Dangerous dementia link

Visiting Dementia Awareness Week lecturer, Dr Kristine Yaffe, says there needs to be greater public awareness of the dangerous links between some of the country’s most serious chronic diseases that affect millions of Australians.

She was speaking at Parliament House, Sydney, on the importance of people maximising their brain health yesterday.

“There is a growing body of evidence showing that other chronic diseases like heart disease, stroke and diabetes, as well as risk factors including depression, obesity and sleep, are associated with cognitive decline.

“If left unchecked, these chronic diseases can increase a person’s risk of developing dementia.”

Dr Yaffe, who is Professor of Psychiatry, Neurology and Epidemiology at the University of California, San Francisco (UCSF), is in Australia at the invitation of Alzheimer’s Australia for a public lecture tour that will include Canberra, Melbourne, Adelaide and Brisbane.

Due to demographic shifts and changes in life expectancy, the prevalence of dementia is projected to triple over the next 50 years with a concomitant rise in the costs of dementia care. Interventions that delay the onset of cognitive impairment and dementia could have a large impact on public health, and a substantial body of research suggests that modifiable risk factors may play a pivotal role in maximising cognitive health.

One of the most ground breaking findings in this field is the critical connection between chronic medical conditions and cognitive impairment. Numerous large, observational studies have demonstrated that cardiovascular and metabolic risk factors like hypertension, obesity, and diabetes are associated with accelerated cognitive ageing suggesting that treatment of these risk factors could help maintain cognitive health.

In addition to chronic medical conditions, several lifestyle behaviours have also been identified as potential risk factors. Studies suggest that there may be multiple pathways linking physical and cognitive activity to better cognitive function, and preliminary intervention trials have been encouraging. Observational studies have also demonstrated consistent associations between smoking and increased risk of cognitive decline as well as associations between single classes of nutrient deficiencies like antioxidants and omega-3 fatty acids and cognitive impairment.

More recent investigations have focused on multi-nutrient supplementation or healthy dietary patterns like the Mediterranean diet which may be more effective approaches for maintaining cognitive function.

Evidence is also evolving for risk factors like depression and sleep disorders. The risk relationship between depression and cognitive decline may be bidirectional, and observational studies of patients with depression suggest that treatment is beneficial for cognition. The link between disturbed sleep and dementia has long been recognised, but now, features of sleep including poor sleep quality, sleep disordered breathing, and altered circadian rhythms have also emerged as risk factors for cognitive impairment.

The outlook towards successful cognitive ageing is promising, and modifiable risk factor reduction at the population based level could considerably alter dementia prevalence. However, in order to further optimise the potential for efficacy, strategies which target multiple risk factors with a better understanding of cognitive ageing across the life course are needed.

Australian of the Year 2013 and Alzheimer’s Australia National President, Ita Buttrose, also spoke at Parliament House. Ms Buttrose said Alzheimer’s Australia has been a long time advocate of preventive health strategies.

“Maximising your brain health and managing your blood sugar, cholesterol levels, blood pressure and body weight can help reduce the risk of developing some of the most debilitating chronic diseases, including dementia.

“During Dementia Awareness Week we want to encourage people to adopt healthier lifestyles and understand the connection between their physical health and their brain health. As our population ages, it’s vital for people to understand and improve their overall health, and that includes their brains as well as their bodies,” Ms Buttrose said.

This year’s theme for Dementia Awareness Week is Brain Health: Making the Connections. Dementia Awareness Week is the national flagship week for Alzheimer’s Australia’s community awareness activities.