Over the years, research has shown ways to reduce the chances of developing dementia, as well as managing some of the more challenging symptoms.
Certain risk factors that contribute to dementia can be controlled or treated, such as longstanding heavy alcohol use, high cholesterol, heart disease, and depression. Of all the strategies known to prevent or delay dementia, exercise may be the most impactful. There are many risk factors that influence both the odds of developing dementia and the age when dementia appears that consistent exercise can both lower and delay.
Because nearly one-third of dementias have a vascular component, anything that improves the health of one’s arteries and veins throughout her lifetime will lead to less cell death in the brain, lower memory loss, and a decreased risk for dementia.
Research suggests vigorous exercise leads to changes in brain chemistry and more and tighter connections between neurons, which may build one’s degree of resistance to dementia.
Exercise also helps to improve mood, so depression is another risk factor for dementia that exercise can modify.
Several treatments have been approved for dementia. Though none have been shown to be highly efficacious, nor to cure the disease, they may be effective in slowing progression in some persons. Recently approved medications include Aduhelm and Leqembi. Please speak with your physicians about various medication options.
Other symptom management includes types of therapies including speech therapy, occupational therapy and creative arts therapies. Many people living with dementia benefit from a variety of treatments.
Individuals living with more advanced dementia and their families can choose from a variety of care settings and services. When working with a physician to create a treatment plan, first consider the differences between skilled and unskilled care.
Skilled care is short-term medical care that requires a licensed and trained professional—usually a nurse or therapist—who can monitor and assess the patient, educate the family, and document and communicate observations to the physician. Skilled care can be provided in almost any setting, requires the certification and oversight of a physician, and is typically paid for by Medicare or private health insurance.
Unskilled care refers to the support family members give for daily living activities such as getting out of bed, ambulating, using the toilet, meal preparation and housework, and grooming. Unskilled care is a long-term need, does not require the oversight of a physician, and typically is paid for out of pocket. The amount of skilled and unskilled care a patient receives depends on the treatment setting.
Home health describes skilled medical services reserved for homebound patients and focused on a specific medical problem. Home health professionals visit a patient once or twice a week, and a physician oversees the care.
Home care is unskilled care provided to loved ones for support in daily living activities. Home care must be conducted on an ongoing basis.
Nursing facilities provide a combination of skilled and unskilled care. Eighty percent of residents live there full-time; the other twenty percent attend part-time to receive skilled care only. Nursing facilities typically accept Medicare and private health insurance.
Assisted living residences provide room, board, and recreation opportunities. Additional services such as primary and skilled care are not mandated, and the residence charges for extra services it chooses to provide. Many patients pay for partial or full assisted living costs out of pocket.