Experts Say the Rate of Dementia Is Declining
Keep it up, seniors! You're making brain-healthy choices that are showing up in the data.
Caring Right at Home has reported extensively on the challenges our nation will face as the number of cases of dementia increases with the aging of our population. Past Caring Right at Home polls have shown that many of our readers are caring for loved ones who have Alzheimer's and other types of dementia, so they are more than familiar with the issues these patients and their families will deal with.
Here's a quick review of the numbers: Projections are that by the year 2050, more than 13 million Americans will be living with Alzheimer's disease and other types of dementia. Worldwide, the projection is for 10 times that, according to Alzheimer's Disease International.
And yet, among the dire predictions is a bit of good news. Researchers at Boston University School of Medicine (BUSM) recently reported that while the total number of cases of dementia will continue to grow, the rate of dementia in the population—that is, the percentage of us who will be living with cognitive impairment—seems to be trending downward. The team also reported that the signs of dementia are showing up on average a few years later in life than before, giving people a few more years of good cognitive health.
What is behind this encouraging trend? According to BUSM neurology professor Dr. Sudha Seshadri, "Effective prevention could diminish in some measure the projected explosion in the number of persons affected with the disease in the next few decades." Dr. Seshadri explains, "Currently there are no effective treatments to prevent or cure dementia; however, our study offers hope that some of the dementia cases might be preventable—or at least delayed—through primary (keep the disease process from starting) or secondary (keep it from progressing to clinically obvious dementia) progression."
According to Dr. Seshadri's team, more people today are taking heed of admonishments to monitor their blood pressure and cholesterol. Fewer people smoke. Our level of education, which is linked with cognitive well-being, is on average higher. And improved care for people who've experienced a stroke, heart attack or head injury helps these patients recover with less cognitive impairment than in the past.
Listen to Dr. Sudha Seshadri discuss the Boston University School of Medicine study here.
The "Do This, Don't Do That" of Brain Health
So what can we do to be part of this trend? While not all dementia can be prevented, memory health experts offer a to-do list to lower the risk:
Get enough exercise. Study after study shows that physical activity is a top factor in brain health. Every little bit helps, and an exercise program need not be strenuous. Talk to your doctor about the workout that's best for you. It will no doubt include aerobic, muscle-strengthening and stretching activities. Mindfulness exercises such as yoga and tai chi also have proven to have benefit.
Give your brain a workout, too. Studies show that education is protective of brain health throughout life. Using our brains helps build stronger neural connections that help us ward off the symptoms of dementia. Fortunately, it's never too late to benefit from learning a new skill, taking a class or studying a foreign language.
Choose a brain-healthy diet. Nutritionists and neurologists continue to refine their nutritional recommendations, but in general, what’s good for the heart is good for the brain. Eat lots of fruits and vegetables, whole grains and healthy fats, and avoid heavily processed foods and trans fats.
Have your medications reviewed. The medications we take help us manage health conditions that are bad for our brains, including heart disease, high blood pressure, diabetes, high cholesterol and depression. On the other hand, some medicines may have a negative effect on our brain. Talk to your healthcare provider or pharmacist about all the medicines you take, both prescription and nonprescription.
Stop smoking and don't drink to excess. Smoking increases the risk of cognitive decline. Talk to your doctor about a smoking cessation program if you've tried unsuccessfully on your own. And when it comes to alcoholic beverages, the verdict is somewhat out on whether moderate drinking is good for the brain—but we do know that drinking too much is linked to brain shrinkage and other mental problems.
What About People Already Diagnosed With Dementia?
Dr. Seshadri's team reminds us that when a person has been diagnosed with Alzheimer's disease or a related dementia, or has suffered a head injury, stroke or other brain-damaging event, brain-healthy lifestyle choices can still be of benefit. In the case of head injury or stroke, a patient may experience significant recovery. And even if the diagnosis is Alzheimer's, diet, exercise, socialization and mood-boosting activities may slow the progression of the disease.
Dementia care today is very different than it was in the past. Today, the emphasis is on helping the person maintain a good quality of life—not only because it's the right thing to do, but also because it helps preserve the abilities a person has left. Care for people with dementia, therefore, revolves not only around their healthcare needs, but also their needs as individuals. Today's professional in-home caregivers are at the forefront of understanding this, and good dementia care is personalized in areas such as …
Diet—Caregivers prepare meals that not only meet clients' nutritional needs, but also provide enjoyment and the incentive to eat. An outing to the grocery store can stimulate the appetite, and if a client has trouble eating, trained caregivers can help with adaptive devices and appropriate food preparation.
Exercise and social connections—Physical activity protects the brain, provides a sense of well-being and improves sleep. And as we saw in "Preserving Social Connections When a Loved One Has Alzheimer's" in the May 2016 issue of Caring Right at Home, loneliness can have a powerful negative effect on people with dementia. Trained caregivers provide companionship as clients engage in safe, appropriate physical activity and social events.
Maintaining dignity—People with dementia are not children, and they should always be treated and spoken to with respect. For example, a person with dementia may not realize they've had an incontinence accident or that they've spilled food on their clothing, yet caring, nonjudgmental personal care provided by a professional caregiver not only promotes good hygiene, but also makes for more comfortable social interactions with other people.
A safe environment—While people with memory and thinking problems require more supervision to be safe, chances are they haven't lost their desire for independence. Trained in-home caregivers know how to provide just the right amount of assistance—unobtrusively, in a nonconfrontational way. They also are mindful to keep the home clear of clutter and other hazards.
Understanding—Dementia caregivers must keep one thing in mind: Many behavior changes caused by the disease or condition are really "the disease talking." Wandering away from the home might mean that a client is looking for something or someone. Aggressive behavior might mean that the client is afraid or in pain. Hallucinations and confusion are ways the mind tries to make sense of things. Professional caregivers are trained to acknowledge these underlying needs with creative solutions and patience.
Next month in Caring Right at Home: Stress and depression also raise the risk of dementia. Family caregivers are key to the emotional health of their loved ones—but is it to the detriment of their own well-being? If you or someone you know is a caregiver, check out tips for regaining balance in life. (If you haven't done so already, subscribe to Caring Right at Home and you’ll get a reminder in your inbox when each issue is published.)
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