Long-known connections between healthy lifestyle choices and well being now extend to reducing the risk of dementia.

In guidelines released May 14, the World Health Organization issued its first recommendations to reduce the risk of dementia. Those recommendations are similar to what medical and public health officials have advocated for years: Regular physical exercise, not using tobacco, drinking less alcohol, maintaining healthy blood pressure and eating a healthy diet — particularly a Mediterranean one — reduce the risk of dementia.

The Mediterranean diet includes simple plant-based cooking, little meat and a heavy emphasis on olive oil.

Michele Bever, executive director of the South Heartland District Health Department, said public health officials have been promoting and raising awareness for years about the connection between physical health, nutrition, mental health and healthy lifestyles across the life span for improving overall health.

“So we know that hypertension and diabetes, hypercholesterolemia, obesity, depression, all of those things can be factors in social isolation and also cognitive inactivity because they are potentially modifiable risk factors that can be addressed. What’s new is we might be able to prevent some dementia if we address these modifiable risk factors.”

Zachary Frey, a family medicine physician at Mary Lanning Healthcare’s Hastings Family Care clinic, said he gets patients who have a family history of dementia asking what can they do to reduce their risk of getting the cognitive disease. Frey said a small percentage of people have the genetic defect that causes early onset dementia before age 65.

His recommendations mirror those within the WHO guidelines.

“With dementia, unfortunately there’s no magic pill or vitamin,” he said.

The WHO report warns against taking dietary supplements in an effort to combat cognitive decline and dementia. Frey agrees with that recommendation.

“We know that oxidated stress on the brain can lead to problems, can lead to dementia,” he said. “Our thought is if we can take antioxidant vitamins that should theoretically help reduce that risk. There have been a lot of studies looking at all the individual antioxidant vitamins in combination, not in combination, and really none of them have panned out to be very successful. A few are even found to be slightly harmful, but none of them have been found to succeed at anything as far as preventing dementia.”

Although, he said it’s important, especially for seniors not to become vitamin D deficient. So if an elderly person is not able to spend much time in sunlight, Frey said it might be a good idea to take a vitamin D supplement in consultation with a doctor.

There are some early studies, he said, looking at the connection between vitamin E and slowing the progression of dementia when it is already present. However, Frey said that is preliminary information.

Reduction in the risk of cognitive diseases like dementia is rooted in the associations of multiple healthy behaviors.

“The for-sure things we know are the healthy lifestyle things, the diet, which typically we recommend either the Mediterranean diet or what’s called the DASH diet (Dietary Approaches to Stop Hypertension),” he said.

There is a big association between heart heath and brain health, he said. That’s why exercise and strengthening the heart is connected to long-term cognitive well being.

Even getting adequate sleep helps long-term memory.

Individuals showing borderline signs of dementia can stave off the disease by staying socially engaged.

“So we try to encourage people to not just sit around and watch TV, but to be socially involved or active with other people,” he said.

Challenging oneself through mental engagement: Completing puzzles, learning musical instruments or playing strategic card games helps strengthen the mind.

“That seems to also either slow the onset or slowly prevent certain types of dementia in the long run,” he said.

He also recommended taking adult education courses at a community college or similar institutions to keep the mind engaged.

When it comes to blood pressure, most people don’t have symptoms until the blood pressure has been really high or it’s been high for a really long time.

“We want to catch people when it’s initially just a little high and we can figure out ways to control it whether with lifestyle changes or medications,” Frey said.

Frey’s clinic and the health department are among entities who have partnered with the Hastings Family YMCA on the YMCA’s blood pressure program that began 2017.

Erika Knott, health and wellness director for the Hastings Family YMCA, said the program now has more than 180 participants.

“We’re really working closely with doctors to get referrals and helping the patient get in that habit of checking blood pressure and knowing the numbers and maybe what’s causing their blood pressure to be higher or lower and walking them through their lifestyles — if they are inactive or the things they are eating — how those things are affecting their blood pressure numbers,” she said.

The Y has Active Older Adult programs that include land exercise, water exercise, social gatherings and educational outings. Among those programs are the SilverSneakers classes that include muscular strength and range of movement, cardio circuit and YogaStretch.

“We try to have exercises that are appropriate for all levels,” Knott said. “We have SilverSneakers. It’s great for our seniors because it gives them some cardio to get their heart pumping and gives them some resistance to help them with that muscle loss and then it also works on their balance and flexibility. It’s just an overall good program.”

Tai chi is also beneficial to seniors, she said, because it has proven to help with balance, flexibility and arthritis.

“We have lots of different classes that are geared to help you age and stay active while you age so you don’t have to be fearful of getting out and about,” she said.

The Golden Friendship Center, which is part of the city of Hastings’ community center at 2015 W. Third St., offers a few different exercise classes for seniors during weekday afternoon, including tai chi.

Bever also advocated tai chi and said any movement is beneficial.

“You don’t have to engage in rigorous physical activity to have an impact,” Bever said. “Gardening and house cleaning and walking up a couple of stairs and tai chi — there’s all sorts of levels of physical activity and it all adds up. It doesn’t have to be a 30-minute sprint.”

Activity throughout the day — that little bit of physical exertion can add up and be important in physical and mental health.

“All of those things are risk factors for chronic disease and now apparently also for dementia, these things are important because they are modifiable,” she said. “We can do something about them. We don’t have to do it all at once but little changes add up. We can make a difference in our health by taking small steps toward living healthier lifestyles.”

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