People have long thought that dementia is unavoidable if you carry risky genes. Now research is slowly but surely debunking this fateful thinking as mounting evidence suggests lifestyle changes could help people retain control over their mental faculties.
In fact, a recent study collated the latest research and found that controllable factors could account for around 35% of the dementia burden – larger than that attributed to the genes typically linked with Alzheimer’s disease, the most common form of dementia.
Signposts have long pointed the way – physical conditions like hypertension, inflammation and heart disease confer greater risk of dementia. So it’s really a no-brainer that the benefits of looking after our physical wellbeing extend to better mental health.
In 2013, Spanish researchers allocated 522 people aged 55-80 at high risk for heart disease to a Mediterranean diet or low-fat diet. More than six years later, those in the Mediterranean diet group had less heart disease and scored higher on cognitive tests used for dementia.
Indeed, research has found that people who follow a Mediterranean diet have less brain atrophy and amyloid-ß that is typical of Alzheimer’s. “If you follow a Western diet, your brain ages faster. A Mediterranean diet is protective,” says neuroscientist Lisa Mosconi.
The traditional Mediterranean diet is high in plant foods: vegetables, fruit, legumes, nuts, seeds and wholegrains, and extra virgin olive oil for cooking and salads. It also features moderate consumption of fish, fermented dairy (cheese, yoghurt) and red wine with meals, and very little processed food or meat.
Physical activity has numerous health benefits, from reducing risk of heart disease and diabetes to some cancers. A grouped analysis of 15 studies in 2010 found that across the board, exercise can also protect against cognitive decline.
Other studies have shown that physical activity can enhance blood flow to the brain and increase levels of brain-derived neurotropic factor – a protective protein.
Even if you don’t fancy donning gym gear and sweating it out with aerobics classes and barbells, just taking opportunities each day to walk, move and be active will reap physical and mental rewards.
Keeping the brain active also confers striking protection against Alzheimer’s disease. Staying educated encourages new neural connections that might compensate for cognitive decline with aging. “It future-proofs your brain,” according to researcher Leon Flicker.
Even people who don’t pursue ongoing education can boost their cognitive reserves in other ways, like reading, doing puzzles or attending quiz nights. Quiz nights may have additional benefits – having a strong social network can also keep the brain healthy. Even being married reduces dementia risk dramatically.
In 2017, researchers pooled data from 27 studies on sleep. They found that sleep problems increase risk of cognitive impairment by 65% and could account for up to 15% of Alzheimer’s diagnoses.
Other protective factors include not smoking and maintaining a healthy weight and blood pressure.
Even if you have a genetic predisposition for Alzheimer’s disease, “there are still things you can do,” says Finnish geriatric epidemiologist Tiia Ngandu.
Richard Isaacson has set up a clinic for preventing Alzheimer’s in the US. The clinic offers individualised prevention strategies for people at risk for dementia.
Based on data they have collected, he estimates that 60% of lifestyle recommendations will apply to most people. Beyond that, strategies may vary from person to person, including, for instance, specific treatments for heart conditions or sleep problems.
Researchers are now optimistic that people can prevent their risk of dementia, and current large studies are underway to strengthen the evidence base.
Some decline in cognitive faculties is inevitable in the twilight years. But several lifestyle factors can help mitigate waning acuity and increasing forgetfulness. One of those could be a pine bark extract that has antioxidant and anti-inflammatory properties.
Fading mental functions and thought processes that occur with aging impact attention, speed of processing information, memory and other aspects of intelligence. The reasons for this are not fully understood. But the accelerated oxidative stress that occurs in aging could be a factor.
A recent study, published by researchers at the Swinburne University of Technology in Melbourne, found that F2-Isoprostanes – a marker of oxidative stress – were associated with impaired ability to verbally retrieve episodic memories in healthy older adults.
Chronic inflammation could also contribute – it has been linked to several chronic conditions including heart disease, depression and dementia, and might help explain the high overlap between these diseases.
A 2017 study investigated blood markers of inflammation in 1,633 adults aged 53 on average. At a follow-up 24 years later, higher levels of inflammation were associated with poorer episodic memory and reduced volume of the hippocampus – a brain region associated with memory – and other areas of the brain associated with Alzheimer’s disease.
A body of research has investigated health benefits of Pycnogenol, the registered trademark name for a product derived from the bark of a pine tree (Pinus pinaster). The active ingredient is also contained in peanut skin, grape seed, and witch hazel bark.
Pycnogenol contains several polyphenolic compounds with antioxidant and anti-inflammatory properties. Some evidence suggests it could reduce symptoms of allergy and asthma and improve circulation and symptoms of ADHD in children.
It may alleviate problems associated with clogged arteries, deep vein thrombosis, high blood sugar, circulation problems in diabetes, blood pressure, menopause and other physical ailments, but more evidence is needed.
Some research has shown that taking Pycnogenol could improve mental function and memory in adults both young and old.
A study published last month builds on this evidence in 55 to 70-year-old healthy adults with signs of mild cognitive impairment – a risk factor for Alzheimer’s disease.
All participants continued their standard care, including healthy sleep patterns, regular exercise, and low sodium and sugar meals. Additionally, half of them were given 150mg Pycnogenol per day for two months.
The treatment group’s Mini-Mental State Examination (MMSE) scores increased significantly by 4 points on average compared to about half a point in controls. The median increase was 18% in the Pycnogenol group and 2.48% in the control group.
