How to untangle dementia theories without panicking

Dementia has been attributed to everything from waist size to spicy food — so what’s to be believed?

August 12, 2019
If you pay attention to the news these days, it seems like dementia is caused by, well, just about everything. Recent studies have attributed it to prescription drugsBMI and a larger waist line, and even eating spicy food. And those are just a few examples.

If these headlines spark a bit of panic, you’re certainly not alone.

But before you start frantically making doctor’s appointments or preparing for the worst, it’s worth noting what the experts have to say about these types of preliminary research.

Considerable spoke with Rebecca Edelmayer, Ph.D., the director of scientific engagement at the Alzheimer’s Association, to find out what people should be concerned about, what they shouldn’t waste energy on, and where all of this info comes from in the first place.

“There’s a large excitement right now about lifestyle and the role it could play, potentially, in decreasing our risk for developing dementia, and maybe even diseases like Alzheimer’s disease in our future as we age,” Edelmayer said.

However, she cautioned, just because two factors have a measurable tendency to occur together (like dementia and anemialiver diseasehearing loss, or surviving the Holocaust) doesn’t mean one causes the other.

“[We have] to make sure that we’re still careful in the language that we use about whether any of these things are causal. We’re still trying to better understand modifiable risk factors — things like diet, exercise. You’ve probably heard things about social and cognitive stimulation and even our management of our cardiovascular health, how they play a role in decreasing our risks for developing dementia as we age. When we talk about really looking at the rigorous research that’s available, I think there’s still pieces of the puzzle that have not been put together yet.

“And so, that’s why when we see some of these studies in the news, we get really excited because they’re starting to put some of those pieces together. But, we have not yet seen very rigorous trials out there that have looked at some of these risk factors.”

Proving cause and effect

Even if they attract media attention, most of these studies are extremely early in the process; they’re not based on sufficiently rigorous trials with large enough control groups to be decisive.

Without cause and effect, it’s likely that spicy food and dementia occur in the same populations because of a third factor, not because one causes the other.

Proving a connection requires multiple independent tests, peer reviews in which other scientists dissect the original researchers’ methods — and identifying a precise way that a factor like spicy food will produce a symptom like dementia. Without cause and effect, it’s likely that spicy food and dementia occur in the same populations because of a third factor, not because one causes the other.

Even without that proof, people can become desperate to grasp onto any claim that Factor X will help reduce dementia risks. And who can blame them, when the disease is so debilitating and so drastically affects the life of millions of Americans?

That’s not to discourage people from practicing healthy physical and mental habits right now.

“We know that the greatest risk factor for Alzheimer’s disease is actually age, and certainly genetics and family history,” Edelmayer told Considerable. “Those are things that we cannot change very easily.

“But there are things like cardiovascular disease, social and cognitive stimulation, traumatic brain injury, and education where we actually do have increasing evidence to suggest that we may be able to take control over some of our risk by incorporating healthy habits into our lifestyle. Really, what we know today is that what’s good for your heart is good for your brain.”

Some of the studies, like the one attributing BMI and waist size to increased dementia risk, can be rationalized because increased BMI often puts a strain on one’s cardiovascular system as well. There is enough research backing the claim that heart health and brain health are linked, so exhibiting strong heart health habits is a good idea in any case. And as for the spicy food scare?

“Really, what we know today is that what’s good for your heart is good for your brain.”

“The data is actually a bit controversial, when you look at the effects of spicy food in the body — there’s evidence that would suggest that it’s actually good for your overall diet or dietary health to keep you at a lower weight. There’s evidence that the sort of the active components of spicy food can actually not only play a role in inflammation as well or even decreasing inflammation,” Edelmayer cautioned. “But whether or not it can lead to an increase in changes that are associated with dementia, I think that we really need to see more research done.

Fret not, hot sauce and chili lovers — so far, the evidence isn’t conclusive that spicy food correlates to dementia in any way.

Reading the news today (oh, boy)

When it comes to navigating the tricky waters of what studies to believe and which ones to toss aside, Edelmayer offered some advice. “There’s nothing wrong with reading science news and research. It is important that people are trying to base some of their decisions about their lifestyle choices in evidence-backed research.

“[Remember to] really look for some of the details and whether these studies were done in large, diverse populations, and whether or not the studies may be very interesting, but still very preliminary. Maybe some of the research is being done in cells or in mice and have not yet actually moved into human clinical studies.”

Dr. George Hennawi, medical director of geriatric services for MedStar Health, also offered some panic-preventing pointers.

“I highly recommend and encourage people concerned about their memory to stay active, stay socially engaged, eat a healthy diet — specifically, a Mediterranean diet — manage their chronic illnesses such as diabetes, high blood pressure, high cholesterol and heart disease,” he told Considerable. “Try to engage their brains in new tasks and learn new habits or new skills.

Edelmayer also warned against any kind of dietary supplement that’s marketed as being good for your brain health.

“There are some myths out there such as aluminum, aspartame, flu shots, dental fillings, spices as possible causes of dementia and memory problems,” Hennawi continued, “but there is no scientific evidence to support that.”

In the same vein, Edelmayer also warned against any kind of dietary supplement that’s marketed as being good for your brain health. Just like diet pills aren’t actually an effective way of maintaining a healthy weight, you need to commit to an overall heart/brain health routine instead of relying on a pill or supplement to do so.

The Alzheimer’s Association is leading a very large clinical trial called the U.S. Pointer Study to look at exactly how a better management of cardiovascular health, diet, exercise, and social and cognitive stimulation reduce one’s risk of dementia.

The study will take a look at exactly how changes in one’s lifestyle affect the brain, and will hopefully lead to definitive steps to prevent memory loss.

In the meantime, healthy diet, exercise and socializing are safe bets to improve your quality of life — and very likely to stave off dementia.

For more hints on how to improve brain health, check out the Alzheimer’s Association’s 10 Ways to Love Your Brain.

And unless you’re battling acid reflux or indigestion, don’t panic about laying off the spice just yet.

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