Can we reduce the risk?

September is World Alzheimer’s Month (#WAM2014), an international campaign to raise awareness and challenge stigma that is led by Alzheimer’s Disease International. For 2014, the focus is on ways to reduce the risk of developing dementia with brain friendly lifestyles.

Reduction and prevention of dementia are two very interesting topics. Ever since I began this blog and my wider work, I’ve met people from all walks of life who’ve heard my dad’s story and then asked me what they can do to ensure that they don’t develop a type of dementia.  Based on that, you’d assume that it would be something I’d have written about extensively, but reduction and prevention of dementia don’t seem to make for very popular copy.

In 2012 I wrote ‘Five-a-day to keep dementia away?’ and aside from touching on prevention and reduction in relation to other areas of dementia policy and care, that is the sum total of my writing on these topics to date. It seems that when I’m actively involved in face-to-face discussions, people are genuinely interested in any tips I might have that could help them avoid developing dementia, but there isn’t much appetite for reading about it, despite the fact that dementia is said to be the most feared disease for the over 50’s.

The people who are most actively interested in preventative advice are usually those who’ve been so deeply personally affected by a particular disease that they would do anything to avoid either developing it themselves or seeing other family members living with it. That is certainly true for us as a family. 

My childhood was full of general messages about healthy lifestyles, all of which have stood me in very good stead as an adult. Those messages weren’t linked to avoiding dementia, it was just good advice. Only in the aftermath of my dad’s diagnosis did my mum ask one of his consultants what measures she could take to try and avoid developing dementia. The advice, for what it’s worth, was to take Gingko Biloba.

Gingko, like everything from coconut oil to vitamin D, has been linked to reduction and prevention of dementia. I don’t want to get into the science behind the various claims and counterclaims – I would argue that anything healthy at moderate levels is the common sense approach, but I am not medically or scientifically qualified to take that theory any further.

Ultimately, of course, we are all responsible for ourselves. Prevention of any disease comes with it elements of sacrifice. No one has ever said that eating rubbish, drinking to excess, smoking 50-a-day and never taking exercise is good for you. Some people may be able to go through life like that and live to a ripe age without a complaint in the world, but most of us can’t, and who wants to take the risk that they are in the majority? Sadly far too many people it seems.

Moderation is necessary in all things related to lifestyle, along with education, common sense, an immunity to persuasive advertising campaigns and a basic sense of responsibility to yourself and your loved ones. From the perspective of a healthy lifestyle, this translates in very general terms to:  

• Eating a little of what you fancy does you good, but a lot is likely to give you problems. If it comes out of a packet rather than out of a field, be particularly suspicious.
• Most people can enjoy an occasional social drink without any problems, but anything beyond that will probably be killing off too many brain cells. In other words, a glass may be ok, but a bottle isn’t.
• If you were meant to smoke, you would have been given a chimney in your head (a gem from my parents that was regularly mentioned around the meal table during my childhood – to this day I have never even tried a cigarette).
• Humans were designed to exercise, and as much as some of us may dislike it (myself included!) we are sadly going to have to accept that fact and find something active to do that makes exercise as enjoyable as possible (and let’s face it there are LOADS of options, disliking the gym isn’t an excuse.)

Ultimately healthy genes and a good standard of living where you are knowledgeable, in decent housing, not living in food poverty and have access to outside spaces for recreation are also necessary, it’s just that they are rarely talked about because they touch on big social issues that aren’t entirely comfortable for policy makers. 

 

On a personal level, the most precious skill my parents (mostly my mum) ever taught me was the ability to cook (the joy of cooking with my dad’s home-grown fruits and vegetables was a particular highlight). Making healthy, nutritious meals is the sort of daily life skill that many adults who live off of processed and packaged food would benefit from, and I count myself exceptionally fortunate that I love cooking. That early education from my mum and dad is the essence of good parenting. I was very lucky – others sadly aren’t.

 

I predict that during this year’s World Alzheimer's Month we will see a lot of coverage given to the idea that ‘What’s good for your heart is good for your head’. A great slogan that is yet to really seep into the public consciousness, but maybe September 2014 is the month when some real traction will be given to the vitally important and still greatly neglected reduction and prevention agenda.

World Alzheimer's Month 2014 - Graphic from Alzheimer's Disease International



I love this graphic from Alzheimer’s Disease International for #WAM2014 with five great tips that we can all try to achieve:

• Look after your heart
• Be physically active
• Follow a healthy diet
• Challenge your brain
• Enjoy social activity

For my part, I’m going to start my latest exercise regime – trying to meet the NHS target of 150 minutes of moderate-intensity exercise a week with additional muscle strengthening exercise. I’ve failed with so many exercise regimes, but with renewed enthusiasm I will try to get fitter and reduce my own risk of dementia and other health problems.

