Is it possible to prevent dementia? Maybe. In June, I attended a professional online seminar with Dr. Matthew Pase, associate professor of epidemiology at the T.H. Chan School of Public Health, Harvard University, on the topic of Preventing Dementia. In my twenty years interacting with clients, the issue of dementia is of primary concern. According to Pase, globally, two out of three people believe there is little or no understanding of dementia.
There are numerous types of
dementia, as it is a broad category of disorders. Dementia is defined as the
loss of brain [cognitive] functioning that interferes with independence and
activities of daily living. [As a reminder, memory LOSS is NOT normal aging but misplacing keys is normal at any age.] It may include personality changes and
diminished social skills. Although the risk of dementia has declined 16% in
each decade, the incidence is increasing, attributable to population aging
globally.
In
his recent study published in the Journal of the American Medical
Association [JAMA], Pase et al. (2022) found that Australian study
participants with higher socioeconomic status [higher income] have better
memory and lower dementia scores. Pace discussed how “ideal” cardiovascular
health slows vascular brain aging. It is known in the helping professions that
high income earners have better health outcomes than people living at or below
the poverty line. It was not surprising to me that higher incomes equate to initiative-taking, prescription drug adherence, and preventive care. Further, at risk populations often cannot afford their
prescription drugs and often take half doses to save money. Diet and exercise contribute to ideal cardiovascular health.
Avoiding sugary drinks and getting adequate sleep are essential for promoting
cardiovascular health. What about wearing a fitness tracking device? Is that a
good strategy toward maintaining cardiovascular health by documenting steps,
oxygen levels, and sleep? According to Pace, that is okay but some are not
accurate.
So…..
is dementia preventable? According to his recent study, and numerous others I
have reviewed, factors impacting dementia occurrence are:
·
Age
·
Geographic location [urban, suburban, rural,
etc.]
·
Socioeconomic status [SES]
·
Maintenance of healthy heart habits beginning
in early adulthood
·
Sleep
·
Exercise
·
Healthy diet
Example:
Mrs. Apple is a 65-year old smoker living alone in a rural community with daily
alcohol intake, no exercise, existing on canned food and hot dogs from the
mini-mart, consuming four Coca Colas daily, napping in the recliner instead of
sleeping in a bed, and sleep deprived from working three jobs [crossing guard,
housekeeper, and cook]. Mrs. Apple cannot afford her diabetes testing supplies or insulin. Mrs. Apple is in survival mode, trying her best to
maintain independence despite her limitations. There may be some resources Mrs.
Apple is not even aware of that can help her maintain a high quality of life
and good health outcomes.
A
shortcoming of the study was the impact of alcohol on aging overall, especially
as it impacts cognitive functioning. As I have written here recently, newer
research indicates that alcohol abstinence is a best practice for maintaining optimum
cognitive health.
As
Dr. Pace indicated, more research is needed to understand how practitioners can
promote heart health among those living in poverty and with low income, as they
have fewer resources at their disposal. Memory assessments must be developed
for lower income seniors and minorities and should be more relatable to everyday
daily functioning.
Dr. Pace’s credentials:
https://www.hsph.harvard.edu/profile/matthew-p-pase/
Pase, M.P, Rowsthorn, E., Cavuoto, M.G., et al. (2022). Association of neighborhood-level socioeconomic measures with cognition and dementia
risk in Australian adults. JAMA
Netw Open, 5(3):e224071.
doi:10.1001/jamanetworkopen.2022.4071 Retrieved from
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790517
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