Dementia, the leading cause of death in the UK, affects nearly a million people nationwide. While new medications like Lecanemab and Donanemab offer hope, they're not yet available on the NHS.
However, recent research suggests that a significant portion of dementia cases could be prevented or delayed through lifestyle modifications.
In July 2024, 27 of the world's leading experts published a landmark paper in The Lancet, identifying 14 risk factors for dementia. Dr. Tim Beanland, head of knowledge at Alzheimer's Society, states, "The potential for prevention is high and, overall, nearly half of dementias could theoretically be prevented by eliminating these 14 risk factors. It is never too early, or too late to start reducing your dementia risk."
Samantha Benham-Hermetz at Alzheimer's Research UK adds, "Dementia devastates lives, and if nothing changes, one in two of us will be affected by it, either by developing it ourselves, caring for someone with it, or both. But it is not an inevitable part of ageing and research shows there is a way to shift the dial on these stark statistics."
Reducing vascular (blood vessel) damage
Preventing direct damage to the brain
Building up cognitive reserve (the mind's ability to resist damage)
This article will explore the various ways you can protect your brain and reduce your risk of dementia.
Traumatic brain injury (TBI) can increase the risk of or exacerbate dementia, by creating inflammation, atrophy of brain cells, and changes in proteins associated with diseases such as Alzheimer's.
Prevention strategies:
Wear a helmet when cycling
Follow concussion protocols in contact sports
Avoid alcohol-related falls or violence (the most common cause of TBI)
Cognitive stimulation throughout life, particularly from midlife onwards, is crucial for brain health.
Research-backed activities:
Learning new languages
Playing music
Reading
Doing puzzles
A study by the Karolinska Institute in Sweden found that a stimulating job can build up cognitive reserve, protecting the brain from decline. However, excessive stress can negate these benefits.
A review by University College London (UCL) concluded that people who are socially engaged when middle-aged and beyond are 30-50% less likely to develop dementia later on.
Depression and dementia have a complex relationship, potentially influencing each other. One theory suggests that depression could lead to reduced self-care, social isolation, and over-secretion of cortisol, leading to brain atrophy and inflammation.
Research has shown that treating depression in midlife may reduce future dementia risk. It's essential to watch for depressive symptoms and seek support when needed.
Hearing loss is linked to increased dementia risk, with the risk rising in line with severity.
Potential mechanisms include:
Reduced environmental stimuli leading to decreased cognitive reserve
Vascular disease affecting connections between the ear and brain
Social isolation and depression resulting from hearing difficulties
Prevention strategies:
Regular hearing checks
Protecting ears from loud noises
Using hearing aids when necessary
A study by the English Longitudinal Study of Ageing found that people who were obese and had a high waist circumference had a 28% increased risk of dementia.
Tips for maintaining a healthy weight:
Follow a Mediterranean-style diet rich in fruits, vegetables, and oily fish
Limit ultra-processed foods
Exercise regularly
Drink alcohol in moderation
Eat meals within a 10-hour window
High levels of LDL (low-density lipoprotein) cholesterol can increase the risk of stroke and protein buildup in the brain. A 2023 review found that each 1 mmol/L increase in LDL cholesterol was associated with an 8% increase in all-cause dementia.
Strategies to lower cholesterol:
Replace saturated fats with unsaturated fats
Increase exercise
Reduce alcohol consumption
Quit smoking
Select foods with added Plant sterols, or take a Plant sterol supplement.
Hypertension, particularly in midlife, is a risk factor for stroke and vascular dementia.
Tips for maintaining healthy blood pressure:
Regular blood pressure checks
Minimise alcohol consumption
Reduce salt intake
Exercise regularly
Prioritise sleep (aim for at least 7 hours per night)
Regular physical activity is crucial for reducing dementia risk. A 2022 review found that people who exercised regularly had a 17% lower risk of developing dementia compared to those who did not.
Recommended activities:
Aerobic exercise (walking, running, swimming, cycling)
Strength training (weightlifting, resistance exercises)
Daily activities (gardening, household chores)
Smoking directly increases the risk of developing cardiovascular problems linked to dementia. Stopping smoking can lower your risk at any age.
Emerging evidence also links air pollution to cognitive decline and dementia incidence. A study in Atlanta, Georgia, USA, found that higher exposure to traffic-related fine particulate matter was associated with increased amyloid plaques in the brain.
Tips for reducing exposure to air pollution:
Limit outdoor exercise on high pollution days
Walk on back streets instead of main roads
Keep car windows closed when driving in heavy traffic
Excessive alcohol consumption can damage nerve cells and reduce white matter in the brain.
Drinking more than 21 UK units per week in midlife is associated with an increased risk of all-cause dementia. The Lancet commission recommends limiting alcohol consumption to well under 10 units per week for optimal brain health.
Diabetes, particularly insulin resistance, is connected to a higher risk of dementia. The inflammation caused by diabetes is also associated with cognitive decline.
Strategies for diabetes prevention and management:
Adopt a low-carb diet, high in dietary fibre
Exercise regularly
Consider a low-calorie "soup and shake" plan for reversing type 2 diabetes (as prescribed by the NHS)
By implementing these evidence-based strategies, you can take proactive steps to protect your brain health and reduce your risk of dementia. Remember, it's never too early or too late to start making positive changes for your cognitive well-being.
1. Is dementia inevitable as we age?
No, dementia is not an inevitable part of aging. Research shows that nearly half of dementia cases could potentially be prevented or delayed through lifestyle modifications.
2. At what age should I start taking steps to prevent dementia?
It's never too early or too late to start reducing your dementia risk. However, many studies emphasise the importance of adopting healthy habits in midlife (40s to 60s).
3. Can exercise really help prevent dementia?
Yes, regular physical activity is one of the most effective ways to reduce dementia risk. Both aerobic exercise and strength training are beneficial for brain health.
4. How does diet affect dementia risk?
A healthy diet, particularly the Mediterranean diet, can help reduce dementia risk by promoting cardiovascular health and maintaining a healthy weight. Limiting ultra-processed foods and excessive alcohol consumption is also important.
5. How important is social interaction for brain health?
Social engagement is very important for cognitive health. Studies show that people who remain socially active in midlife and beyond have a significantly lower risk of developing dementia.
This article is for general information only and is not intended to treat or diagnose medical conditions. If in doubt please check with your GP first.
References:
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National Health Service. (2024). Dementia guide. https://www.nhs.uk/conditions/dementia/
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