Category: Blog Post

Depression can affect people at any age, whereas dementia often affects older people. Depressive symptoms, particularly clinical depression, are a chief symptom of dementia, but they may also be a significant predictor of dementia later in life.

With depression, the time course also varies significantly, with some people having only brief depression with complete recovery, while others experience remitting and relapsing depression over many years. Chronic depression can occur in certain persons; however, it is uncommon. All of these diverse categories may have varied long-term health outcomes.

The current research indicates the association of depression with increased dementia risk. However, it is still ongoing and needs further investigation.

What does the Research Say?

Scientists have conducted a lot of research to establish a connection between dementia and depression. Although some studies suggest a relationship between Alzheimer’s and depression, it is uncertain if it is a risk factor for the disease, an early sign of neurodegeneration, or a reaction to early cognitive abnormalities. Similarly, some studies have reported that depression symptoms occur soon after the onset of AD rather than before it. Furthermore, some others have indicated that depression has only a mild effect on dementia and does not increase the likelihood of Alzheimer’s.

There is also emerging evidence that depression is associated with cognitive decline. According to a meta-analysis of behavioral and psychological symptoms in cognitively normal middle-aged or older adults, depression was the most consistently related risk factor with behavioral or psychological symptoms and cognitive deterioration in Alzheimer’s patients.

In a study published in the Lancet Psychiatry, the researchers reported that those with growing depression symptoms were consistently associated with a higher probability of getting dementia. On the other hand, those who suffered from depression with less severe but persistent symptoms did not exhibit an elevated risk of acquiring the disease. However, another large-cohort study (with 10,000 participants) has concluded that early-life depressive symptoms did not increase dementia risk.

Both the above investigations discovered that extended depressed symptoms in later life (during the decade preceding dementia onset rather than earlier) are good predictors of increased dementia risk. Other studies have discovered similar links, such as the fact that having depression later in life doubles the risk of acquiring dementia. Furthermore, multiple studies have established that late-life depression might increase the risk of all-cause dementia, vascular dementia, and Alzheimer’s.

Researchers in San Francisco recently tried to investigate the possibility of early adulthood depression as a potential risk factor for dementia. They reported in the published study that depressive symptoms in young adulthood are associated with a 59% higher dementia risk.

A Swedish study evaluated the risk of dementia in individuals with and without depression. The researchers found that those with a depression diagnosis were more likely to develop dementia. The risk of dementia seemed to be the most significant in the first year following a diagnosis of depression. After that, it declined substantially over time but remained elevated for more than 20 years after the diagnosis.

Brain Changes in Dementia and Depression

Some previous studies suggest plausible mechanisms that make depressed people more prone to dementia.

Depressed individuals exhibit hyperactivity in the adrenal gland-stimulating area of the brain. As a result, these glands produce more glucocorticoids (such as the stress hormone cortisol). Higher cortisol levels can cause the impairment of the hippocampus, an area of the brain crucial for memory and cognitive function. Research has also revealed that people with Alzheimer’s may experience hippocampus atrophy.

According to research, other factors contributing to cognitive decline may also be at work. Vascular disease, changes in glucocorticoid steroid levels, hippocampus shrinkage, increased amyloid plaque deposition, inflammatory changes, and nerve growth factor abnormalities are among the possible molecular processes linking depression to dementia.

Brain training involves various activities such as crosswords, puzzles, and customized video games to challenge and stimulate the brain. Some commercial game providers claim that brain training can help prevent dementia. However, is it what the scientific studies say?

According to some studies, cognitive training can help middle-aged or older adults enhance some aspects of their memory and thinking. No research has yet demonstrated that brain training can prevent dementia. To assess if brain training impacts the onset of cognitive decline or dementia, most studies in this area have been either too small or too brief because it is a relatively new field of study.

Although some evidence indicates that brain training may improve an older person’s ability to manage daily tasks, longer-term studies are required to determine whether or not these activities may reduce a person’s risk of dementia.

What is the theory behind claims about brain training and dementia?

Many people practice brain exercises believing that keeping their minds sharp would help them retain or advance their cognitive talents as they age.

The principle of “use it or lose it” is the foundation for brain training. According to a widely accepted idea, cognitive impairment (a decline in one’s capacity for memory or learning) and dementia are less likely to occur in later life if you constantly challenge your brain.

The argument has originated from the observation that individuals with complex jobs or those who consistently engage in challenging activities like crossword puzzles or acquiring new hobbies throughout their lives appear to have lower risks of dementia.

There are now computer-based brain training games that test cognitive abilities like memory, problem-solving, and reasoning, which can deteriorate with age

What does the research say about brain training and dementia?

According to some studies3, people who engage in cognitively stimulating activities may be less likely to experience cognitive decline and dementia. However, such research cannot conclusively demonstrate that brain training exercises are responsible for lower dementia risk.

While there haven’t been any interventional studies examining the impact of Sudoku or crossword puzzles on cognition and dementia risk in older persons, several of these studies have examined computer brain training games. Most of these studies were small or only followed participants for a brief period. Therefore, there is a lack of solid data to support the claim that brain training games can improve cognitive function in older individuals.

