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Neustatter: Dementia is a big concern for many seniors |



I mentioned earlier that a group of us gather at Eileen one morning a week to shoot the breeze and fix the world. This often involves someone telling a favorite anecdote – and there's the catch.

Most of us love to hear these quaint stories. The history of a medical procedure; something funny one of our kids did; something that happened to a vehicle we once owned; a special travel adventure.

One of the group, however, tends to twist their eyes and grind their teeth. That's because he's the only one who has a reasonably decent memory – which means he remembers hearing the same anecdote a thousand times. The rest of us join the banter in happy, amnesian, oblivion.

So we are all, but the one on the way to Alzheimer's?

dementia? Forget it!

Fear of dementia ̵

1; or of Alzheimer's, which is a particularly severe form – is alleged that the aging old guys like us are the most worried. (The British Daily Mail says 1 in 10 fears cancer, but two-thirds of people over age 50 are worried about dementia.)

This fear is that Ethnologist Stephen Post of Case Western University is a "hypercognitive society." Rational thinking and memory are basic values.

But if you can not remember the name of Joe Blow, who just greeted you like an old friend; or where you parked your car in the Wally World car park, does that mean that you have Alzheimer's?

It is not uncommon for people to consult their doctor about "dementia phobia." My smartass to my patients is, "If you think you're getting Alzheimer's, you're not." Deep dementia robs you of this insight.

A study in the Journal of Clinical Psychology supports me, saying, "Those who are aware of their memory problems probably did not develop dementia."

How did you know that?

Other types of dementia can be caused by a variety of diseases such as vascular disease or quite a few organ dysfunction; Poisons, such as alcohol and medicines; poor diet; emotional problems. But that's usually less profound.

All types tend to have memory loss, language problems, disorientation, disturbed directional orientation, personality changes, executive function problems (they can not balance and make your checkbook bad) judgment calls – though if those last two were the only two criteria, I have a lot Know people who would qualify.

People with Alzheimer's tend to be much more like this. They can do extreme things, such as putting shoes in the fridge or undressing in public. My dad got quite angry, although he did not really have Alzheimer's disease – but when I visited him shortly before his death, he thought I was Prince Charles.

A test, namely an examination of mental status (which evaluates behavior, memory, reasoning and the ability to follow directions) is essential to make the diagnosis. You may need the expertise of a neurologist if it is unclear.

Unfortunately, there is no blood or imaging test that (yet) diagnoses Alzheimer's.

But often tests are done to rule out other causes.

Preventing Diet and Exercise

Lately, there has been a lot of talk about things you can do to prevent your brain from becoming mush. Mental gymnastics seems to help – and it does not have to be chess or sudoku. Things like reading, playing with children, attending school and learning a language. Then there are many apps and programs that offer specific brain exercises. Luminosity is one of the best known.

There is also a growing realization that, like so many other organs in our body, the brain is supported by proper nutrition and physical activity.

Exercise does not have to be anything especially exhausting. Just walking is good enough – at least 20 minutes three times a week is the minimalist recipe I've always favored. However, a 2013 CDC report states that only 20 percent of adults fully comply with physical activity recommendations.

As far as nutrition is concerned, the Mediterranean and DASH diets were studied. But as recommended for everyone, it's the same message. Give up the cheeseburgers, the pizza, the donuts, the Danes. Eat a vegetable, unrefined, whole grain, no added sugar diet. (Join the Fredericksburg Food Co-op to get the right foods.)

Perhaps it's an irony in us forget old guys meet at Eileen, where we are very tempted by the pleasures that are not always the ones Nutritional Guidelines

Patrick Neustatter is the medical director of the Lloyd Moss Free Clinic in Fredericksburg and the author of "Managing Your Doctor: The Intelligent Patient Guide to Effective and Affordable Health Care." Visit managingyourdoctor.com. [19659026] / *
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