Issue link: http://digital.copcomm.com/i/750495
3 2 | PULSE Fa l l 2 0 1 6 N ow where did I put my keys? Why did I walk into this room? What's the word I'm thinking of …? Everyone forgets things from time to time; it's normal. And it's normal to become more forgetful with age—that doesn't mean you have dementia. Unfortunately, forgetfulness combined with other symptoms of diminished mental and physical acuity—confusion, disorientation, amnesia, language and visual spatial problems—can signal the onset of dementia in older individuals. When these symptoms affect tasks like keeping a checkbook, using a computer or remote control, cooking a meal and driving, then a diagnosis of dementia is made. For all types of dementia, aging is the biggest risk factor, according to Torrance Memorial Medical Center neurologist and associate professor of neurolog y at UCLA, Bernard Ullman, MD. With 30 years of experience, Dr. Ullman estimates that roughly 50% of people aged 95 and older have some form of dementia. ere are various types, including Alzheimer's disease, which is the most common and accounts for an estimated 60% to 80% of cases. e disease can be caused by genetic inheritance, especially with onset before age 65. Aer 65, the genetic component of dementia becomes much less pronounced. REDUCING THE RISK While we can't control our genes, Dr. Ullman notes we can control the risk factors for vascular dementia, also known as multi-infarct or post-stroke dementia. Vascular dementia is less common than Alzheimer's, but still accounts for a significant number of cases. Vascular and Alzheimer's disease can occur together in "mixed dementia," especially in those with significant cardiovascular risk factors. ese risk factors are the same risk factors as coronary heart disease and stroke. ey include: hypertension, elevated cholesterol and lipids, diabetes, cigarette use, and lack of exercise. Controlling these lifestyle factors is possible and "very important in terms of reducing your risk or delaying the onset of dementia," says Dr. Ullman. NEVER TOO SOON When should you start thinking about keeping your brain fit? e earlier the better, says Dr. Ullman, but even in midlife, adopting a brain-healthy lifestyle can help keep you sharp as a tack for years to come. (See Top Tips to Stay Tack-Sharp on p. 34.) Besides lifestyle and genetics, there are other risk factors for dementia: exposure to heavy metals, low vitamin B12, viral encephalitis and repetitive brain injury. "ere are protective factors, too. Epidemiologic studies have shown that higher levels of education, higher socioeconomic status and high work complexity correlate with lower levels of dementia, although the relation between them isn't fully understood," says Dr. Ullman. He suggests that early education, good nutrition and healthy living environments for our children now would reduce levels of dementia in the future. While we can take measures to reduce our risk of developing some forms of dementia, currently there is no medication to prevent or reverse it. Physicians can test individuals' genetic predisposition for Alzheimer's and can perform brain scans and test spinal fluid for the buildup of amyloid and Tau proteins associated with Alzheimer's disease. In young patients who