WHAT is Dementia?? At our Lunch and Learn program on May 17, 2023, our speaker, Dr. Tim Kockler, PhD, Neuropsychologist, told us that it is not just one disease entity but is an umbrella term for all subtypes of cognitive disturbances. Symptoms may be loss of memory or evidence of impaired executive function of the brain. It was interesting to learn that our cognitive decline begins at age 40! Most of us experience mild cognitive impairment (MCI) as we age which may be manifested by our inability to readily retrieve information that is stored in memory but can be recalled at a later time. MCI between the ages of 60 to 80 can be a precursor to diagnosis of dementia 6-8 years later. If concerns about one's mental abilities are identified, the neuropsychologist will examine the patient and order extensive cognitive testing-covered by most insurance (including Medicare) before determining which type(s) of dementia may be present. This diagnosis will also determine the course and possible outcome of the disease.

Types of Dementia:

  • Alzheimer's Dementia - the most common form, results from a buildup of amyloid plaques and 'tangles' in the brain causing short term memory loss, thinking, reasoning, planning, organizing and personality and behavioral changes. It can have early or late onset and less than 1% of cases are genetic. Other risk factors may be age, being female, air pollution, excessive alcohol consumption, poor sleep, lack of exercise, obesity, smoking, history of high blood pressure, high cholesterol, and type 2 diabetes.
  • Lewy Body Dementia - caused by an abnormal buildup of proteins, known as Lewy bodies, in the brain, seen more frequently in males after age 60 and manifested by hallucinations, movement disorders, poor regulation of vital signs, cognitive decline, sleep difficulties, decreased attention, depression and apathy. Lewy Body Dementia symptoms like movement disorder and hallucinations have sometimes been misdiagnosed as Parkinson's. Because treatments are different for each, it is most important that the correct diagnosis is made.
  • Vascular Dementia - results from changes in brain cell activity because of damage to blood vessels which nourish those cells. Anything that increases risk for stroke or heart disease such as high blood pressure, cholesterol or blood sugar, sleep apnea, COPD, emphysema, and poor lifestyle choices, can cause damage to or hardening of the arteries resulting in loss of mental acuity and ability to plan and organize using good judgment and informed decision-making.
  • Frontal Temporal Dementia - called Pick's disease, a rare form of dementia, is seen in those as young as 45 and can be caused by genetic mutations. The front and side parts of the brain, responsible for language and behavior, become affected by abnormal deposits (tau proteins) causing such symptoms as loss of inhibition or motivation, increase in compulsive activity and problems communicating.

Although we hear so much about dementia in our society today, Dr. Kockler emphasized there are lifestyle choices we can make to give our brains the best chances for good health and he stated the importance of the "big" three:

  • Socialization, including challenging our brains with reading, Internet use, crossword puzzles and chatting with others, to help keep brain cells alive.
  • Exercise, the value of which cannot be quantified. EVERYTHING (formal or informal) counts - 30 minutes, five times a week is the current gold standard. Walking helps both your brain and your bones - Movement is Medicine!
  • Diet. The latest research and thinking says that we are most benefited by consuming a diet lower in protein and higher in carbohydrates. Avoid fried foods and other processed food items. Fresh is best! He also told us to beware of unproven supplements, like Prevagen, which promise to boost brain health but deliver nothing. Take only medications prescribed as a result of findings from professional testing. Bottom line: maintain healthy blood pressure, cholesterol and blood sugar levels and weight, don't smoke, eat a healthy diet and drink alcohol only in moderation. Your brain cells will thank you for it!

If you would like to listen to the audio from Dr. Kockler's presentation, it can be found here. The PowerPoint slides from the presentation can be found here.