If you are under 40 and can’t remember where you’ve left your car keys, is just one of those things: you decide to pay more attention next time you put them down. But if you’re in your 50s or 60s it brings a stab of fear and the question – could this be the beginning of dementia? The brain changes that lead to Alzheimer’s disease begin many years before symptoms appear and although it’s not a natural part of ageing the fear of dementia increases as you grow older.
In a recent poll of attitudes to ageing conducted by YouGov for our charity, the Pilgrims’ Friend Society, some 62% of 40 to 60-year-olds in the UK said that they are worried about developing dementia in later life. The disease still holds the dread that cancer did 30 years ago, although it is less now that many cancers can be treated. In contrast, only a few drugs help people with dementia and there is no cure in sight. Dementia is not only a terminal disease but one that hits our greatest fear – of losing control of our lives, and our very being.
But people in this age group have more control over their ‘dementia destiny’ than they realise, certainly more than previous generations.
Over the last 30 years, the rate of new cases of dementia (the incidence) has dropped by 20 percent in our Western world. [i] If this trend continues, by 2040 there will be 15 million fewer people with dementia in these countries. The fall is because people have listened to public health advice and adopted healthy lifestyles, and now have better cardiovascular health, as well as higher levels of education, which help prevent dementia. Neurologist Jonathan Scott of UCL, London, said that the findings ‘reinforce the importance of population-based efforts to improve vascular health and suggests that we may already be seeing dementia prevention in action.’
It could also be the answer to the big question prompted by the controversial theory that Alzheimer’s disease is caused by protein deposits on the brain (amyloid plaques and neurofibrillary tangles). These deposits are referred to as ‘the hallmark of Alzheimer’s’ yet they are also found in the brains of most older people who never develop the disease, or any other type of dementia, including those living into their 90s and 100s.[i] Like Dr Scott many believe this is because good cardiovascular and brain health staves off their effects, while others question whether the plaques are the cause at all.
Now more attention is being given to the effects of mental health on the brain and dementia. In a study of 1.7 million New Zealand citizens over three decades, those with a mental-disorder diagnosis were found to be more than four times as likely to develop all types of dementia than those without:[ii] and other studies show the same. More women than men develop Alzheimer’s disease, and while a factor is that women live longer than men this is thought not to be the only reason. Women’s brains are wired differently to men’s, which is why they experience higher levels of empathy and emotional understanding than men.[iii] While these are generally positive qualities they are closely tied to depression, anxiety and stress. Women are three times more likely than men to experience common mental health problems, say researchers at the Mental Health Foundation, who attribute it to social pressures and life disadvantages. For example, thousands of middle-aged women find themselves caring for their families as well as an elderly parent, with all the stress involved, and it’s known that that women living with chronic stress in middle age have an increased risk of dementia in their latter years.
Women are also more likely to suffer mental stress-induced constricted blood vessels than men, according to the American Heart Association. Their experts say that women need to think about ways of protecting their hearts, such as relaxation techniques, physical exercise, and nurturing family and friendships. The NHS therapy of choice is Cognitive Behavioural Therapy, that helps recognise and tackle the negative thinking and emotions that cause stress. A good self-help handbook, available from Amazon, is ‘The Little CBT Workbook, A step-by-step guide to controlling your life.’ It can be challenging work changing a life-time’s habits, but it’s worth it for a happier life now and a future without Alzheimer’s disease. Starting now, women can ensure a place among the 15 million extra living dementia free in 2040.
Look out for new resources, coming soon from Pilgrims’ Friend Society, to help those in mid-life make the changes now which can lead to a great later life.
[i] https://www.alzforum.org/news/research-news/those-declining-dementia-rates-its-not-plaques-and-tangles [ii] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2789298#:~:text=Findings%20In%20this%20population%2Dbased,dementia%20and%20younger%20dementia%20onset.