have another future post planned for: when is it regular aging or when do you worry.

Lastly, what about genetic risk? You can’t change that, but a recent study showed working on lifestyle makes a difference even if the genes aren’t in your favor. From the LIBRA study, “On the environmental side, modifiable lifestyle and related risk factors, which are actionable to primary prevention by individual behavioral changes, could represent ≥ 40% of the attributable risk of dementia and thus appear at the forefront of prevention. The risk factors with the most compelling epidemiological evidence so far in relation to cognitive aging include psychosocial factors (low education level, depression, low cognitive stimulation), lifestyle (unhealthy diet, low physical activity, alcohol use, smoking), and related cardiometabolic health (diabetes, hypertension, obesity, high cholesterol)”

Source: Association of LIfestyle for BRAin health risk score (LIBRA) and genetic susceptibility with incident dementia and cognitive decline J. Neuffer et al. published: 22 May 2024 in Alzheimer’s and Dementia journal.