According to the Alzheimer's society there are 700,000 people with dementia in the UK. This will rise to over 1 million people by 2025 and 1.7 million by 2051. On average it affects one in 14 people over the age of 65, rising to one in six over the age of 80. It costs the country over £17 billion each year, yet just two per cent of government funding through the Medical Research Council is spent on dementia research.
Dementia is not a single illness but rather a group of symptoms caused by different brain disorders which trigger loss of brain function. Symptoms are brought on by the destruction of nerve cells in the brain - while nerve cell loss is a normal symptom of ageing, it occurs much more rapidly in dementia patients. The deterioration of the nerves affects healthy levels of neurotransmitters in the brain, critical for memory, resulting in impaired brain function.
Of the 100 and more types of dementia, Alzheimer's disease is the most common, affecting 62% of those diagnosed. As well as age and medical history posing as risk factors, research suggests that diet, exercise and lifestyle affect the proponensity towards developing dementia.
Despite there being no cure for Alzheimer's disease or indeed any other type of dementia, appropriate treatment can lessen symptoms of memory loss, confusion, speech problems and hallucinations. Indeed conventional treatment often takes the form of antispychotic medication.
Campaigners are concerned, however, over the overprescription of antipsychotic drugs, particularly in care homes where sufferers are, on average, prescibed over four times as many drugs as a person cared for in their own home.
Sometimes drugs are prescribed without attempt to investigate the cause of behaviour, and they are known to cause undesirable side effects. They may mask underlying problems, and their use has been reported to worsen the symptoms of dementia. According to a recent study [i], short-term use of anyipsychotics more than doubles the risk of death and triples the risk of stroke in people with dementia living in the community.
According to Professor Clive Ballard, Director of Research at the Alzheimer's society, "up to 105,000 people with dementia in the UK are inappropriately prescribed them as a quick fix for treating challenging behaviour, such as aggression and agitation. Urgent action is needed to ensure these dangerous drugs are always a last resort. Antipsychotics should only be used in extreme circumstances…"
Critics argue that the sedative effect of the drugs means that they are more likely to benefit the carers, by controlling behaviour they find difficult to deal with, as opposed to helping the person with dementia.
Related research suggests that safe alternatives are available. The growing link between diet and onset of degenerative brain disorders in later life suggests that we are, to a degree, responsible for our health in old age, such that clinicians are increasingly imploring people to make positive changes to their diet and lifestyle in order to reduce dementia risk.
In a large study from Chicago's Rush Institute for Healthy Ageing, consuming fish once a week was associated with a 60% lower risk of developing Alzheimer's disease compared with those who never ate fish.[ii] A cohort study published in the British Medical Journal also concluded that eating fish or seafood at least once a week significantly reduced the risk of developing dementia, including Alzheimer's.[iii]
Possible explanations for this protective effect have centred on the benefits of long-chain fatty acids, found in plentiful supply in highly concentrated fish oil. As well as helping to reduce inflammation in the brain and encouraging the regeneration of nerve cells, certain omega-3s such as EPA also appear to reduce the production of chemicals that cause cell inflammation in the first place [iv] - together these properties provide a protective effect against cognitive decline.[v]
As more research is being conducted, scientists are discovering a stronger biochemical link between fatty acid consumption and dementia. It has even been demonstrated that omega fatty acids such as EPA may slow the degeneration of brain tissue and in some cases improve motor function.
Using state-of-the-art brain scanning techniques, Professor B.K.Puri, Professor K.S. Vaddadi and colleagues carried out a six-month placebo-controlled pilot study into the effects of ethyl-EPA supplementation on patients with advanced Huntington's disease. MRI scans were taken at baseline and at six-month follow-up; while those on the placebo experienced progressive cerebral atrophy (loss of brain tissue), treatment with EPA was associated with a reverse process - a reduction in the size of the ventricles (spaces in the brain). Symptomatic improvements were seen in terms of the amount of brain tissue as well as motor function after supplementation with fatty acids compared with the placebo.[vi]
While research is ongoing, evidence suggests that fatty acids have an important role in cognitive function. Essential for the composition of cell membranes and cerebral function, omega-3 long-chain fatty acids may offer a protective effect against symptoms of dementia;[vii] indeed they have been shown to reverse degeneration of brain tissue, even in advanced cases.[viii]
Of course, there's no way to guarantee you'll prevent dementia by making healthy lifestyle changes and improving your diet, but the evidence is strong and experts believe that eating healthily could help reduce your risk. For further information, log on to www.alzheimers.org.uk or visit www.igennus.com
References
[i] Paula A. Rochon, M.D., M.P.H., F.R.C.P.C., (2008) Short-Term Use of Antipsychotics in Older Adults With Dementia Associated With Serious Adverse Events. Arch Intern Med. 2008;168[10]:1090-1096.
[ii] Morris, M.C., Evans, D.A., Bionias, J.L. et al. Consumption of fish and n-3 fatty acids and risk of incident Alzheimer disease. Arch Neurol. (2003), 60: pp.940-946.
[iii] Barberger-Gateau, P., Letenneur, L., Deschamps, V., Peres, K., Dartigues, J. & Renaud, S. Fish, meat and risk of dementia: cohort study, BMJ, (2002) 325; pp.932-933.
[iv] Kalmijn, S. Fatty acid intake and the risk of dementia and cognitive decline: a review of clinical and epidemiological studies. J. Nutr Health Aging, (2000); 4: pp.202-207.
[v] Whalley L.J., Fox H.C., Wahle K.W., Starr J.M., Deary I.J. Cognitive aging, childhood intelligence, and the use of food supplements: possible involvement of n-3 fatty acids. Am J Clin Nutr. (2004)80:1650-1657.
[vi] Puri, B.K., Vaddadi, K.S. et al. MRI and neuropsychological improvement in Huntington disease following ethyl-EPA treatment, Clin Neuroscience, (2002), Vol. 13, pp.1-4.
[vii] Bourre, J.M. Roles of unsaturated fatty acids (especially omega-3 fatty acids) in the brain at various ages and during ageing, J Nutr Health Aging, Vol. 8(3); pp.163-74.
[viii] Bourre, J.M. Dietary Omega-3 Fatty Acids and Psychiatry: Mood, Behaviour, Stress, Depression, Dementia and Ageing.,. (2005) J Nutr Health Aging, 9(1) pp. 31-38.
Dr Nina Bailey specialises in the role of fatty acids in health and
disease, with a primary interest in the omega-3 fatty acid EPA from marine
fish oil. For more information on Dr Nina Bailey, please visit http://www.drninabailey.com/ , and for additional information concerning how fish oils could help you, go to http://www.igennus.com/
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