Experts Discuss Dementia Risks and Brain Health Amid Miki Berkovich’s Diagnosis

The recent revelation that former professional athlete Miki Berkovich is battling severe dementia has sparked widespread concern and questions about brain health protection. Berkovich, known for his lifelong dedication to fitness and healthy living, was reported by his family to have shown initial symptoms during the COVID-19 pandemic, including visual disturbances and disorientation, progressing to cognitive decline requiring 24-hour care. Media reports suggest his diagnosis is dementia with Lewy bodies (DLB), a lesser-known form of dementia characterized by abnormal protein deposits affecting cognition, movement, sleep, and autonomic functions.

Dr. Osnat Raziel, director of the multidisciplinary center at Assuta Ramat Hahayal, explains that dementia is not a single disease but a group of neurodegenerative conditions, with Alzheimer’s being the most common. DLB differs from Alzheimer’s in that memory loss may not be the first symptom; instead, patients often experience visual-spatial difficulties, fluctuating cognition, vivid visual hallucinations, Parkinsonism-like symptoms, and REM sleep behavior disorder. DLB and Parkinson’s disease dementia share biological features related to alpha-synuclein protein accumulation.

Despite Berkovich’s healthy lifestyle, experts emphasize that dementia risk is multifactorial, involving age, genetics, brain biology, vascular health, environment, and lifestyle. While a healthy lifestyle cannot guarantee prevention, it can reduce risk. Approximately 45% of dementia cases are linked to modifiable factors such as education, hearing loss, high LDL cholesterol, hypertension, obesity, diabetes, smoking, physical inactivity, depression, head trauma, excessive alcohol, social isolation, air pollution, and untreated vision problems.

Recent intervention studies like the U.S. POINTER trial demonstrate that comprehensive lifestyle programs combining physical exercise, cognitive and social activities, and cardiovascular risk management can improve cognitive function in at-risk older adults. Current recommendations to protect brain health include aerobic and strength training exercises, managing vascular risk factors, quitting smoking, treating hearing and vision impairments, adopting a Mediterranean diet, engaging in lifelong learning, maintaining social connections, ensuring quality sleep, and preventing head injuries.

While no cure exists for DLB or other dementias, modern multidisciplinary treatments can improve symptoms and quality of life. Medications may help cognition and behavioral symptoms, but some drugs, especially antipsychotics, can worsen DLB symptoms and require careful use. Early and accurate diagnosis is crucial for tailored treatment and family support, which is vital as dementia affects both patients and caregivers. New Alzheimer’s drugs targeting amyloid protein are not currently indicated for DLB.

The case of Miki Berkovich highlights that even optimal health habits do not confer immunity from neurodegenerative diseases, but prevention efforts remain essential to delay onset and preserve brain function. Recognizing early cognitive changes and seeking medical evaluation can lead to better management and improved outcomes.