anticholinergic drugs, dementia, Alzheimer's, cognitive decline, preventing dementia, deterioration from Alzheimer disease

The prospect of dementia is just as frightening to many people as the possibility of a cancer diagnosis. With the population aging, increasing numbers of Americans will suffer from Alzheimer disease. Millions of us are interested in preventing dementia. This week there is conflicting news on whether and how we might reduce our risk.

Bad News on Preventing Dementia:

A series of meta-analyses looked at randomized studies and found little solid evidence of any interventions that prevent dementia. The authors examined data from drug trials as well as research on supplements and brain games. They also looked at studies of physical activity, such as tai chi.

One author concluded, “there’s no magic bullet.” That said, they did find some evidence that combining cognitive training, physical activity and a healthful diet might slow cognitive decline.

Quality of Studies:

Part of the problem is that too many of the studies on preventing dementia are not of the highest quality. The researchers note of the studies of drugs to delay dementia that they are limited due to “High attrition, short follow-up, inconsistent cognitive outcomes, and possible selective reporting and publication.” The studies of physical and mental training exercises and those of dietary supplements have similar flaws, if not worse.

All three reviews were published in the Annals of Internal Medicine, Dec. 19, 2017:

Fink et al, Annals of Internal Medicine, Dec. 19, 2017 (Drugs)

Brasure et al, Annals of Internal Medicine, Dec. 19, 2017 (Exercise)

Butler et al, Annals of Internal Medicine, Dec. 19, 2017 (OTC supplements)

Butler et al, Annals of Internal Medicine, Dec. 19, 2017 (Brain training)

These reviews were requested by the Agency for Healthcare Research and Quality and the National Institute on Aging.

A More Hopeful Outlook on Preventing Dementia:

A different review conducted for The Lancet Commission on Dementia Prevention, Intervention, and Care found that several common-sense health approaches can make a difference in the risk of dementia. Getting a good education in childhood reduces the risk by 8 percent. Not smoking, controlling weight, getting regular exercise, social interaction and blood sugar control all are important as people grow older, even if no one factor stands alone.

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  1. Sara
    Clearwater, FL
    Reply

    My doctor said that researchers are learning that the Alzheimer’s form of dementia is not as common as they once thought, that dementia can be caused by clogged arteries and reduced blood flow to the brain over time. Makes sense to me. Depriving the brain of oxygen and nutrients can’t be good. What he was telling me is that the problem with the drugs they have tried using is that they can’t get to certain areas of the brain because those parts have reduced blood flow. I don’t know if this is accurate, but the idea makes sense to me.

  2. Jean
    Chapel Hill, NC
    Reply

    What about cell phone use. I read that ear plugs in the ears give off emissions that could be dangerous, also head sets, even holding your phone against your face. Since everyone seems to be doing these things, maybe there should be someone looking into that as well.

  3. Dianne
    Reply

    What do you think about The End of Alzheimer’s by Dale E. Bredesen, M.D.?

  4. Donna
    Minnesota
    Reply

    What about the Posit Science BRain HQ program? I think you mentioned it a year or so ago, and from what I can tell, the evidence for it is pretty solid.

  5. Brent
    NW IL
    Reply

    This is just more well-practiced perpetuation of ignorance. In India, Alzheimer’s is virtually non-existent because their diets are so high in spices like turmeric (curry). Bharat Aggarwal wrote a book called ‘The Healing Spices’ but apparently ran afoul of the cancer establishment since I haven’t heard him do any radio interviews for a while. (He used to work for the MD Anderson Cancer Center folks). Also Green Med Info has substantial evidence of the benefits of turmeric and other spices like ginger on brain health. Everyone should add more of these (in moderation of course) to their diets for a sharper mind and brighter future!

  6. Judith R M. D.
    Kfar Saba, Israel
    Reply

    I don’t understand this search for a single intervention to prevent dementia. Dementia is not a disease but a symptom. There are many causes of dementia, and Alzheimer’s is only one of them, although it is mistakenly used to mean dementia.

    In the early days after the first refrigerator was made, and it was called Frigidaire, many people said Frigidaire when they meant refrigerator.

    We do know how to prevent SOME dementias, such as that caused by thiamine deficiency, but it doesn’t make sense to look for an intervention to prevent a symptom which can be caused by many diseases.

  7. Kathleen
    Greenville NC
    Reply

    A year and a half ago, I noticed my reaction time and the time it takes to make a split second decision in traffic was changing. I saw increased lag time in my job related actions as an Operating room nurse. This was not acceptable to me so I retired. In the meantime, I read about Choline, through Dr. Low Dog, on her Facebook page. I began taking this supplement. After a month, I felt as if someone had dusted my brain! I now have little apprehension in driving and could go back to work if I wanted to. A year away from 70, I think I’ll just leave that stethoscope on the hook.

  8. Janet
    Elk Grove, CA
    Reply

    Those who eat animal products are more likely to have dementia than those who don’t. Many studies have been done on this, but the meat and dairy industry doesn’t want anyone to know this! The meat and dairy industry will probably fund the studies that show a bias toward their products. Vegans don’t have the dementia rate or cancer rate that animal eaters do. Vegans are almost heart attack proof! Here is a study that shows the link between ANIMAL PRODUCTS and DEMENTIA: https://prime.peta.org/2013/02/dementia

    • Terry Graedon
      Reply

      Please keep in mind that PETA is People for the Ethical Treatment of Animals, not a research organization.

  9. Jeanie
    Gibsonville, NC
    Reply

    I am speaking from personal experience in regard to people being prescribed blood thinners, in particular the newer blood thinners that have not been used for a long period of time. I was prescribed Eliquis to prevent strokes after I was diagnosed with Afib. After taking the drug for less than three months, I began to forget appointments, forgot to take my medicine, things I had never had problems with at anytime. I am eighty three years old, a retired nurse, try to eat the proper foods, walk regularly, keep my weight to a healthy level and yet I started having memory problems during the time I took Eliquis. I wonder how many other older people, possibly younger people also, have memory problems from the medicines they are being prescribed. I seem to have regained the memory loss after asking my doctor to take me off Eliquis. I have not found possible memory loss listed as a side effect for Eliquis.

  10. Marilyn
    bethlehem pa
    Reply

    My husband had a quickly moving dementia related to strokes and required placement in a small, very good dementia facility. This facility was very expensive and attracted residents with high educational background, accomplished employment histories and life long participation in physical activities. Most were in robust physical health when moving into the facility but the various dementias were devastating as time went on. I learned nothing about the cause of these illnesses but received the irreplaceable gift of appreciating each new day.

  11. Molly
    Columbia, SC
    Reply

    The practice of NOT TAKING STATINS is not mentioned as a possible way to prevent dementia.

  12. Brooke
    Reply

    Did they look at the amounts of drugs that have anticholergenic effects? There are many both prescription and OTC. People are taking multiple drugs and many for long periods of time.
    The government gives these drugs according to their anticholergenic load. Or would that make angry the gods of big Pharma? . The effects of too many of these drugs must be studied.

  13. Lydia E
    Reply

    I think there is a conflict here between your headline article that says there is basically nothing you can do to prevent dementia and the book you are selling about overcoming Alzheimers’s disease.

  14. June
    Ohio
    Reply

    You should read the book. The end of Alzheimer’s it has examples of people cured. It’s a hard read because medical terms but he is curing people and preventing it.

  15. Caryn
    Reply

    Dr. Dale Bredesen has been successfully helping people reverse Alzheimer’s through nutrition and lifestyle changes, essentially giving them their lives back.

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