Jolie Crowder, PhD(c), MSN, RN, CCM
Kendra Kuehn, MSW
Everyone slows down a bit as they get older, in both body and mind. However, forgetfulness or big changes in thinking and understanding that make it hard to get through the day do not happen to everyone, and they might be early signs of a disease called dementia.
Dementia is a disease of the brain, but taking steps to try to prevent it start with the heart. The latest science indicates that that the things that injure the heart and blood vessels, also increase the risk for developing Alzheimer’s or certain types of dementia. High blood pressure, high cholesterol, being overweight and having diabetes—all directly tied to heart health—and now Alzheimer’s disease and dementia.
Dementia has many forms, and Alzheimer’s disease is the most common. Every type of dementia gets worse over time, causing problems with memory, thinking, and behavior. Signs of dementia include new difficulties with reading, writing, or talking; problems with judgment and coordination, and changes in personality or how emotions are managed. Behavior changes may include trouble sleeping, agitation, anxiety, anger, depression, or wandering.
Today, almost six million people in the United States have Alzheimer’s disease, including one out of every 10 people age 65 and older. It is the nation’s sixth leading cause of death for people of all ages.
Unfortunately, not much is known about dementia in American Indian and Alaska Native (Native) elders. But a few studies that have included Native elders found that they tend to get dementia more often than other groups, that their dementia usually occurs along with other health problems, and that it often appears at an earlier age.
A study that looked at more than 270,000 older adults living in California, including American Indians and Alaska Native elders, found that one in three Natives (35 percent) who live to be 65 years old will develop dementia in the next two decades. That is significantly more than people who identify as white, Latino/Latina, or Asian who will develop dementia.
Another study found that Natives who have diabetes were at the highest risk for getting dementia compared to other races. Almost twice as many new cases of dementia were diagnosed in Native elders with diabetes than in people who identified as Asian and had diabetes.
A third study found that a form of Alzheimer’s disease that occurs before age 65, is more likely to occur in Native people and other minority populations, often along with depression and anxiety. While people with early dementia do not make up a lot of the total number of cases of Alzheimer’s disease, many of those people are Native.
There currently is no cure for dementia or Alzheimer’s disease, but elders and their family members — and even people in their 40s and 50s — can take a few simple steps now that may protect their minds from problems later.
Many of these steps begin with helping the heart. Science suggests that a healthy heart and normal blood pressure may help keep people from getting Alzheimer’s disease or other dementia.
The River of Life Begins with the Heart
Picture the heart as the center of a free-flowing river inside the body. The veins and arteries that carry blood to and from the heart are like many connected streams that deliver oxygen and energy to all parts of the body, including the brain.
Now imagine what would happen if the streams feeding the brain were clogged with high cholesterol or nicotine, the river beds were narrowed by stiffness from high blood pressure, or the heart were injured and could not push the river along. The body would suffer. The brain would suffer.
Elders and their family members can do these things to help keep the river flowing freely and keep their minds, hearts and bodies well:
- Call your doctor today for an appointment to talk about how to keep your mind and heart healthy.
- Schedule “wellness” checkups and health screenings every year. Blood pressure and diabetes screenings are usually free with Medicare Part B or through the Indian Health Service.
- Get a little exercise every day.
- Eat more fresh fruits and vegetables and foods low in salt and sugar.
- Stop smoking and chewing tobacco.
- Get help managing high blood pressure, diabetes, high cholesterol, and depression or anxiety.
- Protect your head. Falls are the number one cause of head injury in older adults.
- If memory problems or forgetfulness already make it hard to get through the day, elders or their family members should call a doctor right away to talk about what is happening.
Fear or shame can keep some elders from telling a doctor or their family they notice they are having problems with their memory or thinking. This is not good, because the sooner elders and their families know what is going on, the sooner they can get the latest available treatment, find the right services and supports, and plan for the future. There is no shame in an Alzheimer’s or dementia diagnosis.
Remember, a healthy heart is important to a healthy mind. The heart pumps the river of life that protects mind and body. Elders should call their doctors today to talk about steps they can take to keep their minds and hearts healthy.
Checklist for a Healthy Mind and Heart
You can take steps to keep the streams flowing freely through your body and to prevent your heart and brain from being damaged.
Working with Your Doctor
- Make an appointment for health screening tests and “wellness” checkups every year. They are usually free with Medicare Part B or through the Indian Health Service.
- Have your blood pressure checked regularly and know your numbers. A blood pressure of less than 120/80 mmHg is normal.
- Ask your doctor to go over how to measure and track your own blood pressure results and find out where you can go in your community to check your blood pressure yourself.
- Have your cholesterol checked regularly and know your numbers. Talk to your doctor about what you can do if your cholesterol is high.
- If you do not have diabetes, have your blood sugar level checked regularly. Blood sugar should be less than 100 mg/dl.
- If you do have diabetes, have your blood sugar and A1C levels checked regularly, and work with your doctor to get them to normal levels. Your A1C should be less than 5.7%.
- Talk with your doctor about your medicines and vitamins to make sure they do not cause problems with your memory, sleep, or brain function.
Working on Your Own
- Be active or walk every day. Try to get 1 ½ - 2 hours of exercise each week.
- Eat more fruits and vegetables and less salt and sugar.
- Take your blood pressure and diabetes medicine even if you feel good.
- If you smoke or chew tobacco, stop. Talk to your doctor if you need help quitting.
- If you are overweight, try to lose weight with exercise and a healthy diet. Losing even a few pounds can make a difference. Talk to your doctor for help.
- Read food labels to see how much salt (sodium) or fat is in your food. If you don’t know how to read food labels, ask your doctor for help.
- Limit alcoholic drinks. No more than one drink per day for women and no more than two for men. Talk to your doctor if you need help.
- Get at least seven hours of sleep each night. Talk to your doctor if you have trouble sleeping.
- Keep your mind active. Go out and visit with people in your community, take classes, go to your senior center, play cards, and visit with others.
This article is provided by the International Association for Indigenous Aging (IA2). IA2 is a non-profit educational association that works to improve services for American Indian and Alaska Native elders around the country, and address the most significant issues facing Indigenous elders including issues of health and wellness, environmentalism, community engagement, elder abuse and neglect and more. To learn more visit www.iasquared.org.