Nutrition and Dementia
Photo by Buenosia Carol from Pexels
by Dr Henry Sztulman
The human life span is increasing and there is a need to maintain functional well-being in old age. Cognitive function is a major factor determining quality of life in older age. The number of elderly people who will suffer from cognitive impairment and dementia will further increase in the near future as a consequence of the progressive ageing of the population. The onset of dementia is insidious, and the underlying degenerative processes are believed to be active for many years before the loss of memory becomes apparent. Cognitive impairment can be influenced by a number of factors and the potential effect of nutrition has become a topic of increasing scientific and public interest. In particular, there are arguments suggesting that nutrients (food and/or supplements) such as vitamins, trace minerals or lipids can affect the risk of cognitive decline and dementia, especially in frail elderly people at risk of
deficiencies.
Ageing is accompanied by major stages which lead to changes in eating habits: retirement and cessation of outside activity, involving reorganisation of daily life (fewer meals taken outside the home, lower income, redistribution of domestic roles, fewer invitations and loss of friends and family leading to less varied meals); declining health and loss of independence requiring the provision of assistance because of difficulty with shopping and meal
preparation.
Dietary Considerations
There is strong evidence that dietary patterns, such as the Mediterranean Diet, are related to lower risk for cardiovascular disease, several forms of cancer and overall mortality. The Mediterranean Diet includes many of the components reported as beneficial for cognitive decline and dementia. It is characterized by high intake of vegetables, legumes, fruits and cereals; high intake of unsaturated fatty acids (mostly in the form of olive oil), but low intake of saturated fats; a moderately high intake of fish, a low to moderate intake of dairy products; a low intake of meat and poultry; and a regular but moderate amount of alcohol, primarily in the form of wine and generally during meals. A recent study showed that higher adherence to a diet approaching the Mediterranean Diet is associated with reduced risk for Alzheimer’s disease.
In addition, foods high in botanical antioxidants, such as flavonoids and carotenoids, which are found in purple, red, orange and yellow fruit (especially blueberries and raspberries) and vegetables, protect the brain from free radical damage, thus prolonging optimal function. Also, specific antioxidants, including vitamins C, E complex and enzymatic cofactors of antioxidant enzymes, such as zinc and selenium, may also reduce neuronal damage and death from oxidative stress.
The Importance of B-Vitamins
The B group of vitamins plays an important role in energy-producing metabolic pathways, whilst folic acid and vitamin B12 are particularly essential for healthy brain function. Vitamin B12 deficiency is common with older age, occurring in more than 20% of persons 65 years and older, as the result of increased prevalence of gastritis and other digestive conditions that interfere with absorption. Individuals with biologically significant vitamin B12 and folate depletion almost always have elevated plasma levels of homocysteine (a by-product of metabolism). It has been found that increased levels of homocysteine directly correlate to increased probability of dementia and recently published clinical trials found that lowering homocysteine levels can slow down the process of brain degeneration.
It has also been found that the best time to get optimal results with dementia prevention is before it becomes a clinical problem.
Testosterone
Similarly, testosterone deficiency, especially in males, is associated with speedier rates of onset of dementia and some recent, small-scale trials of testosterone replacement, showed promising results with improved cognitive function.
The human life span is increasing and there is a need to maintain functional well-being in old age. Cognitive function is a major factor determining quality of life in older age. The number of elderly people who will suffer from cognitive impairment and dementia will further increase in the near future as a consequence of the progressive ageing of the population. The onset of dementia is insidious, and the underlying degenerative processes are believed to be active for many years before the loss of memory becomes apparent. Cognitive impairment can be influenced by a number of factors and the potential effect of nutrition has become a topic of increasing scientific and public interest. In particular, there are arguments suggesting that nutrients (food and/or supplements) such as vitamins, trace minerals or lipids can affect the risk of cognitive decline and dementia, especially in frail elderly people at risk of
deficiencies.
Ageing is accompanied by major stages which lead to changes in eating habits: retirement and cessation of outside activity, involving reorganisation of daily life (fewer meals taken outside the home, lower income, redistribution of domestic roles, fewer invitations and loss of friends and family leading to less varied meals); declining health and loss of independence requiring the provision of assistance because of difficulty with shopping and meal
preparation.
Dietary Considerations
There is strong evidence that dietary patterns, such as the Mediterranean Diet, are related to lower risk for cardiovascular disease, several forms of cancer and overall mortality. The Mediterranean Diet includes many of the components reported as beneficial for cognitive decline and dementia. It is characterized by high intake of vegetables, legumes, fruits and cereals; high intake of unsaturated fatty acids (mostly in the form of olive oil), but low intake of saturated fats; a moderately high intake of fish, a low to moderate intake of dairy products; a low intake of meat and poultry; and a regular but moderate amount of alcohol, primarily in the form of wine and generally during meals. A recent study showed that higher adherence to a diet approaching the Mediterranean Diet is associated with reduced risk for Alzheimer’s disease.
In addition, foods high in botanical antioxidants, such as flavonoids and carotenoids, which are found in purple, red, orange and yellow fruit (especially blueberries and raspberries) and vegetables, protect the brain from free radical damage, thus prolonging optimal function. Also, specific antioxidants, including vitamins C, E complex and enzymatic cofactors of antioxidant enzymes, such as zinc and selenium, may also reduce neuronal damage and death from oxidative stress.
The Importance of B-Vitamins
The B group of vitamins plays an important role in energy-producing metabolic pathways, whilst folic acid and vitamin B12 are particularly essential for healthy brain function. Vitamin B12 deficiency is common with older age, occurring in more than 20% of persons 65 years and older, as the result of increased prevalence of gastritis and other digestive conditions that interfere with absorption. Individuals with biologically significant vitamin B12 and folate depletion almost always have elevated plasma levels of homocysteine (a by-product of metabolism). It has been found that increased levels of homocysteine directly correlate to increased probability of dementia and recently published clinical trials found that lowering homocysteine levels can slow down the process of brain degeneration.
It has also been found that the best time to get optimal results with dementia prevention is before it becomes a clinical problem.
Testosterone
Similarly, testosterone deficiency, especially in males, is associated with speedier rates of onset of dementia and some recent, small-scale trials of testosterone replacement, showed promising results with improved cognitive function.