There has been a significant rise in the cases of dementia in recent years. The word 'Dementia' describes the symptoms of a decline in brain function. Needless to say, it is a significant health risk that can reduce your quality of life and cause cognitive and mental difficulties.
It includes neurodegenerative diseases causing memory loss and cognitive impairment and impacting day-to-day living, communicative skills as well as behavioral and personality changes.
Evidence suggests several modifiable risk factors in early life, such as lesser education, and in mid-life such as hearing loss, hypertension, traumatic brain injury, obesity, and alcohol misuse. And in later life, such as smoking, physical inactivity, depression, diabetes, social isolation, and air pollution can contribute greatly to increased dementia risk.
There are several risk factors for dementia. Some of them only slightly increase the risk for a person, while others make the probability of the person developing the condition much higher. However, the most significant risk factors for dementia are ageing and genes.
A person's risk of getting dementia can also be increased by their gender and sex, ethnicity, amount of cognitive reserve, i.e., the ability of their brain to cope with the disease, other health conditions (if any), lifestyle factors such as social isolation, smoking and excessive alcohol use, exposure to air pollution etc. While risk factors for dementia like aging and genes can’t be avoided, there are a lot of risk factors that can be avoided or at least decreased by making healthy life choices, such as not drinking too much alcohol or quitting smoking.
A person can deal with diseases in their brain and build up by keeping the brain active over a lifetime. The more cognitive reserve a person has, the longer it takes for any disease in their brain to cause problems with everyday tasks.
It means people with a larger cognitive reserve can delay the start of dementia symptoms for longer. People with a smaller cognitive reserve are at a greater risk of getting dementia in their lifetime. The three most important factors that can lead to a smaller cognitive reserve are:
Those who left school at an early age are more likely to have a smaller cognitive reserve (probably a reason why certain ethnic groups and women are more vulnerable) than those who stayed in full-time education for longer or continued learning throughout their lives.
Those who have not used a range of mental skills during their lifetime of work, such as memory, problem-solving, reasoning, communication and organizational skills, are more likely to have a smaller cognitive reserve.
Those who have not interacted much with other people during their life may also have a smaller cognitive reserve. While most people's cognitive reserve is built up during their early years, there are many things they can do to increase their cognitive reserve later in life, such as staying mentally and socially active.
Lifestyle Diseases like Diabetes and Cardiovascular diseases: Cardiovascular disease (CVD) damages the heart or makes it harder for blood to circulate in the body and can increase the risk of dementia.
Most of the risk factors for CVD are also risk factors for dementia, such as high blood pressure, increasingly stiff and blocked arteries (atherosclerosis), high blood cholesterol levels, obesity, type 2 Diabetes and being physically unfit. CVD risk factors can also increase the risk of Alzheimer’s disease.
Most people can avoid these CVD risk factors by making positive lifestyle changes and by contacting organizations that provide support.
Some ethnic groups may generally have less access to education and work opportunities than others leading to a smaller cognitive reserve and increased risk of dementia.
People living in deprived areas have limited access to primary resources and services, such as suitable housing, education and work opportunities. Lack of further education and access to jobs that keep a person mentally active throughout their life with higher levels of air pollution and lesser access to healthcare and social care can lead to dementia.
If the hearing of a person gets worse in mid-life, their risk of developing dementia when they get older increases. It happens because those with hearing loss are more likely to withdraw from social situations and become more isolated over time, which reduces their cognitive reserve and makes it harder for other mental processes to work correctly.
Moreover, diseases that cause dementia can also affect hearing. According to studies, getting regular hearing tests done as they get older and using a hearing aid can reduce the risk of dementia.
Traumatic brain injuries (TBIs) can start a process in the brain where the substances that cause Alzheimer’s disease build up around the injured area.
TBIs in younger people are mostly caused by road traffic accidents, active service in the armed forces, an object accidentally hitting their head, sports such as boxing, football, cycling, rugby, skiing and horse riding, and can increase the risk of developing dementia when they get older.
People who experience periods of depression in their lives also have a higher risk of developing dementia. Because depression has harmful long-term effects on the brain where a person thinks and copes with problems on the way.
Thus, preventing depression from happening is likely to decrease the risk. Vice versa, dementia itself may be the cause of depression in some cases.
Some long-term medical conditions, such as multiple sclerosis, HIV, and rheumatoid arthritis may also increase the risk of developing dementia later in life.
Small particles from traffic fumes or burning wood in a fireplace may cause damage to blood vessels in a person’s brain, as well as a build-up of substances that can cause Alzheimer’s disease. Governments need to develop better environmental policies to reduce air pollution, such as banning heating fuels that produce lots of smoke particles.
