As the average age of the world's population increases, so does the incidence of dementias such as Alzheimer's disease. New research shows that lifestyle factors such as diet can influence the chances of dementia. Good smells and bright lights can improve the quality of life for those who suffer from it.
The group Alzheimer's Disease International says 18 million people around the world currently live with dementia - brain disorders characterized by confusion, memory loss and an increasing inability to function in daily life. Two-thirds of the patients are in developing countries.
While pharmaceutical companies seek drugs to control the disorders, other researchers have found that several lifestyle factors affect them.
Among them is diet. At the recent Chicago meeting of the International Psychogeriatric Association, Dr. Antonio Capurso of the University of Bari in Italy recommended the so-called Mediterranean diet, which has already been shown to help prevent heart disease. It uses a lot of healthy fats, such as monounsaturated and polyunsaturated oils. Dr. Capurso says that, in a study of 550 elderly adults, those who consumed a lot of those oils did better on tests of brain function than those whose diets were low in them.
"The fats were almost exclusively derived from olive oil, and particularly from extra virgin olive oil," he explained. "So in our population, roughly 30 percent of daily calories are derived from fats, of which more than two-thirds were from olive oil."
Dr. Capurso points out that the healthy dietary fats may help maintain the structural integrity and function of nerve cells in the brain.
Previous studies have shown that so-called anti-oxidant vitamins found in vegetables and fruits also protect against dementia, as do non-steroidal anti-inflammatory drugs like aspirin.
An American-Swedish study presented at the Chicago conference showed that the risk of elderly dementia increases if a person experiences a psychological or physical trauma early in life. These include child abuse or the death of a parent.
The Swedish scientists also found that small head size and, hence, a smaller brain, also boosts dementia risk. A smaller brain might be caused by traumas such as premature birth, birth injuries, genetic defects, and child abuse.
These studies add to ones that have found a variety of other factors increasing the chance of dementia, including obesity, heart disease, diabetes, education level, and occupation. People with higher education and professional office jobs appear to be at less risk.
These brain disorders often leave patients depressed. But studies presented at the Chicago meeting reveal that alternative therapies can help improve their mood and quality of life.
Investigators at the Manchester Royal Infirmary in Britain found that patients exposed to a bright light box for two hours each morning for two weeks slept better and were less agitated than others who sat in front of dim light for the same amount of time. According to psychiatrist Harry Allen, the benefits are much greater in winter when days are shorter.
"Patients in nursing homes need daylight," he said. "Just having breakfast facing an easterly window could help your agitation, could help your sleep. It may be possible to delay the transfer of patients to nursing home care by reducing their agitation and sleeplessness with these small adjustments to daily activity or just with a light box."
Similarly, University of Newcastle scientists found that the smell of lemon balm also sharply reduced agitation in adults with dementia. According to researcher Elaine Perry, one-third of patients exposed to lemon balm were calmer after four weeks compared to only one-tenth of patients exposed to odorless substances for the same amount of time.
"We were seeing highly significant reductions in agitation, but in addition to reductions in agitation, there were improvements in the quality of life as indicated by reduction in social withdrawal and an increase in constructive activities," she said.
But therapies can proceed only if a person is diagnosed. Sadly, most are not, according to psychiatrist Sanford Finkel of the University of Chicago Medical School. He notes that U.S. physicians do not notice symptoms in 80 percent of their older patients who are experiencing early cognitive disorders.
"It's not a criticism of the physicians because they have an enormous amount to contend with in limited amounts of time, but it is a need that's not being picked up there and likely not picked up actually anywhere," he said.
Dr. Finkel says physicians should be alert to older patients who become listless and depressed, socialize less, lose weight suddenly, answer questions vaguely, or have trouble following instructions.
