From Our Medical Director - Parc Provence

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    From Our Medical Director

    From Our Medical Director

    Dr. David B. Carr, Parc Provence’s Medical Director, is an expert in dementia and memory loss. In his interview on the Jennifer and Wendy Show on Big 550 KTRS St. Louis, he discusses cognitive impairment symptoms and decisions that individuals and their loved ones face. Listen to the interview here:

     

    In a subsequent interview, listen to Dr. Carr’s discussion regarding recent developments in dementia and Alzheimer’s disease.

     

    Frequently Asked Questions

    Is there a blood test to diagnose Alzheimer's disease?

    It is an exciting time in research. While it’s in the early stages of validation, researchers, including those at Washington University School of Medicine, are actively studying blood-based biomarkers that may help diagnosis Alzheimer’s and other forms of dementia. These biomarkers include proteins such as amyloid beta and tau, which are known to accumulate in the brains of individuals with Alzheimer’s disease.

    While these biomarkers show promise, further research is needed to validate their accuracy and reliability for routine clinical use. In clinical practice, diagnosis of Alzheimer’s disease typically involves a combination of medical history, cognitive assessments, blood work for reversible causes of dementia, brain imaging (such as MRI or PET scans), and sometimes cerebrospinal fluid analysis.

    A study released in January of 2024 shows promising results for testing a person’s blood for phosphorylated tau, or p-tau. Read more about the study here.

    What are the risk factors for dementia?

    Dementia risk factors can vary, but some common ones include:

    • Age: The likelihood of developing dementia increases significantly with age.
    • Genetics: Family history and genetic predisposition can play a role. Certain genetic mutations increase the risk of developing specific types of dementia, such as early-onset Alzheimer’s disease.
    • Lifestyle factors: These factors include unhealthy habits like smoking, excessive alcohol consumption, lack of physical activity, and poor diet.
    • Cardiovascular health: Conditions that affect the heart and blood vessels, such as high blood pressure, high cholesterol, diabetes, and obesity, are associated with a higher risk of developing dementia. Atrial fibrillation also appears to be a risk factor for dementia.
    • Traumatic brain injury: A history of significant head injuries, particularly repeated injuries, may increase the risk of dementia later in life.
    • Cognitive inactivity: Lack of mental stimulation and engagement in intellectually stimulating activities throughout life can play a role.
    • Hearing loss: There is growing evidence suggesting that hearing loss may be a risk factor for cognitive decline. However, more research is needed to fully understand the relationship between hearing loss and dementia.
    • Social isolation: Limited social interaction and loneliness have been linked to a higher risk of dementia.
    • Depression and other mental health disorders: These disorders include chronic depression and certain other mental health conditions.
    • Environmental factors: Exposure to environmental toxins or pollutants over time may potentially increase the risk of dementia, although the exact mechanisms are still being studied.
    • Sleep disturbances: Chronic sleep problems, such as sleep apnea or insomnia, have been associated with an increased risk of cognitive decline and dementia.

    While these factors may influence the likelihood of developing dementia, it’s important to remember that not everyone with these risk factors will develop the condition, and some individuals may develop dementia without any known risk factors.

    To learn more about causes and risk factors for Alzheimer’s disease, click here.

    How do you reduce the risk for dementia?

    Reducing the risk of dementia involves adopting a healthy lifestyle and taking proactive steps to promote brain health. Here are some strategies:

