Reader's Digest (Canada)



- BY Lisa Bendall photograph by carlo ricci

WHEN MARIO GREGORIO was diagnosed with dementia in 2008, he immediatel­y had a dark thought: this is the end. “But then I decided to look at what I could do,” says the 71-year-old retired data analyst, who lives in Burnaby, a suburb of Vancouver. “I thought, maybe I can prevent it from progressin­g.” His hunch was right.

In 2017, The Lancet published a lengthy report by two-dozen internatio­nal experts who examined the evidence to date. That study concluded that 35 per cent of dementia risk is within our control. Lifestyle changes, the authors suggested, can slow down the disease or forestall it altogether.

After Gregorio did his own research, he switched to a mostly plant-based diet, became an avid swimmer and got more involved in community activities. “My gerontolog­ist told me I’m doing all the right things,” he says. In fact, Gregorio feels healthier now than when he received his diagnosis. His blood sugar has improved, he has fewer falls and he no longer walks with the cane he’d been using for several years.

There are over a dozen types of dementia; many Canadians have more than one type. In fact, the condition has a higher impact on our healthcare system than both cancer and heart disease. Due to our aging population, over the next 15 years the cost of dementia to our economy will surpass $16.6 billion, according to the Alzheimer Society of Canada. “The number of people living with dementia is only going to grow,” says Dr. Samir Sinha, director of geriatrics at Toronto’s Sinai Health System and University Health Network.

Sinha is on Canada’s ministeria­l advisory board on dementia, which helped the minister of health develop a national strategy that includes an investment of $50 million over five years in public education and research. “If we’re better aware of what dementia is and isn’t, we’re better able to help people get access to care and support earlier. But in many cases,” he adds, “there are things we can do to prevent it.”

Here are 25 habits that can offer you and your loved ones protection.

Control Your Chronic Conditions Get regular blood-pressure and cholestero­l checks.

You may not actually feel any symptoms from high blood pressure and raised cholestero­l levels, but both of these are risk factors for vascular dementia, in which damaged blood vessels can’t deliver the oxygen and nutrients the brain needs. “In countries where there are good screening programs and effective treatment for cardiovasc­ular disease, we may be seeing new cases of dementia starting to level off,” says Dr. Cheryl Wellington, a researcher at the University of British Columbia’s faculty of medicine. “That’s very promising.”

Look after your diabetes.

If you have type 2 diabetes (another risk factor), put tighter controls in place. Take your medication­s, test your blood sugar and follow any other advice your physician gives you. Not only will this protect the health of your blood vessels, it reduces inflammati­on in your brain.

Don’t ignore depression.

Tell your doctor about persistent symptoms like sadness or loss of interest. “Dementia can sometimes look like severe depression,” says Sinha, who adds that the two also share the symptom of poor concentrat­ion.

Get a hearing test.

Watch for signs you might need hearing aids, such as having trouble following conversati­ons in noisy restaurant­s. “If you have hearing loss, getting it treated can actually prevent the onset of dementia,” Sinha says. “We rely on a lot of sources of informatio­n to stay oriented. When part of the brain isn’t stimulated by sound, it’s harder to interpret the world and know what’s going on.”

Move Your Body

Take daily walks.

It’s well-establishe­d that exercise and physical fitness are associated with slower age-related changes in the brain. Physical activity also helps that organ compensate for these changes in a variety of ways, for example by increasing its volume. You’re encouraged to get at least 150 minutes a week of moderate-intensity exercise, like brisk walking. “It should be faster than leisurely walking,” says Padmaja Genesh, a learning specialist at the Alzheimer Society of Calgary. “Your heart rate is increasing, but you’re not gasping for breath. That has been found to have the most benefit.”

Get up and about.

If you’re doing a sedentary activity, stand up and move around at least once every hour. “Sitting for too long has harmful effects,” says Genesh. Her tip: “Drink water while you’re sitting,

and then you’ll naturally have to get up to go to the bathroom!”

Adopt a new physical activity.

Sign up for dance classes or tennis lessons, or go golfing. When done regularly, these types of activities help you stay fit and give you social opportunit­ies. After Gregorio’s diagnosis, he joined his local YMCA and began using the pool three times a week. He also takes a weekly tai chi class at a community centre. “I don’t remember the moves, but I just look around and follow along. It’s not important to be perfect!”

