July Blog: Dementia

July Blog

This month I want to think with you about the important and disturbing subject of dementia. But don’t think it is all doom and gloom, because there is encouraging evidence that we may be able to start preventative action now to reduce the risk of this miserable condition.

Back in the day, (now when did that phrase creep into common usage? Maybe it comes from Afro-American music lyrics from the 70’s, or even earlier) there was a time, thirty years ago, when awareness of dementia was not nearly as pressing as today.

According to the Alzheimer’s Society,ELDERLY LADY

    There are currently 800,000 people with dementia in the UK.

    There will be over a million people with dementia by 2021.

    The proportion of people with dementia doubles for every 5-year age group.

    60,000 deaths a year are directly attributable to dementia.

The financial cost of dementia to the UK was over £23 billion in 2012. Some fearsome statistics, but what is dementia. It is several different diseases characterised by a set of symptoms that include both, loss of memory, mood changes, and problems with communication and reasoning. Alzheimer’s along with vascular dementia are by far the commonest forms of dementia.

A large and depressing subject, far too big for a little blog, but having seen my mother fade away over fifteen years with vascular dementia, it is a subject close to home, not only for me, but sadly for far too many of us today. As we age the chances of developing dementia increase.  As we are able to live longer, one of the unintended consequences of the happy extension of our life expectancy is the growing risk of suffering dementia.

The World Health Organization estimated that in 2000 the total number of people with dementia stood at 22 million. The average life expectancy in the UK has increased in the last two decades by 4.7 years for men and 5.1 years for women. But as the average world population increases, with better life expectancy, by 2050 the numbers suffering from dementia are expected to reach 114 million worldwide.

As you will have noticed, if you are a regular reader of my blogs, a common theme running through much of them is, what we may be able to do, practically, to reduce the risks of such negative outcomes. Today I am, briefly, going to look at what we know, and what we suspect, might help us, reduce the risks of dementia.

If genes load the gun and our environment pulls the trigger, it behoves us, if not for ourselves, then for the future generations who are likely to have to carry the huge burden of sadness and expense, to do all we can now, to weigh the chances in our favour.

Apart from some rare types of dementia, genetic factors may not play as big a causative part, as we might think.

Once upon a time, no one knew what to do about the heart attack epidemic spreading through the western world. Now, decades later, things have changed. While, along with strokes, heart disease is still the major cause of death, better understanding means we can see the links to lifestyle factors, like diet and smoking and, painfully slowly, we are beginning to reverse some of those fatal choices we made that led to this twentieth century heart disease epidemic. Gradually we are seeing that dementia is less a random horror, like we used to see heart disease, and it is starting to look like any other disease, with some understandable and even may be, preventable, antecedents and triggers.

Recent studies suggest that vascular disease may contribute to the cause of Alzheimer disease (AD). Since elevated plasma total homocysteine level is a risk factor for vascular disease, it may also be relevant to AD.

OPTIMA (Oxford Project to Investigate Memory and Ageing) Professor David Smith, suggests that far from being an inevitable part of normal aging, dementia is a true disease, and therefore we can tackle the causes of the disease, and, if not cure it, due to the loss of parts of the brain inherent in the disease, find ways of preventing it.

While thousands of millions of pounds are being spent by drug companies on drugs to cure the disease, almost nothing is being spent on researching the prevention of the disease through lifestyle changes. Many of the clues that may, in part, link these to dementia, are starting to look hopeful. Yet governments are reluctant to spend the kind of money that would verify such scientific hunches, and, of course, the drug companies have no financial incentive to do so.BRAIN

Evidence shows brain shrinkage, occurs five times faster than normal in dementia patients. This seems linked to levels of the amino acid homocysteine in the blood, which, in turn, is linked to the body’s ability to safely detoxify itself. Happily reducing your homocysteine level is easily and cheaply done with the right level of certain B vitamins. With those with an initial high homocysteine score (below 6 is ideal) who were supplemented with B vitamins showed a significant reduction of brain shrinkage.

 Health Journalist Jeremy Burne recently summarized some of the issues around these ideas. Some are skeptical as you might expect, and this caution is, in a way, understandable, and yet such skepticism, so often shown to lifestyle preventative aspects, are not so forthcoming when drugs are concerned.

While most prescriptions cause no great harm and some are truly life saving, a 2004 study by the University of Liverpool, suggested that as many as 10,000 patients annually were dying in the UK because of adverse reactions to drugs. Sugary drinks (soda) may account for 180,000 deaths world wide per annum, the risks, from eating a healthier diet, moving more, or even taking a few supplements, are infinitesimally small, in comparison.

Food For the Brain champions optimal nutrition for the mind. While the experts fight over the minutiae of the arguments, there seems good enough evidence to turn our attention to key areas of health that we can influence, by changes of our own life, let alone the kind of wholesale changes to our economy that would encourage and facilitate these simple, individual, changes. 

