Ponte Vedra Y lecture reviews the science of dementia


The Y Healthy Living Center of Ponte Vedra’s YMCA played host to another “Talk with the Expert” seminar Nov. 9, this time welcoming Baptist Health’s gerontology educator, Robert Trenholm, MSN, RN, of the AgeWell Center for Senior Health to present new research on dementia.

Trenholm started by reminding the group of the “three Ds” commonly discussed in the same realm: delirium, depression and dementia.

“It’s important to understand all three of these things because, out of the things that can happen to our brains as we age, those three are the most common and the most high risk,” he said. “And they are often confused with one another.”

In that vein, Trenholm introduced relatively new research obtained from a study more than three decades in the making with the Framingham Heart Study. The study followed the health of an original cohort in 1948 and two subsequent generations. According to Trenholm, the people in the study showed a small but definite decrease in the number of dementia diagnoses, and scientists have offered a few theories as to why it might be happening.

“Researchers decided to look at the lifestyle issues correlated with the reduction,” Trenholm said. “And one thing that the date suggested was … a higher level of neuroprotective (activity).”

Trenholm explained the scientific aspect of the research, including the development of neurons and how they work proactively to fend off the onset of dementia.

The average human brain, he said, has about 100 billion neurons. Most activity in the brain occurs either inside the neuron or between the cells where they communicate with one another, and where chemicals and “synaptic connections” cross paths. Those cells and what goes on in and around them is what allows them to manufacture the chemicals needed to communicate with one another.

But it’s possible to lose neurons due to disease – especially at the onset or in the throes of dementia. “You’d be left to operate with 50 billion neurons, which isn’t too good,” Trenholm said.

Trenholm suggested that an “extra buildup” of neurons is something that occurs in childhood when the brain is still growing. That growth continues throughout life, but the process of adding neurons slows greatly as people get older.

But that doesn’t mean adult brain growth stops.

“The other part of this equation is the synaptic neuron,” Trenholm said. “Each one of those neurons has branches like tree limbs that reach out to other neurons. The more of those that they have, the more connections they make and the more memory patterns you can create with those neurons communicating with each other.”

It’s with this knowledge that Framingham researchers were able to form one hypothesis about the slow-down of dementia diagnoses amongs study subjects: The key to reducing new dementia cases could be education. When separated, scientists found that the group of subjects who only had a high school level education didn’t see a decrease in the percentage of dementia. The group of subjects with post-secondary education, however, did see a drop.

The growth of synaptic connections – a process that naturally occurs each time something new is learned – can offset the lack of “extra” neurons, and it’s easier to do than forming new ones.

“This is what’s known as neuroplasticity,” Trenholm said, noting that the active learning environment of a post-secondary education could naturally encourage the growth of connections formed in the brain, making it neuroprotective. “That’s our brains’ ability to continue to grow and learn throughout our life. And we continue to form … synaptic connections throughout our whole lives.”

Another theory suggested by researchers was that people who received higher education might know more about health and make better choices to help reduce their risk. The third theory was that people who don’t receive post-secondary education had less access to health care coverage and resources due to lower wages, which put them at greater risk over the decades the study was conducted.

Trenholm noted that the research is still in its early stages, and the theories need more testing before any one cause can be determined – but he also encouraged the group to look to tried and true advice.

“Unfortunately, there’s no ‘silver bullet’ to preventing dementia,” he said. “The usual advice of eating well, exercising, avoiding stress and learning new things all apply. But ‘exercising’ the brain and being a proactive learner is … a good place to start.”