Brain health also known as cognitive health ensures one can perform all the mental processes, such as the ability to learn new things, intuition, judgement, language and recall.
Key cognitive domains are:
- Complex attention and processing speed
- Executive function: planning, decision making, working memory, responding to feedback, overriding habits, mental flexibility.
- Learning and memory
- Language (expressive and receptive)
- Perceptual motor responding to sensory stimuli
- Social cognition (emotions, theory of mind)
As we age some of us will experience cognitive decline that is in abilities such as memory and thinking skills. Measurable/noticeable decline that are greater than normal age-related changes may indicate an increased risk of developing dementia especially alzheimer’s disease. Current research has shown that cognitive decline can start as early as age of 45.
Dementia is not a specific disease. It is a term used to describe causes of memory loss in an older person. There are many causes of memory loss and dementia is the general term used for all. However alzheimers disease accounts for about 60% and multi-infarct another 30%. The common symptoms of dementia usually affect memory, communication and language, ability to focus and pay attention, reasoning and judgement and visual perception. However the first symptom is usually short term memory loss.
Dementia is a disease of the older person and the risk increases with age. Treatable causes of memory loss include depression, medication side effects, excess use of alcohol, thyroid problems and vitamin deficiencies especially vitamins B12 and folic acid.
There is no cure for alzheimers disease. Certain drugs can slow the progression of the disease and certain gingko derivatives and phospholipids may help in prevention and progression of disease.
Risk assessment and early detection are important as early interventions can slow down the disease process.
How do we know we are at risk? Screening using the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) score can be used to predict dementia risk in middle aged people. The CAIDE Dementia Risk Score looks at seven areas, namely Age, Education, Sex, Systolic Blood Pressure, Body Mass Index, Total Cholesterol and Physical Activity. A score of 0-8 is low risk, 9-11 is intermediate and 12-15 high risk. Persons with intermediate and high risk should look at preventive strategies and regular screening with more comprehensive test, Mini Mental State Examination (MMSE) which is a 30 point score which looks at Orientation, Registration, Attention and Calculation, Recall and Language. A score of 27-30 is normal and a score below 27 could suggest impaired cognitive function.
Prevention includes mental and physical exercise, a healthy diet like the Mediterranean and Okinawan diets where the people in this regions have lower incidence of dementia, keep blood pressure, cholesterol and blood sugar within recommended limits and maintain a healthy weight. Remember what affects the heart also affects the brain.
Dementia incidence is increasing all over the world and there is still no cure. Therefore the focus should be on prevention and early detection to slow down the progression of the disease.