Mind aerobics fight dementia

In the past 100 years the Australian population has undergone a dramatic demographic change which is characterised by the increasing life expectancy of every new generation. This trend happens globally and in many countries adults 80 years and older represent the fastest growing group of the population.

While it seems to be a privilege of modern times that we, at least statistically, can expect a longer life, it raises many questions and recently terms like “greying of a nation” have been coined when mentioning the ageing baby boomer generation.

So let’s face it: ageing is a fact of life – it happens to all of us. But how can we make the most of this privilege of a long life? How can we age successfully?

“Successful ageing” is not a new term. Already in 1987 authors Rowe & Kahn discussed in their landmark Science publication what the difference might be between “usual” and “successful” ageing.

They suggested that successful ageing requires the absence of chronic disease and disability, high cognitive and physical functioning and active engagement with life. They concluded that the combination of genetic factors with lifestyle and psychosocial factors determines successful ageing.

So how can we work towards successful ageing? Since changing genes at present is not a practical option, can we do something about environmental factors? Let’s use mental ageing as an example.

One of the biggest threats to healthy mental ageing is the development of dementia in later life. Alzheimer’s disease, as one of the most common causes of dementia, has age as its strongest risk factor. The prevalence of the illness doubles approximately every five years after age 65.

Dementia Awareness Week recently reminded us that currently more than 26 million people globally suffer from Alzheimer’s disease, which is expected to rise to more than 106 million in the year 2050.

A comparable rise is expected in Australia from currently between 113 000 and 159 000 people suffering from Alzheimer’s disease to more than 730 000.

There is no doubt that Alzheimer’s disease is an organic neurodegenerative brain disease and enormous combined efforts are being made around the globe to try to develop a new generation of pharmacological treatment with the ultimate aim to prevent and cure the illness. But until this landmark is reached, is there anything we can do to protect our brain to be able to enjoy a long life?

Several environmental factors have been discussed as potentially protective of the ageing brain. I mention here just two of them: cognitive and physical activity.

The term “use it or lose it” is based on the assumption that by continually challenging the mind with cognitively stimulating activities, the clinical onset of memory problems or dementia could be delayed. This also relates to the “cognitive reserve” hypothesis which is based on the observation that mentally very active people tend to show less severe symptoms of Alzheimer’s disease than less active people, even if they have the same amount of disease pathology in their brain.

So can cognitive activity give us a “reserve” to cope with age-related brain disease? This cannot be answered clearly at present, but many research projects, including those in Australia, are trying to find out. In the meantime cognitive stimulating activities, which are enjoyable depending on personal preference, such as reading, learning a new language or a new instrument, studying, board games, and stimulating conversations, might be a good idea to pursue.

Charles Darwin had a similar thought when he wrote in 1887 in his autobiography, “If I had to live my life again I would have made a rule to read some poetry and listen to some music at least once a week; for perhaps the parts of my brain now atrophied could thus have been kept active through use”.

We all have heard that regular exercise is good for your health. More recently evidence is mounting that regular physical activity might also be protective of the brain. The underlying mechanism which might make this work is not clear yet, but just as with cognitive activity, many research teams around the globe are currently trying to find out. The key is to find a physical activity that is fun, suitable and safe to do. So if you are older, it might be wise to consult your GP to find out what type of exercise might be good for you. There is no need to aim for vigorous exercise. Simple approaches, like regular walking, might do the trick.

Many of us who work in the field of mental health hope that combined efforts can achieve successful developments for supporting healthy mental ageing similar to those in past decades aimed at preventing heart disease and stroke.

(Source: University of Melbourne: Nicola T Lautenschlager: November 2008)