How Can we Prevent the Risk of Dementia?
I have a background as a CNS in gerontology and education, so it is understandable that I am interested in this one!
In the talk, Genova states that we can reduce our risk of getting Alzheimer’s disease by implementing lifestyle changes. So whilst she notes that we cannot stop the ageing process or change our genes (yet…), there are things that we can do, and things that we as nurses can educate clients about, to prevent risk factors for dementia.
“For example, APOE4 is a gene variant that increases amyloid, but you can inherit a copy of APOE4 from mom and dad and still never get Alzheimer’s, which means that for most of us, our DNA alone does not determine whether we get Alzheimer’s. So what does? We can’t do anything about getting older or the genes we’ve inherited.”
(Genova 2017)A Good Night’s Sleep
Genova highlights that even just one night without enough sleep can increase amyloid beta – the main protein build up that contributes to the plaques found to cause Alzheimer’s (2017). Ironically, amyloid build-up also interrupts sleep meaning this can easily lead to a cycle of even more amyloid accumulation.
This may raise some issues for nursing staff who are wondering if shift-work is impacting their health.
Furthermore, when working, it is evident that there is a need to promote adequate sleep for clients. Perhaps more so as the clients age, develop more co-morbidities or if they already show signs of dementia; as they will likely be more at risk of dementia or progression of the disease.Strong Body, Strong Mind
Aerobic exercise has been reported by Genova (2017) and the NHS (2014) as important for the prevention of dementia.
The NHS conveys that exercising 150 minutes per week (e.g. 30 minutes daily for 5 days of the week), is important for helping the circulatory system to function. This exercise should be of moderate intensity (e.g. fast walking) and can help to improve blood pressure and blood cholesterol levels (NHS, 2014).
The NHS (2014) and Genova (2017) again both concur that cardiovascular health is imperative for preventing dementia. In fact, it has been estimated that 80% of people with Alzheimer’s disease also had heart disease (Genova 2017). Alzheimer’s disease is more likely to develop in people that have: hypertension, diabetes, obesity, high cholesterol or are smokers.
Smoking leads to artery-narrowing, which can increase your blood pressure and again lead to more chance of developing heart disease and dementia (NHS, 2014). Drinking too much alcohol can also raise your blood pressure and cholesterol levels; thus, increasing risk of heart disease and dementia.What Can Nurses Do to Help Prevent Dementia?
So what does this mean for nurses, discharge planners, doctors, and other health workers?
Firstly, education and primary healthcare for clients is essential for disease prevention. Also, referring clients to resources and relevant health practitioners (e.g. exercise physiologists, physiotherapists, weight management practitioners, fitness instructors etc.) is an important aspect of continuing care.
It may be reassuring to hear that “Every time we learn something new, we are creating and strengthening new neural connections, new synapses.” (Genova, 2017). In nursing, there is a strong focus on CPD (continuous professional development) and thereby ‘learning something new’. But it is also important to teach your clients something new.
When teaching nursing students, I find that I often learn something new or gain a different perspective on existing knowledge. We have enjoyed incorporating games into lessons to promote different types of learning or cognitive development. For example, word puzzles, numeric puzzles and finding hidden items within pictures. Learning or doing something new is also an opportunity for innovation and leading change. It can therefore be thought of as a quality improvement activity.
So whilst there is no one clear path to eliminating or preventing dementia, it is possible to reduce your risk factors by improving lifestyle behaviours (Alzheimer’s Australia n. d.). There are coaches dedicated to healthy living and they may be an untapped resource for you and/or your clients.
Keep in mind when making referrals that coaching is usually privately-purchased as ‘health coaches’, ‘wellness coaches’, ‘life coaches’, and even registered nurses are not listed on the application forms for Medicare Provider Numbers (Department of Human Services, 2017). However, a few may have some coverage by certain private health insurance groups. This may improve affordability and accessibility of healthcare for some Australians.
There is even a free Get Healthy telephone coaching resource run by Get Healthy NSW (n. d.) which can be found at the following link http://www.gethealthynsw.com.au/. This wonderful resource can go for months and help individuals with eating healthy, losing weight or getting more physically active (Get Healthy NSW). Health professionals might consider referring clients to some of these resources upon discharge or for follow-up care.
If you would like to keep up-to-date with research into dementia, please visit the following link https://yourbrainmatters.org.au/
For support or information about dementia, please seek medical attention and/or call the National Dementia Helpline on 1800 100 500.References
- Alzheimer’s Australia n. d., Risk reduction and prevention, viewed 20 July 2017, https://www.fightdementia.org.au/about-dementia/dementia-research/reduction-and-prevention
- Department of Human Services 2017, Medicare provider number for health professionals, Australian Government, Canberram ACT, viewed 20 July 2017, https://www.humanservices.gov.au/health-professionals/services/medicare/medicare-provider-number-health-professionals
- Genova, L 2017, What can you do to prevent Alzheimer’s?, viewed 20 July 2017, https://www.ted.com/talks/lisa_genova_what_you_can_do_to_prevent_alzheimer_s
- Get Healthy NSW n. d., Your guide to getting healthy, viewed 20 July 2017, http://www.gethealthynsw.com.au/
- NHS Choices 2014, Can dementia be prevented?, NHS, Gov.UK, viewed 20 July 2017, http://www.nhs.uk/Conditions/dementia-guide/Pages/dementia-prevention.aspx
Madeline Gilkes, CNS, RN, is a <a href="https://www.lifestylemedicine.org.au/fellows" target="_blank">Fellow of the Australasian Society of Lifestyle Medicine</a>. She focussed her master of healthcare leadership research project on health coaching for long-term weight loss in obese adults. In recent years, Madeline has found a passion for preventative nursing, transitioning from leadership roles (CNS Gerontology & Education, Clinical Facilitator) in hospital settings to primary healthcare nursing. Madeline’s vision is to implement lifestyle medicine to prevent and treat chronic conditions. She is planning to complete a PhD in health education, and currently works mostly in the role of Head of Nursing. Madeline’s philosophy focuses on using humanistic management, adult learning theories/evidence and self-efficacy theories and interventions to promote positive learning environments. In addition to her master of healthcare leadership, Madeline has a graduate certificate in adult and vocational education, graduate certificate of aged care nursing, and a bachelor of nursing. Madeline is currently nearing completion of a graduate certificate of diabetes education and management. See Educator Profile