Worried about dementia? Don’t go it alone

As we enter our senior years, many of us worry about memory loss, but a recent study shows that most of us aren’t getting the information we need.

Research shows that although fewer than 20 percent of people who reach 65 will develop Alzheimer’s disease or dementia, nearly half of those surveyed in the National Poll on Healthy Aging felt they were likely to.

Despite those fears, only 5 percent said they had talked with their doctor about the best ways to prevent memory problems. Instead most were taking supplements or doing things like crossword puzzles to try to stave off cognition loss.

“It’s okay to bring up your concerns,” said Mathew Pulicken, MD, a neurologist at Neurologists of Cape Cod in Hyannis. Screenings can detect cognitive issues. “If someone is concerned about cognitive changes, we can perform tests to assess for possible neurodegenerative diseases. If there’s no problem, it’s good to know that.”

The national poll was carried out by the University of Michigan Institute for Healthcare Policy and Innovation. It asked 1,028 adults ages 50 to 64 a range of brain health questions.

“While many people in this age range expressed concerns about losing memory, and say they take active steps to prevent it, most haven’t sought advice from medical professionals, who could help them understand which steps actually have scientific evidence behind them,” Donovan Maust, M.D., a geriatric psychiatrist who helped design the poll and analyze the results, said in a press release.

It’s better to have concrete information from a medical provider about ways to prevent dementia – and if someone develops it, to get the best help possible to deal with it, said Dr. Pulicken.

There has been a lot of interest in supplements, especially as there is no known cure for dementia. None have shown benefit in improving memory or slowing cognitive decline in scientific studies, he said. More recently, the FDA has taken action to cut down on false advertising about supplements.

Doing crossword puzzles or brain teasers can be fun, but doing these puzzles regularly may not challenge the brain over time and may not offer much help in the long run.

“You may be able to do it without it being demanding on the brain,” he said.

So What Works?

Exercise: “The biggest part we emphasize is the role of aerobic exercise,” said Dr. Pulicken, “You can't change your genetics, but you can change your lifestyle and manage the known risk factors. The benefits of exercise have been shown in animal models to slow degeneration and improve performance.”

Manage your blood pressure: High blood pressure can cause narrowing of the blood vessels in the brain.

“These can lead to small vessel changes in the brain and contribute to a condition called vascular dementia, which does not respond to medications available to slow down cognitive decline,” he said. “That's why you don't wait until your 70s to control your blood pressure.”

Other diseases like diabetes and hyperlipidemia could also contribute to small vessel changes in the brain.

Learn a new skill: Instead of doing crossword puzzles repeatedly for brain strength, you should challenge your brain in other ways.

“What is more beneficial is learning newer things,” Dr. Pulicken said. “Learning a new language or taking up a new activity that you have never done before can be measures to stimulate the brain.”

If you notice any cognitive changes, or are just concerned about the possibility, you should talk to your primary care physician about it.

A new state law requires that physicians, physician assistants and nurses in Massachusetts have training in detection, diagnosis and treatment of Alzheimer’s and other dementias to obtain or renew their license.