Alzheimer’s Disease

Taking care of the ageing brain

Sri Lanka where I grew up has one of the most rapidly ageing populations in Asia – and according to a 2003 study by Prof Asita de Silva of Kelaniya University, the reported prevalence of Dementia (an overall decline in brain function) in this country is one of the highest in the Indian subcontinent..

Although Dementia has several causes (for example Vascular dementia, Lewy body dementia etc), one of the commonest forms of cognitive decline is Alzheimer’s disease.  Unfortunately, we have still not discovered a cure for this condition, so current research is focused on finding ways of preventing it – or at least delaying its progression.

Previous research has shown that people who regularly engage in mentally challenging activities –  playing chess or bridge, doing crosswords, learning a new language or undertaking the kind of work that requires them to actively utilize their brains – appear less likely to suffer from Alzheimer’s in later years. Similarly, people who are physically active — walking, cycling, swimming or dancing regularly — seem better protected against cognitive decline.

The problem in interpreting these findings is that it isn’t possible to determine whether the reduced likelihood of such people developing dementia is directly due to their increased mental and physical exercising – or simply an association reflecting the fact that those are active like this are the very folk who have inherited good genes. Showing the association between such activities and the reduced risk of Alzheimer’s is easy – but proving that one is a direct effect of the other is not so easy!

Abnormal Blood Pressure and High Cholesterol

The OPTIMA Longitudinal Study analysing the association between blood pressure, dementia and Alzheimer’s disease was recently published by Tasmania University’s Prof. George Razay in the journal Dementia and Cognitive Geriatric Disorders. This found over five years of follow up that people who had abnormal levels of Diastolic blood pressure  (greater than 110 mm Hg or less than 60 mm Hg) were prone to faster cognitive decline than those who had normal blood pressure.

In another research study from Finland, Sweden, Boston and California, the relationship between cholesterol levels in middle age and the likelihood of developing Alzheimer’s disease in later life was investigated in a group of over 9800 participants.

Dr. Alina Solomon’s team found that even moderately high levels of cholesterol in middle age were associated with an increased risk of Alzheimer’s disease and vascular dementia. They concluded that the risk factors for dementia need to be addressed as early as in the middle years of life BEFORE the symptoms and signs of the disease appear.

We cannot at present cure Alzheimer’s disease.

All we can do with our present state of knowledge is to do the best we can to prevent it coming on as we get older.