Last week we looked at age-related mental decline, in particular how medication could be the cause of this condition with many names.

Dementia has been described as a disorder that deprives people of their identity and, even worse, goes on to destroy every faculty that makes them human.

Unless you have experienced someone close to you with this disorder, it is difficult to understand how the description of losing identity and humanity can apply to someone you thought you knew so well.

Dementia is the most feared disease of old age, where the mind swiftly dies, followed by a long, lingering death of the body – a living death. From a rare occurrence half a century ago, dementia is now rapidly becoming the most expensive disease in developed nations’ healthcare budgets.

A case in point is the UK, where there were 850,000 cases of dementia in 2014, costing an estimated £26 billion a year.

These figures are predicted to double in 20 years and could rise even higher if a correct diagnosis and treatment are not found in the early stages.

There are a number of drugs used to treat dementia, none of which I will discuss here. There are various studies, none showing remarkable results. One company’s own initial clinical trials showed that the drug was useless, reporting that it “failed to improve cognitive or functional ability” (N. Eng. J. Med., 2014). However, it was said that the data did reveal a small subset of patients with early-stage mild dementia, who may have benefited, so it merited further clinical trials.

The billions spent on drug research has gone nowhere. Why? Two main reasons have been proposed. One is that dementia is notoriously difficult to diagnose. Post-mortems show that as many as one in four people with suspected dementia may not have it at all (J. Alzheimers Dis., 2014). This is due to dementia-like symptoms having a wide variety of causes, including underactive thyroid, depression, vitamin deficiencies, alcohol abuse and diabetes.

The second reason is the recent realisation that the pharmaceutical companies may have been targeting the symptoms of Alzheimer’s disease and not the cause.

Dementia is the most feared disease of old age, where the mind swiftly dies, followed by a long, lingering death of the body

For the past 40 years, Alzheimer’s has been thought to result from the development of neurofibrillary beta-amyloid plaques in the brain. This idea is now doubtful. An increasing number of experts speculate that the plaques are a manifestation of the disease and not the cause.

I discussed this in more detail last week. As a result, the search for anti-amyloid drugs is fruitless and, as one pharmaceutical company recently acknowledged in a drug trial, they “might have a deleterious effect on the symptoms, the course or the signs of Alzheimer’s disease” (N. J. Eng. J. Med., 2014).

Dementia is the feared disease of old age, but statistics show that the vast majority of older people do not get it, so what are they doing right? The good news is that your lifestyle choices can reduce the risk of dementia. Latest evidence has shown that dietary changes can have major benefits.

Choose a Mediterranean diet (the correct one), which more than halves the risk of Alzheimer’s The main components of this type of diet (I don’t mean a diet to lose weight, but a dietary change of lifestyle) are olive oil, red wine and coffee.

A Danish study of over 1,600 seniors found that those who drank wine had about half the risk of dementia as non-drinkers. A French study found that old people who drank up to half a litre of wine a day reduced their dementia risk by as much as 80 per cent. It must be stressed that alcohol consumption should be in moderation.

The coffee drinking component is debatable, as the studies are at odds with each other. Some say caffeine has a protective effect in the brain, while others warn of the negative effects of heavy coffee drinking. Again, it seems very moderate coffee drinking is helpful.

Moving on to food, which includes green leafy vegetables, other vegetables, nuts, berries, beans, wholegrains, seafood, poultry and olive oil, all have the greatest protection against cognitive decline. Nutritionists at Tufts University recommend high antioxidant foods such as berries, Concord grapes and walnuts.

It is important to avoid foods that could increase the risk of diabetes. These include refined carbohydrates. Population studies show that diabetes is a major risk factor for dementia; it more than doubles the risk.

Fruit boosts brain functions due to the chemicals it contains. These are capable of modulating signalling pathways involved in inflammation, cell survival, neurotransmission and enhancing neuroplasticity (Neural Regen. Res., 2014).

Keep challenging your brain. A reduced risk of Alzheimer’s has been found in people with high job complexity, a cognitively active lifestyle and increased mental activity.

Taking supplements to support the body has shown to be beneficial. Low levels of vitamin A, B9 (folate), B12, C and E have been consistently found in Alzheimer’s patients. They also have low levels of zinc and selenium, but all should be taken following a practitioner’s advice.

Studies convincingly show that even moderate regular exercise is good for brain health. An eight-year study tracking 2,509 seniors in California found that those who exercised moderately to vigorously at least once a week had a 30 per cent lower risk of Alzheimer’s.

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