Forgetting things or downright losing their memory worries many seniors. If these cognitive disorders do not yet have effective treatments, they can however be avoided, delayed or limited. Education, vascular risk control and behavioral changes can prevent the onset of cognitive problems and even delay the onset of degenerative brain disease.
Posted yesterday at 1:00 p.m.
Alzheimer’s disease is probably the condition most feared by seniors. Along with other degenerative diseases called dementia, it affects 5 to 8% of people over 65. The frequency of these diseases increases rapidly with age and the aging of the population will therefore lead to an explosion in the number of people affected.
These diseases have significant consequences, so much so that it is estimated that they are responsible for 12% of the years lived in disability. They often cause a loss of autonomy which requires admission to a residential institution. We must also consider their impact on caregivers, both in terms of health and psychological and even financial repercussions. Available drug treatments have a modest effect on these conditions at best. Some people experience transient improvement or a condition that stabilizes, but for a fairly limited duration.
Mild cognitive impairments are even more frequent (15 to 20%) and are also associated with age. Although they only appear in the form of simple oversights without functional consequences, they are a source of concern since a certain proportion will progress to a degenerative disease.
We are beginning to better understand the mechanism of appearance of these benign cognitive disorders and dementias. On the one hand, we speak of cerebral reserve: the more cognitive functions are activated, the more the brain develops connections between neurons.
Thus, the level of education of a person and his intellectual activities increase this reserve. If the reserve is strong, it will take more time before it starts to start significantly and the slope of the decline will be less pronounced.
On the other hand, certain attacks on the brain destroy or damage its cells. The mechanism of the accumulation of waste products produced by cells such as amyloid or tau protein are less well understood. On the other hand, that of vascular, traumatic or inflammatory damage has been well demonstrated. The link between dementia and hypertension, hyperlipidemia, diabetes, obesity and head trauma is explained by this pathway.
Knowledge of these mechanisms stimulates scientists to discover new treatments. But above all, it opens the way to the immediate implementation of effective prevention strategies. It is estimated that modifiable risk factors explain 40% of the frequency of dementia and mild cognitive impairment. These factors are: education, high blood pressure, physical inactivity, diabetes, smoking, obesity, immoderate alcohol consumption (more than 21 drinks per week), lack of social contact, head trauma , deafness, depression and air pollution. If education occurs more at a young age, the prevention of head injuries or the control of diseases such as hypertension, diabetes, hyperlipidemia or obesity must continue throughout life. Smoking cessation, control of alcohol consumption, regular physical activity or social participation are behaviors that are still conducive to healthy cognition even in retirement. Finally, detecting and treating deafness or depression can improve brain function. In addition, many studies explore the impact of activities aimed at stimulating intellectual functions in order to maintain or improve cerebral reserve.
These factors probably explain the decrease in the frequency of degenerative brain diseases over the past decades in developed countries because new generations are more educated, have better diets and adopt healthier behaviors.
Clinical studies have demonstrated the effectiveness of multidimensional preventive programs in preventing if not delaying the onset of dementia and mild cognitive impairment.
These programs combine the control of risk factors with intellectual stimulation and social participation. Added to this is the adoption of healthy nutritional habits, in particular the Mediterranean diet which promotes cardiovascular health. A Canadian study using a digital strategy and personalized advice is currently being set up to confirm the impact of such a program on people over 60.
Cognitive disorders, Alzheimer’s disease and other dementias are conditions that alter the quality of life during aging and have considerable repercussions on the victims, their loved ones, the healthcare system and society. While treatments are still pending, we can prevent these conditions by increasing our neuronal reserve through education and maintaining intellectual activity or by decreasing the attacks on our brain by controlling harmful behaviors or diseases. Training physically and intellectually, eating better and maintaining social participation are probably the secret to a healthy and lit old age.