The Winnfield Rotary Club’s meeting on May 25, 2022, saw the return of a recent guest speaker, Erin Boyt with the Natchitoches Regional Medical Center. Ms. Boyt, in commemoration of May as National Mental Health Awareness month, had previously informed local Rotarians of mental health services available in our area. It was only fitting that the last meeting of the month related to mental health awareness as well. On this occasion, although the mental health theme was the same, the topic was dementia and Alzheimer’s Disease, at the request of Bo Walker, Rotarian of the day.
According to Ms. Boyt, who works with NRMC’s mental health division, more than 50 million people worldwide are afflicted with dementia, and the most common form of dementia is Alzheimer’s disease. The symptoms of all forms of dementia are similar, including short term memory loss, with intact long term memory, as well as some thinking and intellectual impairment, accompanied by mood and emotional changes. The symptoms are caused by shrinkage of the brain due to decreased blood flow to the brain, disconnection of neurons or clumping together of neurons in the brain causing decreased brain function as a result of the buildup of amyloid plaque also referred to as white matter, and a decrease in the volume of healthy brain tissue, called gray matter.
External signs of dementia often show up as coping skills people develop to cover up the problems with memory and cognitive function, such as writing notes to themselves to remind themselves of rudimentary activities like making coffee, making a sandwich, finding things around the house or locations with which the person has been familiar for years. Some people forget how to operate home appliances, forget to blow out a candle, or forget they have retired and go to work. That last is more common in men than women.
Heredity is a cause of early onset dementia/Alzheimer occurring before the patient reaches the age of 60. If a parent with early-onset dementia has three children, one of the three has a 70% chance of developing it as well. On the other hand, if the parent’s dementia manifests after the age of 60, there is no hereditary factor.
Several conditions of physical health contribute to the development of dementia/Alzheimer’s disease, including coronary artery disease, other diseases resulting in reduced blood flow to the brain such as high blood pressure and diabetes, and depression or stress. Both of the latter cause inflammation of the brain, which damages the telomeres which protect the ends of chromosomes in the brain. That damage prevents the telomeres from fusing normally with nearby chromosomes. An individual’s isolation worsens the symptoms of dementia.
There is currently no cure for Alzheimer’s disease or dementia. The patient will never regain the short term memory or cognitive function lost as a result of the condition. There are medications that may slow or stop the progression of the disease. If one notices any of the symptoms discussed above in himself or a loved one, talk to the person’s primary care physician, and get a referral to a neurologist. While the brain cannot be examined to determine a definitive diagnosis, there are tests that will allow neurologists to make a determination that Alzheimer’s disease or some other type of dementia is present. A CT scan of the brain allows diagnosticians to see an increase in white matter or a decrease in gray matter, and cognitive testing aids in the diagnosis. This testing must be done without the patient being aware he or she is being tested because people are very good at developing coping skills to cover up the memory loss from others. According to Boyt, tests will also allow determination of the stage of the disorder, early, late or final.
“There are many things we can do to help prevent the development of dementia,” says Ms. Boyt. These include physical exercise, mental exercises such as word games and puzzles, brain games, learning something new like a new language, socializing and providing service to others, good sleep and sleep habits, and good nutrition.
Good sleep aids in preventing dementia by allowing spinal fluid to migrate to the brain and remove toxins from the brain. This benefit of sleep has been discovered through the study of football players. Researchers have discovered that head, neck and spinal injuries sustained by football players impede the flow of spinal fluid to the brain during sleep, such that toxins are not eliminated and memory as well as cognitive function decline.
“Nutrition is important,” says Ms. Boyt, “we can prevent dementia by avoiding processed food which contains nitrates, nitrites and other additives harmful to the brain.” We should limit the consumption of bacon, processed meats, processed cheese, microwave popcorn and other foods which contain brain-damaging additives. Eat locally produced foods that undergo less processing than distantly-sourced foods. Avoid or limit consumption of white foods, such as white potatoes, rice, and refined flour products. Eat whole-grain foods such as quinoa. Fish are good for your brain, especially cold-water fish such as salmon, flounder, cod, and limit farmed fish. Avoid foods containing heavy metals such as mercury, and eat dark green leafy vegetables like spinach, romaine lettuce, kale, mustard, collard and turnip greens, both raw and cooked. These vegetables are effective at clearing heavy metals from our bodies. Other beneficial foods for brain health include all dark berries like blackberries, blueberries, cranberries, red wine in moderation, dark chocolate in moderation, coffee in moderation (so as not to disturb one’s sleep), and cold-pressed extra virgin olive oil and coconut oil. Avoid any oils that are produced by heat pressing because petroleum products are used in this process and even though they are filtered to reduce the petroleum, they cannot be completely removed.
Ms. Boyt pointed out that everyone experiences a normal cognitive decline as we age, and there is a big difference between that and the decline caused by dementia/Alzheimer’s disease. Some mild decline in memory and function does not warrant evaluation by a neurologist. But when a person has difficulty with routine and well-known processes, it is important to consult medical professionals right away to minimize loss of function if possible.
If Alzheimer’s disease/dementia is present, a continuum of care is available, depending on the stage of the disease. One may just need sitters at home to assist the caregiver, or require home health care or hospice care which can be done in the home. That includes regular visits by nursing assistants and nurses. The next step up from care in the home may be assisted living, which involves medication assistance, meals, and regular checks on the individual by trained staff. Nursing homes or memory care centers are the last resort on the continuum, so a diagnosis of dementia/Alzheimer’s disease does not require an immediate move to residential care. The family and the patient can select the minimum assistance needed based on the stage of the disease and the specific family situation.
As customary, after Ms. Boyt answered questions from the audience, the meeting was adjourned with the Rotary motto, “Service above self!”