All your questions ANSWERED

WHAT EXACTLY IS DEMENTIA?

‘It’s a word used to describe the collection of warning signs that show up when the brain stops working as well as it used to,’ says Professor June Andrews, author of Dementia: The One Stop Guide and advisor to the Dementia Services Development Trust. ‘It’s defined as dementia only if the signs continue to get worse, with a permanent deterioration over time. Dementia is more than just memory problems – it’s a range of diseases that cause changes in the brain that give rise to dementia symptoms. There are more than 100 of these diseases but only about three are common, with Alzheimer’s making up the majority of cases.’

SO DOES GETTING OLDER MEAN IT S INEVITABLE?

It’s not a normal part of ageing. Dementia is caused by diseases of the brain, and the causes of these aren’t fully understood as the brain is so complex – something that hampers the attempt to find a cure. ‘With Alzheimer’s, abnormal clumps appear in the brain tissue along with tangled fibres that should not be there,’ says Dr Clare Walton of the Alzheimer’s Society. ‘This damages the structure and chemistry of the brain, which results in symptoms like memory loss and changes in thinking speed, mental agility, language, understanding and judgment.’ Different types of dementia cause damage to different parts of the brain and often different symptoms.

IT SEEMS UNFAIR… WHY ARE WOMEN AT GREATER RISK?

‘It was believed to be because women live longer than men and so have more time to get dementia, but the numbers don’t add up, suggesting other factors are also at work,’ says Dr Macsweeney. For example, studies have found that women who have the APOE4 gene – a common Alzheimer’s indicator – are twice as likely to develop Alzheimer’s as men who have the same gene. The reasons aren’t understood, but researchers are exploring the impact of female hormones and genetic factors, as well as health issues relevant to women, including certain medications, pregnancy and menopause.

WILL THERE BE A CURE ANY TIME SOON?

‘Dementia is progressive and irreversible and there’s currently no cure,’ says Professor Robert Howard, Professor of Old Age Psychiatry at University College London. ‘After years of research, there’s still a lot we don’t know about dementia, about the condition itself, about the disease mechanisms and how it can be treated. An effective drug could materialise in the next five years, but it may take a lifetime – we don’t know.’

Scientists are working flat out to find a much-wanted cure. ‘Brain cells can’t be regenerated, so much of the work is being done on keeping them alive in the first place,’ says Dr Macsweeney. ‘For example, medications are being designed to slow the progression of symptoms as well as slow the death of brain cells (disease-modifying drugs) but also to boost memory and other cognitive functions to help dying brain cells work more effectively (symptomatic drugs).’

YOUTH BOOST YOUR BRAIN

Take simple steps to tone your brain today and it will thank you tomorrow…

EXERCISE YOUR MIND

Research has found that constantly learning and doing new things could build and fortify the neural connections that can slow brain ageing, and it’s also been suggested that people who challenge their grey matter with complex jobs, night school, or crosswords and puzzles could be less likely to get dementia. ‘Studies have found that some people with a high IQ have essentially delayed the symptoms of dementia appearing by four or five years,’ says Professor Howard. ‘However, it’s important to note that using your mind more or upping your IQ does not stop you from getting Alzheimer’s disease or vascular disease. Instead, there’s a theory

that learning gives you greater reserves on which to draw as your brain declines.’ Here are three ideas to try today:

START ON THAT WISH LIST

Forget what you’re good at – it won’t stimulate you. Instead, get out of your comfort zone to challenge your brain. From learning the violin to making your own jewellery, from drawing and painting to doodling, the sky is the limit. One study found that those who started acting classes boosted their ability to remember words, numbers and short stories by up to 19%.

THINK OUTSIDE THE CROSSWORDS

Instead of focusing on things that use only a narrow part of your brain, you may be better off doing a wider range of activities that use a whole host of mental processes. Challenge your brain with different games and puzzles, remembering that the best games are the ones you enjoy the most, because it’s persevering that makes all the difference.

STAY CONNECTED

‘Those with a richer social life seem to have some protection against dementia,’ says Professor Andrews. ‘No one knows for sure why this is the case, but it could be that just keeping up with people in itself is mental exercise. For example, if you’re meeting friends, the complexities of organising the catch-up, how you’re going to get there, what you need, can be a mental workout in itself!’

HAPPY HEART, HAPPY BRAIN

Keeping your heart healthy is one of the best things you can do to keep your brain healthy.

One study found that the more heart-healthy habits people had, the less cognitive decline they displayed. Some of the same risk factors for heart disease, such as high cholesterol levels, high blood pressure and diabetes, can put you at greater risk of developing dementia. It’s not fully understood why, but poor heart health means less blood flow to the brain, which is vital for nourishing brain nerves and maintaining healthy nerve connections. So add these heart-boosting steps to your must-do list.

KEEP YOUR BLOOD PRESSURE HEALTHY

High blood pressure in mid life can increase your risk of developing dementia, particularly vascular dementia, which is the second most common form. ‘This is caused by reduced blood flow to the brain, which starves brain cells of the nutrients they need to function correctly,’ says Dr Walton of the Alzheimer’s Society.

GET CHOLESTEROL UNDER CONTROL

There’s a link between high cholesterol levels in the blood in mid life and going on to develop dementia. ‘The way that cholesterol is processed in the brain is important for the health of brain cells,’ says Dr Walton.

MOVE IT

A new review of 39 large-scale studies found that aerobic exercise and strength training could improve memory, attention and how well people carry out tasks. ‘Of all the lifestyle changes that have been studied, taking regular physical exercise appears to be one of the best things you can do to reduce your risk of dementia,’ says Dr Walton. The reason it’s so good? ‘Oxygen is the fuel for your brain, so it’s worth doing everything you can to improve your heart and the circulation of your blood, which helps carry this oxygen.’ Interestingly, some research has also found that the relaxation techniques used in yoga and meditation can lower your risk of mild cognitive impairment and even dementia, as it helps lift anxiety, fatigue, stress and insomnia – issues that can muddle thinking.

EAT SMART

Studies have suggested that the antioxidant found in olive oil could reduce the plaque formation that’s characteristic of Alzheimer’s disease, while the long chain omega-3 fats EPA and DHA, found in oily fish, could play an important structural role in your brain. But simply filling your cupboards with a single food isn’t going to prevent dementia. In reality, the evidence on the effects of specific nutrients, vitamins, foods, or food groups is often limited and conflicting. So what do the experts advise?

EAT THE MED

‘There’s some promising evidence suggesting a heart-healthy, Mediterranean-style diet could reduce your risk of developing problems with memory and thinking, and perhaps even some forms of dementia,’ says Dr Macsweeney. The diet is generally healthy and balanced, with its emphasis on fruit, vegetables, legumes and fish, and limited consumption of meat, sugar and saturated fat. It’s also high in antioxidants that may help protect against some of the damage to brain