Walking away from dementia

Dementia is not a single disease but encompasses a wide range of medical
conditions. It includes a loss of memory and thinking that is severe enough to interfere with
daily life. There is no cure for dementia yet, so the number of cases of dementia is projected
to increase as the population ages. The diagnosis of dementia is mainly clinical and is
supported by MRI and PET scans of the brain, as a brain biopsy that is needed for the
pathological diagnosis of dementia is often deemed to be too invasive. Alzheimers’s disease
is the most common cause of dementia and constitutes about 60-80% of all cases- caused
by the deposition of ‘tau’ protein both inside and outside the brain cell which disrupts
cellular communication. Though the exact cause is unknown, genetics may play a part and
people with affected parents or siblings seem to be more at risk of developing the disease.
Vascular dementia is the second most common cause of dementia which is caused by
bleeding and blockages in the blood vessels. While a person cannot control his age or his
genes, there seem to be three modifiable factors that help delay the onset of dementia. –
physical activity, blood pressure control and cognitive training.

The effect of physical activity on the heart has been well known for decades now-
but the positive effect of physical activity on the brain is just emerging. In a recent review,
walking about 5 miles (or 9800 steps) a day reduces the risk of dementia by 51% If that is
too much, even walking 3800 steps a day cuts the risk by 25%. Not only does it have a
positive effect on dementia, 2.5 hours of brisk walking per week also reduces the risk of
depression by 25% -untreated depression is a major risk factor for developing dementia. The
recent tic-toc craze of 3-2-8- which includes 3 days of lifting weights, 2 days of pilates and/or
stretching and 8000 steps a day has really caught the imagination of fitness gurus and
longevity experts alike as it combines the virtues of strength training to prevent age related
muscle loss, pilates to improve balance and mobility, thereby reducing falls and 8000 steps a
day to improve general fitness which has an additional positive effect on brain health.
Though walking is a start, it may not be enough for everyone. High intensity interval training
(or HIIT which includes alternating intervals of high and low intensity exercise) has been
shown to dramatically improve physical and mental well-being- even if performed for short
periods of time 2-3 days a week. Many fitness classes incorporate various dance forms to
make the fitness journey more enjoyable often employ HIIT in their routines.

High blood pressure has been independently shown to be a risk factor in vascular
dementia. Though walking and exercise have a positive effect on the reduction of blood
pressure, the control of blood pressure is important, and measures must be taken to
supplement exercise and walking with medication as and when required. Leading a healthy
lifestyle, reduction of weight where appropriate, managing blood sugar, and stopping
smoking in addition to keeping active contribute to reducing the risk.

Social isolation and lack of cognitive output also have a deleterious effect on the
brain. The ‘blue zones’ (where people live longest in the world) have shown the value of
living in close communities with frequent social interaction. People often sit down to eat
together or play cards or board games to keep their minds active. Problem solving in the
form of cross words or sudoku also help to delay the onset of symptoms.