SUBJ: SPECIAL EDITION: Reducing the risk for dementia

SUBtitle: Most powerful tool to prevent dementia is exercise.

I just read a chapter in Outlive, the science and art of longevity, by Peter Attia, MD.  Focus is on dementia.

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NOTES:

From the Chapter, can Neurodegenerative disease be prevented? A 2015 stuudy of 1,200 at risk older adults showed nutrition, physical activity, and cognitive training have prevented cognitive decline.  Female Alzheimer’s (AD) outnumber men by 2 to 1.Brain builds over a lifetime.  Education and experience, complex skill development like learning foreign languages or playing musical instruments, provide a cognitive reserve to resist AD. Movement reserve like athletes resists and slows Parkinson’s Disease (PD).  Movement and exercise are primary treatment strategies for PD.  Brain is a greedy organ, using 20% of energy daily for 2% of body weight.  Inflammation promotes atherosclerotic damage to blood vessels, setting the stage for dementias.

The preventive plan: We know more about preventing dementia than about preventing cancer.  Goal is to improve glucose metabolism, inflammation, and oxidative stress. Eat a Mediterranean diet, monounsaturated fats, and fatty fish. Unoxidized DHA, found in krill oil, is a good supplement.  A ketogenic diet has a great advantage – supplement BHB.  Single most powerful tool is exercise.  Grip strength is a great proxy for overall strength.  Lowest quartile of grip strength in people had a 72% higher rate of dementia.  Sleep is also a powerful tool against AD.  During sleep, the brain “cleans house” sweeping away extracellular debris – the brain opens like a sponge during sleep.  Hearing loss is also associated with dementia, perhaps due to decreased interaction with others.  To reduce systematic inflammation, tooth brushing and flossing are very important.  Flossing removes G. gingivalis which has shown up in the brains of Alzheimer’s patients.

BASIC STRATEGY:

  1. What’s good for the heart is good for the brain. Low inflammation (fish, vitamin D), low oxidative stress (vitamin C).
  2. What’s good for the liver is good for the brain. Metabolic health, cholesterol, reduced sugar.
  3. Time is key. Start prevention when you are young – now. Exercise, diet, manage stress, sleep.
  4. Most powerful tool to prevent dementia is exercise.