Supplements do not prevent dementia. But these steps could.



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Donna Kaye Hill realized that her 80-year-old mother was cognitively impaired when her phone suddenly stopped working. When Ms. Hill called the phone company, "they told me that she had not paid her bill for three months".

Finding other alarming evidence of gaps in memory, she took her mother, Katie, to a memory clinic. A geriatrician diagnosed dementia and recommended two prescription medications and a dietary supplement, a form of vitamin E.

Katie Hill conscientiously took vitamin E capsules, as well as many other medications, until her death four years later. As she refused, her daughter did not think that the vitamin, or both prescription drugs, made a big difference.

"But if it does not hurt, if there is a chance it helps, even a little bit, why not?" She says to herself. Hill, 62, a retired civil servant in Danville, Va., Herself taking fish oil capsules daily, hoping they will help fight the disease that killed her mother .

But there are other ways that people can reduce their risk of dementia. Two prestigious panels, examining numerous prevention studies, have recently made several recommendations.


Dr. Kristine Yaffe

University of California at San Francisco


The most conservative report of the National Academies of Science, Engineering and Medicine in 2017, was based mainly on large randomized clinical trials.

Since there are not many of them, the panel approved only three interventions "supported by encouraging but inconclusive evidence" to prevent, delay or slow down cognitive decline.

L & # 39; shaft:

  • Increase in physical activity;

  • Management of blood pressure in people with hypertension, especially in their forties;

  • And cognitive training.

The latter recommendation does not necessarily refer to commercial online brain games, said Dr. Kristine Yaffe, a neuropsychiatrist and epidemiologist at the University of California at San Francisco, who was part of the panel.

"It's really the concept of mental activity," she said. "Find something you love where you are learning something new, stimulating and stimulating your brain."

Although the evidence to date does not establish which mental training has the greatest impact or how often people should engage in it, "they are not expensive and they do not cause side effects," he said. Dr. Yaffe.

The recommendation regarding blood pressure was strengthened in January by the latest findings of the Sprint trial. A multisite study was discontinued in early 2015 when intensive treatment of hypertension (a goal of systolic blood pressure lower than 120, compared to standard 140) reduced cardiovascular events and deaths.

The investigators, however, continued the trial with 9,361 hypertensive participants (mean age: 68 years) and completed their cognitive follow-up assessments.

Their results, published in JAMA, showed that the intensive treatment group was less likely to develop dementia than the standard treatment. but not by a statistically significant margin. Intensive treatment, however, significantly reduced the risk of mild cognitive impairment, often a precursor to dementia, in participants.

"For me, this has been one of the most exciting discoveries in recent years," said Dr. Yaffe, who noted in an accompanying editorial that it was about first large-scale trial to demonstrate an effective strategy for the prevention of age-related cognitive impairment.

"The same things we recommend for heart health turn out to be important for cognition," she said. "It's a field in bloom."

The Lancet Commission on Prevention, Intervention and Dementia Care has also recommended hypertension treatment for middle-aged people, as well as exercise, l-39. social engagement and quitting, as well as the management of obesity, diabetes, hearing loss and depression. Such measures could prevent or delay a third of cases of dementia, the commission said.

When Dr. Yaffe gives lectures on the prevention of dementia, she also mentions good sleep hygiene and urges listeners to protect themselves against brain damage.

This is an important tip, but sadly dramatic. Where is the magic bullet? Do not we already know how to stay active physically and mentally, maintain normal weight, treat high blood pressure, etc.?

In addition, "it's not foolproof," acknowledged Dr. Yaffe. In the lottery of dementia, "there is a role for genetics. Bad luck has a role to play. "

She added: "The concept is important. You can do something about it. You can reduce your risk. "

That's why the most useful approach Donna Kaye Hill uses to protect herself from dementia probably does not take fish oil.

This includes the use of medications to control his blood pressure. And read biographies and mysteries and join a reading group with friends. And walk four or five thousand five days a week with Annie, a yellow Labrador.

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