Alzheimer’s and Dementia Risk Reduction for Brain Injury Survivors

Many scientific studies have shown clear links to brain injury and the development of dementia.  The MIND diet is a way of eating intended to slow the decline of brain health as we age as well as reduce the risk of developing Alzheimer’s disease – and this may be very important for both acquired and traumatic brain injury survivors.  MIND is an acronym for Mediterranean-DASH Intervention for Neurodegenerative Delay; it is a combination of core principles of the Mediterranean diet and the DASH diet (Dietary Approaches to Stop Hypertension)⁽¹⁾.

The Risks

The risk of developing Alzheimer’s disease (AD), the most common type of dementia, increases with the severity of the damage incurred from the brain injury.  Multiple sub-concussive, mild TBI’s increase the risk of chronic encephalopathy (CTE), a common precursor to dementia.  TBI has been found to be a risk factor for various neurodegenerative disorders associated with the development of dementia, and even lowers the onset age for related neurocognitive issues⁽²⁾.

This means that with the severity of my TBI, not only am I at risk for developing AD, or another form of dementia, but that onset could begin at a much younger age than expected.  When we add in the fact that I’m already in my sixties, it’s probably clear why this issue has gained my full attention.

The Cost of Dementia

My mother’s dementia started simply, with things like forgetting minor details and misplacing her belongings.  As it progressed, there were times when she no longer even knew who I was.  Family and caregivers of AD or dementia patients experience not just a single loss at the end of the patient’s life, but a continuously increasing sense of loss as the person they know and love disappears a little more each day.  Studies show the 5-year mortality rate from dementia at 60-65%, with men being at higher risk than women⁽³⁾.

The cost of dementia for the patient is a gradual, beginning with loss of ability to function well, loss of dignity, and the disappearance of all their future plans.  As it progresses, it grows into an inability to care for themselves, leading into a complete loss of self-identity, and finally an early end to their life.  No one wants this future for themselves.

Then we come to the family and the caregivers’ cost, including the economic burden, difficult emotional burdens, and psychological distress leading to decreased quality of life⁽⁴⁾.  The full scope of caregiver loss is broad and varied depending on their relationship with the patient.  It may include loss of independence, the feeling of having lost control of their life direction, loss of their carefully planned future and of financial security.  For family members it may include the pain associated with loss of a treasured relationship with that family member, loss of a spouse, a best friend, a sibling, child, parent, or grandparent.  Then there is the loss of sleep, the stress and anxiety – there is so much more at risk here⁽⁵⁾.

A Proactive Approach is Warranted

The cost of dementia to the patient is too high for me to willingly accept this ever happening to me.  When we add in the potential cost to my wife and my son, I won’t let it happen without doing everything in my power to prevent that outcome.  This means I need to do absolutely everything that I can to prevent this outcome.  Through my research, I discovered a scientifically proven method to slow cognitive decline and reduce the risk of AD and other forms of dementia.  A way of eating termed the Mediterranean- DASH Intervention for Neurodegenerative Delay, also called the MIND diet.

Unlike so many “diets” out there, the MIND diet is supported by multiple scientific studies showing a consistent and measurable level of protection against both cognitive decline and AD^(1)(6)(7) as well as reduced incidence of Parkinsonism in old age⁽⁸⁾. There are even studies showing that the MIND diet slows cognitive decline after a stroke⁽⁹⁾.   Note that I’ve only referenced a handful of studies, but if you search the National Library of Medicine listings, you will find dozens of studies showing similar results.

Then comes the other many benefits of the Mediterranean style of eating: lower blood pressure, reduced incidence of heart disease, stroke, and diabetes.  It’s also associated with increased longevity, weight loss, and increased agility in our golden years.

Another point to note here is that the Mediterranean and MIND diets are more of an eating pattern as opposed to a hard-core structured and restrictive diet.  It’s a way of eating.  All of this convinces me beyond any doubt that the Mediterranean and MIND dietary approaches are how I need to be planning my meals for the rest of my days.

But What IS the MIND Diet?

