Dementia is a general term for the loss of memory and intellectual abilities. Alzheimer’s disease is the 6th leading cause of death in the U.S., and the most common form of age-related dementia, contributing to 70% of the almost 50 million cases worldwide. Alzheimer’s and other forms of dementia are expected to dramatically increase as the population ages, with some estimates predicting 150 million cases by 2050. While there is currently no cure for dementia, a large body of research suggests that modifiable risk factors may hold the most promise for prevention of the progressive decline in mental function due to generalized brain deterioration.
No strategies are guaranteed to protect long term brain health. However, researchers have reviewed a large body of evidence, and have identified nine controllable risk factors, through various stages of life, that affect the likelihood of developing dementia. The study, recently published in The Lancet, brought together 24 international experts to review existing dementia research and determine strategies for prevention and intervention. As well, they looked for ways to improve care for those already living with the disease. While the focus has been on developing medicines for prevention and treatment, non-pharmaceutical preventative approaches that strengthen brain networks early in life may help reduce dementia cases by one-third.
Alzheimer’s causes a gradual decline in memory, thinking, and reasoning skills. There’s no question that many more trials and ongoing research into developing treatments is necessary, yet the researchers considered the scientific evidence strong enough to suggest that preventing dementia and age-related cognitive decline might be possible. Of course, there are no guarantees, and prevention needs to start before there are signs of decline, preferably before middle age.
The nine modifiable risk factors that affect the likelihood of developing dementia are:
- Hypertension management. Controlled blood pressure levels aid in preserving brain blood vessel health. This is considered most effective when initiated early on in life, but management of blood pressure is advised at every age.
- Increased physical activity. Aerobic exercise is associated with a reduced risk of cognitive impairment and dementia. Vascular risk factors are well known to be reduced by aerobic exercise. Evidence suggests that physical activity may slow the progression of neurodegenerative processes and age-related loss of synapses in the brain.
- Cognitive training. Mental stimulation that challenges the brain helps to strengthen the brain’s networks. Getting a good education in early life, and continuing at least through high school, may have a direct effect on the wiring of the brain. Challenging the brain may increase “cognitive reserve” built through a lifetime of continued learning and curiosity. Research has shown that those with greater cognitive reserve are better able to fend off degenerative brain changes.
- Lose weight if needed. Being overweight or obese at midlife independently increases the risk of dementia, Alzheimer’s, and vascular dementia in later life.
- Prevent or control diabetes. Studies suggest that people with type 2 diabetes are at a higher risk of developing Alzheimer’s and vascular dementia. Taking steps to manage diabetes may help to avoid potential cognitive decline.
- Avoid or address hearing loss. It remains unclear whether hearing loss is the result of changes linked to dementia or whether hearing loss itself contributes to cognitive decline. Research suggests that those who experience hearing loss may be at greater risk of cognitive problems later in life than those without auditory problems.
- Manage depression. Depression has been proposed as both a risk factor for and an early symptom of dementia. Approximately half of those with late-onset depression have cognitive impairment.
- Remain socially active. Studies show that social interaction is key to mental health, and that those with larger social networks are 25 percent less likely to develop dementia than those with smaller networks.
- Quit smoking. Smoking is damaging to cardiovascular and overall health and may lead to cognitive decline. Studies show that smokers have a 40 percent increased risk of Alzheimer’s and vascular dementia. Smoking causes oxidative stress, which appears to promote the formation of the amyloid plaques and neurofibrillary tangles in the brain that are closely associated with Alzheimer’s disease.
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Defeating Alzheimer’s disease and other dementias. http://www.thelancet.com/commissions/dementia
One-third of dementia cases could be prevented, report says. http://www.cbsnews.com/news/one-third-of-dementia-cases-could-be-prevented-alzheimers-report/
10 Early Signs and Symptoms of Alzheimer’s. http://www.alz.org/10-signs-symptoms-alzheimers-dementia.asp
2016 Alzheimer’s Statistics. http://www.alzheimers.net/resources/alzheimers-statistics/
Can Dementia Be Prevented? Education May Bolster Brain Against Risk. http://www.npr.org/sections/health-shots/2016/02/11/466403316/can-dementia-be-prevented-education-may-bolster-brain-against-risk
What is cognitive reserve? http://www.health.harvard.edu/mind-and-mood/what-is-cognitive-reserve
Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3258000/
Midlife overweight and obesity increase late-life dementia risk. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100125/
Diabetes and Alzheimer’s linked. http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/diabetes-and-alzheimers/art-20046987?pg=2
The complex relationship between depression and dementia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3039168/
Friends Make You Smart. http://www.aarp.org/health/brain-health/info-11-2008/friends-are-good-for-your-brain.html
Smoking and Dementia: What to Know. https://www.healthafter50.com/memory/article/smoking-and-dementia-what-to-know