Monday, 15 January 2024

What does the latest research say about how to reduce dementia risk?

 Extract from ABC News

You may be aware that smoking, lack of exercise, poor diet and too much alcohol are linked to dementia and stroke.

But there are some other, perhaps surprising, ways you can reduce your risk of cognitive impairment as you age.

Sleep, socialising, challenging your brain, and small amounts of alcohol have all been found to improve brain health.

Neuroscience Research Australia chief executive and Brain Foundation president Professor Matthew Kiernan takes us through the latest research, and we hear from people who are trying to reduce their dementia risk.

Katrina Coleman and Cathy Kerrison sit next to each other at a table upon which jigsaw puzzle pieces are spread out
Doing jigsaw puzzles is one way to keep the brain active, and it can double as a social activity.( ABC News: Luke Bowden )

Let's start with a good sleep

Scientists have become more aware of the importance of sleep on brain health in recent years.

During deep sleep the glymphatic system is activated.

A bedside table with a lamp next to a wooden bed
The Brain Foundation says it's important to get between six and eight hours of sleep a night.(Supplied: Calum Lewis/Unsplash)

"This is really a reservoir that puts all of the fluid through the brain and cleans out toxic chemicals," Professor Kiernan said.

"It only becomes active when we're in the deepest REM (rapid eye movement) sleep"

Professor Kiernan said it was important to get between six and eight hours of sleep a night.

The Brain Foundation suggests staying off your phone and not looking at work emails after 9pm, that you stop drinking caffeine after midday and not going to bed until you feel sleepy.

Socialising and challenging your brain

Katrina Coleman is doing her brain a favour with a group jigsaw puzzle session.

Ms Coleman won a national puzzle championship and came 20th in the World Jigsaw Puzzle Championships in Spain last year.

A photo taken from above of four people doing a jigsaw puzzle together on a black table
Katrina Coleman (centre) says it's important to keep your brain active.( ABC News: Luke Bowden )

She's known about the importance of challenging her brain since she was a child.

"My grandmother used to do a lot of crosswords as well as the puzzles and she had a very active brain right up until she passed," Ms Coleman said.

"That is always something in the back of my mind — to keep your brain ticking over for longevity."

Adding a social element to puzzling is a new thing.

"If you can socialise with other people while doing your puzzles you can reduce anxiety levels and keep that social interaction happening particularly as you get a little bit older," Ms Coleman said.

Katrina Coleman and Cathy Kerrison sit next to each other at a table upon which jigsaw puzzle pieces are spread out
Jigsaw puzzles have become a social activity for Katrina Coleman.( ABC News: Luke Bowden )

According to the Brain Foundation, cognitive functioning decreases with age because of a loss of connective structures called synapses.

Like any other muscle, the connections in the brain need to be used and challenged to stay strong.

Professor Kiernan said that could mean trying new things like going to the theatre, travelling, reading or doing crosswords.

"The more that we can engage different parts of the brain, different parts of the network, the better the brain functions."

He said while socialising was also incredibly important for the brain, it's not clear why it works.

"Maybe it's through the release of other neurotransmitters in the brain, including oxytocin and dopamine, that enhance brain function longer term," Professor Kiernan said.

Alcohol and HRT

There's new evidence that hormone replacement therapy (HRT) may reduce the risk of Alzheimer's disease in women.

A study recently published in the journal Frontiers in Aging Neuroscience has found that estrogen therapy could protect the female brain from Alzheimer's and dementia if the hormones were taken when menopausal symptoms began.

Professor Kiernan said the results from the large scale study were promising.

"That's something that's cutting edge and obviously needs to be explored in greater detail," he said.

Professor Matthew Kiernan, wearing a light pink shirt and dark suit jacket stands in a park and looks at the camera
Matthew Kiernan says the more different parts of the brain are engaged, the better the brain functions.(Supplied)

Previous studies have shown that beginning HRT later in life could carry a greater risk of developing dementia.

The Australian Menopause Society stated there was weight to the "timing theory" which suggested initiation of hormone therapy around the time of menopause may have health benefits, whereas beginning the therapy later in life carried greater risk.

There was also a sweet spot when it came to alcohol consumption. Small amounts of alcohol can improve cognitive function long term, Professor Kiernan said.

"Particularly red wine which may be through antioxidant and vasodilator effects."

But he said intake must be limited.

"That means basically one or two standard drinks per day … and less than 10 alcoholic drinks per week."

Six glasses of red wine being held up for a toast, the drinkers' hands are visible
Small amounts of alcohol, particularly red wine, can improve cognitive function in the long term.(Supplied: Kelsey Knight/Unsplash)

Jon's story

Jon Moore's mother had dementia.

"She passed away at quite an early age," Mr Moore said.

"It's amazing the effect it has on you, and it's a very sad thing, sad for the person and very hard for the family."

Jon Moore stands in front of a wooden wall with a landscape painting haning on it, he has his head turned to one side
Jon Moore's mother had dementia.( ABC News: Luke Bowden )

Mr Moore is participating in what's been described as the world's largest dementia prevention study.

"We just feel we want to help out … hopefully find some sort of, maybe not a cure, but maybe something that is going to bring the numbers down."

The study is called the Island Project, and it's run by the Wicking Dementia Centre in Tasmania.

The project is looking to sign up more than 20,000 people aged over 50 years to take part in the study.

It involved participants doing a series of online tasks and movements, like tapping their fingertips.

Artificial intelligence is used to determine if there might be subtle changes in some of those movements which might indicate changes in brain function.

Professor James Vickers speaks to a woman who is out of focus and has her back to the camera
James Vickers says he hopes the Island Project will give participants a chance to slow or prevent the onset of dementia.( ABC News: Luke Bowden )

The Wicking Centre's James Vickers said those subtle changes could indicate a neurodegenerative process "years before you start to develop symptoms, the obvious symptoms of dementia".

Professor Vickers said these early indications could give participants a chance to slow or prevent the onset of dementia by making lifestyle changes.

That could mean addressing issues like obesity, smoking and high blood pressure.

"Hopefully [it will] motivate participants in the projects to tackle those health factors and reduce the risk of dementia in their lifetime," Professor Vickers said.

Jon Moore sits at a table in front of a laptop and holds up his hands, a young woman sits beside him watching
Jon Moore is taking part in what's been described as the world's biggest dementia prevention study.( ABC News: Luke Bowden )

While most of the risk for dementia was associated with ageing, research has shown about a third of dementia cases could be prevented if risk factors were addressed, particularly from middle age onwards.

Professor Vickers said there were risks people may not be aware of yet.

"Depression in older age is linked to risk of dementia," he said.

"Educational attainment is an interesting one; the more education you have earlier in your life the less chance you have of developing dementia later in your life."

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