Fear that must not be named
When I tell people that I’m a brain health coach focusing on dementia prevention, I often get some interesting responses. Many will have a string of questions about how to do it, but there are a good number of skeptics as well.
And that’s a good thing.
You definitely need a healthy dose of skepticism in order to be a savvy consumer of health information these days. There is so much health advice out there now that it can feel overwhelming to know how to sort it out. What’s real and what’s not? Who is trying to help you? Who is trying to help you by selling you something of value? And who is just trying to sell you something?
Dementia prevention is a quiet movement because people aren’t comfortable talking about it
Occasionally people will say that I can’t go around telling people that dementia is preventable through lifestyle choices, because I’ll just be raising expectations that will end up disappointing them. Usually they do so in a hushed tone - like somehow even talking about it will get us in trouble. It reminds me of when people who feared Voldemort kept telling Harry Potter not to say his name out loud: instead they would call him “He-Who-Must-Not-Be-Named” or “the Dark Lord.” Is that really how much we fear dementia?
I get it
When I first learned about dementia prevention through lifestyle choices like exercise, sleep and nutrition, I didn’t want to believe it either. It sounded too good to be true. I couldn’t understand why more people didn’t know about this. Why weren’t we shouting it from the rooftops?
And that was after I had vetted this information with my doctor brain and healthy consumer skepticism. I had gone through everything written by Dr Richard Isaacson of the Weill Cornell University Alzheimer Prevention Unit. I had reviewed his free online teaching modules about how to prevent dementia.
I had reviewed numerous source research articles, including the first observational studies on the Framingham cohort and other population studies. I looked into the pathophysiology of dementia and tried to understand the mechanisms of brain injury and what is happening at the cellular level.
Then I looked at the seminal Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGERs), which was published as far back as 2009. And I saw the network of scientists all around the world that had found the evidence so compelling that they signed up to participate as well.
Simple not easy
And then I realized that this was more than just health information. This was a movement. A quiet movement because dementia is not something people are comfortable talking about. A small movement because there was no big money to be made behind selling people on exercise, sleep, and nutrition.
But how meaningful it is to be able to empower people by showing them how to “mom their brains”! At first I couldn’t believe that it was just a matter of educating people that lifestyle choices could reduce the odds of getting dementia by one third. It sounded too easy.
Dementia terrifies me, but I just don’t find fear to be motivating
But it turns out that many do fear dementia so much that they don’t want to hear about it. Or maybe they're so busy taking care of elderly loved ones that they don’t have the bandwidth to listen.
People want an easy breakthrough cure, not yet more advice about how to take care of themselves properly. Most don’t see the relevance of purpose, or the importance of intentionally building connection and stress reduction into their daily lives. A pill would be so much easier, right?
Why vs How
And here’s where decades of scientific evidence on heart disease prevention tells us that knowledge alone doesn’t necessarily help people to exercise or lose weight. And partly that comes back to the issue of confusion around the “how” part. What exactly is a heart healthy diet or the best way to lose weight?
Perhaps it’s because we know that people survive heart attacks, or that they can take medicines or get a stent to address clogged arteries. Research shows that patients are never more motivated to engage in lifestyle measures to prevent heart disease than when they are about to be discharged from the hospital after a heart procedure. It literally takes a brush with death for most people to pay attention.
I love sharing the experience of empowerment over fear and passivity
And that makes sense. Humans are reactive by nature after all. We naturally avoid what we fear. But what if we could be motivated by love and not fear? It’s not that I’m not afraid of dementia - it terrifies me.. I just don’t find fear to be motivating - fear creates a threat response through neurochemicals like cortisol and adrenaline that makes us want to freeze or hide.
So I choose love as the fuel for the choices and actions that I make each day. I know that when I am managing my stress and taking care of my body, that I am proactively promoting a safe environment for myself internally. And it’s when I feel safe that I am able to tap back into why I want to take care of my brain in the first place. It’s so that I can enjoy meaningful contribution to the lives of my children and grandchildren when I’m 99, And to continue to share the experience of not being disappointed that I chose empowerment over fear and passivity.
Alzheimer’s Universe is an education website hosted by Weill Cornell Medicine providing free educational material on dementia prevention based on research evidence. Take assessments to test your memory or learn more about personal risk.