There’s plenty not to love about being middle-aged. But by the time today’s forty- and fifty-somethings reach the age when they may develop Alzheimer’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 and probably have drugs to treat it before it even shows symptoms.
Perhaps even more heartening, increasing evidence shows that dementia is not inevitable. This week, scientists at Harvard published research on an elite group of retired people, dubbed ''super agers’’, who have brains that resemble those of people a third their age, which could provide vital clues about how to prevent declines in memory.
Studies are studying how biomarkers in people aged 40-59 may help predict changes in cognitive function, are set to confirm this further.
“In the next 10 years we’re going to get more and more evidence about the things people can do to prevent Alzheimer’s and dementia,” says Craig Ritchie, professor of the psychiatry of ageing at the University of Edinburgh who is leading the trial.
“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?
Forget Sudoku and learn a language
Brain stimulation, not brain training, is essential in preventing cognitive decline. The 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, 'I do lots of crosswords and Sudoku, will that protect me from dementia?’”
But the evidence now suggests that taking up new hobbies and interests that challenge you are more beneficial. “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.”
Build your cognitive reserve
Protecting the brain against dementia is all about building cognitive reserve – the connections within the brain network.
As we age, the brain shrinks and these connections weaken but the bigger your cognitive reserve is, the longer you’ll last before suffering memory problems. Stimulating the brain with certain behaviors help to maintain cognitive reserve.
Someone with 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.
The more of these factors you have, she says, the more protected you may be – if you develop a bit of cognitive impairment, it will take longer for it to turn into dementia.
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 laborers.
Aspirin and the brain
Some 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 study into the effects of aspirin on the heart and the brain is set to confirm the link.
“Aspirin acts to reduce the risk of blood clotting and therefore heart attack and stroke, and both of those two things are associated with measurable effects on cognitive function,” says Jane Armitage, professor of clinical trials at Oxford University who is leading the research. Results are expected in 2018.
In the meantime, remember aspirin can have side effects such as gastrointestinal bleeding and hemorrhagic stroke, so talk to your doctor to see if it will benefit you.
Should I take fish oils?
Although small studies such as one, published in 2014 in the Journal of Alzheimer’s Disease, have found that supplementation with omega-3 helped slow the decline of cognitive function on those with Alzheimer’s disease, no substantial studies have yet affirmed the link.
So the jury’s still out, but it does look like eating fish regularly, particularly oily fish such as salmon or mackerel, as part of a balanced diet is good for overall health, including brain health.
Healthy body, healthy brain
The same processes that cause heart attacks and strokes are also associated with the development of dementia. 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.
So the lifestyle factors that help the heart – avoiding smoking, keeping to a healthy weight and taking regular exercise – can also maintain cognitive function.
Evidence suggests the ideal diet to prevent dementia is a Mediterranean-style one rich in polyunsaturated fat from nuts, seeds and fish, vegetables, fruit and grains (and small amounts of red wine).
Meanwhile, all the scientists said moderate exercise as the number one factor that could help prevent the onset of dementia. And it doesn’t even have to be very hard.
Just try and move more, from taking a 20-minute walk on most days to having a swim. 'Doing a sport is particularly helpful as it also involves social engagement, which is hugely important.
(A little) red wine is fine
News to pop a cork over came out when scientists 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 pinot noir and pinot Meniere – 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.
Experts advise sticking to the government recommended limit of 14 units spread over a week – equivalent to six pints of beer or 10 small glasses of low-strength wine.
For information on Alzheimer's care, contact Spring Arbor.