With voices ringing out in the background, Sandi Lubrant was all smiles sharing how much it meant to bring the Singing Hills Chorus of Mankato, Minnesota, back together for a summer singalong.

The chorus, a program that began in 2017, is composed of people with Alzheimer’s disease or dementia and their care partners.

Members need not be classically trained singers to participate. The program is more about building social connections through song than it is about matching pitch.

“It shows a different side to Alzheimer’s, that there’s joy and community,” said Lubrant, team lead of Act on Alzheimer’s, a Mankato and North Mankato program that oversees the choir. “There’s a lot of loss associated with the disease, but it doesn’t have to be all loss.”

Research shows social engagement can play an important role in slowing dementia progression and onset. Loneliness and isolation, in contrast, are among the predictors of dementia onset.

While there is no particular brain activity that is more beneficial than another, staying mentally active is important. That could entail reading, doing puzzles, working or volunteering.

“We know that people who are socially isolated and develop depression are also at increased risk for developing dementia. We think it sort of accelerates the process,” said Dr. Lee Jennings, a geriatrician in Oklahoma City and associate professor at the University of Oklahoma Health Sciences Center.

“So, if you are feeling lonely, reaching out to your health care provider, or a therapist or a faith-based group or anything like that. That may be helpful to keep you engaged from a physical and mental health standpoint.”

Diet, exercise can help

Lifestyle influences someone’s likelihood of developing Alzheimer’s, said Dr. Vijay K. Ramanan, a cognitive neurologist at Mayo Clinic. Other factors include environment and genetics.

He likened each factor to how chili can have many different ingredients, with the combination and proportion of them ultimately determining how the chili tastes.

A growing number of genes (80 to 100) is known to have some impact on Alzheimer’s risk. Testing for these genetic markers — blood tests are currently in development — could alert people to their risk levels and prompt prevention strategies.

But genetic markers are only one factor altering someone’s chances of having Alzheimer’s. Social stimulation, dietary choices, access to healthy food, quality of sleep and exercise are all additional considerations.

These lifestyle factors, like genetics, aren’t necessarily the dominant factors in dementia onset or progression, Ramanan said, but they can play a role. Seeking out social outlets, hobbies and learning opportunities all have positive impacts on brain health, he said.

Underlying causes of dementia are mostly unknown, and the same can be said for a cure.

There are medications used to manage neurological symptoms and help patients live more comfortably. Behavioral symptoms are managed with sleep aids or anti-anxiety medications. Therapeutic activities engage the mind and body.

Because causes remain a mystery, there’s no definitive method for preventing dementia. But members of the medical and research community recommend basic steps for healthy living.

Healthy living

“Preventative care is really one of our best opportunities,” said Dr. Glen R. Finney, a board member of the Alzheimer’s Association Greater Pennsylvania Chapter and director of the Geisinger Memory and Cognition Program.

“What that looks like is things we all should be doing anyway,” he said. That includes:

• Good exercise. That means 30 minutes daily of medium intensity cardio, Finney said.

• Good diet. Moderate consumption and a focus on healthy foods is useful. The idea is to focus on eating planned portions of brain-healthy foods like fruits and vegetables, whole grains, poultry and fish.

• Stay sharp. Word puzzles, board games and even video games can be useful, Finney said. He suggested continued learning. Study up on something old or new. Explore a new language. The idea is to force an aging brain to function like it’s young again, he said.

While prevention is unproven for dementia, avoiding or treating high blood pressure, diabetes and high cholesterol promotes good heart health and can help reduce the risk of stroke and the development of vascular dementia, the second most common form of dementia behind Alzheimer’s. “You can bend the curve. If you exercise regularly, if you’re thoughtful a little bit, if you manage your other health problems, especially cardiovascular problems, that may help bend the curve,” said Dr. Anton Porsteinsson, of the University of Rochester Medical Center, a leading Alzheimer’s researcher.

“Maybe instead of you being 20 years out from clinical symptoms, you can bend the curve so you’re 25 or even 30 years out,” Porsteinsson said.