Nine Risks for Cognitive DeclineJuly 24, 2017
Nine Risks for Cognitive Decline
This week, in London, the Alzheimer's Association International Congress, just met. One of their presentations was a publication in the Lancet detailing the current best evidence of risk factors for developing cognitive decline. The overarching principle is that the brain does show changes with time that eventually lead to withdrawal and loss of cognitive function. It shows up as short-term memory loss, but starts with other risks.
Prevention should be focused on building a "cognitive reserve" earlier in life. If there is to be an inevitable downward slope, change the grade of the slope. Your brain is constantly tasked with deciding what to keep and what to throw away. It is not a hoarder. It repeatedly questions what memories to discard, what is important, and which are less important. The stop sign you passed on the way to work may not be all that important to remember. It gets tossed. Where you put your keys is important, only in the short term, but can be forgotten. Your spouse's birthday, now, that is important. Your brain has to sort those out. Routine and repetition can lead to letting go. In order to do all that sorting, your brain needs data. It needs to be exercised, flexed, challenged, used.
Knowing that, the list presented at the meeting makes sense. They estimated that approximately one-third of dementia was amenable to prevention by early intervention. That starts with mid-life hearing loss. This is the first paper that I have seen with a meta-analysis of multiple high-quality studies of hearing loss as a risk for cognitive decline. It accounted for 9% of the risk. Following that was lack of a completed high school education (8% risk), smoking (5% risk), failure to seek early treatment for depression, (4%), physical inactivity, 3%, social isolation (2%), high blood pressure (2%), obesity (1%), Type II diabetes (1%). These all add up to the 35% percent of modifiable risk factors. Continuing life long learning keeps your brain working with new data. Doing something "hard" every day, keeps your brain solving problems. Staying socially engaged with humans keeps all your filters of human interaction functioning.
These factors appear to be important, and make sense. They flatten the slope of decline. What is quite new in this examination is the consideration that diabetes accounts for only 1% of risk, obesity 1%, smoking 5% and physical inactivity 3%. These are far lower than prior estimates and suggest that there was no attempt or discussion about reduction and change of lifestyle risk factors. That is likely because the prior model of weight loss is all about low fat, which doesn't work. Hence, no one has been able to succeed with weight loss, diabetes reversal, high blood pressure reversal etc. With the proper use of low carb for weight loss, modifiable risks for cognitive decline will appear to be more meaningful and effective.
WWW.what will work for me. I'm paying attention to the hearing loss concern. This is the first study that shows it to be so high on the list. It's never been so high in any prior study. I'm going to find a time to get myself checked. I haven't seen any other study like this, so this could be a statistical blip, but it sure catches my eye. Pay attention.
- The current article suggests that as much as 35% of dementia can be prevented. T or F Answer: That's there data from statistical analysis. I think the number can be much high.
- Mid life hearing loss can be postponed until you are on Medicare. T or F Answer: False. It leads to social isolation.
- Cognitive decline is a natural process. T or F Answer: Sadly true if you live long enough. Age is the strongest risk factor. What is not discussed here but is quite intriguing is that dementia may be the result of a protective or natural process going awry.
- Hearing loss may be far more important a risk factor than we care to acknowledge. T or F Answer: Yup
- The combination of diabetes, high blood pressure, obesity are all one parcel of common problems best reversed with a low fat American Heart Diet. T or F Answer: It's true they are all one parcel, it's false that the AHA diet will help you.