Food and Mental Stimulation to Prevent Dementia docx

Food and Mental Stimulation to Food and Mental Stimulation to Prevent Dem entia Prevent Dem entia Gerontological Gerontological Research Research Programme Programme , , National University of Singapore National University of Singapore Department of Psychological Medicine Department of Psychological Medicine Ng Tze Pin Ng Tze Pin Public Seminar: Good News of Ageing, 1 March 2008 Food and Mental Stimulation to Food and Mental Stimulation to Prevent Dementia Prevent Dementia Gerontological Gerontological Research Research Programme Programme , , National University of Singapore National University of Singapore Department of Psychological Medicine Department of Psychological Medicine Ng Tze Pin Ng Tze Pin Public Seminar: Good News of Ageing, 1 March 2008 Stay mentally healthy in old age Stay mentally healthy in old age “Do not go gentle into that good night” The Last Battle of the Mind Dementia “Do not go gentle into that good night” The Last Battle of the Mind Dementia “Do not go gentle into that good night” The Last Battle of the Mind Dementia Dementia Dementia National Institute of Neurological Disorders and Stroke  A brain problem that makes it hard for a person to remember, learn and communicate  Unable able to think well enough to do normal activities, such as getting dressed or eating.  Lose their ability to solve problems or control their emotions.  Personalities may change.  Become agitated or see things that are not there.  Memory loss is common but by itself does not mean dementia Dementia Dementia National Institute of Neurological Disorders and Stroke  A group of symptoms due by damage and poor functioning of brain cells  Caused by head injury, stroke, Alzheimer's disease, drugs, alcohol, nutritional deficiencies, etc  Available drugs cannot cure dementia but may improve symptoms or slow down the disease Prevalence of Cognitive Impairment Among Elderly Aged 60+ in Singapore 6% 18% 76% Severe Mild to Moderate No Cognitive impairment is defined by MMSE score <24; Mild to moderate: 19 to 23; Severe:18 or less Prevalence of Dementia in Singapore National Mental Health Survey of the Elderly, 2003 % (95% C.I.) ≥ 60 years 5.2 ( 3.6 – 6.7 ) ≥ 65 years 6.0 ( 4.0 – 8.0 ) ≥ 75 years 13.9 ( 7.9 – 19.9) Fight dementia Fight dementia Maintain good cognitive function Maintain good cognitive function Maintain good cognitive function  The brain is ‘plastic’  Brain cells are able to grow and regenerate even in old age  Build up functional ‘cognitive reserve’  Preserving good cognitive function is the best defense against dementia 0 5 10 15 20 25 30 35 60 70 80 90 Normal Demented Cognitive decline Age [...]... et al, Age and Ageing, 2008 (In Press) Go gentle on those sauces % with cogntive decline 40 35 30 25 20 Low BP Normal BP High BP Not diagnosed and Not Treated Low BP Normal BP High BP Diagnosed and Treated for High BP ‘Brain’ Food? Micronutrients and phytochemicals possess anti-oxidant, anti-inflammatory properties Vitamins A, C, E from vegetables and fruits Cachecins from tea Flavonoids and terpenoids... fruits/vegetable/milk products (less than once a day) Having tooth or mouth problems that make it hard to eat Without wanting, having lost or gained 4 kg in the last 6 months Having 3 or more drinks of beer/liquor/wine almost every day Not always physically able to shop, cook and/ or feed by self Eating fewer than 2 meals per day Not always having enough money to buy the food needed N=2611 40.3% 25.0% 14.5% 9.0% 5.2%... Omega-3 Poly-saturated Fatty Acids (PUFA) from fish and other sources Curcumins from turmeric in curry Current state of knowledge Experimental evidence abundantly support biological basis Human evidence are limited Few randomized controlled trials have provided conclusive evidence to support the safe use of nutritional supplements for preventing or slowing dementia Salmon, cod, tuna None 1 fish meal 2+...Factors Influencing Cognitive Functioning Age, Gender, Ethnicity Education Vascular factors: high blood pressure, diabetes, heart disease, stroke Nutrition: Anti-Oxidants and Micronutrients Physical, social and productive activities Mean Cognitive Function (MMSE) Scores 30.0 MMSE score 25.0 20.0 15.0 None Primary Chinese Malays # Adjusted for demographic, social, biological and health variables... risk of malnutrition Factors: chronic diseases multiple drugs use reduced mobility age-related physiological and social changes Marginal or biochemical (‘subclinical’) deficiencies have significant health effects Nutritional Health of Singaporean Seniors DETERMINE Your Nutritional Health Checklist At Risk of Poor Nutrition Having illness that change the kind and/ or amount of food consumed Taking 3 or... -0.05 -0.1 Forgetting % -0.15 -0.2 Ng TP, et al, Am J Clin Nutrition, 2007 Foods rich in folate Dark green leafy vegetables Fruits Peas and beans Rice, Grains and Cereals Cook them in curry Cognitive Scores 28 26 24 22 20 18 Rarely (Less than once in 6 months) Occasionally (Less often than once a month) Frequently (Once amonth to Daily) Ng, T P, et al American Journal of Epidemiology 2006 Tea, anyone?... healthy and well-balanced diet is not only good for the body, but also good for the mind General Nutritional Status and Cognitive Health Relative Risks of Cognitive Impairment 2.5 2.5 2.5 2.0 2.0 2.0 1.5 1.5 1.5 1.0 1.0 1.0 0.5 0.5 0.5 0.0 0.0 0-20% 21-40% 41-60% 61-80% 81-100% 20 Percentiles of Albumin 0.0 0-20% 21-40% 41-60% 61-80% 81-100% 20 Percentiles of Haemoglobin Yes No Underweight and Chronic... 20.0 15.0 None Primary Chinese Malays # Adjusted for demographic, social, biological and health variables Secondary + Indians Education makes a difference Don’t stop your education Develop the habit of life long learning Stay physically, mentally and socially active Physical/fitness activities Walking/ jogging Physical calisthenics routines Active sports or swimming Taiji Social activities Attending church/temple/mosque... nutritional status and Low risk 3-5: Moderate risk of poor nutrition 6+: High risk of poor nutrition At risk of poor nutrition (score of 3 or more): 30% Nutritional Status of Senior Singaporeans Body Mass Index1 (BMI, kg/m2) Underweight (=27.5) Increased Waist-Hip ratio (>0.8 in women or 0.9 in men) 5.5 36.8 39.8 17.9 63.2 High total cholesterol... High Tea Intake Data from the Singapore Longitudinal Aging Studies Ng TP, et al., American Journal of Clinical Nutrition, 2007 Ta Bau, A simple menu for good cognitive health Stay physically, socially and mentally active Eat a healthy well-balanced diet Eat lots of fish Cook them in curry With lots of green vegetables Wash down with cups after cups of tea Thank You . Ageing, 1 March 2008 Food and Mental Stimulation to Food and Mental Stimulation to Prevent Dementia Prevent Dementia Gerontological Gerontological Research. Food and Mental Stimulation to Food and Mental Stimulation to Prevent Dem entia Prevent Dem entia Gerontological Gerontological Research