[Wanqingyi Care]Manage the body, adjust life, add points to the brain and prevent cognitive impairment

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Text◆Huang Biwen “Ming Pao”

The problem of population aging is becoming more and more serious, and dementia is becoming more and more common. According to the “Mental Health Review Report” released by the government in 2017, the number of patients with dementia in Hong Kong is estimated to be 100,000, and it is expected that by 2039, the number of patients aged 60 and over will exceed 300,000.

In addition to increasing age, the urban disease “three highs” are known high risk factors. The latest research integrates the three major areas of physical health, lifestyle, and social emotions to score brain care. By managing the body and adjusting life, adding points to the brain can reduce the risk of dementia by half.

(Hong Kong News) According to the World Health Organization, there are more than 55 million people with dementia around the world, with nearly 10 million new cases every year, making it the seventh leading cause of death in the world.

A study in “Frontiers in Neurology” in December last year proposed the “Brain Care Score” (BCS) test tool (see table) to assess three major categories: physical condition, lifestyle and social emotions. The test includes 12 health-related factors, with a total of 21 points. The higher the score, the lower the risk of Alzheimer’s disease or stroke.

Obesity increases risk

Researchers calculated “brain care scores” and tracked health status for nearly 400,000 people in the UK between 2006 and 2010, and compared the scores with scores 12 years later. The results found that for people under 50 years old, for every five points, the risk of Alzheimer’s disease was reduced by 59% and the risk of stroke was reduced by 48%.

The main cause of dementia is neuronal cell disease in the brain. Professor Kwok Chi-rui of the Department of Medicine and Therapeutics at the Chinese University of Hong Kong explained that among the dementias, the most common is Alzheimer’s disease, which causes fibrillar amyloid protein plaques and taurin. Continuous deposition in the brain causes surrounding brain cells to rapidly degenerate or die, causing the brain to gradually shrink and memory, speech and judgment abilities to be impaired.

Symptoms are divided into early, middle and late stages

However, Guo Zhirui emphasized that it is important not to misunderstand that dementia is only caused by age-related degeneration, and vascular disease is also a risk. If you have problems such as obesity, tobacco and alcohol consumption, and the three highs (high blood sugar, high cholesterol, and high blood pressure) when you are young, it is easy to affect the health of blood vessels. “The brain needs blood for nourishment. Once blood vessels are occluded, blood cannot reach the brain, leading to stroke, brain cell damage and death, affecting memory and mobility, and leading to vascular cognitive impairment at any time.”

Many people mistakenly believe that patients with Alzheimer’s disease only have memory loss, but in fact when brain degeneration gradually becomes more severe, the patient’s understanding, language, learning, calculation and judgment will be affected, and some people may even have mood, behavior and Changes in feelings, etc. “Patients lose short-term memory from the early stage, gradually to the middle and late stages. The rate of deterioration varies from person to person, generally ranging from a few years to more than 10 years.”

Symptoms of dementia:

Early stage: loss of short-term memory, erratic mood or behavior, lack of motivation for life, but basic self-care ability

Mid-term: confusion between long-term and current memories, more unstable emotions, and needing help from others for daily self-care activities

Late stage: memory impairment, confusion of biological clock, inability to express and communicate effectively, and inability to handle daily life

Brain score for those over 30 years old

Once you are worried that your family member has dementia, you need to see a doctor as soon as possible for evaluation through intelligence tests, computed tomography scans, magnetic resonance imaging examinations, blood tests, etc. It is also recommended that people over 30 years old calculate a “brain care score” for themselves.

Guo Zhirui said that the entire study is of forward-looking significance. The scoring items not only focus on the three highs or healthy diet, but also involve exercise, interpersonal relationships and life goals, all of which are closely related to dementia.

“Generally, people over the age of 40 are focusing on family and career development, and they may not think about the rapid decline in physical condition in the next 10 or 20 years.”

Guo Zhirui said that the “Brain Care Score” can be imagined as a vigilance tool to remind everyone to save their personal health scores as soon as possible. For example, if you control your blood pressure and blood sugar well, you can get 3 points and 2 points respectively; if you have good interpersonal relationships and life goals, you can get 1 point respectively; and if you do aerobic exercise for 150 minutes a week, you can get 1 point. “Research shows that every five points can reduce the risk of dementia and stroke, regardless of age.”

Reluctant to let go without asking for help Category 2 caregivers at high risk

“I want to die”, “so tired”, “so lonely” and “feeling tired” are the bitter experiences of many family members and caregivers of patients with dementia.

Cui Zhiwen, deputy general manager and registered social worker of the Jockey Club Center for the Elderly, who has been engaged in Alzheimer’s disease services for 18 years, admitted that patients have high mood swings, gradually weakened self-care ability, and have poor memory, which makes them prone to friction with their caregivers and makes them uncomfortable. Those who have few caregivers feel lost and weak, even depressed to the point of suicidal thoughts.

Communicate with doctors and nurses to express emotions

There are two categories of caregivers who are at high risk. Cui Zhiwen said that the first is to refuse to let go, believing that handling it by oneself is the best way; the second is to not seek help, but the cognition, mobility and emotions of patients with Alzheimer’s disease will continue to change and require professional help.

Ai Li’s father was diagnosed with Alzheimer’s disease in 2020 and was initially taken care of by domestic helpers. However, his father’s condition gradually deteriorated. Day and night were reversed. He would get up in the middle of the night to cook. He also suffered from delirium. He accused his mother of cheating and kept her locked in the room all day. .

Aili once felt stressed and confused. Fortunately, she actively sought help from the community and tried to get her father to participate in day care activities. She found that his mood gradually stabilized and his physical and mental condition improved. However, when there was no “school” day, my father went to bed from morning to night. Later, he decided to apply for a residential care home. He also participated in the caregiver’s classes and communicated with the medical staff in a timely manner to express his personal emotions.

It is often said that dementia cannot be cured, but Cui Zhiwen said that if patients receive appropriate care early, it can help delay the disease.

Proper care can help delay the disease

“And caregivers cannot fight alone, and must learn “PREFERS”. That is, taking care of personal physical condition (P: physical condition), handling family relationships (R: relationship), personal emotional management (E: emotion), and financial mobilization ( F: financial burden), learning caregiving methods (E: education), finding community resource assistance (R: resources) and social relationship support (S: social burden), etc., only through the cooperation of multiple aspects can it become a healthy and effective care provider. By.”

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