Unfortunately, research findings have not always been convincing. Many studies present conflicting results. Consumers are confused and discouraged by differing study results and the wide variety of memory aid products available.
Today, we are living longer. We are taking responsibility for our own health and preventing disease. Most of us know that exercising regularly, eating a healthy diet and controlling weight helps prevent conditions such as cardiovascular disease. We also know that smoking greatly increases the risk of a variety of illnesses, including lung cancer.
When it comes to mental health, the advice is not always as clear. Our understanding of brain disease lags behind that of many physical illnesses. In particular, progressive memory loss and dementia are not well understood or managed.
We all hope to maintain our mental health as we age. However, many questions remain. What is normal memory loss? How can we protect our mental abilities and avoid dementia? Do any medications help prevent memory loss? Can anything protect our current abilities and keep us mentally fit?
Gradual memory loss has long been described as a normal part of aging. As we get older, the brain is thought to produce less neuromodulators. These chemicals help us to learn and remember. Although a number of processes likely contribute to this, many have yet to be discovered. While memory loss is considered a normal part of growing older, it varies in severity.
Mild cognitive problems often signal an intermediate stage between normal mental function and dementia. In general, they suggest a decline in mental function, but are not yet considered dementia. The line between the two is flexible, and the movement from one stage to the next hard to predict.
Dementia is diagnosed when someone has problems with memory and at least one other area of mental function, including:
Such problems must be serious enough to interfere with daily activities and independence. They must also show a decline from previous abilities. Dementia can be further divided into specific illnesses such as Alzheimer’s and vascular dementia. These are not considered a normal part of aging.
Much of our information about dementia comes from observational studies, or watching and following groups of people over time. Observations find certain factors are more common in those with dementia, but cannot prove a direct link. Many other factors, such as education and economic status, complicate study results.
Age appears to be the biggest risk factor, along with family history of dementia and certain inherited factors. Unfortunately, these cannot be changed.
However, others are within our control. Certain factors increase the risk of vascular (blood vessel) disease, which can lead to heart attack and stroke. Research suggests the same factors may contribute to mental decline and dementia. High blood pressure, elevated cholesterol, diabetes and smoking are all risks. Evidence suggests carrying extra weight is another risk. It may be possible to prevent the start of dementia by controlling these risk factors.
Extensive research has been done on finding a medication to prevent memory loss. Even now, many studies are looking at the effect of various medications on memory loss. If one medication were proven to prevent mental decline, it would rapidly become one of the most commonly used medications today. Unfortunately, more questions than answers exist right now.
The anticholinesterases are one class of drugs approved in treating mild to moderate dementia. In some studies, their use has mildly improved mental function. However, this improvement can carry significant side effects and is short-lived. These drugs simply delay the progression of mental difficulties. They cannot prevent memory loss or dementia.
Although other medications have been studied to see if they can prevent or treat dementia, results have not been conclusive. These include melatonin, vitamin B6, vitamin B12, folic acid, alpha lipoic acid, lecithin, acetyl-L-carnitine, selegiline, D-cycloserine, physostigmine, piracetam, statins, thiamine, nicotine, and many others.
Remember, anything that has potential benefits also carries risks. Some medications that were previously tried actually harmed the users. Clearly these are not recommended. For instance, hormone replacement therapy (HRT) was first thought to help prevent dementia. However, we now know that it does not protect but rather increases the risk.
Similarly, the antioxidant Vitamin E protects was very promising in theory. Early observational studies suggested it might prevent memory decline. However, larger, better-designed studies showed no benefits. One study found that more deaths occurred with increased doses.
Drugs that reduce inflammation, such as ibuprofen, also showed early promise. However, evidence now suggests that they may increase the risk of cardiovascular disease. They are not recommended for the prevention of dementia.
Much interest has been shown in the diet and its relationship to the start of dementia. However, most studies done to date are observational and subject to bias. A diet rich in certain foods, such as fruit, vegetables and fish, may help lower the risk. However, the evidence is not overly convincing. Too many foods high in cholesterol and fatty acids may actually increase the risk. Until more information is available, no recommendations on diet can be made.
In recent years, evidence has suggested that more physical and mental activity, as well as social interaction, may help maintain mental function. While this is not an earth-shattering idea, it does seem to have the most support.
Recently, a large study incorporated cognitive training with healthy adults over the age of 65. The resulting improved mental abilities continued for at least five years. The training included many sessions of one of:
These findings support the findings of many smaller studies.
We once believed that as we age, learning networks in the brain become fixed. Some scientists are now challenging this idea. Recent theories about mental health and aging revolve around the idea of brain ‘plasticity.’ This is the lifelong ability of the brain to reorganize learning pathways based on new experiences.
Continuing to gain new skills and information may help the brain to constantly remodel itself. In turn, this promotes mental health. Physical activity and social interaction may help increase production of various brain chemicals. However, how this actually works is not well understood.
At this time, no super pill can prevent the start of memory loss. Although easy solutions to the problem may seem promising, they could harm either our health or our pocketbooks.
The best strategy involves protecting blood vessels. These can be damaged by high blood pressure, high cholesterol, diabetes, obesity and smoking. Time and again, it has been proven that a healthy diet and regular exercise are the best place to start.
It’s common knowledge that we can improve our physical health with physical activity. Our current understanding suggests that we may be able to improve mental health by doing challenging mental activities. However, no particular exercises are suggested. In light of all the options, this seems a safe, low-cost and fun way to promote mental fitness for years to come.