A lot of evidence suggests that the following lifestyle choices can affect the risk of developing dementia.
Being physically inactive can damage the health of a person’s heart, lungs and blood circulation and make their blood sugar control poor. It, in turn, increases the risk of stroke, heart disease, and type 2 diabetes, which are all risk factors for dementia.
Smoking damages a person’s heart, lungs and blood circulation, especially the blood vessels in the brain. It causes harmful substances to build up in the brain that causes inflammation and prevents enough oxygen from reaching the nerve cells. These substances also increase the risk of stroke which can lead to vascular dementia.
A diet lacking a good range of healthy foods may increase the risk of dementia for many reasons, such as high blood pressure which is a risk factor for dementia. Too much salt (more than a tsp per day) is also associated with high BP and therefore a higher risk of dementia.
Drinking regularly above the recommended quantity of alcohol exposes the brain to high levels of toxic substances that can damage nerve cells over some time. The recommended quantity of alcohol per week is 14 units, spread over at least three days rather than all at once. Drinking very high levels of alcohol over a long period also increases the risk of Korsakoff’s syndrome and alcohol-related brain damage, which increases the risk of dementia.
There are no sure-shot ways to prevent all types of dementia, as researchers are still investigating how the condition develops. However, there is good evidence that a healthy lifestyle can help reduce your risk of dementia when you are older by one-third.
A healthy lifestyle can also help prevent cardiovascular diseases, such as stroke and heart attacks, which are risk factors for Alzheimer's disease and vascular dementia. Therefore, something good for your heart is also good for your brain.
It means that you can help reduce your risk of dementia by eating a healthy and balanced diet, maintaining a healthy weight, exercising regularly, keeping alcohol within recommended limits, stopping smoking and keeping your blood pressure at a healthy level as follows:
A diet high in saturated fat, salt, and sugar and low in fiber can increase your risk of high cholesterol, high blood pressure, obesity, and type 2 diabetes. Low levels of Vitamin B12 can induce symptoms like memory loss and aggravate the development of dementia.
An ideal diet comprises lots of wholegrain cereals, fruits and vegetables, low-fat dairy, fish, beans and pulses, and less red or processed meats like sausages, ham or bacon. Mediterranean and DASH diets have proven to be particularly helpful in reducing the risk of dementia.
Being overweight can increase your blood pressure and the risk of type 2 diabetes which are linked to a higher risk of Alzheimer's disease and vascular dementia. Use the healthy weight calculator to check if your weight is within the healthy range. If you are overweight, even losing 5% to 10% of the excess weight can help reduce your risk of dementia.
A lack of regular physical activity can increase your risk of heart disease, obesity, and type 2 diabetes, which is all linked to a higher risk of dementia. Older adults who do not exercise are also more likely to have problems with memory or thinking as it slows down the brain.
Doing at least 150 minutes of moderate-intensity aerobic activity each week, such as brisk walking, cycling or dancing or strengthening exercises such as gardening or yoga at least twice a week, sitting lesser and trying to get up and move around regularly, taking the stairs, walking up escalators, and making phone calls while standing up and meditation will reduce your risk greatly.
Not only is it vital to keep our brains sharp and in shape as we age, but exercising releases good endorphins, elevates your heart rate and promotes blood flow to the brain, which keeps the brain healthy.
Drinking excessive amounts of alcohol increases your risk of stroke, heart disease, and certain cancers, besides damaging your nervous system, including your brain. Sticking to the recommended limit of drinking no more than 14 units of alcohol a week spread over three or more days and having several alcohol-free days each week will lessen your risk.
Smoking causes your arteries to become narrower, which can raise your blood pressure. It also increases your risk of cardiovascular disease as well as several types of cancer. So, kicking the butt is the best way out!
Low mood, anxiety or untreated depression can affect your ability to be socially active and engage in mentally stimulating activities. The pandemic has made people experience extreme isolation with negative health effects, especially on cognitive health. Social isolation is acutely related to declining cognitive health.
Not only does prolonged isolation increase the risk of stress and anxiety, but it also affects brain health, thus, increasing the risk of developing dementia early on.
Gratitude, a positive outlook and engaging in social activities within the communities can be good ways to connect and stay physically and mentally healthy. These should be continued even into the golden years of life.
Lack of sleep is extremely bad for health. It makes you grumpy and tired, besides negatively impacting the brain and accelerating the rate of development of dementia. It lowers your energy levels and doesn't give time for the body's vital organs, including the brain time to recharge well.
Moreover, lack of sleep can result in difficulties in memory thinking, retention and cognition and causes different areas of the brain to shrink. So, sleep well for better brain health and lower the risk of dementia.
Thank you John Francis for contributing this article.