Tia Powell MD

Dementia Reimagined

Dementia

Taking Steps Against Dementia: Dos and Don'ts

What works and what doesn't for maintaining cognitive function.

Posted Apr 26, 2019

Don’ts

1. Don’t bother with genetic testing unless you have relatives who had dementia well before they turned 65.

Genetic testing sounds very scientific and official; that doesn’t mean it produces useful information. Take APOE e4, a common genetic variant that increases the risk for dementia in those older than 65. If you test positive for it, then you have an increased risk above the general population. Does dementia run in your family? Then I can tell you right now you have an increased risk. Could you get tested and rejoice if you’re free of this genetic variant? Unfortunately, no. The majority of people with dementia test negative for APOE e4. Things are different if you have relatives who developed dementia before age 60. They may have different risky genes, and it may be more useful for people in this group to be tested, especially if your affected relative can also be tested. If you’re in that group, consider consulting a genetic counselor.

2. Don’t take the many supplements that claim to prevent or cure dementia.

The FDA recently sent warning letters to a dozen sellers of supplements who claim they can do great things for dementia, because their claims are unsupported by data. Save your money.

3. Mostly, don’t lose hope.

There is a lot you can do now to improve a possible future with dementia. Is your home safe for aging in place? Can you fix problems—add lights and grab bars, for example, and subtract tripping hazards—or do you need to find someplace better suited to aging and cognitive disability? What activities do you enjoy that you may be able to carry forward into a future with a disability? If you’d like to see yourself in a seniors' singing group, does such a thing exist in your community? Can you help get one started? Is there a community garden? An appealing day program? Helping others now may be the best way to help yourself later, and it will always be good to have benefited your community.

Matthew Schwartz/Creative Commons
Old man lonely in the park
Source: Matthew Schwartz/Creative Commons

Dos

1. Stay fit!

Most of us are not competing with Serena Williams, but that doesn’t mean we should give up. Find something active you like to do and your odds of keeping it up will improve. How about walking regularly with a friend? That will combine the benefits of fitness with those of social engagement, both good for maintaining your cognitive abilities. Use the money you would have spent on supplements and genetic testing for walking shoes or a gym membership: These will have a greater likelihood of holding off dementia.

2. Eat well.

Ramp up the fresh fruits and vegetables, and dial down the meat and dairy. I know it’s tough. I personally loooove good cheese. But now I try to use it as punctuation, not the whole paragraph.

3. Know that all lives can and should include joy, and this is true for a life with dementia.

Our biased image of dementia focuses on the final stage of severe disability. We need to make sure that people at the end are comfortable and well cared for. But that end-stage picture is inaccurate for the vast majority of those with dementia, who are in earlier phases. They are our neighbors, our friends, the man ahead of you at the grocery store. With some kindness and support, we can decrease the shame that afflicts those with dementia. We can work to improve our communities and support those who are aging with cognitive impairment. We can do this for others, and we can do it for our future selves.

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