Dementia is not 'normal aging'

Dementia is not a normal part of aging.

This phrase was uttered more than once by Sarah Putman, director of education and quality for the Alzheimer Society Niagara Region, to a packed house this Saturday at RiverBrink Art Museum in Queenston.

Putman provided tips to maintain brain health that may reduce or delay, by 40 per cent, incidences of dementia, which may include symptoms such as memory loss, changes in language, changes in judgment and personality, or issues with mobility.

A series of portraits called The Mom Project, by artist Mark Crofton Bell, was exhibited in the same room where Putman spoke. All the paintings are of Bell’s mother, who suffered from the challenges of dementia and were painted during the final years of her life.

Before Putman outlined 12 ways in which lifestyle plays a role in staving off dementia, she explained that there are three things that cannot be modified or controlled: age, sex, and genetics. That risk increases with age is undeniable, she said, noting that 61 per cent of all those diagnosed with Alzheimer's disease are women, who have a longer lifespan, “which puts them in that risk category.”

Genetics “is a question I get all the time. If my mother has it, or my father has it, am I going to get dementia,” said Putman, who explained that less than five per cent of dementias are  genetically passed down from generation to generation. “Genetics do play a small part, but they're not a definite piece, to say you're going to develop dementia.”

“In decades past it was thought that people just got older and their brain started to fail and it was considered part of normal aging, but dementia is not a normal part of aging,” said Putman.

Dementia is an umbrella term which encompasses almost 100 different syndromes and conditions that can cause the symptoms of dementia.

A 2020 study, called the Lancet Report, outlines how to maintain a healthy brain.

Be physically active. “What's good for your heart is good for your brain,” said Putman, who advises that jumping into exercise without working up to it, and without doctor input, is not the best way to approach exercise for a sedentary person.

“Start slow. I used to say to my family member, get up and walk around the house during commercials. Some of us are at various entry points, depending on what our life has brought us, whether we have old injuries or just have a sedentary life. Exercise should be sustained and should be regular, but you can vary it up as well.”

Putman listed yoga, water aerobics or Qigong, which is like Tai chi and is offered at the  Alzheimer's Society. Niagara Region offers a Healthy, Safe and Strong exercise program “where you can join in and participate in exercise for your brain, for your socialization and for your health.”

Protect your heart.  Vascular dementia is the second leading cause of dementia and is typically caused by somebody having a stoppage of oxygen to their brain, usually as a result of a stroke or a heart attack. Putman advises having regular checkups for cholesterol, blood pressure, diabetes, and having these conditions treated.

Be socially active. “Social isolation is now considered in the same sort of realm as smoking or having a sedentary lifestyle. We've had a really hard five years when it comes to the idea of social isolation and we saw, throughout the pandemic and post pandemic, people who were in the realm of mild cognitive impairment move into that realm of dementia more quickly.”

Socialization can occur through the phone, over the internet with apps like Zoom, or simply by talking with neighbours.

Putman suggested joining programs offered by organizations such as the museum or library “because they have lots of events and they make it easy for us to find socialization.”

“Talking to a stranger is actually really good for your brain,” said Putman. “It actually encourages your brain to engage in a different way.” Also, make the most of daily opportunities to chat with the cashier, cab driver or someone in the elevator.

Manage medical conditions. Putman advised knowing and understanding your medical conditions. Track cholesterol and blood pressure numbers, take medication as prescribed and do not rely on Doctor Google.

Challenge your thinking. “Taking on mental leisure activities that you enjoy is really important,” said Putman whose suggestions included looking at art, completing Sudoku, crosswords and word games, learning a new language, and involving yourself in games that also require socialization, such as Scrabble or chess.

"Try something new as well,” said Putman. Making new neural pathways are really important for stimulating the brain. Music, for example, is an important source of brain stimulation, especially when new genres are given a listen.

Get a good night's sleep. Strive for six to eight hours of quality sleep every night. General tips for sleeping better include sleeping on a quality mattress and pillow, keeping the temperature at what is the most comfortable for you, and avoiding electronics an hour before sleep.

Have depression treated. “Depression is really more than just feeling down and, as we get older, depression can look different. Sometimes it's a lack of appetite and some sleep issues, or not wanting to be engaged in normal activities.” Putman added that mood and personality changes can be a symptom of a dementia.

Avoid excessive alcohol intake. “For low risk of harm, we want to stick to consuming less than two standard drinks a week.” However, noted Putman, an appropriate five-ounce glass of red wine has a lot of antioxidants.

Maintain your hearing. “This is a big one,” said Putman, who explained that many people have a resistance to managing their hearing. Hearing loss has been linked to an increased risk of dementia and leads to social isolation and a loss of independence.

Find meaning in life. Your purpose for getting out of bed can be as simple as having a pet to care for. “Come at life from a place of gratitude, find joy and purpose, and incorporate that into a daily routine,” she suggested.

Avoid all types of head injury. “Seems obvious,” said Putman. Wear a seatbelt, put on a helmet while riding a bike or scooter, and reduce trip hazards that might cause a fall. Wear the right shoes and maintain your health. If it’s suggested that you use a mobility aid such as a walker or cane, make sure you're using one that is the right height, size and weight for you, and that you're using it properly and you use it as prescribed.

Adopt healthy behaviours. Follow the Canadian Food Guide, which has been updated and is no longer a pyramid but a plate, with vegetables and fruits taking up half of the plate, whole grains a quarter, and proteins the other quarter. “Hydration is really important. By the time you're 40,  by the time you feel thirsty, you're actually already starting to be dehydrated.”

Reduce avoidable stress and quit or reduce smoking are two other healthy behaviours that can be adopted to maintain a healthy brain.

“If we all knew what our avoidable stress was we would avoid it,” acknowledged Putman. She was not referring to short-term or acute stress, “where you feel that fight or flight situation,” and when anxiety helps your body to release adrenaline in dangerous situations or stressful situations. Long-term stress, which is when we're not able to relax, releases cortisol, which doesn't subside and is actually damaging to our brain.” Putman said that it is really important to talk about stress and to be open to treatment options.

Finishing her presentation by opening the floor to questions, she was asked about cannabis use and dementia, and said the scientific data isn’t there, yet.

When asked how Medical Assistance in Dying (MAID) works for those with dementia, Putman first noted that “the Alzheimer's Society doesn't have an opinion either way on MAID,” before adding that “if you are diagnosed with dementia in the early stages and still have the ability to make decisions and are considered capable, you can choose MAID.”

“You have to sign the forms and set your date. If you are not capable at the time of the administration of MAID, you are able to still receive it without giving consent. At that moment, however, your family can withdraw consent.” For more information, she added, contact the Alzheimer Society and ask for the MAID practitioner.

The mother from Bell’s Mom Project is seen in many portraits around the room. The exhibition includes only a portion of nearly 400 finished projects Bell completed over four years, arranged in chronological order, beginning with the earliest and ending in “uncertainty,” according to the abstract posted alongside the portraits. The Mom Project can be viewed until Jan. 27.