If you knew that making critical lifestyle changes now might result in avoiding dementia or Alzheimer’s later, would you make them? Recent research indicates that lifestyle choices, exercise and certain activities may have an impact on those who suffer from dementia or Alzheimer’s.

First things first, the bad news is that some people are destined to have dementia and Alzheimer’s. The Alzheimer’s Association of Washington D.C., reports that greatest risk factors to late-onset “sporadic” Alzheimer’s disease and other dementias are age, family history, and genetic susceptibility genes. These are the factors that cannot be modified by medicine or lifestyle choices. The association reports that “an estimated 47 million people worldwide are living with dementia in 2015 and this number is expected to triple by 2050.”¹

The good news is that there may be more that you can do to help yourself than you might imagine.

For those of you with aging parents, and people entering into their twilight years, the above statistics are quite chilling. The good news is that there may be more that you can do to help yourself than you might imagine. The following information is a compendium of risk factors for dementia and Alzheimer’s. Also included in this article is information on the Chinese medicine perspective and treatment of dementia and Alzheimer’s.

RISK FACTORS

Diabetes
There appears to be a strong correlation between those who have diabetes and mild cognitive impairment and dementia.

Weight
Those who are obese at mid-life are at a higher risk, but those later in life, who are obese, are at a reduced risk for dementia and Alzheimer’s.

Hypertension and elevated cholesterol
According to research, mid-life hypertension may have a link with cognitive decline but the jury is still out on a direct link with dementia. There has not been a direct link proven between elevated cholesterol, but it is listed as one of the risk factors.

LIFE STYLE RISK FACTORS

Smoking
Researchers have found a link between smoking and cognitive decline and dementia.

Being active
Studies have found that even mild physical activity has a positive bearing on cognitive function and that even inactive seniors who begin a regular exercise program can improve.

Diet
Researchers have found that eating a healthy diet — Mediterranean diet or Mediterranean-DASH diet — consisting of whole grains, fruits and vegetables, fish, nuts and olive oils, with little or no red meat is indicated to reduce the risk of dementia.

Alcohol
Interestingly, researchers have found that there may be a correlation between mild alcohol consumption and the reduced risk of dementia, however experts are reluctant to advise seniors to start drinking, due to risk of falls.

Cognitive training and social engagement
Both of these factors have shown to have some benefit in reducing cognitive decline, however more research is necessary. Interestingly, in a 2003 opinion piece in the New England Journal of Medicine, Dr. Joseph T Coyle quoted a study that indicated that seniors who participate in effortful leisure activities such as playing board games, reading and learning to play a musical instrument were more protected against dementia than those who did only physical activity. He said, “effortful mental activity may not only strengthen existing synaptic connections and generate new ones, it may also stimulate neurogenesis, especially in the hippocampus.” Thus, persistent engagement in effortful mental activities may promote plastic changes in the brain that circumvent the pathology underlying the symptoms of dementia.”²

… effortful mental activity may not only strengthen existing synaptic connections and generate new ones, it may also stimulate neurogenesis, especially in the hippocampus.

Dr. Coyle also mentioned research that found that nuns who wrote diaries with very complex sentence structure in early adulthood seemed to be protected against dementia in their later years. Therefore, even elderly people may benefit from brain plasticity through activities that stimulate the brain.

OTHER RISKS

Level of education
There appears to be a correlation between years of education and dementia. People with more years of education seem to be at less of a risk of dementia than those with fewer years.

Traumatic brain injury
Athletes and soldiers who have suffered repeated blows to the head resulting in traumatic brain injury may be more at risk of cognitive decline and dementia.

Depression and sleeping disorders
Those who have suffered depression may be at risk but further research is needed. People who have sleeping disorders may be at risk of cognitive decline. Experts are still trying to understand whether depression and or sleeping disorders cause dementia or are a precursor.

The Alzheimer’s association concluded that the best approach to mitigating the risk of cognitive decline and dementia is a proactive approach involving lifestyle changes including regular exercise, a healthy low-fat diet, life-long learning, and social interaction.

CHINESE MEDICINE PERSPECTIVE

According to Chinese medicine, dementia and Alzheimer’s come about through a weakening of the kidney energy as a consequence of aging. The energy of the kidneys is thought of as the life force — the Chi — that drives and animates the body. The kidneys in Chinese medicine correspond to the adrenal glands that perform an important function in maintaining the balance of energy in the body through the balance of hormones. The adrenals regulate cortisol levels in the blood and help us out by supplying energy in emergency situations through the “flight or fight system.” When people get burned out it is because the adrenals get tapped-out or fatigued. Therapeutic approaches in Chinese medicine involve supporting the kidneys (adrenals) and building up a person when illness strikes. Chinese medicine treats dementia and Alzheimer’s by supporting and replenishing the energy to the adrenal glands. This support comes in the form of herbs, acupuncture, Chinese massotherapy, and exercises such as Tai Chi and Chi Kung.

Chinese medicine treats dementia and Alzheimer’s by supporting and replenishing the energy to the adrenal glands. This support comes in the form of herbs, acupuncture, Chinese massotherapy, and exercises such as Tai Chi and Chi Kung.

Effortful activities and dementia
In a study published in the International Journal of Geriatric Psychiatry, researchers concluded that Tai Chi might provide a cognitive benefit. They studied 389 geriatric participants with dementia or mild cognitive impairment. They divided participants into a Tai Chi group and a strengthening and toning group. After 5 weeks of tri-weekly practice sessions both groups showed improvement in cognitive function, delayed recall and subjective complaints. However only the Tai Chi group maintained a stable clinical dementia rating and showed improvements in visual spans. Other studies have shown that Tai Chi improves motor speed and visual attention in elderly individuals.³

To learn Tai Chi you must memorize a choreography of dance-like movements. Because it is an exercise that involves an effortful mental activity it may have the effect of improving the brain through plasticity. Tai Chi may increase brain volume and cognition in non-demented elders. Researchers studied 120 elderly people from Shanghai China. Participants were randomized into 4 groups (Tai Chi, Walking, Social Interaction, and No Intervention). Researchers administered MRIs to participants before and after the intervention period, also a neuropsychological battery was administered at 20 weeks and 40 weeks. Researchers found that the Tai Chi group faired best of the four with an increase in brain volume and best overall scores in cognition.⁴ Research has also found that Tai Chi may help those with Parkinson’s.

To learn Tai Chi you must memorize a choreography of dance-like movements. Because it is an exercise that involves an effortful mental activity it may have the effect of improving the brain through plasticity.

We cannot escape our genes, and the fact is that we all are aging and many will end up with dementia and Alzheimer’s. But research indicates that some of us may be able to improve our odds by practicing a healthy lifestyle including exercise, good diet, social interaction, healthy weight and blood pressure. A common thread in research also indicates that effortful activities such as reading, writing, learning a musical instrument and exercises that require memorization such as Tai Chi, and Chi Kung may be helpful in warding off dementia and Alzheimer’s.

1. M. Baumgart et al. /Alzheimer’s & Dementia 11 (2015) 718-726
2. N Eng J MED 348;25 June 19, 2003
3. Int J Geriatr Psychiatry. 2011; 26(21495078): 733-740.
4. J Alzheimers Dis. 2012; 30(4): 757-766. Doi: 10.3233/JAD-2012-120079