[Health Tip] Today is 'Dementia Overcoming Day'... Prevent it with Exercise and Diet Management

Every year on September 21st, the World Health Organization (WHO) and the International Alzheimer's Association (ADI) designate this day as 'World Alzheimer's Day' to raise new awareness about the issues faced by dementia patients. In South Korea, the same day, September 21st, has been designated as 'Dementia Overcoming Day' to overcome dementia.

Dementia refers to the acquired decline in intellectual abilities, including memory, that interferes with daily life. According to the Central Dementia Center, the estimated number of dementia patients aged 65 and older last year was approximately 935,086. This corresponds to about 1 in 10 people aged 65 and above. As the population ages, the number of dementia patients continues to increase. Among types of dementia, Alzheimer's type dementia is known to account for more than half of the cases.

Professor Lim Jae-sung of the Neurology Department at Seoul Asan Medical Center explained, "50-60% of dementia cases in South Korea are neurodegenerative dementias including Alzheimer's disease. Next, vascular dementia caused by blood circulation disorders in the brain such as stroke accounts for 20-30%, and the remaining 10-30% are due to other causes."

The age at which Alzheimer's type dementia most commonly appears is after 65 years old. It develops very gradually and progresses progressively. Symptoms include memory impairment, disorientation (the ability to recognize the current date, time, and location), attention deficits, language impairment, visuospatial dysfunction, and frontal lobe executive dysfunction, all of which are neurocognitive impairments.

Additionally, mood disorders such as depression may accompany the early stages, sometimes causing emotional changes like easily getting angry over trivial matters. As the disease progresses, delusions, hallucinations, obsessive behaviors related to food or money, or collecting specific objects may occur. These symptoms cause significant difficulties for caregivers in looking after patients, often leading to the admission of patients to treatment or care facilities.

In particular, the difference between normal age-related memory decline and Alzheimer's type dementia is that normal memory decline mainly involves occasionally forgetting 'minor' details, whereas Alzheimer's type dementia involves forgetting 'both' minor and important details. Furthermore, beyond suddenly forgetting the names of old friends, Alzheimer's symptoms include not remembering the names of family members or close people, and going to buy items but forgetting the purpose of the trip and returning without purchasing anything.

[Image source=Getty Images]

For diagnosing Alzheimer's type dementia, it is important that the caregiver who knows the patient best accurately describes the patient's symptoms. It is necessary to check whether there has been a change in cognitive functions, including memory, compared to before, when it started, and how it has manifested, followed by precise testing to make a diagnosis. Tests mainly include cognitive function tests to assess which cognitive domains are impaired and to what extent, as well as blood tests and brain imaging to identify the underlying causes.

Cognitive screening tests conducted during initial visits to dementia relief centers or hospitals take about 10-15 minutes and provide a brief assessment of the patient's cognitive function. If problems are detected, a comprehensive cognitive function test lasting 1-2 hours is performed for an accurate diagnosis. Even if dementia is not diagnosed but memory decline is evident, it is necessary to undergo cognitive function tests at intervals of 6 months to 1 year to monitor changes.

If the comprehensive cognitive function test confirms dementia or mild cognitive impairment (MCI), which is a prodromal stage of dementia, blood tests and brain imaging are conducted to identify the cause. It is important to note that dementia cannot be diagnosed by magnetic resonance imaging (MRI) alone; cognitive evaluation through cognitive function tests must precede to enable an accurate diagnosis.

MCI, the prodromal stage of dementia, involves memory decline but the individual can still perform all daily activities independently. There are various causes, but MCI caused by Alzheimer's disease has a high likelihood of progressing to dementia. Therefore, annual follow-up with cognitive function tests is necessary to monitor worsening memory decline. Depression can also cause MCI, but with appropriate treatment and counseling, cognitive function can improve without progressing to dementia.

Currently, the cornerstone of dementia treatment is preventing progression to severe stages. Although the disease cannot be cured, early detection and treatment can prevent worsening to severe dementia and extend the period during which independent living is possible. Drug therapy is the main method, but controlling risk factors such as hypertension, diabetes, smoking, and heart disease also helps prevent cognitive decline. Additionally, non-pharmacological treatments such as exercise therapy to safely and efficiently move necessary joints and muscles, reality orientation training that provides systematic information to help patients re-recognize basic facts about themselves and their environment, and cognitive training to improve impaired functions such as memory, concentration, and visuospatial abilities, can maximize and preserve the current functions of dementia patients for as long as possible.

Professor Lim Jae-sung stated, "Recently, a new treatment that removes the causative substances of Alzheimer's disease has been developed and approved by the U.S. Food and Drug Administration (FDA). However, its effects are still limited, and clinical trials for other drugs are actively underway." Experts expect significant innovations in the diagnosis and treatment of Alzheimer's dementia within the next 5 to 10 years.

Eisai and Biogen's Alzheimer's dementia treatment 'Leqembi (generic name: lecanemab)' [Image source=AP Yonhap News]

Recent studies indicate that the process of dementia begins in the 40s or even earlier. Therefore, managing risk factors appropriately from adolescence through each life stage is necessary, and it has been reported that nearly half of dementia cases can be prevented through this. First, during adolescence, patients with sufficient education had a lower risk of dementia than those without. In middle age, from the 40s to 50s, avoiding head trauma and controlling hypertension, excessive drinking, and obesity are helpful.

In old age, when the incidence is highest, it is important to avoid social isolation and depression. Continuously engaging in social activities and regularly meeting and communicating with others is crucial. Regular aerobic exercise, stretching, and strength training also help manage dementia by promoting the secretion of substances that protect the brain. Research shows that walking and exercising for about 30 minutes a day, five times a week, benefits memory. Dietary recommendations include whole grains, green and yellow vegetables, nuts, adequate protein intake through poultry, and consumption of blue-backed fish, while limiting red meat, high-fat cheese, bread, sugar, snacks, and fast food.

It is natural for memory to decline with age. However, if the decline worsens daily to the extent that it interferes with daily life, dementia should be suspected, and early consultation with a specialist for diagnosis is recommended.