Tag Archives: dementia

Want to Reduce Risk of Dementia? Don’t Diet!

Debbie says:

I know I’m not alone in being more frightened of old-age dementia than any other thing that could happen to me. Everyone is different about these things, but for me, my mind is me, and without it I do not want to survive.

That fear, a lifetime of body image activism, and my hatred of junk science combine to make this the best science news possible.

The analysis of nearly two million British people, in the Lancet Diabetes & Endocrinology, showed underweight people had the highest risk. …

Dementia is one of the most pressing modern health issues. The number of patients globally is expected to treble to 135 million by 2050.

At least by basic criteria, the science is impeccable. There were 1,958,000 subjects.

Compared with people of a “healthy weight,” underweight people (BMI <20 kg/m2) had a 34% higher (95% CI 29–38) risk of dementia. Furthermore, the incidence of dementia continued to fall for every increasing BMI category, with very obese people (BMI >40 kg/m2) having a 29% lower (95% CI 22–36) dementia risk than people of a “healthy weight.” These patterns persisted throughout two decades of follow-up … [quotation marks added]

In other words, it’s not just that low BMI correlates with greater dementia, but higher BMI, well into the categories that modern medicine continues to describe as “morbidly obese,” correlates with even less dementia. The difference between having an “underweight” BMI and an “obese” BMI is a 54% (!) reduced risk of dementia. That’s a gigantic number.

Of course, BMI is and always has been a bullshit benchmark. Also of course, the scientists are thrown for a loop by their own findings, because they went in assuming that fat would fry your brain, just as their counterparts continue to insist (against evidence) that fat destroys your body. They really have to grasp for their “faith sentence” here, and what they came up with is:

… the findings were not an excuse to pile on the pounds or binge on Easter eggs.

“You can’t walk away and think it’s OK to be overweight or obese. Even if there is a protective effect, you may not live long enough to get the benefits,” he added.

We know from other large-population studies and analyses that this isn’t true.

Of course,  no one is suggesting that these results suggest that low-BMI people should try to gain weight. Just to be clear, I’m not suggesting that either; people find their own weight and everything, including dementia risk, has multiple complex factors. But you do know what they would be saying if the study had gone the way they expected!

For me, I will continue to live the way I live, to follow my doctor’s advice (“Whatever you’re doing, keep doing it”), to appreciate my fat body, and I will breathe just a little easier when fear of dementia sneaks up and ambushes me.

A Clue to Rethinking Dementia Care

Debbie says:

I don’t know when I’ve been as excited by a new concept as I have by this one (okay, I was just as excited by the article from last week’s links about Arunachalam Muruganantham), but this is very different and equally important.

… in the small town of Weesp, in Holland—that bastion of social progressivism—at a dementia-focused living center called De Hogeweyk, aka Dementiavillage, the relationship between patients and their care is serving as a model for the rest of the world.

floor plan of the village

The interior of the security perimeter is its own little village—which means that patients can move about as they wish without being in danger.

“The fact that a resident cannot function ‘normally’ in certain areas, being handicapped by dementia, does not mean that they no longer have a valid opinion on their day to day life and surroundings,” say administrators.

Thanks to Stefanie for the link!

The Gizmodo article at the link starts by talking dementia statistics: basically, the problem is already staggering and is growing by leaps and bounds. And the baby boom generation is just touching the leading edge of the age cohort in which this is a problem. We cannot afford current styles of dementia care as a culture, and we certainly cannot afford it as individuals–nor can we afford the intense emotional suffering of both people with dementia and people who love them.

I haven’t been around advanced dementia much. I watched my sister-in-law’s mother go down that road; I’ve seen the occasional other person while visiting nursing homes or hospitals. I fear it for myself more than anything else. I sometimes look at my friends around my age and wonder, “Which ones, which ones?” And until I saw this article, I had never seen a model, or even a hint, for compassionate, potentially affordable approaches to care.

Hogeweyk was … the brainchild of Yvonne van Amerongen, a caregiver who has worked with memory patients for decades. Starting in the early 1990s, van Amerongen and a group of like-minded caregivers began researching and designing a type of home where residents would participate in life, the same way they did before they entered a dementia care unit.

What Hogeweyk reveals … is the culturally-ingrained way we distinguish between those who do and don’t suffer from dementia. By treating residents as normal people, Hogeweyk seems to suggest that there isn’t such a huge difference, deep down—just differing needs. By designing a city tailored to those unique needs, residents avoid the dehumanization that long-term medical care can unintentionally cause.

According to the article, the idea is spreading at least a little: to Switzerland, maybe to more of Europe, maybe to the U.S. I’m crossing my fingers.