Genes and Environment

These last few blogs about research have impressed us with the importance of the recognition of dementia risk. For some time it has been possible for someone with a family history of AD to be tested and find out if they are also likely to develop the disorder eventually. Many people don’t do this. They say, “Why should I? Alzheimer’s is not curable and so knowing ahead will only be depressing.” People with Parkinson’s or at risk for LBD would say similar things. They didn’t want to know what was ahead. They used to have a point. But not anymore.

Researchers now say that it takes two things for dementia to develop: the right (or wrong) genes and a “toxic” environment. While we are still learning what both of these mean, the biggest lesson for right now is that it does take both. Even if you have the genes, dementia is not a sure thing. When I was a substance abuse counselor, I worked with Alaska natives who, as a group, have a strong genetic tendency for alcoholism. They were well aware of this and many avoided becoming alcoholics by choosing not to drink. People with the genetic makeup for dementia can also make lifestyle choices that limit their chances of developing their gene-related disorder. Even if a person already has early signs of dementia, it isn’t too late to make these lifestyle changes and see results. However, if you wait until the dementia is full-blown, all bets are off. Yes, you can still decrease the severity of the symptoms and improve quality of life, but that’s about all. It is like a cancer that has become “inoperable.”

Concerning genes, researchers are learning what genes mandate eventual dementia and what genes mandate LBD specifically. We know a lot more about this than we did a few years ago, but it is still mostly in the hands of the researchers. It isn’t much help for the average person—yet. As far as LBD is concerned, the best guide at present is still to look at the symptoms. If you have REM sleep behavior disorder, Parkinson’s or mild cognitive impairment, you are at risk for eventual dementia. If you have hallucinations, the dementia is close.

The second requirement for dementia is a toxic environment. As with genes, researchers are still exploring what this means. They do know that people who grew up around herbicides and pesticides are more at risk for dementia than those who didn’t. Preservatives with nitrates and nitrites have also been identified as possible toxins, as have heavy metals such as mercury. Air pollution from factory emissions and even smog have been linked to cognitive dysfunction.

So what can we do? We can’t choose our parents. Our genes are what they are. We can’t change our childhood. Where we grew up is in the past and like our genes, it is what it is. But we can change our present and our future.

• Live a healthy lifestyle. A Mediterranean type diet, adequate fluids and sleep have been shown to decrease the risks of dementia, and may slow—or stop--the growth early stage dementia.

• Avoid toxins. While you may have lived around toxins in the past, it still isn’t too late to avoid known or suspected airborne, dietary or other toxins and decrease your risk for eventual dementia.

In addition, you can make your body stronger and better able to battle invading dementia by:

• Challenge yourself physically and mentally. Challenges should be interesting but not overwhelming. That’s when they get stressful and destructive.

• Be social. Developing and maintaining meaningful relationships is as important as mental stimulation.

• Be positive. Make being positive a daily goal. Look for the silver linings and reframe thoughts into positive expressions.

• Relax. Meditating, deep breathing and practicing regular stress reduction exercises all revive the body and keep it working well.

• Have fun. Laugh and do activities that you love. Live in the now and enjoy life as it is.

Read more about all of the above and more in our latest book, Managing Cognitive Issues in Parkinson’s & Other Lewy Body Disorders. Yes, these suggestions take a lot more time and effort than swallowing a pill or even having surgery or undergoing some other medical treatment—but they will likely be more effective too! There could be a blog for everyone of the above items. Well, there have been blogs in the past about some of these and there will definitely be more in the future.

For information about Lewy body disorders, read our books:

A Caregivers’ Guide to Lewy Body Dementia

Managing Cognitive Issues in Parkinson’s & Other Lewy Body Disorders