DEAR DR. ROACH: The females in my family on my mother’s side seem to develop dementia/Alzheimer’s on a fairly regular basis. It seems to become noticeable once the women are in their mid-70s or so. We girls are concerned as we head toward our elderly years and wondered which sort of diet or supplemental changes we should look into? There seems to be so many articles and opinions that it’s hard to know where to start.
On the positive side, our father’s side of the family seems healthy and robust well into their 80s and 90s. Our extended family has females ranging from their mid-30s to 71 years of age. Are we being overly concerned? Could this be a genetic thing? Any suggestions would be helpful in calming some real fears that we have. — E.J. ANSWER: I don’t think supplements are going to be the answer for dementia. I haven’t seen any good data to support any of the supplements I see that are touted to prevent, slow, treat or cure dementia.
I do think that diet may help slow dementia, and one of the best diets according to the studies that have been done so far remains a Mediterranean-style diet. This includes plenty of fresh fruits and vegetables, whole grains, nuts and legumes, fish (especially fatty fish), limited amounts of red meat, and minimally processed foods. Alcohol is increasingly likely to be problematic, and I recommend against more than occasional alcohol use for people who want to minimize their risk of dementia.
Regular moderate exercise has a pretty clear protective effect. Although cognitive exercises like games and puzzles help improve memory short-term, it’s not clear that they are preventing or delaying the onset of dementia.
Advanced imaging, such as PET scans, are beginning to show the ability to diagnose Alzheimer’s dementia in people with early symptoms. Early treatment to attack amyloids in the brain with lecanemab or donanemab slows progression of dementia by approximately 25% to 30%.
