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2019 AUTUMN

vol.39

Staying active as a member ofsociety is the most effective
way to prevent dementia
Yuta Manabe

Professor, Department of Dementia and Geriatric Internal
Medicine, Kanagawa Dental University Hospital

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EnglishChineseProfessor Yuta Manabe

Staying active as a member ofsociety is the most effective
way to prevent dementia

Department of Dementia
and Geriatric Internal
Medicine, Kanagawa Dental
University Hospital─ What kind of assistance doyou offer to people who havestarted to experience forgetfulness symptoms?

There are no standard drugs that can be used to treat
the estimated 4.62 million people afflicted with dementia,
which is why preventive measures are so important. We talked
with Professor Yuta Manabe, who is involved in joint dementia prevention efforts together with dentistry professionals,
about how to deal with dementia as a part of one's life.
─ How did you get your startin the ﬁeld of dementia?
Around the time I finisheduniversity studies and became aresident, I developed an interestin neurology and wanted to go
into that ﬁeld to study Parkinson's
disease, but in the end I went into
general internal medicine instead.
During my first year of graduate
school, I approached Doctor Kenji
Kosaka̶the psychiatrist who discovered dementia with Lewy bodies [DLB]̶to ask if I could study
under him.
Later on, Doctor Kosaka told me
to create a comprehensive DLB
medical center that handles everything from initial examinations
through to treatment, so I transferred to the Yokohamashintoshi
Neurosurgical Hospital and established the Internal Medicine and
Dementia Diagnosis Center, known
as "Forgetfulness Clinic." I am
truly grateful that I was given thisopportunity.
2

─ Are numbers of dementia
patients increasing?
As we grow older, we tend to
become more forgetful, which issometimes a sign of Alzheimer's
disease. In some cases, it's possible
to minimize the eﬀects of the disease if the symptoms are spotted
early. That's why it's important toundergo examinations rather thanmaking arbitrary excuses, such as
blaming it on old age. When those
types of patients are factored in, I
believe there would be more than
4.62 million dementia patients.
In regions with large elderly
populations, about 80% of patients
who received memory-related
health checkups [to confirm brain
and memory functions] were told
to come in again for further testing. Not all cases are Alzheimer's,and in addition to patients clearly
suffering from some form of dementia, some have mild cognitive
impairment, or MCI, that serves

as a precursor to dementia. Only
about 10% to 20% of patients ﬁnish
these examinations without any
signs of dementia.
As our lifespans grow longer,
dementia numbers increase overall.
Many believe that DLB is increasing in prominence, but that's only
because we have become more capable of detecting it. "Dementia" refers not to a speciﬁc disease, but toa pathology, and encompasses various brain diseases including Alzheimer's, DLB, and other disorders
with differing causes. Doctors at
smaller, local clinics have becomemuch more knowledgeable about
these things and now write speciﬁc
disease names on patient referral
forms, but experts at larger institutions, myself included, carry a lotof the responsibility. I feel that ourefforts to spread knowledge andawareness in this field, centering
on Doctor Kosaka, have really paidoﬀ.

I tell them to avoid cutting themselves off from social interactions,and explain that becoming more
active as a member of society will
help them improve. Conversationand other forms of communication
are the best ways to preservecognitive functions, which is why
going out and talking to other people is so important. If the patientis employed in a position with considerable responsibility, I tell themto avoid quitting and stick with it.
Some people tell me that because
they are becoming more forgetful,at their age it's probably a goodtime to quit their job, but the actual solution is just the opposite.
Teeth are also important. Withdementia, many people experienceapathy, which reduces their desire
to stay active and do things in general. The anterior cingulate gyrus
is responsible for this apathy, andits function has been shown to correlate with tongue movement andpressure. A common belief you
might hear in Japan is that people
who chew their food thoroughlywhile eating are more proactive
and energetic, and in this case thebelief may be right on target.
In some cases, we can use ultrasonic devices and similar to stimulate the cranial area and thus improve blood flow and metabolism.
Increased cranial blood ﬂow boosts
nerve cell metabolism, which im-proves brain function̶ in addition
to following logically, this has been
proven through basic research andit is currently the subject of clinical research aimed at developing
treatment methods.
It is also important for dementia
patients to avoid believing information provided by popular media without first doing their own
research to conﬁrm. For example,
the widespread beliefs that caﬀeine
and alcohol can worsen dementia
is not only wrong, but contrary to
the truth̶in the case of caffeineor alcohol consumed in reasonableamounts, that is. Many also believethat loosening up the contents ofcanned mackerel, a popular food,after removing it from the can,or else heating it, eliminates EPA[eicosapentaenoic acid] and DHA[docosahexaenoic acid] content
and thus destroys the antioxidant
eﬀects̶again, this is not true. It's
important for everyone to develop
a reasonable amount of reliableknowledge on the topic of dementia.
─ So communication is mostimportant, correct?
Yes, dementia patients should
engage in conversation and othercommunication in general. Furthermore, staying active prevents muscle strength deterioration, and also
lowers the risk of sarcopenia [lossof muscle mass caused by factors
such as aging and illness, leading
to deteriorating bodily functions]as well as the risk of general frail-ty [brought on by age].
Currently, we're preparing an
event in which we will set up abooth oﬀering vegetables from theMiura Peninsula, gather elderly
people together, and use the opportunity to engage in interpersonalcommunication. In short, talking
with people and moving aroundare important. For those who don't
like leaving the house, nursing-careand rehabilitation personnel canmake home visits, or patients caninvite friends to come over to theirhouse.

PROFILE

Yuta Manabe
Professor, Department of Dementia and Geriatric Internal
Medicine, Kanagawa Dental
University Hospital; Doctorof medicine and visiting professor, Emergency & Critical
Medicine Department, Fujita
Health University Hospital;
Medical specialist and instructor, Japan Society for Dementia Research; Recommended
doctor, Research Society for
Dementia with Lewy Bodies;Tokyo consulting physician,Dementia with Lewy Bodies
Support Network3

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Showing at JSDP 2019Japan Self Care Research Society Website Completed

Based on the theme of dementia prevention focused on oneself and one's family, The 9th Annual Meeting of the Japan Society for Dementia Prevention(JSDP 2019) is a source for the latest developments and information related
not only to dementia prevention, but prevention of disease progression in existing dementia cases.

The Japan Self Care Research Society
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http://www.japan-selfcare-i.jp/■ 9th Annual Meeting of the Japan Society for Dementia Prevention(JSDP 2019)
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