Dementia (cont.)
Can Dementia be Prevented?
Research has revealed a number of factors that may be able to prevent or
delay the onset of dementia in some people. For example, studies have shown that
people who maintain tight control over their glucose levels tend to score better
on tests of cognitive function than those with poorly controlled diabetes.
Several studies also have suggested that people who engage in intellectually
stimulating activities, such as social interactions, chess, crossword puzzles,
and playing a musical instrument, significantly lower their risk of developing
AD and other forms of dementia. Scientists believe mental activities may
stimulate the brain in a way that increases the person's "cognitive reserve" -
the ability to cope with or compensate for the pathologic changes associated
with dementia.
Researchers are studying other steps people can take that may help prevent AD
in some cases. So far, none of these factors has been definitively proven to
make a difference in the risk of developing the disease. Moreover, most of the
studies addressed only AD, and the results may or may not apply to other forms
of dementia. Nevertheless, scientists are encouraged by the results of these
early studies and many believe it will eventually become possible to prevent
some forms of dementia. Possible preventive actions include:
- Lowering homocysteine. In one study, elevated blood levels of the
amino acid
homocysteine were associated with a 2.9 times greater risk of AD and a 4.9 times
greater risk of vascular dementia. A preliminary study has shown that high doses
of three B vitamins that help lower homocysteine levels - folic acid, B12, and
B6 - appear to slow the progression of AD. Researchers are conducting a
multi-center clinical trial to test this effect in a larger group of patients.
- Lowering cholesterol levels. Research has suggested that people with
high
cholesterol levels have an increased risk of developing AD. Cholesterol is
involved in formation of amyloid plaques in the brain. Mutations in a gene
called CYP46 and the apoE E4 gene variant, both of which have been linked to an
increased risk of AD, are also involved in cholesterol metabolism. Several
studies have also found that the use of drugs called statins, which lower
cholesterol levels, is associated with a lower likelihood of cognitive
impairment.
- Lowering blood pressure. Several studies have shown that antihypertensive
medicine reduces the odds of cognitive impairment in elderly people with high
blood pressure. One large European study found a 55 percent lower risk of
dementia in people over 60 who received drug treatment for hypertension. These
people had a reduced risk of both AD and vascular dementia.
- Exercise. Regular exercise stimulates production of chemicals called growth
factors that help neurons survive and adapt to new situations. These gains may
help to delay the onset of dementia symptoms. Exercise also may reduce the risk
of brain damage from atherosclerosis.
- Education. Researchers have found evidence that formal education may help
protect people against the effects of AD. In one study, researchers found that
people with more years of formal education had relatively less mental decline
than people with less schooling, regardless of the number of amyloid plaques and
neurofibrillary tangles each person had in his or her brain. The researchers
think education may cause the brain to develop robust nerve cell networks that
can help compensate for the cell damage caused by AD.
- Controlling inflammation. Many studies have suggested that inflammation may
contribute to AD. Moreover, autopsies of people who died with AD have shown
widespread inflammation in the brain that appeared to be caused by the
accumulation of beta amyloid. Another study found that men with high levels of
C-reactive protein, a general marker of inflammation, had a significantly
increased risk of AD and other kinds of dementia.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Research indicates that
long-term use of NSAIDs - ibuprofen, naproxen, and similar drugs - may prevent
or delay the onset of AD. Researchers are not sure how these drugs may protect
against the disease, but some or all of the effect may be due to reduced
inflammation. A 2003 study showed that these drugs also bind to amyloid plaques
and may help to dissolve them and prevent formation of new plaques.
The risk of vascular dementia is strongly correlated with risk factors for
stroke, including high blood pressure, diabetes, elevated cholesterol levels,
and smoking. This type of dementia may be prevented in many cases by changing
lifestyle factors, such as excessive weight and high blood pressure, which are
associated with an increased risk of cerebrovascular disease. One European study
found that treating isolated systolic hypertension (high blood pressure in which
only the systolic or top number is high) in people age 60 and older reduced the
risk of dementia by 50 percent. These studies strongly suggest that effective
use of current treatments can prevent many future cases of vascular dementia.
A study published in 2005 found that people with mild cognitive impairment
who took 10 mg/day of the drug donepezil had a significantly reduced risk of
developing AD during the first two years of treatment, compared to people who
received vitamin E or a placebo. By the end of the third year, however, the rate
of AD was just as high in the people treated with donepezil as it was in the
other two groups.
Next: What Kind of Care Does a Person with Dementia Need? »
- ginkgo (Ginkgo biloba)-oral - Consumer information about the medication GINKGO (Ginkgo biloba) - ORAL , includes side effects, drug interactions, recommended dosages, and storage information. Read more about the prescription drug GINKGO (Ginkgo biloba) - ORAL.
- Complete Blood Count (CBC) - A complete blood count (CBC) measures the concentration of white blood cells, red blood cells, and platelets in the blood and aids in the diagnosis of conditions and diseases such as anemia, malignancies, and immune disorders.
- Lyme Disease - Get the facts on Lyme disease symptoms, signs, causes and transmission (bites from ticks infected with Borrelia burgdorferi), history, diagnosis, treatment and prevention.
Latest Medical News
Alzheimer's RSS