More than 2,800 initially healthy persons 65 and older participated in an ACTIVE study. They attended nearly ten speed-of-processing brain training sessions for five to six weeks. The participants also attended up to four booster training sessions at 11 months and a second set of about four booster sessions at 35 months. The training concentrated on memory, reasoning, and speed of processing information. Scientists tracked the outcomes of participants for ten years, after which they concluded that the cognitive training reduced the risk of dementia by up to 25% in initially healthy older adults compared to the untreated group. Additionally, the participants showed improvement in performing routine tasks like handling money and housekeeping.

A study examined the findings of 52 interventional studies. During the study, the authors found that computerized cognitive training may exhibit minor improvement in older people’s thinking and memory. The investigation also revealed that older individuals who performed the brain training unsupervised did not see an improvement in memory or thinking.

Nearly 7,000 adults over 50 participated in one of the largest studies to date that evaluated computer brain training. The brain training program used in this study put participants’ critical thinking and problem-solving abilities to the test. The outcomes demonstrated that this training program improved reasoning and remembering after six months. The more exercises participants completed, the more likely they exhibited improvements in these brain functions.

Commercial Brain Training Games

Several commercial brain training tools are available on the market. Some studies have analyzed a few tools, but many are still unevaluated. All brain training games may evaluate a different kind of brain function, so it is impossible to generalize the findings of research that examine a specific training program to all of them.

People should exercise caution if they come across commercial products claiming they can stop or slow down cognitive aging because there is currently insufficient proof to support these claims. One of the top producers of commercial brain training games was recently penalized for making exaggerated promises about the advantages of their offering.

Currently, there is no known cure for dementia, but some treatment options can help treat its symptoms and improve the quality of life. Researchers and pharmaceutical companies are exploring and developing novel medicines to delay the disease, alleviate its symptoms, and ultimately discover a cure.

Simultaneously, researchers are examining lifestyle factors to determine whether particular routines or pursuits can assist in maintaining brain health and delaying the onset of various forms of dementia, including Alzheimer’s disease.

There is emerging evidence that regular engagement in intellectual, mental, or cognitive activity lowers the risk of cognitive decline. People with early-stage Alzheimer’s can still learn and process new knowledge, helping them to advance their cognitive abilities.

By keeping your patient occupied with games and activities that stimulate the mind and test their mental, physical, and functional abilities, you may help prevent the decline of their memory and cognition and allow them to remain independent for as long as possible.

There are numerous brain-stimulating games and activities that you can engage in with your dementia patient as a caregiver.

Games for dementia patients

What does the research say?

One of the numerous things that can occupy and entertain the human mind and, most importantly, keep it active is playing games. Games are crucial for older persons, especially those at risk for dementia. For instance, researchers found significant working memory and executive function improvement in older adults after they participated in 16 weeks of combined cognitive and physical “exergame” training.

Another study examined the impact of computerized cognitive training- in the area of reasoning, memory, language, and attention- on the development of mild cognitive impairment. The findings revealed that exercise enhanced the gray matter volume in the brain and may help maintain general cognition.

So, what do brain games for dementia have to do with these studies? Many cognitive abilities (discussed in these studies) deteriorate when a person develops dementia, including memory and reasoning. More recent research has revealed that gaming can enhance these cognitive abilities in dementia patients.

In a recent review, researchers explored three types of games and their role in dementia care. Their findings were as follows:

• Board games can aid in improving cognitive abilities like memory, communication, and emotional control.
• Video games can specifically target certain cognitive functions, including memory and reasoning.
• Virtual reality games can reinforce physical abilities and cognition (depending on the game).

The review further stated that patients in the early and middle stages of dementia who played serious games improved diverse cognitive abilities, such as short-term memory, communication, logical reasoning, and problem-solving.

What are the best games for dementia patients?

Following are a few games that may help a range of cognitive abilities, particularly for dementia patients.

1. Word Puzzles

Word puzzles are a type of game that focuses on language. According to a study, playing games, such as crosswords and other puzzles, may lead to cognitive improvements in verbal learning, speed, memory, and other areas. You can consider games including crosswords, anagrams, word searches, cryptograms, and branded games like Scrabble.

2. Jigsaw Puzzle

Jigsaw puzzles are specifically helpful for memory and reasoning. Their difficulty can range from basic puzzles requiring little hand-eye coordination to more sophisticated ones that demand memory recall. Since dementia patients frequently struggle with cognitive abilities such as reasoning and memory recall, these games may be an easy way to support these abilities.

3. Card Games

Card games are excellent for honing skills, including reasoning, problem-solving, memory, and concentration, which frequently deteriorate in dementia patients. You can start with games like matching games (like Go Fish), specific games (like Uno), trick-taking games (like Bridge), collectible games (like trading card games), and Solitaire variations.

4.Dice Games

Some cognitive conditions, such as dementia, can cause a decline in numerical and calculation skills, and dice games can help improve them. Some brain-stimulating dice games include Backgammon, Kismet, Yahtzee, and Shut the Box.

