Ask the Doctor: Slowing Down Dementia; Diabetes and Brain Health; Changing Outlook Over Time

Q: Can you slow down dementia once symptoms have started?

A: This is a question people with the early signs of dementia and their family members ask frequently, and unfortunately there is no simple or guaranteed answer. Dementia, whether the result of Alzheimer’s disease or other cause, is a very individualized condition. It moves at its own pace and can be difficult to predict. However, there are some lifestyle changes you can make that are associated with delaying the onset of dementia symptoms or slowing the progression of conditions such as Alzheimer’s disease. Remain physically healthy through regular exercise and a diet featuring a variety of vegetables and fruits, whole grains and lean proteins, and one that is low in added sugars, saturated fats, and sodium. Keep mentally alert with activities such as reading, puzzles, and learning. And don’t underestimate the brain benefits of social engagement. By working or volunteering with other people or by joining clubs or other social groups, you keep your brain active, potentially staving off damage to brain cells that can accompany social isolation and boredom.

There are some medications designed to slow the cognitive symptoms of Alzheimer’s disease. These include cholinesterase inhibitors (Aricept, Exelon) for mild to moderate stages and memantine (Namenda) for more advanced stages. These medications and healthy lifestyle steps can’t guarantee a slower progression of dementia, but they give you the best chance of preserving optimal brain power longer.

Q: I now have type 2 diabetes. I know it can affect your cardiovascular health, but my doctor said it can harm the brain, too. How so?

A: Elevated levels of blood glucose (sugar) from type 1 or type 2 diabetes can affect the brain in a few serious ways. Studies have shown that high levels of blood glucose can injure blood vessels, including those in the brain. Research has also shown that the inflammation that accompanies diabetes can affect blood flow regulation in the body, potentially interfering with a healthy flow of blood and the delivery of oxygen and glucose to the brain during periods of heightened brain activity.

Of course, diabetes can also harm the heart, kidneys, eyes, feet and other parts of the body. Managing your blood glucose levels is essential for good health from head to toe, so if you haven’t had yours checked recently, do so soon.

Q: As I get older, I take some things much more easily than I used to, but get riled up more about other things that didn’t bother me as much when I was younger. Is this normal?

A: Yes, what you’re experiencing is fairly typical as our perspective on life’s troubles and inconveniences changes over time. The ability to take more things in stride can come from being able to take a longer view of life. You know that ups and downs occur, but most of the downs don’t have long-term consequences. You won’t remember the rude store clerk a month from now, for instance, so what’s the point of letting the rest of the day be spoiled? You may also feel like you just don’t have time to worry about trivial stuff. You may, even without always consciously realizing it, want to infuse more happiness and more quality of life into your days. That outlook isn’t always a priority when we’re young and not spending as much time thinking about aging and mortality.

As for getting more upset about certain things, that also may be a direct result of the greater perspective that accompanies advancing years. Your finances in retirement, for example, may be the source of heightened concern because you’re no longer earning a paycheck. If you find yourself getting abnormally upset about events or circumstances, talk about those feelings with a friend or loved one, or consider seeing a therapist to help you find the tools to cope without unnecessary anger or worry.

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