This month’s post is again from Ken Pope’s listserv, where he kindly provides daily summaries of current articles in the field.
The article is as follows (excerpting and editing is by Ken Pope):
This morning’s Globe & Mail includes an article: “Dementia is not a runaway train. We can delay its onset” by Andre Picard.
Here are some excerpts:
There are few things that aging baby boomers fear more than dementia, a condition that robs one of memory – and too often dignity – and leaves you dying little by little, piece by piece.
The numbers are frightful: An estimated 564,000 Canadians are currently living with dementia, and that figure is expected to rise to 937,000 within 15 years.
Globally, it is estimated that almost 50 million people are afflicted with dementia and that is forecast to rise to 131 million by 2050.
Yet, there are little glimmers of hope – in particular, research showing that dementia is preventable, at least in part.
A study published in medical journal The Lancet shows one in three cases could be prevented or delayed if people took better care of their brains.
Based on a review of scientific literature and mathematical modelling, a panel of 24 global experts identified nine factors that increase the risk of dementia and how much those risks could be lowered if they were addressed.
- Mid-life hearing loss: 9 per cent;
- Failing to complete secondary (high-school and above) education: 8 per cent;
- Smoking: 6 per cent;
- Failing to seek early treatment for depression: 4 per cent;
- Physical inactivity: 3 per cent;
- Social isolation: 2 per cent;
- High blood pressure: 2 per cent;
- Obesity: 1 per cent;
- Type 2 diabetes: 1 per cent.
All told, the potential risk reduction adds up to 36 per cent – but, of course, health problems are easier to avoid in theory than in practice.
Still, some important lessons can be drawn from this list of modifiable risk factors. While things such as smoking and inactivity are commonly seen as lifestyle choices, they are largely symptoms of poor socioeconomic conditions.
That’s a reminder that, as Dr. Martin Prince of the Institute of Psychiatry, Psychology and Neuroscience at King’s College London writes in The Lancet: “Dementia selectively affects the old and frail, women and the socioeconomically and educationally disadvantaged.”
The research also drives home another key point: The brain changes at the root of dementia occur years before the onset of symptoms.
Dr. Antoine Hakim, emeritus professor of neurology at the University of Ottawa, stresses this point in his new book, Save Your Mind: Seven Rules To Avoid Dementia.
While the script for dementia is written early, perhaps as early as our teenage years, he writes, the risk of dementia is modifiable – up to and including when symptoms of cognitive decline begin – because of the plasticity of the brain.
Dementia is caused by the death of brain cells. But Dr. Hakim notes that most cases are not Alzheimer’s – characterized by tangles and plaques in the brain – but caused by vascular problems such as high blood pressure and stroke.
In other words, what’s good for the heart is good for the brain (and vice versa).
Of his seven golden rules for brain health and reducing dementia risk, Dr. Hakim’s No. 1 recommendation is to “save for a rainy day,” to grow the brain’s capacity and resiliency by exercising it like a muscle.
We can’t prevent dementia from killing people, but we can delay its onset. A one-year delay would translate into nine million fewer cases by 2050; a five-year delay would halve the prevalence of dementia globally in that same time period.
Want to stave off dementia?
Read. Write. Play music. Be physically active. Be socially engaged. Eat healthy food. Maintain a healthy weight. Sleep well. Don’t sit mindlessly in front of the TV.
Those simple counsels are the best tools we have in a world where there are no drugs or treatments that prevent dementia.
There are 100 billion neurons, trillions of contact points known as synapses and 600 kilometres of blood vessels in the brain, and “everything we do – and don’t do – affects the health of these cells and their connections,” Dr. Hakim writes.
Dementia is not a natural consequence of aging. Risk depends, in part, on genetics, and on the lifestyle “choices” we make. (And we have to be careful with that word because major factors such as poverty and education are rarely a choice.)
As The Lancet notes, “dementia is the greatest global challenge for health and social care in the 21st century.”
But it is not a runaway train. We have the ability prevent – or more realistically, delay – the disease.
We can save a lot of minds by using our heads.
The article is online at:
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FIVE STEPS TO STRENGTHEN ETHICS IN ORGANIZATIONS AND INDIVIDUALS:
EFFECTIVE STRATEGIES INFORMED BY RESEARCH AND HISTORY
AWARD ADDRESS: “THE CODE NOT TAKEN: THE PATH FROM GUILD ETHICS TO TORTURE AND OUR CONTINUING CHOICES”—
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“A man of no convictions, no habits, no traditions…by the strangest freaks of chance, as it seems, rises above the seething parties…and without attaching himself to any one of them, advances to a prominent position. The incompetence of his colleagues, the weakness and insignificance of his opponents, the frankness of the deception, and the dazzling and self-confident limitation of the man raise him…. His childish insolence and conceit gain him…glory. Innumerable so-called chance circumstances attend him everywhere. The disfavour into which he falls…turns to his advantage…. He was several times on the verge of destruction, and was every time saved in an unexpected fashion…. A whole series of outrages is perpetrated on the almost unarmed inhabitants. And the men perpetrating these atrocities, and their leader most of all, persuade themselves that it is noble, it is glory, that it is like Cæsar and Alexander of Macedon, and that it is fine. That ideal of glory and of greatness, consisting in esteeming nothing one does wrong, and glorying in every crime, and ascribing to it an incomprehensible, supernatural value—that ideal, destined to guide this man and those connected with him, is elaborated on a grand scale…. His ignoble [acts], abandoning his comrades in misfortune, does him good service…. At the moment when, completely intoxicated by the success of his crimes and ready for the part he has to play, he arrives…entirely without any plan…. He has no sort of plan; he is afraid of everything; but all parties clutch at him and insist on his support. He alone—with the ideal of glory and greatness he has acquired…, with his frenzy of self-adoration, with his insolence in crime, and his frankness in mendacity—he alone can justify what has to be accomplished.”
—Leo Tolstoy in Chapter 3 of War and Peace (1869, Constance Garnett Translation)