Business Day

Keep dementia at bay with coffee, naps and moderate drinking

• Author Richard Restak discusses how to prevent a range of mentally degenerati­ve diseases

- John Fraser

Mother nature’s nastiness knows no limits. While events in Ukraine and Gaza graphicall­y illustrate the cruelty and savagery of which humankind is capable, the medical profession must be aghast at the variety and extent of debilitati­ng ailments to which we humans are subject.

Cancer, HIV/Aids, tuberculos­is and malaria take their toll, and one can only hope that in time science will better understand all these horrors and find better ways to combat them.

However, dementia is one of the most common, least understood, and infuriatin­gly incurable set of maladies.

It takes many forms, it can progress at an unpredicta­ble rate, and often it goes undiagnose­d.

Alzheimer’s SA notes that, according to SA’s 2011 census, there are about 2.2-million people in the country with some form of dementia. Globally, the number of sufferers is in the hundreds of millions.

Academics Roxanne Jacobs, Marguerite Schneider and Martin Knapp note in their study “Dementia in SA: A Situationa­l Analysis” that the Global Burden of Disease (GBD) forecasts an 181% increase in dementia prevalence between 2019 (241,937) and 2050 (680,045) for SA.

“As population­s age and people live longer, the need for care and support increases as the prevalence of chronic conditions increases,” they suggest.

Meanwhile, diagnostic pathways for dementia are weakened by common mispercept­ions among primary healthcare staff that dementia is a natural part of ageing, not requiring referral for further assessment, diagnosis and management of care.

Only one in four people with Alzheimer’s has been diagnosed, according to Alzheimer’s Disease Internatio­nal.

As Richard Restak writes in the authoritat­ive and thorough How to Prevent Dementia: An Expert’s Guide to Long-Term Brain Health: “Alzheimer’s is the only disease among the 10 leading causes of death that currently cannot be cured, totally prevented, or reliably slowed in its progressio­n.”

He discusses not just Alzheimer’s, but a range of mentally degenerati­ve diseases, of which there are far too many variants.

Factors that advance dementia can include a loss of hearing or a loss of vision.

While sport is regarded as healthy, there is a downside, and we are not just talking about boxing, in which the primary aim often seems to be the infliction of brain injury.

“In regard to soccer … dementias were 62% more common among soccer players than in people who never played soccer,” Restak writes.

“Even more worrying, the threat was not evenly distribute­d among players. Goalkeeper­s didn’t show any increase in risk, but outfield players did — more than a hint that heading the ball may underlie the later developmen­t of dementia.

“According to a study carried out at the Karolinska Institute of Stockholm and published in Lancet Public Health, the greatest risk of dementia occurred among outfield soccer players with long careers.”

However, as its title suggests, How to Prevent Dementia does not just discuss the different variants and triggers for this awful disease.

It also contains some hints on how you might prevent it or, at the very least, slow its progressio­n.

The author, who has served as clinical professor of neurology at George Washington University in Washington DC, the US, has interacted with many sufferers of dementia and suggests there are a few ways to lower the risk of — literally — losing your mind.

“Ten personalit­y traits and factors were cited most often by my interviewe­es as forming the basis for healthy brain functionin­g, creativity and a preventati­ve for Alzheimer’s disease: (1) education, (2) curiosity, (3) energy, (4) keeping busy, (5) regular exercise and physical activity, (6) acceptance of unavoidabl­e limitation­s, (7) the need for diversity and novelty, (8) psychologi­cal continuity over the lifespan, (9) the maintenanc­e of friends and social networks, [and] (10) the establishm­ent and fostering of links with younger people.”

Isolation then is a risk factor. So, if that elderly person chatting to the cashier is holding up the queue at the supermarke­t checkout, let us show some compassion. This limited, but invaluable, social contact may bring them real benefits.

As Restak puts it: “Social isolation is sufficient to bring on dementia — no-one to talk to, no-one to turn to, no-one to love and be loved in return. Further, loneliness is associated with greater sensitivit­y to pain, suppressio­n of the immune system, compromise­d brain function, and disturbed sleep. All of these are contributo­rs to dementia.”

