Dementia: Can You Decrease the Risk?

A new study suggests that a number of factors,
including mid-life hearing loss, could contribute
to some types of dementia.

There are no guarantees against dementia, but a major international study just published in the esteemed journal Lancet, reports it is possible that one in three cases of dementia could be prevented if more people looked at their brain health throughout life.

According to the researchers, there are life style factors that may make the brain more vulnerable to problems with memory and thinking as we age. Dementia is diagnosed later in life, but changes in the brain begin to develop many years earlier.

Here are 9 factors that contribute to the risk of some types of dementia:

• mid-life hearing loss (9%)
• failing to complete secondary education (8%)
• smoking (5%)
• failing to seek treatment for depression (4%)
• physical inactivity (3%)
• social isolation (2%)
• high blood pressure (2%)
• obesity (1%)
• Type 2 diabetes (1%)

While I have been aware of each of these, I was surprised by the degree (9%!) to which hearing loss factored in. There is much that is still unknown about just how hearing loss is connected to cognitive decline. Maybe hearing loss adds to the cognitive burden of a vulnerable brain, or leads to social disengagement or depression, or is related to systemic age-related microvascular changes.

It's also not proven for sure if use of hearing aids eliminates hearing loss as a risk factor. However, it is likely that if amplification fosters social connection and reduces the effort needed to listen, that addressing hearing loss proactively is a big plus. (And, it makes life better, for sure!)

The take home message is the number of people with dementia is increasing globally, although it is decreasing in some countries. Quoting the Lancet: "Be ambitious about prevention. We recommend active treatment of hypertension in middle age and older people without dementia to reduce dementia incidence. Interventions for other risk factors including more childhood education, exercise, maintaining social engagement, reducing smoking, and management of hearing loss, depression, diabetes and obesity might have the potential to delay or prevent a third of dementia cases."

It is a hopeful message: although we cannot totally control our future, there are modifiable risk factors that make an enormous difference, and these addressing them proactively are good for overall health, making good choices a win-win situation.

Borrowed Time

Borrowed time, we hold it now…..  
I want to sit under the stars and watch the night unfold
I want to stay here with you now and whisper really close
Remember what I said as you lay down your head
The only thing that stays with us is love.
From the song "Borrowed Time," by Antigone Rising
(with permission of Nini Camps, Antigone Rising)

As we approach the Thanksgiving and holiday season, my heart seeks what really matters.   We are living in a time of constant visual images.  Our smart phones let us document every occasion for all to see.  But the sound track of our lives is usually more fleeting.   Each day, all day, we hear sound bites - snatches of conversation, the environmental soundscape around us, streams of music…they come, and then they are gone.

In this stream of sounds are a series of moments…and embedded in them are bits of beauty, what I think of as “everyday wisdom.”   I am not thinking of profound wisdom from great teachers, but the simple moments we catch every day.  A whispered “I love you.”  A child’s insight…my grandson, turning 5, asked his mom if he could wish everyone good health as he blew out his birthday candles. Yes, replied my daughter.  Because, he continued, that is a very important wish.

One patient I saw today was amazed she heard birds again with her new hearing aids.  The daughter of another lady said “My mom is so much more engaged.  She and my sister enjoyed a movie together – it was the first time in ages they could do that.”

So, you can see these are not earth-shattering moments.  They are little memories of the past few days. They are the moments that add up to our days and nights, and that’s what there is!  Here is a long-ago bit of everyday wisdom that has stayed with me:  I was a little girl and was at a birthday party. The children were playing a game.  I was shy, hanging back, and my mom encouraged me to play.  "I'll play later," I said. My mom replied that the game was on now, if I waited till later, I'd miss out.   If you have concerns about your hearing, address it now – don’t let those precious moments slip away.

Happy Thanksgiving.  I wish us all gratitude for our blessings.  In the words of this song:

So make the most of it
Like a wave crashes the shore
Make the most of it
‘Cause we can’t come back for more
Make the most of every minute as it turns into a day
Before it slips away…