En español | More middle-aged adults should be talking with their doctors about their risk for dementia, experts say. But new research suggests few are having this conversation.
A recent report in JAMA Neurology analyzed survey results from more than 1,000 adults ages 50 to 64 and found that while nearly half of respondents thought they were likely to develop dementia, only about 5 percent had discussed dementia prevention with their physicians.
One likely reason: fear of diagnosis, says Scott Turner, a neurologist and director of the Memory Disorders Program at Georgetown University. There is no cure for the disease, which is expected to affect nearly 14 million Americans by 2060, according to the Centers for Disease Control and Prevention (CDC). What's more, there are just a handful of medications to treat its symptoms.
Another factor preventing dementia discussions: shorter appointments, which leaves less time for patients and physicians to talk about matters not of immediate concern. Plus, adults who have early signs of memory loss may be unaware or in denial of their cognitive changes, says Turner, who was not involved in the JAMA report.
But bringing up brain health is important, even if signs of memory loss are absent and it's years before the disease is typically diagnosed.
Reducing dementia risk starts in midlife
As with other chronic conditions, such as heart disease and cancer, adults can minimize their risk for developing dementia later in life by staying physically active and maintaining a healthy weight in their 30s, 40s and 50s, Turner says.
Lowering high blood pressure, avoiding tobacco and controlling cholesterol levels also help reduce dementia risk, according to the CDC. Plus, research shows that limiting alcohol, getting enough sleep, and wearing eyeglasses and hearing aids, if needed, can keep the brain healthy.
"People underappreciate what they could actually do to reduce the risk of dementia and what their doctor might be able to do to help reduce that risk,” says Donovan Maust, a geriatric psychiatrist at the University of Michigan and the lead author of the JAMA report.
Most adults are familiar with the link between a healthy lifestyle and a healthy heart, Maust says. Survey respondents in fair or poor physical health, however, were not aware that their risk for developing dementia was higher than that of their peers who were more physically active.
Educating patients about the role that diet and exercise play in the development of dementia could be “a really powerful motivator” to encourage behavior change and chronic disease management, Maust adds.
Sharing strategies based on science that promote brain health can also help patients save time and money on products that claim to improve memory but are not backed by research. While only 5.2 percent of survey respondents discussed dementia prevention with their doctors, more than 30 percent endorsed using supplements to reduce their likelihood of developing the condition.
"There's a lot of quackery out there, and a lot of people fall for it,” Turner observes. “And I understand why — we don't have really good, effective treatments — but I think most of it is just a waste of money.”
In a report released last June, the AARP-founded Global Council on Brain Health revealed that supplements to preserve or boost memory or cognition aren't worth the plastic they're bottled in.
"Supplements for brain health appear to be a huge waste of money for the 25 percent of adults over 50 who take them,” says Sarah Lenz Lock, AARP senior vice president for policy and the council's executive director.
Your memory problems could be treatable
Dementia isn't the only condition that causes memory-related issues. Thyroid disorders, vitamin deficiencies, sleep apnea, depression and certain medications can affect memory, as well.
"And this [happens] to quite a lot of people,” Turner notes, referring to patients who come in with treatable and reversible memory difficulties. “So there is an advantage to coming in early and getting evaluated.”
A doctor can also help adults who are concerned about memory loss differentiate “normal” age-related changes in memory and thinking from the beginning signs of dementia. Misplacing keys, forgetting the name of an acquaintance and occasionally struggling to find a word can all be attributed to normal aging, the CDC reports. Confusion and memory loss that disrupt daily activities, however, should not be ignored.
Advantages of early diagnosis
Unlike with cancer and other chronic conditions, screening for dementia is not routine, and it likely won't be until there are more effective treatments. Even so, physicians should consider screening adults who bring up memory concerns in their 50s and 60s, Turner advises — especially since there are advantages to an early dementia diagnosis, including access to treatments.
Researchers are testing new therapies that may be “more effective if we start early in the disease course,” Turner says. And individuals with an early diagnosis are eligible for a wider variety of clinical trials.
Making lifestyle changes, even after a dementia diagnosis, may also help preserve cognitive function, according to the Alzheimer's Association. Further, knowing about dementia early on gives individuals more time to plan their legal and financial futures with family and friends.