25 March 2014

One of my regular patients returned to my clinic this week. I was pleased to see him, and was looking forward to hearing about his progress. The last time we’d met we agreed that he needed to lose some weight and that he’d go home and start making some changes. “How did you get on?” I asked. “How did I get on with what?” he replied. “How did you get on with losing weight?” I asked again. “Sorry Doc, I haven’t lost any weight. In fact I haven’t even tried. I forgot…….”

Easily done. There are so many competing pressures for our time and our memory. We revisited the subject, and I reminded him of why he’d said initially that he wanted to improve his lifestyle, lose some weight, and reduce his risk of future illness. I hope he’ll make some changes this time because his poor memory might just depend on it.

Dementia affects 1 in 20 of us and it’s increasing every year. It’s a terribly debilitating problem for those who suffer from it, but also for those who have the task of caring for them. It can ruin a whole family’s life. The most common type of dementia is Alzheimer’s but there are other kinds too. Most often it presents with a deteriorating memory, increasing confusion, deteriorating self-confidence, and self-neglect. It can quickly lead to a total dependency on others and a sufferer’s life can collapse within a few months or years. Research has confirmed what we’ve known for some years, that being obese can increase your risk of developing dementia by up to 300%. But what was most revealing for me was that the researchers from Sweden, who investigated more than 8000 twins from their mid-30’s, also showed that even just carrying a few pounds of excess weight, being in the BMI of 25-30 or “overweight” category, also increases your risk, by around 71%. And the risk starts to increase not just in later life, but from middle-age

Overweight causes high blood pressure, raised cholesterol and blood glucose, but also increases what doctors call “inflammatory markers” in the blood, all of which we know can lead to an increased risk of arterial disease and……dementia. But so much of it is preventable. There is a lot we can do to help ourselves and reduce our risk. Significantly. In a nutshell? Yes, of course weight loss. Losing 5-10% of our body weight, or returning to a “normal” weight range can largely undo that increased risk.  Being physically active is also vital, to achieve weight loss and reduce disease risk.  And the time to start is now, regardless of your age.

Normally I like to close my blogs with something to make you smile. This time I’ll give it a miss. I can’t make dementia funny, or be light hearted about the suffering of those affected. As I told my forgetful patient, if this news doesn’t help him remember, I don’t know what will.