Can I prevent Dementia?

We cannot prevent someone from developing dementia any more than we can cure someone who has dementia. 

However, there are things that we can do to reduce our risk of developing the condition.  This is because the development of dementia is multifactorial.  This means that it is not one thing alone that causes someone to develop dementia, it is the coming together of the perfect mix of ingredients.

What are the Things Which Predispose to Dementia?

• Underlying heart disease. E.g. having had a heart attack, or angina.

• Underlying brain disease. E.g. traumatic brain injury, recurrent mini-strokes (transient ischaemic attacks) or haemorrhagic or ischaemic stroke.

• Diabetes or pre-diabetes (impaired glucose tolerance or insulin resistance).

• Genetics or family history of dementia.

• Getting older / ageing

What can you do to reduce the risk of dementia?

Obviously, we cannot alter our genetic risk in terms of our family history or our non-modifiable risk factors such as the fact we are getting older.

This means we have to identify our modifiable risk factors and address these.  Luckily for us, there are A LOT of different ways in which we can do this.  Some examples are:

• Protect your brain. E.g. wear a helmet when you ride a bike.

• Reduce your risk of heart disease and stroke by

o   Having a low-fat diet

o   Having a moderate salt intake

o   Maintain blood pressure within a normal range

o   Keeping cholesterol within a normal range and most importantly the ratio of the LDL (bad) to HDL (good) cholesterol within an appropriate limit.

o   Keeping alcohol consumption within the National Health and Medical Research Council’s Guidelines.

o   Maintaining a healthy weight (body mass index between 19 – 25 kg/m2 (within the healthy weight range) and a waist to hip ratio of 0.8 or less for women and 1.0 or less in men).

o   Not smoking

o   Eating 2 serves of fruit and 5 serves of vegetables per day.

o   Eating fish once per week.

o   Exercising regularly, at least 30 mins 5 times per week of aerobic exercise

o   Maintaining good muscle mass to maintain ability to mobilise / walk / socialise

·         Keep socially active

o   There has been good evidence to show that keeping regularly in touch with friends and family and participating in community activities is associated with a reduced risk of cognitive decline.

o   Examples of community activities are walking groups, dancing classes, community gardening, golf tournaments, bush walking.

o   Tennis and pickle ball have recently been shown to be excellent at reducing the risk of dementia.  It is thought that this is due to the combination of being physically active, being social and having to challenge yourself cognitively as you watch the ball, try to figure out where the ball will go next, where your feet need to move across the court and most importantly what the score is.

• Keep mentally active

o   Challenging your brain with learning and thinking.

o   Activities might include learning a new language, doing crossword puzzles, playing bridge, painting, or going to an art gallery.

• Protect your vision

  • New research shows a dramatic increase in the risk of dementia with vision loss, particularly due to cataracts and diabetic retinopathy.

  • The good news is that receiving treatment for these reduces your risk back down again

• Protect your hearing

  • There is also research to show increase in the risk of dementia with hearing loss.

  • It is likely that the loss of vision and hearing are associated with an increase in dementia risk as they increase social isolation.

  • The association between hearing loss and dementia is dose dependant with risk increasing between 4 - 24% with every 10 dB decrease in hearing ability.

  • The good news is that wearing hearing aids significantly reduces that risk.

• Look after your mental health

  • Depression is yet another risk factor for developing dementia. It is possible it may even double the risk.

  • It is thought that depression might result in lower self care and social isolation, both of which increase the risk of dementia independantly. It might also be a change in cortisol levels that is the problem in depression.

  • Treatment with lifestyle changes and antidepressants do reduce the risk of depression on developing dementia.

So, whilst there is no certain prevention or cure, there is a lot we can do to reduce our risk whilst also giving us the added bonus of reducing our risk of stroke, cancer, diabetes, and heart disease.  It will also improve the way we interact with our community.

References

1.      Better Health Channel [https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dementia-reducing-your-risk] (06/09/2024).

2.      Alzheimers Australia [https://www.alz.org/au/dementia-alzheimers-australia.asp#factors] (06/09/2024).

3. Attard, Mariella. Medical Republic, More ways to Reduce our Dementia Risk, 22 August 2024.