5. Board Games

A study revealed that playing more analog games, like board games, showed less cognitive and memory decline from age 70 to 79. Considering that, you can enjoy chess, Monopoly, Cranium, and Trivial pursuit with your dementia patient.

6. Video Games

Video games include a wide range of electronic games, ranging from traditional desktop computer games to games on newer systems such as the Wii and Switch, as well as mobile phone and tablet games. You can play app versions of many brain-stimulating classic games such as word games, card games, dice games, board games, and puzzles.

Other activities for dementia patients

Besides games, some other activities can also help engage your dementia patient and boost their cognitive function. Some of them are as follows:

Learning

Learning new things in later life is an excellent approach to maintaining cognitive abilities, whether through a class, YouTube videos, podcasts, or other platforms.

Reading

Reading is an incredibly beneficial hobby that is not limited to books. Poems, periodicals, newspapers, comic books, and other printed or online content are also available to read.

Art

There are many different types of art, including painting, drawing, and playing an instrument. People with dementia can benefit from any artistic expression.

Entertainment

Listening to the radio or watching television programs are excellent examples of how modern entertainment can keep the brain active.

Some of the activities indicated above may be challenging for some people with severe dementia because they may find it difficult to complete even simple tasks. You can engage them in simple activities like talking and reminiscing, looking at photos, and listening to music.

It is a well-known fact that smoking damages the heart and lungs. However, smokers and medical professionals intermittently pay less attention to how it can damage the brain.

Smoking is quite prevalent in the US and worldwide. Recent data indicates that approximately 8 out of every 100 Americans over the age of 64 currently smoke tobacco. Strangely, this is less than twice as high (16%) smoking rate among US individuals aged 45 to 64. Why is that so? That is because smoking (the leading cause of preventable disease and death in America) causes earlier death. Former smokers are no longer counted in statistics once they have died.

The link between smoking and dementia

We know that smoking causes heart and lung problems, but how does it relate to dementia? The WHO Knowledge Summary on Tobacco and Dementia has explained various reasons for this link. These include the correlation between the two most prevalent types of dementia, Alzheimer’s and vascular dementia, and issues with the vascular system (your heart and blood vessels).

Smoking is known to increase the risk of vascular problems, such as strokes or small bleeds in the brain, both of which are risk factors for dementia. Toxins in cigarette smoke also cause cell inflammation and stress, which may lead to the development of Alzheimer’s disease.

What are the research findings?

With all the harm that cigarette smoking causes to a person’s health, some people think that smoking decreases the risk of dementia. This misinformation, however, is due to some early studies that reported that smoking lowered the possibility of Alzheimer’s disease. Later reviews suggest that these studies were biased due to the researchers’ affiliation with the tobacco industry.

According to WHO, smoking may be responsible for 14% of Alzheimer’s cases worldwide. An analysis of 37 different studies suggested that current smokers are 30% more likely to develop dementia and 40% more likely to develop Alzheimer’s. Furthermore, the study found that smoking 20 cigarettes per day increases the risk of dementia by 34%, implying the more a person smokes, the greater the risk.

The World Alzheimer’s Report 2014⁵ analyzed the results of seven systematic reviews in addition to conducting its analysis. In the evaluation, which comprised 14 studies, the researchers discovered that current smokers had a noticeably higher risk of dementia than nonsmokers.

The 2020 Lancet Commission on dementia risk also highlighted smoking as one of the twelve modifiable risk factors. Overall, comprehensive reviews have determined that smoking increases the incidence of dementia by 30–50%.

How does smoking increase Alzheimer’s risk?

Smoking’s harmful effects on the blood arteries in the brain are likely related to its damaging effects on the brain. Homocysteine, a blood chemical detrimental to blood arteries, circulates in higher amounts due to smoking. Higher homocysteine levels may increase the risk for dementia and stroke. Atherosclerosis damages the arteries of smokers at an earlier age, which is very harmful to the brain because it depends on blood flow for nutrition and oxygen.

Additionally, smoking has a link to increased oxidative stress, a negative impact that causes increased inflammation and brain cell death. Smoking is also an additive risk factor, increasing the risk already brought on by other health conditions. Individuals already at increased risk for dementia due to having the ε4 variant of the APOE gene face an even greater risk if they smoke.

Researchers also warn about the dangers of second-hand smoke exposure. Although not as harmful as direct exposure, one study found that second-hand smoke increased dementia risk by more than 25%, with longer duration and greater frequency of exposure carrying a higher risk.

Does the amount smoked influence the dementia risk?

The World Alzheimer’s Report included only four studies that examined the number of cigarettes smoked and dementia risk. Two studies found a connection between higher tobacco consumption and an increased risk of dementia, but there isn’t enough evidence to know for sure.

Can quitting smoking lower dementia risk?

Since smoking is a modifiable risk factor, quitting may benefit brain health. Current smoking is associated with an increased risk of dementia, particularly Alzheimer’s and vascular dementia, and smoking cessation is a risk reducer. Therefore, quitting smoking and adopting healthier lifestyle choices can reduce the risk of dementia.