Think of your brain as a filing cabinet, every memory you’ve ever made tucked neatly away for safekeeping. This is the analogy Tam Cummings uses to explain the effect of dementia. “Dementia will go backwards through those memories,” says Cummings, a gerontologist who specializes in Alzheimer’s and other dementias.
Said to account for at least two-thirds of cases in the United States, Alzheimer’s disease is the most common form of dementia. The second is vascular dementia, also known as post-stroke dementia, and is largely caused by lifestyle factors such as smoking or high blood pressure. Other common forms include frontotemporal dementias, which affect personality and language; dementia with Lewy bodies, which can produce vivid hallucinations, and detailed delusions. Dementias associated with Parkinson’s, Huntington’s disease and Wernicke-Korsakoff dementia, which is associated with alcohol abuse, are also commonly seen.
In diagnosing dementia, doctors look at the five parts of cognitive function: memory, executive function, personality, speech and language and visual perception.
“The definition of dementia is when two or more out of the five interferes with activities of daily living,” explains Dr. Ronald Devere, a Texas-based neurologist who founded the Alzheimer’s Disease and Memory Disorder Clinic now located in Austin. “That’s the key. It must interfere with ADLs.”
“There’s an entity that we call benign senescent forgetfulness,” explains Dr. Insung Kim, a physician with Saint Francis Health System in Tulsa who specializes in geriatric medicine. “Short-term memory loss that comes with aging and tends to have no real serious consequences.”
Kim says it only becomes a concern when an individual begins asking repetitive questions or having issues with visual spatial skills, such as getting lost or having difficulty driving.
Perhaps the most important factor in cognitive strength is the management of high risk factors. Blood pressure, cholesterol and sugar intake are among the first things doctors will address when dealing with the potential for these disorders.
“These things are easily treated, and they’re more important than worrying about Alzheimer’s,” says Devere.
It’s important to address things early.
“We may be able to find certain reversible causes,” explains Kim. “Low thyroid, low calcium or B-12, uncontrolled sugar or even too many medications (can) affect thought process.”
While dementia itself is irreversible, a lot of the medications on the market are successful in slowing the progression of mental decline caused by the disease.
Much of the research being done today is dedicated to finding ways to identify the disease in an individual before it develops rather than treating it in its active stage.
“Everything is hitting the pre-symptomatic phase, almost 90 percent of the research is trying to be proactive,” notes Devere. “It’s, ‘Can we get rid of it before you develop symptoms?’”
As we age, we must continue to challenge ourselves.
The number one recommendation for keeping the mind engaged is exercise, as it increases blood flow to the brain. Staying social is also important.
Other recommendations include playing cards, completing puzzles such as word searches and Sudoku, and reading. Learning to play an instrument can also be a great way to stimulate a new part of your brain.
“Try to learn new words every week, take up ballroom dancing or bowling, something to stimulate those neurons,” advises Kim, who says continued learning may help slow down the process of cognitive impairment.
“Keep your brain working,” says Devere. “If you don’t use it, you lose it.”
