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In February 2023, the world was shocked and saddened by the news of Bruce Willis's battle with dementia. It was almost surreal to imagine an accomplished actor, household name, and bright mind battling a form of dementia for which there is no treatment.
While dementia has been a prominent topic in the world of cognitive health for decades, public cases such as this one, thanks to the Willis family's transparency and openness, shine an even brighter spotlight on the issue.
Dementia is rarely a vocal, door-slamming, up-in-your-face enemy that immediately makes itself known. It is sneaky, calculated, and often deceptive. Its initial symptoms are mainly easy to brush off, ignore, or pin on a whole other problem. However, while not consistently aggressive, dementia is persistent, determined, and, unfortunately - successful in its malevolent intentions.
The bad news? Dementia has accomplices. The good news? By managing or eliminating these accomplices, we might be able to reach the root of the issue. There's so much to uncover on brain health and dementia, so let's get started.
Dementia is, in fact, a broad term encompassing a series of issues, including behavior changes, cognitive decline, impaired thinking skills, and loss of memory. Therefore, dementia isn't a disease by itself but a condition that may include several types - Alzheimer's disease included.
While there are several different types of dementia, all stem from abnormal changes in the brain that impact a person's cognitive ability, emotions, and social and professional life.[1]
People who develop dementia experience a loss of healthy neurons in the brain at a breakneck pace. While neuron loss is a common and ordinary occurrence in aging, it is the pace and severity of the process that makes dementia so complex. Even those who already experience developmental and intellectual disabilities are at risk of developing dementia at a certain point in their lives.[2]
The severity, manifestation, and duration of dementia symptoms vary depending on the type, the person's medical history, and many other factors. That being said, these are some of the most common signs of dementia[2]:
In the case of dementia, all of these symptoms get progressively worse, which means they can be relatively mild in the beginning. Over time, they become more prominent and life-altering, which is precisely why early detection of dementia is critical.[1]
As we've mentioned, dementia is an umbrella term that includes multiple issues and diseases. Depending on the causes and the brain area affected, it is classified into different types.[2] However, in some instances, the various types of dementia can become intertwined.
The most common type of dementia, Alzheimer's disease, is characterized by memory loss, which starts as a relatively mild impairment at first. The disease targets brain areas responsible for memory, language, and thinking processes. Therefore, as the disease progresses, patients often lose the ability to communicate, respond, and remember.[3]
Caused by a blockage that interrupts the flow of oxygen and blood to the brain, vascular dementia is a result of health issues that affect the function of blood vessels in the brain. It is a rather common form of dementia, mostly stemming from high blood pressure, stroke, high cholesterol, heart disease, obesity, and atherosclerosis. It is not a rare occasion for vascular dementia patients to develop Alzheimer's disease as well.[4]
As opposed to the previous two types, frontotemporal dementia is a rare occurrence, and it usually affects people under the age of 60 - also known as young onset dementia. This particular dementia type is associated with abnormalities of the tau and TDP-43 proteins.[2]
LBD is a brain disorder caused by the clumping of the alpha-synuclein protein in the brain. These clumps, Lewy bodies, accumulate inside neurons, impairing their function and eventually causing the death of these nerve cells. LBD is manifested through hallucinations, impaired spatial and visual abilities, sleep disorders, poor mental health, as well as sensitivity to cold and heat. LBD diagnosed in Parkinson's disease patients is a subtype known as Parkinson's disease dementia.[5]
While multiple mechanisms regarding dementia are still a mystery, and scientists have yet to discover the causes of multiple brain changes related to it, many risk factors for dementia are well-established. By considering a person's risk of developing dementia, we might be able to make some crucial lifestyle changes to target the problem at the root.
According to recent studies, particularly one published in Nature Communications in March of this year, a specific brain area labeled as a "weak spot" has a solid connection to an increased risk of dementia. This area is the last segment to develop fully but the first to start declining as we age. The study suggests that potential genetic changes could affect the "weak spot" - related to the development of multiple cognitive conditions, including Alzheimer's disease, schizophrenia, and Parkinson's disease.[6]
So, what are the main risk factors affecting this vulnerable brain area and leading to rapid cognitive decline? The three most prominent factors related to the increased risk of dementia include air pollution, diabetes, and alcohol consumption.
The adverse effects of air pollution are no secret. However, recent findings about the effects of environmental factors reveal that some people have an increased risk of developing dementia as a result of air pollution.[6]
Simply put, genetically predisposed individuals (with a particular XG gene type) are more sensitive to the damaging effects of air pollution, which could damage the vulnerable areas of the brain and lead to dementia. That being said, the genetic mutations in question are also influenced by multiple early-life factors, including the number of siblings, breastfeeding in childhood, and the mother's behavior during pregnancy (there is a higher risk of cognitive issues if the mother is a smoker).[6]
Dementia develops as a mixture of both clinical and biological factors, one of the most prominent being type 2 diabetes. In fact, a study conducted by the American Diabetes Association found that the risk of developing dementia is increased by 60% if you're suffering from type 2 diabetes. [7] The connection between the two conditions is so strong that a specific term was coined to describe diabetes-induced dementia: "type 3 diabetes."
While drinking alcohol in moderation has not been linked to developing dementia, Alzheimer's disease, or any other type of dementia, alcohol abuse is a significant risk factor - especially for young-onset dementia. Alcohol-related brain damage (ARBD) and alcohol-related brain injury (ARBI) are classified as one of the main prerequisites for degenerative cognitive conditions, including dementia. In fact, there is a specific condition known as the Wernicke-Korsakoff syndrome or alcohol-related dementia, resembling Alzheimer's disease.[8]
Air quality, environmental pollution, and genetic predispositions aren't something we can control. However, the key to making an impactful change is taking the wheel in areas that can be improved, such as lifestyle, fitness, and nutrition.
Research suggests that regular physical activity, whatever it may be, can reduce the risk of dementia development by 28%. In the case of Alzheimer's disease, this reaches a jaw-dropping 45%! Keep in mind that physical activity doesn't necessarily mean strenuous exercise. Staying consistently active through walking, hobbies, or strength training is vital.[9]
While cognitive training is often mentioned as a means of regaining cognitive ability in cases of mild dementia, the findings are pretty conflicting. On one hand, it can yield promising results in some patients, while on the other hand, the results seem to be rather individual.[10] What appears to be a far more beneficial approach is taking care of mental health and engaging in social interaction, as depressive moods and social isolation have been linked to dementia.[11]
In addition to excessive drinking, smoking is a pivotal risk factor, as it often leads to vascular dementia and Alzheimer’s disease. Chemicals in cigarettes have been found to cause inflammation in blood vessels, leading to plaque buildup in the arteries and, ultimately, cardiovascular disease. As mentioned before, cardiovascular issues often lead to vascular dementia, which frequently co-occurs with Alzheimer’s disease.[12]
Finally, optimizing your nutrition with brain-supporting natural supplements is another beneficial method for protecting your cognitive health.
When discussing dementia, experts emphasize the fact that no effective treatment has been found. The mystery of this condition doesn’t allow us to grasp its ways entirely or discuss prevention confidently.
However, the efforts of the experts dedicated to this topic are more than promising, and we hope to have a clearer idea about the mechanisms of dementia in the near future. While waiting for new revelations, it is essential not to take risk factors lightly and to nurture our cognitive abilities with positive lifestyle changes and optimized nutrition.
