Preventing Dementia

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  Volume 16, Number 11                                                                 

          One of the most important health goals for adults as they get older is to preserve and maximize cognitive function, as avoiding the development of dementia is a priority. The bad news is that no one strategy or intervention, or combination of strategies, has been shown to be 100% effective in preventing dementia, in part because genetics affect susceptibility to certain types of dementia. The good news is that a number of preventable risk factors for dementia have been identified.

            In August 2020, an article in The Lancet added 3 additional preventable risk factors to the 9 that had been previously identified in the 2017 report, The Lancet Commission on Dementia Prevention, Intervention, and Care. It is believed that approximately 40% of dementia cases around the world can be attributed to these factors. Following are the 12 preventable risk factors for dementia:

  • Having little or no education
  • Hypertension
  • Untreated hearing impairment
  • Smoking
  • Obesity
  • Depression
  • Physical inactivity
  • Diabetes
  • Low social contact
  • Head injuries
  • Excessive alcohol consumption
  • Air pollution exposure in later life

          Note that many of the items on this list are related to having a healthy lifestyle. The phrase, “what’s good for the heart is good for the brain,” has a strong evidence base.

          In July 2020, research published in Neurology found that periodontal disease is associated with increased risk for dementia. Regular brushing and flossing are important habits for decreasing oral infections and risks associated with such infections.

          Depression is one of the risk factors on The Lancet list above. Related to this, research published in Alzheimer’s & Dementia, also in July 2020, described an association of repetitive negative thinking with the development of amyloid and tau proteins in the brain, markers of Alzheimer’s disease. Repetitive negative thinking is a common feature of anxiety and mood disorders, but can be modified and lessened.

          The risk factors mentioned here are not intended to be an exhaustive list of what can be done behaviorally to reduce susceptibility to dementia. The composition of one’s diet, sleep patterns, and regular cognitive engagement/challenge are examples of other factors that have been studied.

          Negative stereotypes about aging are common, including the notion that one cannot have control over cognitive changes. The truth is that there are many steps that adults can take to reduce risk for cognitive decline.

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