Dementia: What Helps the Heart Helps the Brain
Dementia is a disorder categorized by a loss or a decline of at least two of the following: learning and memory, language skills, visual perception, problem solving, self-management, or the ability to focus and pay attention. The cognitive deficits must account for a significant decline from baseline cognitive function and be severe enough to interfere with everyday activities and independence. Most forms of dementia are progressive with symptoms gradually worsening over time.
Sound familiar? Just because you can identify with any of the above symptoms does not mean you have dementia.
Normal aging is associated with mild changes in memory (delayed recall) and information processing that are not progressive and do not interfere with daily activities.
Mild cognitive impairment (MCI) is a measurable decline in cognitive skills greater than that expected for normal aging. MCI may be an intermediate stage between normal aging and dementia and thus may be a target for early investigation and intervention.
Neurogenerative disorders cause over 80% of dementia syndromes. These include Alzheimer’s disease (accounting for 60-80% of all dementia cases), Lewy body dementia, frontotemporal dementia, and Parkinson’s disease dementia. Vascular dementia, which occurs after a stroke (post-stroke dementia), is the second most common type of dementia, accounting for 10% of cases.
Dementia occurs when damaged brain cells lose the ability to communicate effectively with each other. Specific brain regions are responsible for different functions (such as movement, memory, and communication). Damage to a specific region of the brain produces a characteristic deficit relating to the function of that area of the brain.
Therefore, different types of dementia are associated with specific regions of brain. For example, in Alzheimer’s disease, the first and most extensively damaged brain cells are located in the region called the hippocampus, which is the brain’s center of learning and memory.
Is important to mention that even though most dementia disorders are permanent and progress over time, cognitive and memory problems caused by depression, vitamin deficiencies, thyroid problems, alcohol abuse, or medication side effects may improve when the condition is treated.
There is no specific test to determine if someone has dementia. The diagnosis of Alzheimer’s and other types of dementia is based on a combination of a detailed medical history, a physical exam, laboratory tests, and the characteristic changes in day-to-day function, behavior, and thinking.
Treatment of dementia depends on its cause. In most progressive dementias, including Alzheimer’s disease, there is no cure or treatment that slows or stops its progression. But there are alternative drug treatments that may temporarily improve symptoms. The same medications used to treat symptoms in people with Alzheimer’s are also sometimes prescribed to help those with other types of dementias.
Some risk factors for dementia, such as age and genetics, cannot be modified. Diet and exercise are the most important non-medication therapies shown to slow the progression of symptoms. Controlling cardiovascular risk factors may also reduce the risk of dementia and slow its progression.
Cardiovascular risk factors
Damaged blood vessels in the brain are related to vascular dementia. These changes in the blood vessels may contribute to a faster decline or make impairments more severe.The same strategies used to protect the heart can help protect the brain. Controlling blood pressure to an average of 120/80 mmHg has been shown to reduce the onset of mild cognitive impairment—the earliest measurable sign of dementia. Maintaining a healthy weight, keeping cholesterol and blood sugar levels in the normal range, and abstaining from all tobacco products may help improve overall cardiovascular risk and thus the risk of vascular dementia. (Calculate your body mass index BMI) (click here to know your ideal numbers)
Regular physical exercise may help lower the risk of some types of dementia. Evidence suggests exercise may directly benefit brain cells by increasing blood and oxygen flow to the brain.
What you eat matters. Diet can improve brain health by improving heart healthFurthermore, many studies suggest that heart-healthy eating, such as the Mediterranean diet, may also help protect the brain. A Mediterranean diet includes eating relatively little red meat and more whole grains, fruits and vegetables, fish and shellfish, nuts, olive oil, and other healthy fats (click here to know more about the Mediterranean diet).
And remember…if you or someone you know is experiencing memory difficulties or other changes in cognitive skills, don’t ignore them. Seek help in determining the cause. A professional evaluation may detect a treatable condition. And even if symptoms suggest dementia, early diagnosis allows a person to get the maximum benefit from available treatments and provides an opportunity to participate in clinical trials or studies. Early diagnosis also provides time to plan for the future.
Until Next Time!
Thank you to Karla Campos, MD for her assistance in this issue of Straight Talk.