    • Stay mentally active. Engage in activities that challenge your brain, such as puzzles, reading, learning new skills, or playing musical instruments.
    • Stay physically active. Regular exercise, such as walking, swimming, or dancing, not only improves cardiovascular health but also promotes brain health. Aim for at least 150 minutes of moderate-intensity exercise per week.
    • Follow a healthy diet. Eat a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Foods high in antioxidants, omega-3 fatty acids, and vitamins present in food such as B, C, D, and E may help protect the brain. There is little evidence that taking vitamin supplements prevent dementia, except for the case of isolated Vitamin B12 deficiency.
    • Manage cardiovascular risk factors. Control conditions such as high blood pressure, high cholesterol, diabetes, and obesity, through a healthy diet, regular exercise, maintaining a healthy weight, and, if necessary, medication prescribed by your doctor.
    • Get quality sleep: Aim for 7-8 hours of quality sleep each night. Poor sleep habits, such as insomnia or sleep apnea, may increase the risk of cognitive decline.
    • Stay socially engaged: Maintain strong social connections with friends, family, and community. Social interaction can help reduce stress, depression, and anxiety.
    • Limit alcohol consumption: Excessive alcohol intake can impair cognitive function and increase the risk of dementia. Limit alcohol to one drink a day (12 grams of alcohol) or avoid it altogether.
    • Quit smoking: Smoking is a significant risk factor for dementia and other cognitive impairments. Quitting smoking can reduce this risk and improve overall health.
    • Manage stress: Chronic stress can have a negative impact on brain health. Practice stress-reduction techniques such as mindfulness, meditation, yoga, or deep breathing exercises.
    • Protect your head: Head injuries, particularly those involving loss of consciousness, may increase the risk of dementia. Wear seat belts, helmets, and appropriate safety gear to prevent accidents.

    By incorporating these lifestyle changes into your routine, you can help reduce your risk of developing dementia and promote overall brain health as you age.

    The CDC provides a complete list of modifiable risk factors for Alzheimer’s and related dementias here.

    When should someone stop driving when diagnosed with dementia?

    Deciding when to stop driving can be a difficult decision for someone diagnosed with dementia. It’s essential to prioritize safety, both for the individual with dementia and for others on the road. Here are some signs that may indicate it’s time to stop driving:

    • Forgetfulness: If the person frequently forgets where they’re going, how to get there, or how to return home
    • Difficulty with navigation: Getting lost in familiar places or becoming disoriented while driving
    • Decreased reaction time: If there’s evidence of slower reaction times or difficulty responding to unexpected situations on the road
    • Confusion with traffic signs and signals: Trouble understanding or interpreting traffic signs, signals, and road markings
    • Increased accidents or near misses: A history of accidents or near misses, even minor ones
    • Concerns from family, friends, or healthcare providers: If those close to the individual or healthcare professionals express concerns about their driving abilities
    • Changes in mood or behavior: Agitation, aggression, or anxiety related to driving

    When considering driving cessation, it’s crucial to approach the conversation with sensitivity and empathy. The person with dementia may feel a sense of loss or frustration about giving up their independence. Consulting with a healthcare provider or a driving rehabilitation specialist can also provide guidance and support in making this decision.

    State laws vary regarding when a person with Alzheimer’s should stop driving. The National Institute on Aging provides helpful information on this topic here.

    Can anything be done to reverse or postpone Alzheimer’s disease?

    While there’s no cure for a progressive neurodegenerative brain disease such as AD, certain lifestyle changes and medical interventions can help slow its progression or manage its symptoms. Aside from the strategies mentioned above, here are some additional approaches that may be beneficial:

    • Managing chronic conditions: Conditions like high blood pressure, diabetes, and high cholesterol can increase the risk of dementia. Managing these conditions through medication, lifestyle changes, and regular medical check-ups can help reduce that risk.
    • Brain training: While the evidence is mixed, some studies suggest that brain-training exercises and cognitive training programs may help improve cognitive function and delay the onset of dementia.
    • Medication: In some cases, medications may be prescribed to manage symptoms of dementia, such as memory loss, confusion, and agitation. These medications don’t cure dementia, but they can help improve quality of life for some individuals.
    • Seeking support: If you or a loved one is experiencing symptoms of dementia, it’s important to seek support from healthcare professionals, support groups, and community resources. Early diagnosis and intervention can help improve outcomes and quality of life.

    It’s essential to consult with a healthcare professional for personalized advice and recommendations based on individual circumstances. To learn more about available options to cope with symptoms, click here.