Eat Better

Colour your plate.

The MIND (Mediterran­ean-DASH Interventi­on for Neurodegen­erative Delay) diet developed at Chicago’s Rush University Medical Center in 2015 has been linked to slower cognitive decline, lower risk of Alzheimer’s and reduced dementia in stroke survivors. This food plan recommends eating a green, leafy vegetable at least once every day, as well as vegetables of other colours. “Berries are also part of it, because they’re rich in antioxidan­ts, and that’s good for the brain,” says Genesh.

Include whole grains with every meal.

“A lot of the things that are good for your heart are good for your head,” says Dr. Saskia Sivanantha­n, who is a neuroscien­tist and chief of research with the Alzheimer Society of Canada. That’s because habits that improve cardiovasc­ular health will naturally lower the risk of vascular dementia. Whole grains are an important part of a hearthealt­hy diet. If you eat cereal for breakfast, a sandwich at lunch and rice with dinner, prepare whole-grain versions of these foods instead of using processed products.

Track your calories.

Obesity, especially in midlife, increases the likelihood you’ll develop dementia later. People who are obese are at greater risk of the vascular problems that can cause dementia, and they’re also more likely to develop other dementia risk factors like diabetes. Make a point of choosing foods that are low in calories, and drink water or tea instead of sugary beverages such as pop and fruit juices.

Flavour your food with spices, not salt.

Salt is known to increase blood pressure. But a 2016 U.K. study published in the Journal of Cerebral Blood Flow and Metabolism showed that people in the habit of adding extra salt to their food are more likely to have a specific type of vascular damage in their brains. In your cooking, experiment with fragrant herbs as an alternativ­e, like basil and mint, or spices like paprika and cumin.

Prioritize Safety

Wear your seat belt.

“There’s a lot of literature to suggest that severe brain injuries raise the risk of dementia,” says Wellington, who has focused much of her work on this link. There’s still more to be learned, and researcher­s aren’t yet sure how much it depends on the degree of the injury. But, on average, studies point to a threefold increase in risk. Car accidents are among the most common causes of brain injury in adults, according to the Canadian Institute for Health Informatio­n.

Remove falling hazards in your home.

Falls are the leading cause of brain injury in seniors. If you spill something on the floor, clean it up right away, before you can slip on it. Be on the lookout for other tripping hazards, such as electrical cords and boxes resting on the floor. “It’s also recommende­d that small area rugs be removed altogether,” says Wellington.

Turn on the lights.

Instead of fumbling around in the dark, get in the habit of flipping on a light when you get up in the morning to use the bathroom, or before going down the stairs. For middle-of-the-night wake-ups, you can use a low-wattage light that will minimize the impact on your electricit­y bill.

Use a helmet for activities like skiing and biking.

Safety equipment isn’t just for kids. “Everybody, at any age, participat­ing in active sports should be using protective devices,” says Wellington. Make sure the equipment fits properly, and don’t use a secondhand helmet that could be damaged or worn.

Just Say No

Cut back on cocktails.

There are many ways heavy alcohol use has a negative effect on the brain and cardiovasc­ular system. It inflicts direct damage on tissues, but it also increases the risk of falls. Don’t have more than 10 drinks per week (or two a day) if you’re female or 15 per week (or three a day) if you’re male. Don’t drink at all if you’re on prescripti­on medication­s that shouldn’t be combined with alcohol, or you have health conditions like liver or heart disease.

Reconsider your prescripti­ons.

“I was concerned about the effects of the pills I was taking,” says Gregorio, who at one point was on several different drugs for high blood pressure. “I now regularly meet with a gerontolog­ist. I call him my referee because he makes sure the dose is correct and that I’m not taking medication I don’t need.”

Sinha has seen patients who should be reducing their blood-pressure medication­s after reaching a healthy

weight, or stopping a heartburn pill that interferes with their ability to absorb nutrients. It’s important to make these appropriat­e adjustment­s, he says: “A lot of medication­s can affect memory and concentrat­ion.”

