According to Alzheimer’s Disease International, there are today around 50 million people living with dementia in the world, but there are good reasons to believe this number to be much higher.
Dementia can affect any part of the brain and the respective cognitive domain. This is why, although memory loss is often the most prominent symptom, it is nevertheless not the only one.
Many people go years without knowing that they have dementia, some of them never even getting an actual diagnosis. One reason for this could be that primary care physicians are not skilled enough in detecting dementia early one, being hard to differentiate between cognitive decline caused by dementia and moderate cognitive decline caused by ageing. Another, however, is that primary care physicians may think that nothing can be done to treat dementia, and therefore prefer not disclosing the diagnosis to their patients.
While it is true that the treatments available today do not cure dementia, and are not particularly effective in treating symptoms, disclosing a diagnosis and acknowledging it, would allow patients to adopt certain lifestyle changes that have been proven to have significant effects on slowing down and even preventing cognitive decline.
Here at Geras Solutions we believe in and support the multi-modal intervention designed in the “Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability” (FINGER).This study was conducted in 2015 and found out that by implementing certain lifestyle changes, individuals at risk were able to greatly delay and even prevent cognitive decline.
The lifestyle changes proposed by the FINGER study included the following:
- Diet: participants were advised to consumer a diet with 10-20% of daily energy from protein, 25-24% from fat, mostly monounsaturated fatty acids, and 44-55% from carbohydrates, with very low intake of sugar. Salt and alcohol were also kept very low, while fibre intake was encouraged.
- Physical exercise: participants were advised to increase physical exercise both of the resistance and aerobic type. Participants were encouraged to engage in muscle strength training 1 – 3 times per week, and in aerobic exercise 2 – 5 times per week
- Cognitive exercise: participants were able to engage in group meetings and sessions, focused on educational content on age-related cognitive changes, memory, and strategies to face those changes, a number of sessions to check progress in individual computer-based training (think of brain training app exercise) over the course of a year. The individual sessions trained different cognitive domains of the brain, while the group sessions stimulated social activity.
Noticeably, researchers and doctors conducting the study did not prescribe medicine, although they told participants to contact their primary care physician to talk about it in case they felt the need for it.
Researchers were able to observe a greatly reduced pace of cognitive decline in participants, and they were able to say with a reasonable degree of certainty that their multi-domain intervention can improve or maintain cognitive functioning in at-risk elderly people from the general population.
The FINGER protocol is effective, cheap, and safe. By identifying dementia early on, patients may be able to implement those lifestyle changes and dramatically change the course of their disease early on, when the damage to the brain is still contained. This is why ensuring early diagnosis is crucial.
Alzheimer Disease International, (2015), Dementia Statistics.
Alissa Sauer, (2017), alzheimers.net, Alzheimer’s Diagnosis Rarely Disclosed to Patients.
Tiia Ngandu et al., (2015), A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial, The Lancet, 385(9984), pp. 2255 – 2263.