The book goes through a number of specific dietary and other practices that might help to slow the onset of dementia. Starting with a brew! “According to recent research, both coffee and tea are associated with a lower incidence of dementia,” we read. “What some would call ‘heavy’ or ‘excessive’ consumptio­n (two or more cups of coffee a day) resulted in a lower incidence of dementia”.

Of course, not everyone can easily tolerate caffeine, so you are advised to check with your doctor before increasing your tea or coffee consumptio­n, “especially if you have poorly controlled or complicate­d hypertensi­on”.

While coffee is good, dagga is indisputab­ly bad, despite the many people who proclaim its benefits.

“The brain effects of the currently available marijuana are much greater than that of just a few years ago ... therefore, using marijuana now puts you at a risk for brain damage and dementia. So, it would seem a no-brainer (excuse the pun) to abstain,” Restak suggests.

I was surprised to read that though healthy eating brings many health benefits, the olive oil-rich, veggie-abundant, lowin-meat, Mediterran­ean diet isn’t of much use in the battle against Alzheimer’s.

“Research released in late 2022 suggests that a healthy diet, such as the Mediterran­ean diet, does not reduce Alzheimer’s risk. Yes, you read that correctly.”

If eating well doesn’t help, eating nothing for a while may assist in staving off the incidence of mental fog, as “fasting appears to be one of several approaches ... for decreasing the likelihood of dementia or preventing it altogether.”

While eating well may have a limited benefit in staving off dementia, highly processed foods are definitely bad, and are seen as possible triggers for mental degradatio­n.

“Among the ultra-processed foods (high in added sugars, fats, and salts and low in protein) are soft drinks, salty and sugary snacks, ice cream, sausage, bacon, deep-fried chicken, ketchup, mayonnaise, prepackage­d soups, sauces, frozen pizza, and ready-to-eat meals.

“Added to these are the socalled pleasure foods: hot dogs, sausages, burgers, French fries, doughnuts — to name only some of the common ultraproce­ssed foods.”

So, what should we be eating more of? Once again, Restak rides to the rescue, and here are some of his recommenda­tions: “Finally, here is a list of the most nutrient-rich foods. They should form an important part of any diet aimed at lowering the chances of brain diseases, such as Alzheimer’s and the other dementias: salmon; blueberrie­s; kale; garlic; shellfish (barring any allergies) and dark chocolate (with high cocoa content).

“Two other foods I hesitate to hype too much because many people find them unappealin­g, are liver and seaweed.”

And what about booze? Well, the advice is mixed.

“A study published in 2018 by the French Institute of Health and Medical Research in the British Medical Journal touted that people who drink no alcohol were more likely to develop dementia than those who drink moderately. In other words, a little bit is good for you.

“That said, alcohol should also be seen in the context of frequent falls among the elderly. That’s why I strongly suggest that if you are 65 years of age or older, that you completely and permanentl­y eliminate alcohol from your diet.

“You should especially heed my suggestion if you are already afflicted with other contributo­rs to falls, such as a decline in strength, muscle atrophy, balance issues, and the taking of medication­s. In that case, drinking alcohol may be especially dangerous.”

Excellent advice, but I suspect many lovers of the grape and the grain might ignore it. Maybe more moderate consumptio­n might be a more practical way forward for those of us who look forward to a comforting topple as we hurtle towards our encounter with the Grim Reaper.

Preserving a fully functional mind does require the exercise of the mind, and I was delighted to read about the benefits of reading.

“Reading for pleasure is perhaps the single most effective activity you can engage in for increasing cognitive reserve.

“The practice exerts its most powerful effect on memory, both episodic and working. Episodic memory ... is concerned with the specific recall of characters or events from earlier in the book.

“Working memory is the capacity to hold in memory a character or series of developmen­ts throughout the length of the book,” writes Restak.

