Saturday, July 30, 2022

10 Ways to Prevent or Delay Dementia

by Burcin Ikiz Ph.D. 
Reviewed by Gary Drevitch

A couple of months ago, a friend contacted me for a scientific consultation. Her father was recently diagnosed with Alzheimer’s, and she wanted my opinion on available therapies and ongoing clinical trials. As I tried to answer her questions to the best of my knowledge, I noticed something else on her mind that she was keeping quiet about. When I asked her about it, she sheepishly replied: “I don’t want to sound selfish, but seeing my dad like this makes me wonder whether I will get this horrible disease too one day. Is there anything I can do to prevent it?” I told her that her question was not selfish at all. I had also wondered the same thing over the last year as I had observed my grandmother with dementia.

Dementia is an umbrella term for a group of incurable neurological disorders, including Alzheimer’s, characterized by cognitive impairment, such as memory loss and judgment. More than 55 million people worldwide are currently living with dementia. Scientists project this number to triple by 2050, which means that we will all know someone with this condition and will inevitably ask the same question as my friend: What can I change in my life today to reduce my risk for dementia?

Unfortunately, some risk factors are not changeable. These include age (more than 22% of people over 85 in the U.S. are living with dementia), genes (40-65% of people diagnosed with Alzheimer's have the APOE4 gene), and family medical history. However, recent scientific studies show that we can protect our brain from dementia by eliminating or modifying other risk factors, which account for more than 40% of cases, with our lifestyle choices. Moreover, researchers show that these modifications do not have to be significant, life-altering events. Even small changes starting at any stage of life can be effective. It is never too early or too late for dementia prevention, but consistency is key.

Here are the 10 steps we can take at any age to reduce our risk for dementia.

1. Keep active and exercise regularly. Of all the lifestyle changes studied, regular physical activity seems to be the best one to prevent dementia. Cardiovascular risk factors, such as obesity, insulin resistance (i.e., diabetes), hypertension, and high LDL cholesterol, are all linked to increased risk for dementia. Meta-analyses of multi-year longitudinal studies have shown that exercise not only improves cardiovascular health but also significantly improves memory and reduces the risk for dementia. 

2. Follow a heart-healthy diet. Specific heart-healthy diets characterized by a high intake of vegetables, legumes, fruits, nuts, cereals, and olive oil and low intake of saturated fats and meats, such as the Mediterranean and MIND diets, have been shown to protect against cognitive decline. Moreover, a study that analyzed the diets of more than 5,000 elderly people in the U.S. found that the individuals who followed these diets showed more than a 30% lower risk of cognitive impairment.

3. Quit smoking. We all know that smoking is bad for us and causes premature death. Additionally, scientists have found that smokers are at higher risk for dementia than non-smokers. The good news is that stopping smoking even late in life can reduce this risk.

4. Limit alcohol consumption. High alcohol use is associated with brain changes, cognitive impairment, and dementia. The effects of moderate drinking, on the other hand, have been less clear. The general recommendation by experts is to reduce alcohol consumption as much as possible, especially in mid-life, to minimize the risk of developing age-related conditions, such as frailty and dementia.

5. Engage in cognitive activities. Scientists have found less education to be the earliest risk factor for dementia, affecting an individual's cognitive reserve later in life. Similarly, in mid-to-late life, engaging in mentally stimulating activities, such as learning a new language or playing a musical instrument, was associated with improved memory, reduced cognitive decline, and a lower risk for dementia.

6. Manage depression and anxiety. Depression is common among those with dementia. While some studies suggest that it is one of the early symptoms of dementia in older adults, several meta-analyses have found that depression precedes dementia and increases its risk two-fold. Similar analyses have found that anxiety also increases the risk of dementia by 57% among the elderly. Treating these conditions can help prevent the onset of dementia.

7. Be socially involved. Scientists consider social contact, measured by the amount of one's social activity and the extent of their social network, a protective factor against dementia. A meta-analysis of 51 long-term studies looking at the cognition and social isolation of more than 10,000 participants aged 50 or older has found that increased social contact led to a better late-life cognitive function. Being an active community member and maintaining close relationships benefit mental, physical, and brain health.

8. Prevent head injuries. Traumatic brain injuries, usually caused by traffic accidents, military exposure, recreational sports, and falls, are associated with an increased risk of dementia. In a study of early-onset Alzheimer’s patients, a stronger risk was found closer to the time of an injury, resulting in the earlier disease onset. Also, the worse the head injury was, the higher the risk of the disease. Taking safety precautions to protect your head, such as wearing a helmet and preventing falls, can significantly lower this risk.

9. Get sleep. Studies show that sleep disturbances, broadly defined as poor sleep quality, inadequate duration, insomnia, and obstructive sleep apnea, are associated with an increased risk of Alzheimer’s disease and other dementias. Getting 7-8 hours of deep and restorative sleep can be protective against these disorders.

10. Treat hearing loss. While hearing impairment is common in the aging population, studies suggest that diminished hearing is a significant risk factor for dementia, even at very low levels, possibly due to reduced cognitive stimulation. Fortunately, an emerging body of research shows that treating the loss with hearing aids is protective against cognitive decline.

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