Change Your Mind

Take action now to keep dementia from becoming par of your future.
By Lisa Shumate

How do I get to your house again?” The question, posed a year ago by my 73-year-old father, confirmed my darkest suspicions. Dad had already begun to lose track of his car (a good Samaritan helped him find it after one frantic two-hour search), and he often got confused about our dinner dates. Now, he’d forgotten how to get to the house I’d lived in for a decade—and this was only the beginning.

One year later, as I endure the heartbreaking task of selling the car he can no longer drive and moving him into a facility where he will be safe despite his rapidly spiraling dementia, I can’t help but wonder: Is there anything I can do to prevent this from happening to me? According to a growing body of research, the answer is a resounding yes.

Fueled by a better understanding of what causes age-related cognitive decline, brain researchers who have long lamented the lack of a cure are now touting prevention with refreshing optimism. They say everything from what we eat to how we spend our free time can play a pivotal role in fending off Alzheimer’s disease and other forms of dementia. (Get tips for a brain-stimulating lifestyle at “We have discovered that we have more control over our future than we thought,” says Gary Small, MD, a geriatric psychiatrist and director of the University of California, Los Angeles Center on Aging. “There are measures we can take now to protect our brain health, and it is never too early to start.”

Beyond normal forgetfulness
Experts say some minor cognitive decline can be expected with age, as neurons die, synaptic connections thin, and toxins accumulate in brain tissue. By age 50, two-thirds of us experience the occasional “senior moment.” After 65, up to 20 percent have mild cognitive impairment—persistent memory problems severe enough to be noticeable to others.
But one in eight over age 65 will develop Alzheimer’s disease, a form of dementia with a constellation of symptoms (including short-term memory loss, spatial disorientation, and personality changes) that interfere with daily life.

“Dementia is not just an exaggeration of normal age-related forgetfulness,” explains George Washington University neurology professor Richard Restak, MD. “We all forget where we parked the car. But to come out and not know whether you drove or took the bus, that’s different.”

Dementia has an array of causes, but by far the most common culprits are Alzheimer’s (a rapid death of brain cells), vascular dementia (damage to blood vessels that feed the brain), or an insidious combination of the two.

For decades, dementia research has focused on Alzheimer’s, particularly on a gummy protein called amyloid plaque believed to form in the brain, strangling neurons. Yet little is known about why this plaque forms (genetics may play a role) or how to prevent it, says Maine geriatrician Laurel Coleman, MD, an Alzheimer’s Association board member. The news is better for vascular dementia: Scientists have learned a lot about how to prevent it. “It is becoming increasingly clear that what is good for the heart is good for the brain,” says Coleman. She points to studies showing that patients with serious plaque formation in the brain, but healthy vascular systems, show far fewer signs of cognitive decline.

The bottom line: We must wage the battle against dementia on both fronts—by promoting healthy blood vessels and by keeping our brain cells abundant.

Size matters
Mounting data suggests that carrying even a few extra pounds can be a precursor to dementia, and that the heavier you are, the greater the risk. Overweight people tend to suffer more inflammation and free radical production, twin evils that work in concert to kill brain cells. They also have higher rates of atherosclerosis, with constricted arteries obstructing blood flow to the brain.

In a study published in the International Journal of Obesity in June, researchers looked at the body mass index (BMI) of 1,152 twins ages 45 to 65, and followed up for up to 40 years. Those in the top third in terms of BMI for the first screening were 60 percent more likely to have developed dementia by the second. Another study, released at the International Conference on Alzheimer’s Disease in July, found that seniors who had eaten a diet high in whole grains, vegetables, low-fat dairy, and legumes for 11 years scored nearly four points higher on cognitive tests than those who hadn’t.

Studies also show that walking just three times a week for 45 minutes boosts cerebral blood flow, increases gray matter in the frontal lobe, and restores losses in brain volume associated with normal aging. “A daily one-mile walk will reduce the chances of developing Alzheimer’s by 50 percent,” says Restak.

While many mainstream doctors have yet to embrace dietary supplements for brain health, studies suggest that certain ones can be powerful tools in preventing dementia. The most important supplement, says Florida neurologist David Perlmutter, MD, is DHA, or docosahexanenoic acid, an omega-3 fatty acid found in fish and algae. “The brain degenerates when it is inflamed, and DHA is nature’s anti-inflammatory,” says Perlmutter, author of The Better Brain Book (Penguin Group, 2009). Some scientists believe DHA may also interfere with the formation of amyloid plaque and kick-start the process of neurogenesis, or growth of new neurons, in the brain’s memory center.

A July study of 485 healthy adults with mild memory complaints found those who took 900 mg per day of algal DHA for six months made significantly fewer errors on memory tests than they had at the study’s onset. Interestingly, another National Institute on Aging study released in July found that DHA has little impact once serious dementia has already set in. In essence, says Perlmutter, “you have to fix the roof while the sun is still shining.” He recommends taking 800 mg of DHA daily.

Brain-boosting B
B vitamins (B1, B3, B6, folic acid, and B12) help keep levels of the inflammatory amino acid homocysteine in check. High levels of homocysteine can damage vessels carrying blood to the brain, choking off circulation and ultimately leading to dementia-inducing cell death. Studies show that supplementing with a B complex can lower homocysteine levels by as much as 30 percent within 12 weeks.

If you’re worried about memory decline, you can have your homocysteine levels checked with a simple blood test. If your level is above 8, you should be taking a supplement containing at least 50 mg each of B1, B3, and B6; 400 mcg of folic acid; and 500 mcg of B12, says Perlmutter.

Dark-colored fruits, such as blackberries, blueberries, and grapes, are also gaining attention for their hundreds of antioxidant compounds that not only eliminate the free radicals that kill neurons, but also turn off the signals that produce tissue-damaging inflammation, says Jim Joseph, PhD, a research physiologist with the Human Nutrition Research Center on Aging at Tufts University in Boston.

One 2009 Tufts study found that rats fed a blackberry extract for eight weeks showed better motor performance and short-term memory (the two skills that are first to go in dementia patients) than the control rats. Another small human trial found that adults who drank a concentrated grape juice supplement daily showed “significant improvement” in verbal learning (another challenge for Alzheimer’s).

While few human studies have been published, several are underway to determine the impact concentrated resveratrol (a compound found in the skins of red grapes that’s also gaining attention for potential anti-aging properties), may have on preventing dementia. “If I were to pick a supplement that shows a lot of promise in this area, it would be this one,” says Joseph. One pivotal 2008 study conducted by the National Institute on Aging found that older mice fed resveratrol had better heart and bone health, fewer cataracts, and better balance and motor coordination. And a small September study by European researchers found that people given 1,000 mg of resveratrol had increased blood flow to the brain and scored higher on cognitive tests than the control group.

With fewer neurons dying and more being formed, could those who stock up on key nutrients and keep their bodies lean and fit avoid the devastating symptoms of dementia altogether? Ask me in 30 years.

Lisa Shumate is a freelance writer and mother of four who lives in Estes Park, Colorado. After enrolling in a choir and radically changing his diet, her father is doing much better.