Dementia risk falling, but remains a threat [Senior Circles]

On my way to a meeting one morning last month, I heard on my car radio, "Dementia risk falling in the West." This was good news and definitely intriguing and worth some research as to why.

After the meeting, I engaged Ilene Rosenthal in discussion on what I heard about dementia that morning. In her position as program director for Alzheimer's Association Greater Maryland Chapter, I knew she would be aware of the latest news on cognitive impairment issues.


She had provided me with the information I included in my last column on the Medicare Wellness Exam, which includes a check for cognitive impairment in the patient. Ilene quickly followed up by email with several URLs for me to look at, one on the dementia risk falling and the other on a new brain protein tied to Alzheimer's disease, the most common form of dementia.

I hope you aren't getting tired of me writing about dementia and Alzheimer's. These diseases aren't going away any time soon and there is news almost every day on research findings. As a friend recently wrote in a committee report, "Alzheimer's does not take time off."

In her July 2014 health article, "Dementia risk falling for elderly in the West: Better education and drugs keep brains sharp," in the UK's Daily Mail, Fiona Macrae summarized her key points: "Average American over 60 has 44 percent lower risk of disease than 30 years ago; Number of new cases in Germany has also 'significantly declined'; Better control of high blood pressure and cholesterol most likely reason; But rates in poorer counties are increasing due to obesity and diabetes." Her reference to drugs is about medications, which reduce high blood pressure and lower cholesterol, both of which are factors in developing dementia and Alzheimer's.

We have all heard that doing crossword puzzles and other brain stimulating games or pursuits are good for our brains, but that isn't necessarily going to prevent dementia and Alzheimer's. It is highly important that we take a good look at our lifestyles.

Among the lifestyle factors to look at are inactivity, obesity, smoking, high blood pressure and high cholesterol. The most important cause of dementia and Alzheimer's is lack of exercise. Research shows that you can cut your Alzheimer's risk by walking 20 minutes three times a week. Walking, and other forms of exercise, keeps your blood flowing to the brain and reduces plaque build up. We have control over our habits and can take steps to improve our lifestyles.

It is very unfortunate that virtually every drug trial intended to stop or reverse Alzheimer's progress has failed because the patients have already suffered too much brain damage. It is encouraging though that there are some promising tests in development.

One of these tests, still in its early stages, is an eye test, which could be used to diagnose early stage Alzheimer's. There apparently is a key Alzheimer's trait that can be identified in the retina and lens of the eye. Another test used to diagnose Alzheimer's is a smell test. One I read about uses peanut butter. A patient's inability to detect and identify the odor indicates that person has damaged brain cells. The loss of the sense of smell may be a predictor of Alzheimer's. The key is to diagnose the disease early before it has progressed and these two tests sound very promising for the future.

It used to be that a diagnosis of Alzheimer's could only be positively identified after death. We now have imaging agents that can show amyloid on brain scans and an experimental product that does the same for tau. Amyloid and tau make up sticky brain plaque, which are known to be telltale signs of Alzheimer's.

Scientists, led by Dr. Keith Josephs of the Mayo Clinic, have now linked a new brain protein, TDP-43, to Alzheimer's. Apparently everyone has this protein; however, the abnormal form is found in different parts of the brain cell and in ball-like deposits in certain areas of the brain.

This brain protein has already been linked to Lou Gehrig's disease and frontotemporal dementia. According to the Alzheimer's Association, Frontotemporal dementia is "a group of disorders caused by progressive cell degeneration in the brain's frontal lobes (areas behind forehead)."

Let's do all we can to reduce our own risk of dementia and Alzheimer's and thereby reduce the overall risk in this country.