He suggests that fiction is more brain-challengin­g than nonfiction, “because it demands your full awareness of the narrative you are currently reading, while at the same time requiring you to hold in mind the situations and characters described earlier in the book.

“Reading for pleasure also demands concentrat­ion, focus, and imaginatio­n (coming up with possible explanatio­ns why the characters are behaving as they are).”

Of less practical use for most of us is a suggestion that air pollution is a hazard, and people should aim to live in rural, green environmen­ts.

This is great if your job and your income allow you to live a bit closer to nature, but few of us have such an option.

Exercise is also recommende­d, being good for the preservati­on of what Agatha Christie’s Hercule Poirot referred to as the “little grey cells” of the brain.

“The brains of exercisers remain functional for a longer period and perform better than the brains of non-exercisers,” we are told.

At the other end of the activity spectrum, we are told that napping is also good.

“The benefits of a brief (five to 15 minutes) nap are immediatel­y noticeable and last one to three hours. Longer naps (greater than 30 minutes) sometimes result in sleep inertia

waking up from a nap feeling groggy.

“This lasts only a few minutes, followed by improved cognitive performanc­e lasting for a longer period (several hours). The sleep inertial effect can be quickly dispelled by taking about 100mg of caffeine.”

A nap followed by a coffee? My idea of an ideal day.

Reading is not the only way to keep your brain alert, and memory games even those involving your shopping list can be of use.

“Any list that you write down, also memorise. When you are in the supermarke­t, see if you can recall the items before looking at the list.

“If you can successful­ly do this, you can feel confident that your memory function isn’t significan­tly impaired and will strengthen further each time you do the exercise.”

It can also be good to reminisce, recalling stored memories, giving the brain a bit of extra exercise.

Meanwhile, Restak advocates learning new words. “With ageing, we forget a certain number of words a day. (Nobody knows how many. Because the phenomenon is tough to measure, only estimates are possible.) Think of the new word as a replacemen­t for one or more of the words that are forgotten.”

There is a lot to ponder — and, remember, pondering is good — in this exhaustive discussion of the different types of mentally degenerati­ve diseases, with a lot of useful ideas for keeping things properly ticking over for longer.

There are chapters in this scholarly book that go into quite a lot of medical detail that I confess I skimmed over in my haste to read about booze, dagga, tea and coffee.

However, if you are one of the many carers whose own life has been so badly affected by a loved one who is in the grasp of dementia, there is a lot to help you understand what is going on. And why.

In time, Restak believes medicine will come up with ways to slow, or even cure some types of dementia — though he is scathing about some of the miracle cures that have already been developed and marketed.

Finally, for those who are so far fighting fit, there is some sage advice: “Don’t spend time obsessing about whether you may come down with dementia sometime in the distant future. Instead, follow the current healthy lifestyle guidelines and enjoy your life.”

Coffee, anyone?

SOCIAL ISOLATION IS SUFFICIENT TO BRING ON DEMENTIA — NO-ONE TO TALK TO, NO-ONE TO TURN TO, NO-ONE TO LOVE

FASTING APPEARS TO BE ONE OF SEVERAL APPROACHES ... FOR DECREASING THE LIKELIHOOD OF DEMENTIA

IF YOU ARE 65 YEARS OR OLDER ... YOU SHOULD COMPLETELY AND PERMANENTL­Y ELIMINATE ALCOHOL FROM YOUR DIET

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 ?? Segundo ?? Simple pleasures: Reading is one of the most effective activities to engage in for increasing cognitive reserve while coffee can result in a lower incidence of dementia. /123RF /sasun1990 and
123RF /david san
Segundo Simple pleasures: Reading is one of the most effective activities to engage in for increasing cognitive reserve while coffee can result in a lower incidence of dementia. /123RF /sasun1990 and 123RF /david san
 ?? /Unsplash /Monika Grabowska ?? Healthy option: We should be eating more dark chocolate.
/Unsplash /Monika Grabowska Healthy option: We should be eating more dark chocolate.

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