What is dementia?

• The definition of dementia, according to the American Psychiatric Association’s Diagnostic and Statistical Manual I,V is: A condition of loss of memory, accompanied by impairment of decision making or personality change. These changes must be severe enough to impair an individual’s work, social activities, or relationships with others.

• When memory disturbances are present, but they do not significantly affect a person’s work, social activities, or relationships, the condition is referred to as Mild Cognitive Impairment, or MCI.

• Alzheimer’s Dementia is the most common and well known dementia. However, it accounts for only about half of cases of dementia. Other forms of dementia include Vascular, Lewy Body, and Frontotemporal Dementias.

• The diagnosis of dementia can be made only after medical and psychiatric diagnoses have been ruled out. Thus, evaluation of changes in cognitive function must include a good physical examination, blood tests, and consideration of psychiatric contribution.

• Some psychiatric conditions, such as Major depression, and medical conditions, such as low thyroid hormone, vitamin deficiencies, sleep apnea, and other problems can mimic dementia. If diagnosed and treated promptly, loss of cognitive function can sometimes be reversed.

The causes of dementia

• Although some people are genetically predisposed to one or another form of dementia, in most cases dementia is due to poor lifestyle choices. For most people, dementia is avoidable.

• Studies have shown that individuals who immigrate to developed countries, depart from the ways of their traditional cultures, and adopt the lifestyles of the modern societies are at increased risk for dementia.

• In the majority of cases, genes are neither necessary nor sufficient to cause dementia. Genes we inherit from our parents merely tend to determine the primary ways in which bad diet, stress, and the other unhealthy aspects of lifestyle will affect the brain and cognitive function.

• Metabolic Syndrome is a major risk factor for all types of dementia.

• Metabolic Syndrome is a risk factor for heart disease and diabetes, which themselves are risk factors for dementia.

• Metabolic Syndrome is diagnosed by the presence of high blood pressure, high fasting blood glucose, high triglycerides, low HDL (the good cholesterol), and abdominal obesity.

• The underlying cause of Metabolic Syndrome is insulin resistance.

• Metabolic Syndrome is often the result of too much sugar, too much saturated fat, too much stress, too little sleep, not enough exercise, and bad health habits.

• Other risk factors for dementia are Major Depression, sleep apnea, poor educational background, boring work, overindulgence in smoking and drinking, head injury, poor dental care, social isolation, inflammatory processes, hormone imbalances, environmental toxins, and a growing list of bacteria and viruses.

How to avoid dementia

• To stay free of dementia you must fight Metabolic Syndrome, diabetes, heart disease, and other physical risk factors through diet, prudent supplementation, weight loss, exercise, good sleep, and stress reduction.

• For most people, the diet that best reduces the risk of Metabolic Syndrome, heart disease, diabetes and dementia is the Mediterranean Diet.

• The key features of the Mediterranean Diet are fruits and vegetables high in fiber, less red meat and more deep sea fish, less butter and more olive oil, garlic, red wine, spices rich in antioxidants, and few sweets.

• The best diet for weight loss may not be the Mediterranean Diet. For most people, high protein and good fat tends to cut appetite and make weight loss easier.

• Diet plus exercise is the surest way to lose weight.

• Ideal weight for men is 106 pounds for the first 5 feet, then 6 pounds for each additional inch of height. For women, this weight is 100 pounds for the first 5 feet, then 5 pounds for each additional inch of height. Add 10 extra pounds for being over 50 years old, and add or subtract 10 pounds for having a large or small frame.

• There are many herbs , vitamins, and nutraceuticals that can be taken as supplements to help avoid or delay the progression of dementia.

• The actions to look for in a useful combination of supplements include: anti-oxidant effects, anti-inflammatory effects, enhancement of acetylcholine, stimulation of neuron growth, anti-amyloid effects, and prevention of Metabolic Syndrome.

• Steer clear of environmental toxins by drinking clean water, breathing clean air, and eating fresh uncontaminated food.

• In some cases, medications are necessary to avoid Metabolic Syndrome and its adverse effects.

• Medications maybe needed to improve cognitive function and prevent further decline in the early stages of dementia. Currently, the FDA approved medications include NMDA receptor drug, Namenda, and the cholinesterase inhibitors, Aricept, Reminyl, and Exelon.

• Do not despair, research is ongoing, and there are many new medications on the horizon.

• To avoid dementia you must exercise your mind as well as your body. You must keep learning throughout life, and strengthen your mind with challenging work and interesting pastimes.

• Use books, puzzles, and games as supplements, not replacements, for doing intellectually stimulating things with interesting people.

• A good marriage, where the spouse is also a friend and confident, is the best of all possibilities.

• People who are able to maintain close friendships through adulthood and old age are less likely to develop dementia.

• People continue to develop and grow emotionally and spiritually through adulthood and old age.

• Learn to love unconditionally, fulfill your dreams, find meaning and contentment, forgive and come to peace with yourself. 

 
Dr. Mendelson is available for interviews about his new book and the innovative approach to battling dementia that he prescribes.