World Alzheimer’s Day takes place on the 21st September each year during World Alzheimer’s Month. During September many Alzheimer and dementia associations around the world host memory walks, fundraisers, awareness...
This year’s theme ‘Never too early, never too late’, centres on the key risk factors and how to reduce the risk of developing Alzheimer’s disease (1).
Here we’ll look at the symptoms of Alzheimer’s and dementia, the risk factors and will give some lifestyle and nutritional tips to reduce the risk.
Alzheimer's disease (AD) is the most common form of dementia and the most common neurodegenerative disease. It is characterized by a progressive deterioration of memory and cognitive function.
Symptoms
Every person is unique and dementia affects people differently. An individual’s personality, general health and social situation are all important factors in determining the impact of dementia on them.
Symptoms vary between Alzheimer’s disease and other types of dementia, but there are broad similarities between them.
Early symptoms of dementia
Memory loss - declining memory, especially short-term memory, is the most common early symptom of dementia. Memories for things that happened long ago may be preserved.
Difficulty performing familiar tasks - people with dementia may struggle with putting their clothes on in the right order or the steps for preparing a meal.
Problems with language - occasionally everyone has trouble finding the right word but a person with dementia may often forget simple words or substitutes unusual words. They may also have difficulties following a conversation and may become withdrawn.
Disorientation in time and place - people with dementia can become lost in familiar places, forget where they are or how they got there, and not know how to get home. Someone who has dementia may also confuse night and day.
Poor or decreased judgement – for example, people with dementia may dress inappropriately, wearing several layers of clothes on a warm day or very few on a cold day.
Problems with concentration, planning or organising - a person with dementia may find it difficult to make decisions or solve problems.
Misplacing things - anyone can temporarily misplace his or her purse or keys. A person with dementia may put things in unusual places such as an iron in the fridge or a wristwatch in the sugar bowl.
Changes in mood or behaviour - dementia may cause someone to become unusually emotional and experience rapid mood swings or irritability for no apparent reason. Alternatively they may show less emotion than previously.
Trouble with images or spatial relationships - people with dementia can have difficulty in reading, judging distances, seeing objects in three dimensions and in determining colour or contrast.
Withdrawal from work or social activities - a person with dementia may become very passive, sitting in front of the television for hours, sleeping more than usual, or appearing to lose interest in hobbies.
If you are experiencing any of these symptoms or are concerned about a friend or relative, visit your doctor and discuss your concerns.
Diagnosis
When making a diagnosis, it is important to exclude other conditions that can cause similar symptoms such as depression, and acute illnesses such as urinary infection and vitamin deficiency.
Diagnosis begins with gathering information about the development of symptoms from the person affected and from friends and family. You may also be asked about how you function in everyday tasks such as washing, dressing, driving, or cooking. There may be cognitive tests for memory, attention, language and visuospatial abilities (copying a diagram or picture) and depression. There may also be tests of your physical state to help work out your strengths and difficulties. You may be referred for an MRI or CT scan to examine the brain for abnormalities.
Modifiable Risk Factors for Dementia
Ageing and genetics are key risk factors for dementia that we cannot change. However, there are modifiable risk factors which include:
Physical inactivity - regular physical activity is one of the best ways to reduce your risk of dementia. It’s good for your heart, circulation, weight and mental wellbeing.
Smoking - smoking greatly increases your risk of developing dementia, as well as increasing your risk of type 2 diabetes, stroke, and several cancers. It’s never too soon or too late to stop.
Excessive alcohol consumption - alcohol misuse and drinking more than 21 units weekly increase the risk of dementia.
Air pollution - research shows that air pollution increases the risk of dementia. Policymakers should expedite improvements in air quality, particularly in areas with high air pollution.
Head injury - Head injuries are usually from road accidents, sports, falls and assaults. It is important to reduce the risk of these as much as possible.
Infrequent social contact - social contact enhances cognitive reserve and encourages beneficial behaviours.
Less education - a low level of education in early life affects cognitive reserve and is one of the most significant risk factors for dementia. Policy should prioritise education for all.
Obesity - particularly in mid-life, obesity is associated with an increased risk of dementia.
Hypertension - high blood pressure in mid-life increases a person’s risk of dementia, as well as other health problems. Dietary and lifestyle changes can help to lower blood pressure.
Type 2 Diabetes - diet and exercise can both help to improve outcomes for those with, or at risk of, type 2 diabetes.
Depression - depression is associated with dementia incidence and with worse outcomes for those with dementia.
