By J.Ron Eaker, M.D.

Next to cancer, or even COVID-19, most of us fear senile dementia or other neurodegenerative diseases. We have known a family member, friend or colleague who has cognitive decline and/or memory loss. I’d like to define the scope of the problem and, more importantly, list the behaviors, health choices and lifestyle options that will reduce your risk.

Dementia has a spectrum of issues that encompasses many specific entities. Within the group, there is a myriad of differences that can be quite distinctive. Never forget, in discussions of any medical problem, certain generalities are incumbent. The real utility and how it applies to you individually can only be determined by self-assessment and with the guidance and insight of a knowledgeable professional.

The most common forms of dementia are:
Alzheimer’s disease
Vascular dementia
Dementia with Levy bodies (a microscopic finding)
Parkinson’s disease
Frontotemporal dementia

Let me paraphrase a wise saying… an ounce of prevention is worth a megaton of cure, especially as it applies to dementia. We can surgically remove cancer, medicate diabetes, stent clogged arteries, but, at best, we can only slow down dementia. So, early intervention and persistence is the key to prevention. Recent encouraging studies imply that even making some of these changes later in life can be beneficial.

Let’s start with nutrition. Several studies indicate obesity, type 2 diabetes and elevated body fat increase your risk for neurodegenerative diseases. In contrast, a healthy body fat composition, reasonable weight and lower insulin levels can reduce those risks. Some speculate that the underlying insult is inflammation, a general term referring to a physiologic reaction causing small blood vessel clogging, accumulation of waste materials and tissue damage. An inflammation-producing diet is one higher in sugars, processed food, trans-fats and lower in fiber and antioxidants. Simply put… do what your momma advised: eat balanced meals, low in sugar, low saturated and trans-fats, high in fiber and as close as possible to the way God made it.

While I’m all about a good night’s sleep, it was not until recently that I understood how critical restful sleep is to preventing dementia. The research is conclusive that getting less than 6 hours of quality sleep a night can, especially over time, make your risks skyrocket. This is not good news for shift workers, chronic insomniacs, obstetricians or new moms. The mechanism for this risk factor is still being unwound. However, folks who slumber for 8-9 hours a night consistently have a much lower incidence of obesity, diabetes, senile dementia, Alzheimer’s disease and depression. So, if you are chronically sleep-deprived, get help from your doctor or a trained sleep specialist.

Those of you who read this column regularly (thank you, mom!) know that I rarely write topics without working in exercise. This month is no exception because moderate exercise is one of the most universally accepted preventative tools to stave off dementia. You don’t have to train for a marathon. Two and one half to three hours of moderate activity a week is all that is needed to reap some benefit. There is no magic formula or specific exercise that’s best; however, a balance of aerobic activity and muscle preserving resistance training is optimal.

I am often asked by patients if there is a supplement or vitamin that decreases the chance of cognitive decline. My short answer is that the benefit obtained from lifestyle changes (i.e., all the above listed) dwarfs any potential benefit from popping the latest herbal concoction. Taking opossum oil or some such other potion will not protect you in the least if you still smoke and drink liberally every day. There are, however, a few supplements that may provide a benefit if you are practicing healthy habits. The omega-3 fatty acids, in particular DHA and EPA, have been found to lower risks of dementia in animals and human studies ( Other interesting ones like Ginkgo, huperzine A, B complex vitamins and Vinpocetine are being studied.

The take-home is this: eat, exercise and sleep well as ways to lesson your chance of dementia.

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