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What Was The Question Again? - Dementia Prevention

Bear with me... Some of my pet hates are quotations or invoices which are not itemised and/or which do not include VAT, as well as food websites, where one has to scroll through several pages until one gets to the actual ingredients and the recipe. That is why here, I will tell you what I'm going to tell you, then I'm going to explain what I'm telling you and then you have a chance to read the relevant articles yourself, should you want to. Easier, no?


Milly was about to execute a shoulder throw on her assailant.


So, you want to avoid age related dementia (a group of conditions including Alzheìmer's)? Here's a recipe:


Start in early adulthood (before there are any signs of early dementia). This doesn't mean that you can't start later, the results are not as good, however.


Treat high blood pressure (hypertension) and hyperlipidaemia.


Stop smoking and drink alcohol in moderation only (if at all).


Physical activity is important (walking, climbing stairs, dancing have been proven to work). As little as 30 minutes 3 times a week may be effective. Use an accelerometer to monitor this (actigraphy). Resistance training as an adjunct to aerobic exercise is beneficial. Group exercises are better than exercising alone.


Engage in leisure activities of an intellectual nature (chess, bridge, learning a language or coding, reading, debate, crossword puzzles, playing musical instruments).


Engage in leisure activities of a social nature (group exercise, visiting, playing with children, mentoring younger people in a similar field to one's own).


Eat a diet rich in fruits and vegetables, especially carrots. Mediterranean regime diets is supported. Prevent malnutrition with a balanced diet, supplements do not work.


Dementia is common (29 million people by 2020 - that's as if the whole of Australia and New Zealand suddenly became demented... No, don't say it!) and it drastically affects daily life in a negative way. There are no drugs to stop you from getting dementia. The best thing you can do is to treat the known risk factors (hypertension, hyperlipidaemia) and to make the lifestyle changes listed above.


Despite the fact that William had brought props this time, Theodore was getting tired of hearing the story of the proctoscopy for the 100th time.


Just for a second...


A massively important point, which will raise its head repeatedly in this blog: Recommendations are based on findings of meta-analyses. A meta-analysis is an analysis of all the good scientific studies (well conducted studys with a reasonably high level of evidence) pertaining to the question being asked. The outcomes of these metaanalysis studies are extremely powerful, because they allow us to make recommendations based on findings in a massive patient population (all the patients in all the individual studies added together). If you're getting ready to say "but I take essence of fenugreek diluted in CBD oil and it's definitely helped me to remember things better!", then read the above again. I'm not telling you what will work for you as an individual, I can't possibly presume to do that. I'm telling you what has been proven to work for everyone - I'm sure you'll agree, it pays to bet on a winner. It is also way safer than experimenting on oneself. Furthermore, I would advise you strongly to read up around the placebo effect.


Anyway, back to dementia...


If you keep your systolic blood pressure under 160 mmHg and your blood cholesterol under 6.5 mmol per litre, you are on the right track. Specifically with reference to controlling dementia, aspirin, treatment with statins for hypercholesterolaemia and control of type II diabetes are unlikely to make a difference. Out of the 3 above, at least diabetic control is definitely important with respect to a whole range of other diseases. Better ask your GP about aspirin and statin therapy.


The use of nonsteroidal anti-inflammatories, oestrogen (in women only), vitamin - and micro/macronutrient supplements showed low level preventative effects. In other words, provided you can safely take these medications (and you and you don't need to perform regular cash in transit heists to afford them), all that's left to do is to accept the associated risk factors (deep vein clots with oestrogen supplements, stomach ulcers with nonsteroidal anti-inflammatories to name but a few). After all,they may make a small difference (much smaller than the things recommended above though).


Raymond now regretted not buying Ethel the selfie-stick she had asked for.


Physical exercise helps because it increases brain blood flow and decreases brain shrinkage. It improves brain function in older adults. Exercise with actigraphy assistance (accelerometer apps on phones or smart watches) and in groups was shown to be extra beneficial. Unfortunately, if you are already suffering from early signs of dementia, there is no solid evidence to suggest that physical exercise can stop it from getting worse. Obviously, physical exercise will be beneficial in multiple other ways, it just won't affect your worsening dementia.


With regards to cognitive activities and social activities, it seems to be either use it or lose it. People are social by nature and activities performed in a group with maximum interaction are good for you. Leisure activities, which are intellectually stimulating keep you sharp.


We should all be eating a healthy, balanced diet, rich in fruit and vegetables. This is because they are a source of antioxidants, which retard the breakdown of healthy tissue, a process which is associated with ageing in general, as well as with dementia. Importantly, if you take these vitamins and antioxidants as supplements, rather than eating fruit and vegetables, they do not have the same effect. The Blue Zone type Mediterranean diet is recommended, supplements are not.


Have fun getting health (and not getting demented in the process), until the next time.


Ref: Prevention of Dementia: Focus on Lifestyle - Maria Cristina Polidori, Gereon Nelles, and Ludger Pientka


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