Hearing impairment - people with hearing loss have a significantly increased risk of dementia. Using hearing aids may reduce the risk.
Nutrition - in addition to these nutrition plays an essential role in the pathogenesis and evolution of neurodegenerative diseases. Malnutrition, low or high body mass index and insulin resistance are all risk factors (2). Inflammation is an underlying factor in Alzheimer’s disease, possibly contributing to disease progression (3,4).
Diet and Nutrition to Prevent Alzheimer’s and Dementia
Preventative intervention gives the best results if introduced before the first symptoms of dementia, ie: around the age of 50.
There is a direct relation between diet and changes in the brain structure and activity. Eating an anti-inflammatory diet is recommended. Higher adherence to a Mediterranean-type diet, rich in antioxidants, fibre and omega-3 fatty acids, is associated with decreased cognitive decline. Dietary Approach to Stop Hypertension (DASH) and the MIND diets are also associated with slower rates of cognitive decline and significant reduction of AD rate.
MIND Diet Food List
The MIND diet plan aims to protect brain function and prevent neurodegeneration, including age-related cognitive decline and dementia. It focuses on increasing the intake of high nutrient, anti-inflammatory foods and minimising high salt foods, processed meats, fried foods, pastries and sugary foods.
These foods are prioritised on the MIND diet plan:
Green vegetables and other colourful vegetables – spinach, chard, kale, broccoli, rocket, cabbage, beetroot, squash, carrots.
Whole grains - such as brown rice, oats, quinoa, rye, spelt, buckwheat and millet.
Nuts - aim for at least five servings of nuts a week.
Berries – blueberries, blackberries, strawberries and raspberries.
Beans - black beans, chickpeas, haricot beans, cannellini beans, soybeans and lentils are all recommended.
Fish and Poultry – not only are these lean sources of protein, but some are rich in omega-3 fatty acids which promote heart health and brain health.
Wine - in moderation, there’s some evidence that red or white wine can be beneficial for brain health.
Other dietary regimes that are being investigated for their impact on dementia and cognitive function include:
Intermittent Fasting produces several metabolic changes, such as increased insulin sensitivity. Animal studies have also shown that intermittent fasting leads to enhanced cognitive function and improved vascular health. Additionally, caloric restriction in animals is associated with a reduction in beta-amyloid accumulation, which is one of the key markers of AD. So it is hypothesised that intermittent fasting over several years could potentially reverse or delay the development of AD (5).
Fasting mimicking diets, in which a low calorie, low protein, low sugar diet is followed intermittently for 2-5 days, may also reduce beta-amyloid accumulation and inflammation and may improve cognitive function (6).
The ketogenic diet (KD) is a high-fat and low-carbohydrate diet with adequate protein. KD increases the levels of ketone bodies, providing an alternative energy source to glucose. Studies have shown that a KD is beneficial to AD. The potential underlying mechanisms include improved mitochondrial function, optimisation of the gut microbiome, and reduced neuroinflammation and oxidative stress (7). However, more research is needed to ascertain the long term effects of the ketogenic diet on health (8).
Personalised Nutrition
It should be noted that people’s metabolic responses to food vary. A more personalized approach may better fit biological reality and have increased efficacy to prevent dementia (9).
Lifestyle for Brain Health
Some lifestyle habits are beneficial for brain health and cognitive function:
Brain Training – learning new skills, doing crosswords, learning to play a musical instrument or a learning a new language may all aid healthy brain function.
Exercise - it is recommended that adults aim for either 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity each week.
Social Connections - joining a club and volunteering are good ways to stay socially active.
Neuroprotective Nutrients
Neuroprotective nutrients include antioxidants, B vitamins, polyunsaturated fatty acids (10), glutathione, polyphenols, curcumin, coenzyme Q10, vitamins B6, B12, folic acid, lecithin, Urolithin A, caffeine and some probiotics (11).
Tom Oliver Nutrition’s Supplements for Brain Health
B Complex – needed for brain function. Tom Oliver’s B complex contains all the major B vitamins including choline, inositol and folic acid.
Co-Enzyme Q10 – a powerful antioxidant with neuroprotective effects (12).
Curcumin – with antioxidant and anti-inflammatory properties curcumin is protective against many neurological conditions (13).
Fish Oils - Fish and fish oil consumption have been found to be protective against cognitive decline (14).
Vitamin D3 – low vitamin D levels are associated with an increased risk of Alzheimer’s and dementia. Vitamin D has anti-inflammatory and antioxidant activity which may play a part in its protective effects (15).
References
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