Education, healthy lifestyle reduce dementia risk

BETTER education and a healthy lifestyle reduce the number of elderly people who suffer from dementia.

This finding in March 2009 by the UK’s Cambridge University researchers Dr David Llewellyn and Dr Fiona Matthews and the Medical ResearchCouncil Cognitive Function and Ageing Study shows a small but significant improvement in elderly people's mental abilities over the last two decades. Researchers believe this is due to the raising of the compulsory education age, reductions in the number of elderly people smoking and other health developments.

The researchers compared the results of more than 9,000 people over 65 whose mental faculties were tested in 1991 with those of over 5,000 people in 2002.

They were all given a standard test used to detect early signs of dementia, which involves naming as many animals as possible within a minute. The tests showed a small but potentially significant increase in the number of words a minute people used when asked to list words associated with animals.

The study, which was published in the journal Aging, Neuropsychology and Cognition (March 2009), could help to predict future numbers of elderly people who will develop dementia with greater accuracy.

 According to the report, the increase in educational levels that was observed is consistent with changes in the mandatory school leaving age in England. The school leaving age was set at 15 in 1947, rising to 16 in 1972.

Other factors that were also likely to have affected the cognitive abilities of the 2002 group are the decrease in dementia include fewer heart attacks, increased prescription of drugs to reduce high blood pressure, fewer people smoking and improvements in early life nutrition

Dr David Llewellyn, who led the study, told BBC that dementia happens when people decline cognitively to the point where it interferes with their ability to do basic things like cook. “It tends to happen later in life, but the changes that lead to it tend to start much earlier. These findings are important because they affect our projection of what's likely to happen in the future.”

Brain cells dying fast

Dementia is an illness which affects the brain, causing the brain cells to die faster rate than normal. It affects mainly people aged 65 or older.

In Singapore, about 5.2 percent of people over the age of 65 suffer from dementia. In 2005, 22,000 people over 65 years suffered from dementia. By 2020 the figure is expected to reach 53,000, and by 2050 the figure may increase to 187,000

There are two main types of dementia – Alzheimer’s disease and Multi-infarct dementia.

In Alzheimer’s disease, the onset of symptoms and the progression of the illness is gradual. Although the cause is still unknown, present research suggests there is a familial tendency and certain chemicals in the brain are lacking.

Multi-infarct dementia results from a series of strokes in the brain.

Signs of dementia include problems remembering recent events, disorientation of place and time and decreased judgment. As yet, there is no known medical cure for the disease. 

Exercise, education to live & age well

I grow old… I grow old . . .
I shall wear the bottoms of my trousers rolled. – TS Eliot

SINGAPORE Chinese men become sickly, weak and grouchy when they grow old. In the words of healthcare experts, they don’t “age well”, like wine turning into vinegar!

In June 2009, the National University of Singapore’s psychological medicine department conducted a survey of 1,300 Chinese men who were 65 and older. It found that seven in 10 of them did not age well because they were in poor physical condition. Their ailments affect their movement so that they could not live independently. And the chief cause? Lack of exercise and lack of physical activity, says associate professor Ng Tze Pin of the department, who presented the findings at a symposium on health-care for an aging population.

Four factors contribute to aging well:
• Better, continual education
• Regular physical exercise
• Proper, nutritional diet
• Spiritual beliefs and consolation

Education

The better educated you are, the more likely that you live a healthier, longer life. This has been the consistent finding in survey after survey of aging populations in the United States and Europe in the past several decades. While experts are still debating the precise reason for this phenomenon, you might as well go and sign up for more courses of study, regardless of how old you are.

Exercise

Follow the example of  87-year-old Heng Choon Teck who gets up before sun rise each morning and walks for an hour. Although his aging leg muscles are unable to push him up the stairs, he does not suffer knee or other joint pain. Uncle Heng – as he is called among neighbours and friends – says his walking regimen helps to keep him trim, healthy and alert.

So,instead of shuffling your way desolately to the kopitiam (neighbourhood coffee shop) for your morning black coffee, round up a few friends for regular long walks or to exercise in the gym. Many community centres offer gym membership at minimal fees.

Eating & drinking

It’s common and depressing to see old men with pot bellies sitting in kopitiams with bottles of beer by their side, and the beer girl caressing their shoulders to encourage them to drink more. All alcohol is toxic to the body, whether it is beer, wine, brandy or whisky. As one ages, one’s immune system weakens, and pouring alcohol will only make it worse.

And yet, there are old folks who waste good money poisoning themselves. As for food, plain but nutritious meals are best, with little or no meat and lots of green.

Lord Buddha – one of the fittest and wisest men even in old age – said one factor for his longevity and general good health was that he ate once a day, just enough to energise himself for the day’s activities. One meal a day may be a bit too spartan. OK, eat two hearty meals a day: breakfast and a noonday meal, and a light snack in the evening.

Engaging life, enduring values 

People with enduring spiritual beliefs also tend to age more successfully, says Prof Ng, because spiritual help seems to be a source of emotional and mental support. Continue to engage with friends, with relatives, with children and grandchildren, is another strategy to age well. When you retire, don’t withdraw from active life.

Modern technology tools – the radio and TV, the Internet and the mobile phone – have made it easier for old folks to stay connected to everybody else. Take part in social and community activities. Play mahjong, sign up for cooking classes and day tours, and learn Tai Chi movement to keep your body supple.

“Old folks must and can continue to find ways to continue to be meaningful and active. Find a community to engage in, and pursue new learning and interests,” says Dr Tian Cheong Sing, executive director of the Centre for Living Effectively at Mount Elizabeth Medical Centre.

Keeping fit, mentally & financially

Old age is not a gift, unless you have sufficient cash, medical benefits and, above all, you still have your “marbles” with you. If your mind is gone, your family and friends are scarcer by the day, and your cash flow is drying up, then age becomes a physical burden to you and to others, especially to others. For despite whatever brave, consoling words we may utter about caring for someone, we cannot hide the fact that an old, infirm individual really is a burden.

I think it’s our duty when we are still relatively young, to train and develop our mind in concentration, stability, insight, and clarity, as well as to keep ourselves physically fit (not merely flaccidly healthy), so that we minimise whatever burden we may impose on our family and friends as we age. The most effective way to keep our mind sharp, clear and alert is to sit in mindfulness meditation, following techniques taught by Lord Buddha himself.

This applies to financial fitness as well. Old age is no fun but with cash, at least we are assured of a warm bed, an airconditioned home and plenty of dessert after each meal! And when we get really, really old, there are kindly nurses and pleasant attendants in a well-appointed old folks home to give us physical care round-the-clock.

Picture: Uncle Heng, 87, goes on long regular walks to keep himself fit and alert. Here, he's with two volunteers (twin sisters Lee Kah Hion and Kah Tin) from the Lions Befrienders, a charity organisation in Singapore that engages with senior citizens who live alone and are socially isolated and vulnerable. To know more of the Befrienders, visit their Web site.