Crowds of families, unfortunately, encounter the reality of dementias when the hot potato has already exploded in its face or when it is about to explode. We live in a society that as a rule is dedicated to putting out fires instead of spending time and resources in planning and designing firewalls. With others words; we heal but we don't prevent.
We are experts in worrying when a problem appears and we try to do everything in our power to tackle it at the root. What happens when the situation presented to us is chronic in nature? What if in the vast majority of cases it is degenerative? Why don't we strive to get ahead of the problem and try to do our best to prevent it?
We may not do it because we are concerned about other "more important" issues since we believe that this concrete threat is not yet present. Maybe we don't do it because of misinformation. We may not do it because we cling to the reassuring message "this is not going to happen to me." Everyone will have their reasons.
With this short article I want to bring a material that I consider very useful to any reader who wants to know what are the most studied primary prevention measures in dementias. But before continuing, I have to answer the following question briefly.
- 1 What is dementia?
- 2 Current figures
- 3 Primary prevention measures
What is dementia?
There are still many people who really don't know what is dementia?. Well, to try to approach the term in a clear and accessible way, I have chosen a definition that provides, in Spain, the clinical guide specialized in the matter published by the Ministry of Health:
“Dementia is a syndrome - usually chronic or progressive in nature - characterized by the deterioration of cognitive function (that is, the ability to process thinking) beyond what could be considered a consequence of normal aging. Dementia affects memory, thinking, orientation, comprehension, calculation, learning ability, language and judgment. Consciousness is not affected. The deterioration of cognitive function is usually accompanied, and is sometimes preceded, by the deterioration of emotional control, social behavior or motivation.
Dementia is caused by various diseases and injuries that affect the brain primarily or secondaryly, such as Alzheimer's disease or strokes. ”
All of us, in a more or less direct way, have had contact with dementias. Worldwide there are about 47 million people (more than the total population of Spain) suffering from dementia, and approximately 9.9 million new cases are registered each year, which is a new case every 3.2 seconds. But the data does not remain here, WHO expects the total number of people with dementia to go to about 75 million in 2030 and almost triple in 2050 (132 million).
The Alzheimer disease, which is the most common and best known cause of dementia, accounts for between 60% and 70% of cases. In Spain, the prevalence of dementia in people over 60 years of age already reaches 6.3% according to the report of the OECD 'Health at a Glance'.
With these figures, dementia becomes one of the main causes of disability and dependence among older people worldwide.
Primary prevention measures
I don't mean to scare anyone. My only objective is to try to raise awareness of everything that, today, is in our hands to prevent this syndrome. For this, it is necessary to know what are the factors that are closely linked with the appearance and development of this syndrome.
Below I present a list that breaks down the primary prevention measures that enjoy greater scientific support and that collects the Ministry of Health in your clinical practice guide:
- One is recommended balanced diet based on the Mediterranean diet (rich in Omega-3), with foods low in saturated fat and high in vitamins E and C. Due to the characteristics of the Mediterranean diet, it is recommended to consume fish, vegetables, fruits, nuts and vegetable fats. Likewise, it is recommended to avoid very caloric foods, animal fats, saturated fats as well as reducing sugar intake.
- The moderate alcohol consumption (less than 2-3 units / day) in patients with healthy lifestyle habits. Red wine seems to have been shown to have more beneficial effects than the rest, due to the antioxidant effects of grape polyphenols, although in other studies, these findings did not depend on the type of alcohol. At this point, it is convenient to point out and make it clear that excessive or abusive alcohol consumption poses a significant health risk.
- Encourage moderate physical exercise and avoid obesity.
- Keep mentally active (challenge your brain every day), cultivate the relations so much social (part of an active social network) as recreational or idle (dance, walk, play cards, play music, read a novel, write, do sudoku or puzzles, play chess ...), avoid the isolation and the loneliness.
- Control cardiovascular risk factors: arterial hypertension (although not all studies have shown that antihypertensive treatment decreases the risk of dementia), dyslipidemia, diabetes mellitus, avoid smoking and reduce the stress.
- Prevent head injuries, using appropriate security and / or protection measures.
- Prevent and treat diseases that potentially cause dementia: hypothyroidism, chronic alcohol abuse, HIV, syphilis, herpetic encephalitis, etc.
- Deal with aspirin or other antiplatelet agents to subjects with previous cerebrovascular disease, although there are conflicting studies regarding the possible beneficial effect of aspirin in the primary prevention of dementia.
- Do not advise cerebral vasodilators, because its clinical benefits are not significant.
- Rational use of drugs, avoiding, whenever possible, those with potential cognitive toxicity. Examples of drugs used regularly and having cognitive toxicity: anticholinergics, tricyclic antidepressants, lithium, bezodiazepines, neuroleptics, propanolol, methyldopa, clonidine, reserpine, metoclopramide, cimetidine, antihistamines, non-steroidal anti-inflammatories, digoxin, digoxin barbiturates, hydantoins, valproic acid, methotrexate, bismuth.
- The use of the hormone replacement therapy in postmenopausal women It is not recommended as a measure of primary prevention of dementias, as it has been shown that there is an increase in the relative risk of suffering from dementia with its use.
If we prevent better, we will heal later or we may never have to. Think about it and never stop investing in health. Now you have the information, you just need to put the saying of "Prevention is better than cure."