How you can prevent dementia with lifestyle changes including quitting smoking, exercising and finding friendship
Dementia is not an inevitable consequence of ageing. Researchers believe that one-third of cases could be prevented through better management of nine lifestyle factors over the course of a lifetime
Memory loss, personality changes, limited social skills, and impaired reasoning are just a handful of the symptoms associated with dementia. Used as a broad term to describe various neurological conditions which damage brain cells and lead to a loss of brain function, dementia currently affects more than 100,000 Hongkongers and is predicted to affect more than 300,000 in the next 15 to 20 years.
There are many types of dementia, according to Dr Jason Fong, a specialist in neurology at Matilda International Hospital on The Peak in Hong Kong. They include Alzheimer’s disease, which accounts for about half of dementia cases and typically affects people over 65; vascular dementia, which is common in people who have had strokes; and mixed dementia, where more than one type of dementia occurs simultaneously in the brain. He adds that five per cent of dementia cases are due to genetic factors.
Contrary to popular belief, dementia is not an inevitable consequence of ageing. A major review, conducted by the Lancet Commission on Dementia Prevention and Care that was published in July 2017, reported that one-third of dementia cases could be prevented through better management of nine lifestyle factors over the course of a lifetime.
These potentially modifiable risk factors include: low levels of education, mid-life hearing loss, physical inactivity, high blood pressure, type 2 diabetes, obesity, smoking, depression, and social isolation.
Currently there’s no drug treatment to prevent or cure dementia, but Fong says: “If you have high blood pressure or type 2 diabetes, smoke cigarettes, are obese, or don’t exercise, you are at greater risk of developing cardiovascular disease, which is associated with an increased risk for dementia.”
This is because problems in the vascular system, made up of the heart and the blood vessels that transport blood to the brain, can contribute to the development of dementia.
Fong adds: “Getting an education can also help minimise your risk of developing dementia, because the higher your level of education, the stronger the neural connections in your brain. It might therefore take longer for your brain function to deteriorate, compared to someone with a low level of education.”
One study, by the University of Gothenburg in Sweden that was published in the journal Scientific Reports in 2017, found a relationship between higher education in later generations of Swedes and a drop in dementia cases between 1986 and 2008 in that country. Another factor was thought to be better treatment for strokes. During these years, the prevalence of dementia among 85-year-olds fell from 30 per cent to 22 per cent.
Fong also agrees that avoiding social isolation can help lower your risk of dementia, although exactly how the two are linked is unclear. Prior studies show that feelings of loneliness may trigger changes in the nervous system and suppress the connections between brain cells. It has also been speculated that feeling lonely or not having a supportive social network contributes to high blood pressure, thereby raising our risk of heart disease and stroke.
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While social isolation and dementia are connected, it’s hard to tell which causes the other, because many elderly people with dementia tend to withdraw from society as their social skills deteriorate and they experience changes in their personality. And, if they suffer from hearing loss, they may find it even more uncomfortable being around others.
“When you can’t hear what others are saying it’s difficult to communicate,” says Fong. “This might result in fewer social interactions and ultimately, greater feelings of isolation.”
Of course, there’s no guarantee that eliminating all these modifiable factors will prevent dementia. If you currently have dementia, it’s also important to know that eliminating these factors has not been proven to slow down the progression of the disease, although Fong says that doing so might help improve your quality of life.
Steven Chiu has observed this with the dementia patients who use Active Global Specialised Caregivers services, of which Chiu is Hong Kong branch manager. An alternative to nursing homes, the company, which also has service offices in Singapore and Shanghai, provides home-based assistance to patients who suffer from a range of complex medical conditions.
Chiu says that feelings of loneliness and isolation are common in many of the company’s dementia patients, who are between 70 and 90 years old and make up 60 to 70 per cent of its Hong Kong clientele. He adds that companionship, support and understanding go a long way in helping these patients feel cared for and connected.
“Our carers provide a form of companionship to their patients, which is important if the patients’ families or children are unable to spend time with them,” Chiu says. “To stop negative emotions like loneliness from taking over, the carers keep them engaged with activities like painting, exercising, making family photo albums, and walking in the park.”
Emily Lam, operations manager and nursing consultant at Active Global Specialised Caregivers, says that when their patients are depressed, they tend to isolate themselves. The carers can recognise when this happens and make sure to keep the patients company.
“Our elderly patients with dementia understand that their carers care for them,” Chiu adds. “While the companionship may not cure their condition, it does bring these patients out of their shells and puts a smile on their faces.”