Tuesday 8th March 2022
Poor Mental Health is stronger risk factor for Dementia than Chronic Physical Disease
Louise Morse
In our February Zoom meeting we looked at the dementia status quo: what’s known about the causes, the research for a cure, the importance of spiritual support (with a few case studies), and the new drug, Aduhelm and the controversy around its approval by the FDA. (Food and Drug Administration). A week later our content was topped by an article in the British Medical Journal, (BMJ) confirming experts’ concerns that Aduhelm does not improve cognition or slow clinical mental decline and that it has significant side effects. Now an unusually large new study finds that mental disorders are more strongly associated with dementia than chronic physical diseases. These conditions are modifiable, said research lead, Dr Leah S. Richmond-Rakerd and should be addressed to reduce dementia risk in later life. Janet Jacob (former psychogeriatric nurse and home manager) and I (cognitive behavioural therapist) had already planned to talk about helping older people with anxiety and depression in our next Zoom meeting on April 12 and, in the light of this new report. will include those in their middle years.
Published in JAMA Psychiatry, the study included 1.7 million people in New Zealand over a 30-year period, from 1988 to 2018. It was doable because of the country’s integrative national health system, linking health records with population databases.
Mental health disorders were more strongly associated with dementia than chronic physical diseases. Of individuals with a mental disorder in the study, about 6 percent were diagnosed with dementia, compared to only about 2 percent of those without a mental disorder. The connection was seen for both men and women, and was not explained by pre-existing chronic physical illness or socioeconomic deprivation.
‘This was very unexpected,’ Dr Richmond-Rakerd said. ‘It suggests that mental health problems may be an even more important risk factor for dementia than physical diseases.’ She added that people with mental disorders could be encouraged to engage in health behaviours that reduce dementia risk — like increasing physical activity. ‘Mental health problems are not a ‘life sentence’ that always results in dementia.’
Although not quantified in this way before, the effects of loneliness, stress, and depression, have been implicated in dementia for many years. For example, studies have shown that feelings of loneliness are as bad for health as smoking 15 cigarettes a day, and chronic stress in middle age doubles the risk of dementia when older. Depression slows blood flow to the brain.
In his seminal work, ‘Dementia Reconsidered’, (Open University, 2011) Professor Tom Kitwood wrote that ‘all events in human interaction – great and small – have their counterpart at a neurological level’. He said that the standard paradigm of dementia ignores the way in which brain function is translated into brain structure and those aspects of nerve architecture that are developmental, and thus closely related to a person’s experiences and defences.
That brain function is translated into brain structure was illustrated by Eric Kandel, Professor of biochemistry and biophysics at the College of Physicians and Surgeons at Columbia University and Nobel prize winner. In 2009 he led groups of eminent scientists in discussions around the table in the televised Charlie Rose Brain Series. At the close of one session he said, ‘Your thoughts today have shaped the structure of your brain.’ If I hadn’t seen and heard him say it myself, I wouldn’t have believed it. We tend to think of the brain as a fixed, physical structure, as we do our arms and legs. Our hippocampus is a ‘plastic’ and vulnerable structure that gets damaged by a variety of stimuli, and it’s known that it gets affected in a variety of neurological and psychiatric disorders, including dementia.
God who made us in His image knows the power of our thoughts, and has given clear instructions in Philippians 4: 8-9. I like the ‘whatsoevers’ in the King James Version – ‘Finally, brethren, whatsoever things are true, whatsoever things are honest, whatsoever things are just, whatsoever things are pure, whatsoever things are lovely, whatsoever things are of good report; if there be any virtue, and if there be any praise, think on these things. Those things, which ye have both learned, and received, and heard, and seen in me, do: and the God of peace shall be with you.’
To sign up for the meeting on April 12th, at 2:30, click here
