'This is an important public health message' - Trinity professor's warning on dementia risks

Professor Brian Lawlor, of the Global Brain Health Institute,Trinity College, Dublin. Photo: Martin Maher

Geraldine Gittens

In 1986, scientists in the US started to study a group of nuns so they could learn more about the onset of Alzheimer’s disease.

The study had some surprising results.

When a third of the nuns died, post mortem exams on their brains showed that they had Alzheimer’s disease. But when these nuns were alive, they had no symptoms of Alzheimer’s disease at all.

Why was this?

Consultant psychiatrist Professor Brian Lawlor at Trinity College Dublin explains:

“With the nuns, the belief is that those who have this more complex ability to express themselves in language – (maybe they had an innate ability and possibly it was down to education as well) - we believe we can build up a cognitive resource by exposing yourself to lots of things, social engagement, building up more plasticity in the brain.”

“When you develop the pathology of dementia, you can compensate with a positive cognitive reserve - and build up a reserve through education, lifetime activity, and social engagement.”

“In older age groups, the number of people developing dementia is falling off, and we feel that is linked to education and better heart health in the developed world.”

He added: “The idea that we may be able to prevent or delay the onset of Alzheimer’s disease is a realistic goal. It’s about building up your cognitive reserve and plasticity in the brain.”

Depression, isolation, loneliness, and hearing loss are among the factors that lead to an increased risk of dementia and Alzheimer’s disease.

In the same way that doctors recommend an exercise and diet regimen to those who are at risk of diabetes; doctors hope to learn what the signs, or markers, are for a person who is developing dementia, so they can recommend lifestyle changes accordingly.”

Professor Lawlor explains: “The pathology of Alzheimer’s starts to build up in mid-life. We need to build up early markers that appear in mid-life before people develop Alzheimer’s disease.”

“We’re finding that people at the age of 80 in the developed world – who have better control of blood pressure, lower cholesterol in mid-life, and also better education in earlier life – it protects them from the onset of Alzheimer’s disease.”

“We may be able to stave off the signs and symptoms of Alzheimer’s disease; if you delay the onset by 5pc in a population, the numbers of people in the population is greatly reduced by about 40pc.”

“We have a study going on, and it’s linked in with the UK, called ‘Prevent Dementia’, and we’re looking at people between the ages of 40 and 59, some have a history, some don’t have a history of dementia, and it’s about trying to identify markers that will tell us of an increased risk of dementia years later.”

MRIs, blood and urine tests, and neuropsychological tests are all being examined in this study to help find a clue.

“Particularly people over-50, they’re very fearful about Alzheimer’s disease, but they can take charge and do something about it,” Professor Lawlor says.

“This is an important public health message... people really need to know these things.”

Professor Lawlor’s tips to help prevent dementia:

1. Physical exercise: "Aerobic exercise three times a week - getting the heartbeat up a little bit". Low levels of exercise and obesity are associated with an increased risk of alzheimer’s. For people who have mild cognitive impairment, if these people exercise we believe you can decrease the risk of transitioning to dementia.

2. A good Mediterranean-type diet- a colourful diet

3. Expose yourself to new things

4. Remain socially engaged

5. Minimise or avoid stress. Mindfulness can be helpful

6. If you have high blood pressure and high cholesterol, it’s about making sure it’s treated. High blood pressure means an increased risk of stroke and increased risk of dementia

7. Cognitive stimulation – puzzles, Sudoku, brain training – "it may help or have the potential to reduce your risk. We do recommend them," says Professor Lawlor.

The Dementia: Understand Together campaign, led by the HSE in partnership with the Alzheimer Society of Ireland and Genio, aims to create an Ireland that embraces and includes people with dementia, and which displays solidarity with them and their loved ones. For more information, see www.understandtogether.ie or Freephone 1800 341 341.