Several other tests of cognitive function and memory improved by 19.4% to 39.4% in the treatment group compared to 0% to 12.5% in controls. The treatment group also showed a 16 percent reduction in oxidative stress.
This month saw the launch of the Healthy Ageing APAC Summit in Singapore on 12-13 June, covering a smorgasbord of topics related to nutrition and healthy ageing throughout the Asia-Pacific region.
Currently more than half of the world’s over-60s live in the Asia-Pacific. And the region’s number of older adults is expected to double from 547 million in 2016 to nearly 1.3 billion by 2050.
The summit was launched to explore how the nutrition and food industry “can meet the needs of the rapidly ageing populations of today, and more crucially, tomorrow.”
Nikki King attended the summit. “There was just so much information and networking, it really was a fabulous couple of days! I’m very lucky to have been able to attend and learn a lot.” Here are some highlights.
Presenter Chin Juen Seow from Euromonitor pointed out that healthy living has become a major trend – and not just in ageing.
He suggests this is driven by an array of social and cultural influences spanning economics, population change, technological advancement, concerns about the environment and sustainability, and changing values: “Health is the new wealth.”
As a result, 37 percent of packaged food sales in Asia are presented with a health focus, and this is predicted to increase.
Dr Lesley Braun from Blackmores presented new research suggesting that omega-3s may benefit sarcopenia. Bolstered by animal studies that show increased stimulation of muscle protein synthesis, human trials provide some evidence of improved muscle-related biomarkers in older adults after taking omega-3 supplements.
Dementia is now the second highest cause of Australian deaths. It is risky and expensive for pharmaceutical companies to develop drugs for Alzheimer’s disease – the most common form of dementia – according to Dr Shawn Watson from Senescence Life Science, with a 99.6% failure rate of clinical trials. Their focus on amyloids could be the limiting factor.
Increasing research shows that nutrition and sleep can support healthy brain function with ageing, preventing risk of Alzheimer’s via several biological mechanisms including reduced inflammation and oxidative stress. Watson reported positive results from supplementation with turmeric and ginseng.
Alzheimer’s disease has also been nicknamed “diabetes type 3.” When people eat too much sugar, cells are bombarded with insulin, which tells them to take in the glucose for energy. Over time the cells become insulin resistant, leading to diabetes and a host of related health problems. Research has linked a lack of insulin to the formation of plaques associated with Alzheimer’s – one more reason to avoid excess sugar and refined carbohydrates.
Accordingly, the glycemic index (GI) was developed to rank foods by how quickly sugar is released into the blood stream. Kathy Usic from the Glycaemic Index Foundation told the audience about an impending global roll-out of the Low GI Symbol on food packaging to help address the soaring epidemic of chronic disease.
Amidst a wave of related research on low carbohydrate/high protein diets, a study is currently underway to investigate the effects of a low-GI high-protein diet on pre-diabetes/type 2 diabetes prevention. Watch this space!
People may be living longer, but quality of life tends to wane with aging. The burden of disease increases significantly after age 65. As a result, older adults commonly take multiple medications, further exacerbating their risk of frailty and premature death.
But it doesn’t have to be like this. Chronic diseases have solid foundations in lifestyle behaviours, including diet. Addressing some common myths around diet and nutrition in older adults can shine some light on healthy aging.
People lose muscle mass with aging, resulting in lower energy needs. But it’s important to stay active and maintain strong muscles, which also support good bone density. Even if slower metabolism reduces calorie requirements, more than ever, older adults need a full range of nutrients and fibre from a variety of whole foods to maintain good health.
Taste and smell can decline with age, impacting appetite. But skipping meals can cause a downward spiral. It can lower blood glucose levels and increase risk of malnutrition. If appetite is low, eat sweet fruit, add salt and herbs to meals for flavour, and have small portions and regular snacks with high nutrition density – ensuring protein needs are met.
Nutritional supplements can never replace the full range of vitamins, minerals, protein, healthy fats, polyphenols and fibre provided by a whole food diet. Sometimes they are necessary to supplement a healthy diet though. Vitamins most at risk in aging are B12 and Vitamin D. Protein shakes can provide a concentrated protein source if appetite is low.
Although a little extra padding is okay in older years, overweight and obesity increase risk of chronic disease at any age. It is recommended that older people who are overweight shed 5-10% of their body weight over 6 months for improved health. The best approach is to eat whole foods and avoid highly processed foods with refined carbohydrates and unhealthy fats.
While overweight and underweight bring a host of health problems, poor health can still afflict people in the normal weight range. An unhealthy diet can cause chronic inflammation – associated with a range of physical and mental health problems. A whole food diet low in processed foods is important at any age or weight.
Thirst is not generally a reliable indicator of fluid needs, particularly in older years when thirst sensation declines. For this and several other reasons, dehydration is an oft-overlooked problem in older adults. It can lead to poor health, hospitalisation and death. Even mild dehydration can cause weakness, dizziness, low blood pressure and increased falls risk. Ensure plenty of fluids are freely available, particularly water and herbal tea.
Although body parts endure gradual wear and tear with age, being sick is not normal. Good health can be maintained with good nutrition, regular hydration, healthy weight, physical activity, mental stimulation, social engagement and careful monitoring of any unnecessary medications.
Dementia risk is associated with several lifestyle factors including low physical activity and poor diet. Research suggests a Mediterranean-style diet – high in plant foods and healthy fats with moderate amounts of fish and dairy and low intakes of red meat and processed food – is protective. B vitamins, antioxidants (abundant in plant foods) and omega-3s may also reduce dementia risk.