Stop sabotaging your shut-eye.

“What is most important is the quality of sleep, not quantity,” says Genesh. “Research is showing that people who are interrupte­d in the deep-sleep part of their cycle are likely to build up more beta-amyloid plaques and tau tangles in the brain.” Practise sleep hygiene, such as sticking to a regular bedtime and darkening your room.

Quit smoking.

Smokers have a significan­tly higher risk of developing dementia. Likely, part of the reason is that smoking can lead to cardiovasc­ular problems and strokes. But there’s also evidence that the inflammati­on from regular exposure to cigarette smoke may contribute to Alzheimer’s. For those committed to quitting, the Canadian Cancer Society operates a free phone-counsellin­g service (smokershel­

Give bad foods the boot.

The MIND diet recommends avoiding certain foods or eating them only sparingly: red meat, butter, cheese, pastries, sweets, fried food and fast food. “Changing your diet later in life, and even once you have a diagnosis, can still have an impact,” Sivanantha­n notes. “That’s something people don’t realize.”

Engage With the World

Talk to a friend.

Mounting evidence shows that social isolation is a dementia risk factor, especially after age 65. In fact, the Lancet report estimates that the increased relative risk is the same as cigarette smoking. Have a phone or Skype chat with your pals, even if they live far away. “There’s a benefit to you, by talking with somebody, but think also of the benefit to a friend who might be feeling a little bit lonely or isolated,” says David Harvey, who retired from the Alzheimer Society of Ontario in 2017 and now hosts a podcast, Dementia Dialogue, to increase understand­ing of the disease.

Keep learning.

Some universiti­es offer free educationa­l courses to retirees, but learning can be less formal, too. Read books, teach yourself words from a foreign language or study a music score. “Pursue what you’re curious about,” says Harvey. “It can satisfy an interest and maintain intellectu­al activity.”

Do regular volunteer work.

“Maintainin­g a sense of purpose, and feeling that you are valued in society, is really helpful,” Wellington says. “Part of what characteri­zes humankind is that

we need to be connected.” Gregorio contribute­s his time to several health agencies, advocating for greater awareness of dementia. He also volunteers with Tourism Vancouver, helping visitors get more out of the city’s attraction­s. “It requires a bit of research, so it allows my mind to be active,” he says. “And it’s social.”

Up your puzzle game.

Many online “brain games” are marketed as tools for sharpening memory. But 15 minutes a day on a puzzle app might not be doing that much to stave off dementia. “If you do the same game over and over, it becomes habitual and eventually you’re not learning anything anymore,” Sivanantha­n points out. To engage your brain, keep it fresh. If you normally do Sudoku, try crosswords, or learn the rules of a brand-new board game with your family.

Meet with groups.

Increase your social time by participat­ing in community activities such as local clubs, choirs or special events. There are also support groups for people with dementia or mild cognitive impairment. In these settings, you’ll have opportunit­ies to interact with new people, learn new things and lift your spirits. “It’s helping with that brain resilience,” says Sivanantha­n.

GREGORIO REMAINS committed to the lifestyle changes he’s convinced have made a positive difference over the past nine years. “They’re not miracle cures,” he says. “But they’re allowing me to prevent the progressio­n of my illness.”

In the meantime, when he’s not volunteeri­ng or exercising, he also enjoys reading—although he admits his taste in books has changed somewhat. “I used to read World War II novels, but my concentrat­ion is no longer there,” he says. “Now I read cartoons, like The Far Side and Herman.” He adds with a laugh that these days he holds on to his humour books after he’s finished with them. “I forget what I’ve read after a month, so they’re always fresh!”

 ??  ?? Mario Gregorio swims three times a week and is an active
Mario Gregorio swims three times a week and is an active volunteer
 ??  ?? Mario Gregorio, who was diagnosed with dementia in 2008, wants to help decrease the stigma around his disease.
Mario Gregorio, who was diagnosed with dementia in 2008, wants to help decrease the stigma around his disease.
 ??  ??
 ??  ?? Dr. Samir Sinha helped create a national strategy that will bring awareness to dementia risk factors.
Dr. Samir Sinha helped create a national strategy that will bring awareness to dementia risk factors.

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