BUSTING THE AGEING BRAIN MYTH

DR MAUREEN BRUCE SAYS DEMENTIA NOT ALWAYS INEVITABLE WHEN SOCIAL EXERCISE IN ARTILLERY

There’s no denying dementia is one of the major chronic diseases of this century , however, there are many urban myths about  dementia that need to be challenged. For example, the idea that as we age, it is inevitable that we will get dementia.

As the UK Alzheimer’s Association (2016) discovered: Too many people are in the dark about dementia … myths and misunderstandings continue to contribute to the stigma and isolation that many people feel. Whereas, scientific evidence suggests that while age is the strongest known risk factor for cognitive decline, dementia is not a natural or inevitable consequence (World Health Organisation, 2019).

So what is the antidote? There isn’t a silver bullet but there are several ways we can reduce our risk of developing dementia.  Dementia Australia claims social engagement has been found to have benefits related to cognitive functioning, vascular conditions and depression. It is mentally stimulating and may contribute to building brain reserve which in turn contributes to a lower dementia risk.  People who are regularly engaged in social interaction maintain their brain vitality.

However,  the combination of physical and mental activity with social engagement is more effective than any of these factors alone (Your Brain Matters: the Power of Prevention).

 

Dementia: the big picture
The Australian Government’s Institute of Health and Welfare (2018) confirms that: in 2014-16, Australian men aged 65 could expect to live another 20 years and women another 22 years.  The prospect of getting dementia because we are living so much longer is cause for concern not only for the devastating impact on our personal lives but also for the increasing economic costs to our society.

In 2016 Alzheimer’s Australia commissioned the National Centre for Economic and Social Modelling (NATSEM) to examine Australia’s problems with the increasing labour- intensive costs of dementia and the loss of economic productivity by dementia sufferers and their carers. Its 2017 report, The Economic Cost of Dementia in Australia 2016-2056, was prepared by Professor Laurie Brown, Erick Hansnata and Hai Anh La at the University of Canberra.

While this report makes for disturbing reading it provides us with clear priorities for  promoting preventative programs for dementia.  Some of its major findings include:

  • Dementia is one of the major chronic diseases of this century. The health, social and economic costs of the disorder are enormous and growing.
  • Over the next forty years, the number of Australians with probable dementia is projected to increase 2.75 fold.
  • Dementia is now Australia’s second leading cause of death.
  • While dementia is not curable, effective reduction and preventative health measures can delay the onset of dementia for up to five years.
  • A holistic approach to dementia care begins with raising awareness amongst the general population (2017, pp. x-xi).

The report claims that, if Australia actively promoted prevention programs, there would be an estimated 13% reduction in the number of people with dementia by 2036 and a 24% reduction by 2056.

Neuroscience and risk reduction
Kaarin Anstey, a senior principal research scientist at Neuroscience Research Australia, looks at the brain’s capacity to build cognitive reserve to reduce delay risk factors for dementia . In 2018-19, I enrolled in the University of Tasmania’s Wicking Dementia Research and Education Centre’s two online courses: Understanding Dementia and Preventing Dementia (Anstey being was one of their researchers). Here she argued:

Even for older people, benefits come from lifestyle changes to our behaviours if we stay mentally active and cognitively engaged. This allows us to build what is called “cognitive reserve” (Anstey 2018).

Identifying risk
The NATSEM report argues that the prevalence and incidence of dementia is not only related to age and gender but also reflects the joint or interactive effects of a range of “lifestyle” or other factors. It lists many factors known to be associated with an increased risk of developing dementia in later life, including being overweight or obese in mid-life; having diabetes or depression; raised serum cholesterol; at risk alcohol consumption; being a current or ex-smoker; or having low levels of social participation. In fact, being overweight in mid-life imposes a relative risk of 1.5 compared with those who are normal weight; and being obese an increased risk of 1.64 (Anstey 2013).

In contrast, being more physically and cognitively active, as well as having higher levels of fish and vegetable intakes, were reported to offer some protection against dementia (2017, p.12).

In a model developed by the Lancet Dementia Commission, the risks for dementia are outlined by age:

  1. In Early Life: (Potentially non-modifiable 65%)
    Less education
  1. In Midlife: ( Potentially modifiable 35%)
    Hearing loss
    Hypertension
    Obesity
  2. In Later Life: (Potentially modifiable 35%)
    Smoking
    Depression
    Physical inactivity (greatest risk)
    Social isolation
    Diabetes

In addition to the modifiable risks, the Lancet research also recommends cognitively stimulating activities and the Mediterranean diet.

Responding to risk factors
Lancet claims that some of the risks to dementia are best addressed in midlife . Anstey (2018) also states that Alzheimer’s pathology accumulates slowly through middle age with high blood pressure and lifestyle risk factors. She believes that the earlier we start the modification of behaviours, the greater the benefits will be.

The input of UQ students
As a foundation member of Circuit Connections at UQHL, I see the relationship between university students and participants as reciprocal, and an example of the vital contribution these students play in establishing a healthy heart, healthy mind approach to long term wellbeing. Students not only provide additional support for clients, they also bring fresh ideas, enthusiasm and vitality. Their input energises the participants – especially those who have been coming to the class for many years.

There is much potential for even more creative activities to stem from these classes.  Some students are already incorporating dance routines into these sessions, naturally integrating physical (cardio),  cognitive (remembering the steps) and social (lots of laughing) elements. With claims from Dementia Australia that dancing with others is one of the best activities to reduce the risk of the disease, the playfulness of the students has naturally aligned well to these findings.

Where to from here?
As UK’s Alzheimer’s Society has also confirmed, too many people delay seeking a dementia diagnosis by about a year. In one of their surveys of 2,000 adults, they found that nearly two thirds of people said that they feared a diagnosis would mean their life was over.  One in three said they didn’t go to a GP because they thought memory problems were a natural part of the ageing process.

Many may not realise that a half-hourly brisk walk five times a week has the potential to build exercise the brain and cognitive reserve.  Others may not connect their social isolation during the Covid-19 lock down with psychological risks linked to dementia.

Members of the UQHL community, especially those in midlife, should be aware that dementia is not necessarily inevitable. Being alert to the scientific evidence that, while we are exercising our heart, we can also be exercising our brain, could be a game-changing force for some.

For over 10 years Dr Maureen Bruce has engaged with various UQ fitness programs for older participants and has experienced first-hand the benefits of exercising with her peers. Maureen is a foundation member of the UQ Healthy Living community and committed participant in the Circuit Connections sessions. These experiences combined with Maureen’s professional and academic background in education and social research, provides a valuable insight into the ‘healthy heart, healthy mind’ approach to later life. The article is based on her explorations into this topic, including  recent courses in Understanding Dementia and Preventing Dementia (University of Tasmania).

Disclaimer: Any views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of UQHL.  Assumptions made within the analysis may not be reflective of the position of UQHL.