Dementia Prevention: Lifestyle, Nutrition, and Cognitive Health

Introduction

Dementia is a degenerative cognitive health condition that primarily affects the elderly population and is characterized by "impairments in cognitive and intellectual ability, memory, language, reasoning, and judgment," all of which interfere with the individual's ability to function in everyday life (Agency for Healthcare Research and Quality, 2014). The two most common forms of dementia are Alzheimer's disease and vascular dementia (Livingston et al., 2017). While not much is known about the etiology of dementia other than that it is related to cellular damage in the brain, there has been some success in identifying possible ways to prevent it. This paper defines dementia, its manifestations and types, discusses three research articles dealing with dementia prevention, and provides suggestions for future research on this topic.

Defining Dementia

Dementia is a neurodegenerative disorder that results in the irreversible loss of brain functionality. Alzheimer's disease is the most common form and results from neurons in the brain dying; frontotemporal disorders and Lewy body dementia are others; vascular dementia occurs as a result of blockages or bleeding in blood vessels of the brain. Signs and symptoms of dementia tend to be progressive, and the earliest sign is worsening memory loss. Confusion, an inability to concentrate, apathy toward life, general withdrawal from others, personality changes, and an inability to perform everyday tasks are all signs that a person may be suffering from dementia. There is no definitive diagnostic test for dementia, though medical history and clinical assessments can provide doctors with a high degree of certainty about the condition of the individual.

Three Articles on Dementia Prevention

Livingston et al. (2017)

Livingston et al. (2017) argue that about one-third of cases of dementia may be preventable. Their article is based on existing evidence and correlations that other researchers have noted in the past. For instance, Livingston et al. (2017) note that a correlation between hypertension and later onset of dementia could be a reason to begin preventive measures for dementia when one starts being treated for hypertension in middle age. Some of the interventions they recommend start as early as childhood, with increased levels of education in order to strengthen cognitive development and abilities. The researchers also recommend exercising regularly, not smoking, and maintaining an active social life—which they note has positive stimulating effects on the brain and may help prevent neurons from dying. One of the main keys to prevention, however, is building one's resilience (Livingston et al., 2017).

Resilience can be increased through intellectual stimulation early in life and continued throughout adulthood. The evidence suggests that the more engaged one's mind is on a daily basis, the more likely the brain is to stay healthy. It is not a guarantee—even the healthiest individuals, who exercise and eat well, can suffer from heart attacks or strokes. However, what Livingston et al. (2017) indicate is that building up one's resilience can reduce the risk of dementia developing later in life. The best way to boost resilience, according to the research findings, is through intellectual activity, as evidenced by studies showing that more highly educated individuals tend to have lower rates of dementia (Livingston et al., 2017).

Other factors that can help prevent dementia, according to Livingston et al. (2017), include regular exercise, which can reduce cognitive decline; avoiding a lifestyle that could lead to obesity or hypertension, as both have been linked to vascular dementia; avoiding smoking, which contains neurotoxins that can negatively impact cognitive processes; engaging in social outings to avoid depression, which is associated with cerebrovascular pathology and could therefore affect neuronal health; and adopting a Mediterranean diet, which is associated with fewer vascular risks.

McCleery et al. (2018)

McCleery et al. (2018) focused on the role that vitamins and minerals can play in supporting and maintaining a healthy nervous system. They conducted a systematic review of existing literature on whether vitamins and minerals can delay dementia. Criteria for inclusion were placebo-controlled randomized trials for populations not suffering from vitamin or mineral deficiency. However, because only one randomized controlled trial existed across all relevant journals, they also included quasi-randomized trials.

McCleery et al. (2018) found that the vitamins and minerals researchers had previously focused on—totaling five trials in all—were B6, B12, and folic acid. One trial had focused on vitamin E, and another on vitamin C. The researchers noted that because of the small body of literature from which to assess the efficacy of vitamins and minerals on cognitive health, conclusions were limited. They judged, however, that vitamin E likely has no impact on the prevention of dementia. For people with high tHcy levels, vitamin B can improve episodic memory, but that was the only finding supported by the literature.

Van Baal, Hoogendoorn, and Fischer (2016)

Van Baal, Hoogendoorn, and Fischer (2016) used a simulation model to examine the impact of physical activity on the prevention of dementia. They added to the model investments in long-term health and social care to assess what impact these options would also have. They found, according to their model, that when individuals generally focus on caring for their fundamental health by following the routine basic recommendations of dietitians and doctors, they are less likely to develop dementia-like symptoms in the long term.

Conclusion

Is dementia preventable? The indications from the literature suggest that it is possible to prevent approximately one-third of dementia cases; however, because the etiology of dementia is unknown—aside from the basic neurological processes that trigger it—total prevention or cure has not been found. The overall recommendation of researchers is to lead a healthy and cognitively stimulating life in order to reduce the risk of developing dementia later in life.