Your fitness levels in your youth could well determine whether or not you experience dementia in old age. Findings published in February this year, in the Annals of Internal Medicine, suggest that dementia could be linked to fitness levels of individuals. The report looked over 19,000 middle-aged individuals who were given a treadmill exercise test over a period of 38 years. These researchers found over 1,600 cases of dementia and those who stayed fit (used the treadmill at a regular interval) were 40 per cent less likely to develop dementia. A similar study reported in UPI.com, conducted over 20,000 individuals at Cooper Institute in Dallas, found that adults who stayed aerobically fit during middle age were less likely to develop dementia than those who didn't.
What does this mean?
Dr Bharat Shah, psychiatrist, Lilavati Hospital, Mumbai, spells it out, “For the first time, a study has linked dementia to fitness levels, opening a new avenue to avert this age-related disorder for the middle-aged in developing countries like India.” Dementia is a syndrome that can be caused by a number of progressive disorders that affect memory, thinking, behaviour and the ability to perform everyday activities. Alzheimer’s disease is the most common cause of dementia. Other types include vascular dementia (caused by a blockade in the blood circulation system), dementia with Lewy bodies (protein bodies found in Alzheimer’s and Parkinson’s disease patients) and frontotemporal dementia. Dementia might also be due to injury to head, deficiency of Vitamins B12 and D, and intake of intoxicants like alcohol and nicotine that kills brain cells.
Why fitness matters
Dementia mainly affects those over 65, although there have been cases that start before this age. Dr YA Matcheswalla, professor of Psychiatry at Grant Medical College says, “The youngest case of dementia that I have come across is 42, which was a general case without the use of any intoxicants or injuries to the head. Although this is rare, it’s a matter of concern.” After 65, chances of developing dementia roughly doubles every five years.
According to Dr Shah, although the study assumes fitness to be the only factor (not including diet, lifestyle and work environment), the knowledge helps in planning better for those with dementia especially vascular dementia, which is caused by problems in the supply of blood to the brain due to a blockade in the vascular system. “Most who are physically fit could also be assumed to maintain a balanced diet,” he adds. Studies have linked dementia to a Vitamin D deficiency — some link Alzheimer’s to a Vitamin B12 deficiency.
Physical fitness, irrespective of whether or not it prevents dementia, should be given importance, says Dr Pettarusp Wadia, neurologist, Jaslok Hospital. “India’s middle-aged suffer from lifestyle diseases like diabetes, high cholesterol and blood pressure. These could be linked to vascular dementia,” he believes.
Play on the mind
Today, already, 58.5 per cent of people with dementia are from low and middle-income countries like India. By 2050, it’s expected to be around 70 per cent. “India doesn’t have a proper strategy or care centres to look after people with dementia; Mumbai has just two care centres — a day care centre in South Mumbai, and a full care centre in Neral,” rues R Gopalakrishnan, whose full-time care centre is set to open by April-end, in Vasai. Secondly, the fastest growth in the elderly population is in China, India, and their South Asian and Western Pacific neighbours.
By 2020, the old will contribute to 22 per cent of India’s total population. Speaking of numbers, in 2010, Alzheimer’s Disease International (ADI) estimated worldwide costs of dementia to be US$604 billion. These costs account for around 1% of the world’s Gross Domestic Product. Figures aside, Dr Wadia says that physical and mental fitness should be given importance. “Your brain is like a machine. If you don’t use it often, it rusts. In my practice, I have seen that people who use their brain more often or get involved in crossword, puzzles and Sudoku, are more equipped to deal with dementia than those who don’t. Yet, physical fitness is equally important to ensure that your brain gets a regular supply of oxygen, to function well,” he asserts.
Dos and Don'ts with dementia
> Exercise daily or at least practise aerobics .
This helps in blood circulation and oxygenation of brain cells. Oxygen deficiency is one of the main factors that cause dementia.
> Avoid intoxicants like alcohol and nicotine. Both drinking and smoking kills brain cells.
> Always maintain a balanced diet— Ensure that your diet fulfills the daily requirements of Vitamin D and Vitamin B12, as studies have linked dementia to the deficiency of these two nutrients.
> Try to live a stress-controlled life. You should know how to control your stress and at the same time, de-stress yourself.
> Socialise — Adequate social life is also important to keep your brain healthy.
> Develop good hobbies — both physical and mental. It would help keep the vascular system and your brain in order.
> Regular physical and mental check-up is essential to ensure that you receive the right treatment in time.
> Timely intervention is very helpful in dementia care. Early therapeutic intervention can be effective in improving cognitive function, treating depression, improving caregiver mood, and delaying institutionalisation.
> One should not think that there’s no hope or nothing can be done.
> Most people with early-stage dementia would wish to be told of their diagnosis.