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Ask Dr. K: Prevention is key to avoid developing dementia

DEAR DOCTOR K: What is vascular dementia? Can it be prevented?

DEAR READER: The term “dementia” describes a serious impairment of mental function. It may include memory loss, confusion, personality changes and the dwindling ability to perform everyday activities. Alzheimer’s disease is the most common type of dementia. The second most common is vascular dementia.

Vascular dementia results when blood vessels don’t deliver enough oxygen to the brain. There may be atherosclerosis in the arteries that block blood flow. High blood pressure may cause the arteries to narrow and increase the amount of atherosclerosis. Sometimes this leads to a major stroke. Such strokes can cause a person to suddenly lose the ability to move a part of their body, to talk, to understand speech, to feel or to see. After such a major stroke, dementia can occur.

Multiple smaller strokes can occur, as well. They can be so small, and produce such mild symptoms, that a person is not even aware they happened. Slowly, they can degrade mental function and cause dementia. Multiple small strokes sometimes are discovered by brain scans (such as CT and MRI scans) performed to diagnose the cause of mental impairment.

Symptoms of vascular dementia can look just like Alzheimer’s disease. The person may get confused. Speech may slur. Thinking may become less sharp. But symptoms do vary. Depending on what area of the brain is affected, memory may not even be impaired. Instead, other problems may appear, such as difficulties calculating numbers.

Once vascular dementia develops, treatment options are limited. Doctors sometimes prescribe drugs used for Alzheimer’s disease, but they are less effective in people with vascular dementia.

That’s why prevention is key. What’s bad for the heart is also bad for the brain. The same steps you take to prevent heart attacks also reduce your risk of strokes and vascular dementia. They even reduce your risk of Alzheimer’s disease. (And several forms of cancer, but that’s for another column.)

So you won’t be surprised to learn that the following can be profoundly beneficial in protecting your brain from both vascular dementia and Alzheimer’s disease:

— Control blood pressure, cholesterol and blood sugar.

— If you smoke, quit.

— Adopt a heart-healthy diet rich in vegetables, fruits, whole grains, oily fish and unsaturated fats.

— Exercise regularly.

— Drink alcohol in moderation.

And there are other things you can do that are specific to preventing dementia and memory loss:

— Spend time with family and friends.

— Keep your mind active with education, volunteering and hobbies.

— Identify and treat depression.

Like all of us, I never want to develop a serious illness. But if I had to rank all the serious illnesses that I might get, dementia is the one I want most to avoid. Life sometimes has other plans for you, but don’t think that developing dementia is just an act of fate, something you cannot influence. You really can protect yourself against developing dementia.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.

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