Alzheimer's

Stuart Kieran, MD
I'm often asked questions regarding Alzheimer's, dementia and memory. One of the most common questions is: What can I do to slow down or prevent dementia? This can be answered in 2 ways. One way is to do things that help improve memory and other mental functioning now, and the other way is to do things that can decrease the risk of developing dementia. Things that can improve memory include social interactions, keeping physically fit, aerobic exercise and mental exercise such as games, puzzles, and new mental challenges. A recent study has shown that a Mediterranean type diet with fish, fruits, vegetables and moderate degree of unsaturated fats decrease the risk of Alzheimer's disease and stroke. The other aspect is risk modification. While there is nothing that can definitely prevent the onset of Alzheimer's, or other types of dementia, we can decrease the odds of getting it. These things overlap with the above but with more emphasis on general health, and in particular cardiovascular health. It is now felt that what is good for the heart is good for the brain. So again things such as aerobic exercise, proper diet, and attention to blood pressure, blood sugars and not smoking will decrease the risk for heart disease, stroke, and dementia. Sometimes I am asked, "What's the point in doing these things if there is nothing that can definitely prevent mental decline?" The answer lies in a comparison between heart disease and dementia. For example lowering one's cholesterol will not guarantee that someone will not have a myocardial infarction, however it will significantly decrease one's chance of getting one. Added to other risk factor modifications, such as described above and the odds of having Alzheimer's disease are significantly reduced. While it's correct that nothing is guaranteed, it certainly would be a good idea if we can decrease the risk of having Alzheimer's by 25 to 50%, for example by doing the above things.

Are there any nutrients that improve memory for prevent Alzheimer's disease? The short answer is no, in that there is no one particular nutrient that treats or prevents dementia. If one is found to have a deficiency, for example of vitamin B12 then supplementation with that will prevent dementia or other complications of vitamin B12 deficiency. As a general rule, however, specific supplements, vitamins, coenzymes or herbs will not prevent Alzheimer's disease. However, I still return to the point of proper diet in general, i.e. not a specific nutrient that will decrease the risk of Alzheimer's disease.

Do brain exercises help? The answer is probably yes. Whether they are preventative is not entirely clear but many studies have shown that mental exercising does improve brain function. Tasks/games that are difficult to the point of being a challenge yet not so difficult as to be frustrating are ideal. Puzzles, games and other activities - especially if they involve social interactions and physical activity can improve mental functioning. These things however have to be done regularly and have to remain challenging. This sometimes goes to a larger issue of our reliance on technology. We have to be careful that some of the electronic devices that we have available don't make our lives too easy. Smart phones, Internet, social media communicating are all wonderful things but it may not be a bad idea to use some old-school technologies such as paper, pencil, dictionaries and books. Indeed Socrates said over 2000 years ago that writing would be the ruin of civilization because people would not memorize things anymore.

While that may be a little melodramatic, I would question how many of us, even classical Greek scholars have the Iliad memorized.

Questions and or comments regarding this week's health column please contact, Stuart Kieran, MD at Bitterroot Neurology 1019 West Main Street, Hamilton, MT 59840. Working together to build a healthier community!