 

Carpe diem – Seize the day!

 

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Five-a-day to keep dementia away?

Fish pie - Brain food?

One of the things I am most frequently asked is how do you prevent getting dementia? People who have seen how this disease eventually ravages a person would do anything to avoid getting it, and those who have no first-hand experience, but then hear about my father’s physical and mental decline, are generally keen to avoid developing dementia.

Sadly there is no magic solution to prevent getting this disease. The healthiest and most physically and mentally active can still develop some form of dementia during their lives. My father is a prime example of this: he was a very active, hard-working man with a healthy outdoor lifestyle, who very rarely smoked his pipe and only occasionally enjoyed alcohol. Prior to developing dementia he was not over-weight, and had a healthy diet with lots of fruit and vegetables.

The tipping point, in my father’s case, was retirement. His previously busy life as a farmer suddenly stopped; the adjustment coincided with him losing interest in some of his hobbies and his life became more sedentary. The huge mental upheaval of no longer being a working man took its toll, and where his life had previously been about the dawn-till-dusk responsibilities and expectations of tending his animals, he was suddenly as free as a bird. Sadly, however, he never found his wings within this new existence.

Very gradually the type of vascular dementia known as multi-infarct dementia (which is caused by a series of small strokes), set in. These strokes were so tiny that for a long time dad never reported any change in how he felt, even though the strokes had begun to wreak havoc in his brain, and by the time symptoms of what we now know was dad’s dementia were very obvious, damage had occurred, and would continue to for many years before he finally had a diagnosis.

Other relatives in dad’s care home also reported that their loved ones had led healthy and active lives prior to developing dementia, so is there any answer to the question of how to avoid the big D?

Given my interest and research into this subject over many years, and the expert advice, studies and tips I see on a daily basis as part of my job, I would love to report that there is a fail-safe way to avoid developing dementia. To date this has not been found though, and however well people can live with this disease, and I truly believe they can with personalised, therapeutic care in community settings that value, support and embrace them as a person, there will obviously never be a substitute for prevention.

I am not medically trained, but I absorb all the information available and one of the most powerful messages is the one reminding us that what is good for the heart is also good for the brain. I am a great believer in fresh, wholesome food, rich in fruit and vegetables, low in dairy and with meat and fish in moderation. In short, the key to our food and drink intake seems to be about maintaining a good 20% acid/80% alkaline balance.

I avoid processed, ready prepared, or take away meals, always cook from raw ingredients (including staple items like bread), and never touch anything with additives in it. I would rather have a teaspoon of raw cane sugar than anything with so much as a particle of artificial sweetener in it. In fact, in all three of my father’s care homes, where they offered residents squash (laden with artificial sweeteners) throughout the day, we banned them from feeding this to my father and brought him in pure fruit smoothies instead. We firmly believe that the nutrition within those drinks (especially considering that he could eat very few fruits raw due to his swallowing problems), helped his body to recover from the dozens of chest and bladder infections that he endured during the last few years of his life, proving what I wrote about here, that good nutrition is vital to not only preventing dementia but helping those already living with it to have a better quality of life.

I exercise as much as I can (I could always do better), am a big believer in natural (non-chemical) skincare, get as much rest and relaxation as my schedule will allow, and try to keep a healthy work/life balance. If giving the brain a good workout is as beneficial as we are lead to believe, then mine certainly gets a daily dose of that due to my job, and I have no desire to retire, which in the case of my generation is probably just as well! I have never smoked, rarely drink, never touch Coca Cola or the like, and confess to being addicted to water. Wherever possible I also source alternatives to pharmaceutical preparations, something I think most pharmaceutical companies would prefer isn’t encouraged. The only thing I do struggle to influence is the pollution in the atmosphere, which I would be the first to admit is very bad for you.

When my father was initially diagnosed with dementia, we sought the advice of one of the leading old-age psychiatrists treating him to find out her view on what could be done to prevent dementia. She recommended a ginkgo biloba supplement, while other advice I have read more recently suggests supplementing with B vitamins can help to keep the brain healthy. There are literally hundreds of studies out there suggesting positive associations between good brain health and different supplements or foods. What to believe is always the main problem, but my feeling on all things is generally that moderation is the key.

Granted we all have our own choices to make, our own lives to lead and face the consequences of our actions as a result. Whether mine or my family’s choices will make it any less likely that we will develop dementia only time will tell, but I firmly believe that anything that keeps you healthier generally is at least a step in the right direction.

Until next time...

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