As described above, the MIND diet incorporates core principles from the Mediterranean and DASH diets.  A true Mediterranean diet is based on the region’s traditional fruits, vegetables, beans, nuts, seafood, olive oil, and dairy – and perhaps a glass or two of red wine with dinner.  What brought this to the attention of the world was when it was discovered that the inhabitants of the region had some of the lowest known rates of heart disease and chronic ailments, despite having only limited access to medical services. 

The core DASH diet principles include a focus on fruits and vegetables, whole grains, and low-fat dairy products. It also includes fish, poultry, and legumes, along with some nuts and seeds.  DASH also looks to reduce sodium intake to 2300mg/day or less, while increasing potassium, calcium, and magnesium intake with foods rich in these nutrients.

The MIND diet combines these eating styles with a set of guidelines for what you should be eating and what you should avoid.  There are a number of books available that I’ve seen on Amazon, from beginner to advanced, including recipes.  My wife, Marcie, has already been moving us towards a meal plan that’s based on the Mediterranean diet and pulls some amazing recipes from her Blue Zones Cookbook.  Mostly for us, the changes will be reduction of red meat consumption – but that’s ok with me, I love seafood of all kinds, as well as poultry, and I’m starting to get used to the legumes in my diet.  The MIND diet also suggests that you forego fried fast foods, sweets, pastries, butter, margarine, and whole-fat cheeses.  I’m pretty good with this.  Other than the occasional breakfast sandwich from the place with the arches, I really don’t do fast food.

My Thoughts on All This

We all choose where to draw our lines.  Luckily, the Mediterranean diet is pretty much what we already are already working towards, with our intake of red meat probably running a little higher than recommended.  We’ve already switched to seafoods several nights a week, and we’re waiting on an order of pasture raised chickens from a local farm.  I do love butter, bit I’ll reduce it a little at a time, and I can start trying some of the lower fat cheeses in order to move closer to a MIND diet approach.

Adopting a Mediterranean style eating plan is all too easy – I love all that’s on that menu.  Where I’ll find my challenge is with a just handful of the MIND elements.  Luckily, the developers of the MIND diet suggest it should be used as a guideline for avoiding foods that are unhealthy for the brain and encouraging us to eat more brain-friendly foods.  And, as I said before, if I can prevent or at least significantly delay dementia striking me as I age, I’m willing to do whatever it takes.  We’ll be working towards fully incorporating a MIND eating style gradually over the next few months, and I look forward to it becoming my new normal.

References

1. Martha Clare Morris, S.D., Christy C. Tangney, Ph.D., Yamin Wang, Ph.D., Frank M. Sacks, M.D., David A Bennett, M.D., and Neelum T. Aggarwal, M.D., (2015), MIND Diet Associated with Reduced Incidence of Alzheimer’s Disease
2.  Mario F. Mendez, (2017), What is the Relationship of Traumatic Brain Injury to Dementia?
3. Prabhu D. Emmady; Prasanna Tadi, (2021): Dementia
4. Elif Koca, Özlem Taşkapilioğlu, and Mustafa Bakar, (2017), Caregiver Burden in Different Stages of Alzheimer’s Disease
5. Rabbi Jon Sommer, (2013), Grief and Loss
6.  Martha Clare Morris, S.D., Christy C. Tangney, Ph.D., Yamin Wang, Ph.D., Frank M. Sacks, M.D., Lisa L Barnes, Ph.D., David A Bennett, M.D., and Neelum T. Aggarwal, M.D., (2016), MIND diet slows cognitive decline with aging
7. Christy C Tangney, Hong Li, Yamin Wang, Lisa Barnes, Julie A Schneider, David A Bennett, Martha C Morris, (2014), Relation of DASH- and Mediterranean-like Dietary Patterns to Cognitive Decline in Older Persons
8. P. Agarwal, Y. Wang, A.S. Buchman, T.M. Holland, D.A. Bennett, and M.C. Morris, (2019), Mind Diet Associated with Reduced Incidence and Delayed Progression of Parkinsonism in Old Age
9. L Cherian, Y Wang, K Fakuda, S Leurgans, N Aggarwal, M Morris, (2019), Mediterranean-Dash Intervention for Neurodegenerative Delay (MIND) Diet Slows Cognitive Decline After Stroke