Until the facts are all known, in many decades time, the hopeful areas we can all have some impact on are:

  •   Insulin and glucose control, metabolic syndrome and diabetes
  •   Smoking
  •  High Blood Pressure
  •   Possibly, High cholesterol
  •   Poor education
  •   Lack of social interaction
  •   Levels of Essential Fatty Acids
  •  Antioxidants
  •   Homocysteine levels
  •  Chronic inflammation

Nearly all these are amenable to change but are mostly unlikely to respond to ‘magic bullets’ of the drug variety.  However they will require, changes, in society, in the way we organize and prioritize our health service expenditure, use our tax system to encourage good and discourse damaging eating, drinking, education and farming practices and the individual choices we make every day.

I will end with just one, of many, examples of research that underpins this thinking, with an encouraging trend of research findings. Over ten years ago, Morris et al. found that eating fish once a week can slash your risk of developing Alzheimer’s by as much as 60 per cent. As well as following peoples diets, always difficult over the long term, several animal based studies have shown encouraging changes in mouse brains with this kind of essential fatty acid enhanced diets, but science is never quite as straight forward as that, and along come other studies that produced more equivocal results.

What we don’t know, and there are few enough dietary studies anyway, is what would happen if you changed all the above factors at once, would this produce any enhancement of these sometimes encouraging results? For my own part, I don’t intend to wait around for the next few decades to see what the results are, simply because, changing all these risk factors have such multi factorial benefits beyond dementia, and, compared to the alternative, very low risks. So, why not run the experiment on yourself and see?

My aim is to die young, at a very old age, but one can never know for certain what is in store for individuals. What seems very likely is, if the present trends of longer survival but extended disability, continues, is a new and, possibly, unsustainable burden of disability of body and mind.  As populations age worldwide this is going to put impossible burdens on our children and grandchildren . So lets get moving and eating differently and see what happens. What have you got to lose?

 Book of the Month

The Alzheimer’s Prevention Plan: 10 Proven ways to stop memory decline and reduce the risk of Alzheimer’s

By Patrick Holford pp.256.  Published, 2007.

 This is another of Patrick’s well researched and explained, popular and sane books, outlining what is known and what is supected, but as yet not proved beyond doubt, on the encouraging side of the subject. He covers the  quite complex ground with elan.  Broken down into three parts,  Part 1,  explores why Alzheimer’s and memory decline are preventable. Part 2 tackles the ten ways to enhance your memory, Part 3, entitled, in tradmark Holford journalistic style, ‘Say No to Memory Decline,’ focuses on diet, suppliments and exercises to help keep your mind sharp. Packed with useful and reasonable guidance and facts on both the nutrtional science that underpins the growing body of research into this area, as well  helpful quizzes to assess your state and quickly evaluate your possible deficiencies, this is a hopeful guide to what we know so far on ways to prevent this scourge. The picture  for possible prevention is, perhaps, a little  more hopeful than some might think. And certainly Patrick takes this tack without being outragious. For those who want more there are a couple of hundred scientific references to explore.

I have been at nutritional science conferences when people, who know a lot less than Patrick about nutrition, have felt it quite legitimate to rubbish him as a mere suppliment salesman. Such is Patrick’s reach with his million selling books, that there are whole websites set up, by the loony scientism sects, devoted to slandering and  fault-finding with his books. I dare say, not every word he has written has turned out to be correct, but no one is perfect.  I supect his main crime is being a successful populariser. Like TV history dons, such success is bound to attract the carpers.

Over the decades, when ever our paths have crossed, I  have been impressed with Patrick, not only for his entreprenerial skills, and ablility to get interesting, top-flight scientists, to speak at his conferences and take him seriously, but for his skill in  taking the complex area of nutritional medicine and turn it into readerable books for those interested to learn and change their life. This  book is another one.

Some would urge caution in not singing too loudly of the hopeful signs, until much more is known.  I like his optimistic, can-do style. Such jaunty confidence could be seen as to be riding, too blithly, over the endless caviates and cations that the complex web of contradicting evidence  science throws up. But there is a place for diseminating these ideas to the public happy to take responsibility where they can for their own health.

Clearly he is in the business of putting a slight gloss on things to slant his book into the hope-ful rather than hope-less camp. But then even with this seemingly depressing topic,  there are some reasons to be hopeful, even if, sometimes, implimenting the changes, for many, seems too difficult. Old habits do die hard.

Too many, for fear of stepping out of line in the cut throat world of science, are often afraid to say anything at all, for fear of being laughed at in the caviate-laden world of modern science. Patrick, being a maverick, if free to do as he pleases. Over the last thirty years he has pioneered the nutritonally hopeful, science based, self help book.  Here is another, it is worth a read.

2 Comments

  1. Richard Pantlin on October 3, 2013 at 8:26 pm

    Thanks, Clive!

  2. […] July Blog: Dementia […]

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