Major Risk Factors For Dementia: Age Genetic And Others
General health risk factors for life are aspects that increase your likelihood of developing a disease.
These can be related to genetic, lifestyle, and environmental risks. And when it comes to developing dementia, there are several known factors. Some of these drastically increase your chances of developing dementia, while others only slightly increase your risk of developing it.
The biggest risk factors for developing dementia are your age and genes, which cannot be changed. Since some risk factors cannot be changed, it becomes of utmost importance to avoid and eliminate secondary factors that could contribute to the development of dementia.
Lets understand the major risk factors in detail.
Funding Details And Requirements
PHAC is anticipating funding up to 9 projects. The recipient will receive up to $375,000 in fiscal year 2022/23 and up to $341,000 in fiscal year 2023/24. The total maximum funding available over fiscal years 2022/23 and 2023/24 is $716,000.
Projects funded under the DSF may be invited to share information with the Canadian Dementia Learning and Resource Network , which is a closed community of practice for community-based projects funded by PHAC’s Dementia Community Investment .
Age: The Biggest Risk For Dementia
Age is the greatest risk factor for developing dementia. As with our genes, we unfortunately cant do anything to overcome ageing! However, there are environmental factors that seem to influence the likelihood of dementia and could account for about one-third of the overall risk of developing dementia. There is some evidence to suggest we can take steps to lessen the impact of these factors.
Data source: NATSEM calculations using ABS population projections
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What Are The Signs And Symptoms Of Dementia
Because dementia is a general term, its symptoms can vary widely from person to person. People with dementia have problems with:
- Reasoning, judgment, and problem solving
- Visual perception beyond typical age-related changes in vision
Signs that may point to dementia include:
- Getting lost in a familiar neighborhood
- Using unusual words to refer to familiar objects
- Forgetting the name of a close family member or friend
- Forgetting old memories
- Not being able to complete tasks independently
Risk Factors And Prevention
Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of biological ageing. Further, dementia does not exclusively affect older people young onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of cognitive decline and dementia by being physically active, not smoking, avoiding harmful use of alcohol, controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels. Additional risk factors include depression, social isolation, low educational attainment, cognitive inactivity and air pollution.
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Body Risk Factors That Can Be Controlled
- alcohol too much alcohol can damage your brain and lead to an increased risk of developing dementia
- diet the available evidence suggests a healthy diet can play a role in promoting brain health
- physical activity regular physical exercise is associated with better brain function and reduced risk of cognitive decline and dementia.
Cross Sectional Versus Longitudinal Studies
Studies with a longitudinal design are preferred over studies with a cross sectional design for several reasons. It is conceivable that information about risk factors may be systematically different between patients and controls. Patient data must come from a proxy, who might recall the medical history differently than a proxy of a control or the control himself. In addition, prevalence is determined by both the number of new cases over a given period of time, and by the duration of survival once patients have the disease. In analogy, findings of cross sectional studies can reflect the contribution a risk factor makes to developing dementia as well as to surviving after the dementia starts.
Another important issue in this respect is that risk factors may change over time. The impact of environmental factors, such as smoking, diet, physical activity, and vascular disease, may change over time both within an individual and across birth cohorts. Risk factors such as blood pressure change with ageing. Furthermore, the disease, once it has started, may in turn influence the risk factor. For example, the diet of a demented individual may change, when the person forgets to eat his or her meals on a regular basis. Therefore, the relationship between a risk factor and disease may differ depending on the age the risk factor is measured relative to the outcome.
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Pooled Estimates Of Prevalence
In 2000, prevalence data from 11 European population based studies were pooled to obtain stable estimates of prevalence of dementia in the elderly . Age standardised prevalence was 6.4% for dementia , 4.4% for AD, and 1.6% for VaD. Prevalence of dementia was higher in women than in men and nearly doubled with every five year increase in age: 0.8% in the group age 6569 years and 28.5% at age 90 years and older . Of all dementia cases, 54% suffered AD. Prevalence of AD showed the steepest increase with age, from 0.6% in the group age 6569 years to 22.2% in the group aged 90 years and older. VaD accounted for 16% of cases, and prevalence increased with age from 0.3% to 5.2% . More recently, prevalence rates for dementia were compared among 12 population based European studies. Crude prevalence rates varied between 5.9% and 9.4% . Again, an almost exponential increase with age and a female excessmostly after age 75was described.
Pooled prevalence of dementia by sex. Based on Lobo et al.
What Are The Risk Factors For Dementia
A dementia diagnosis can be difficult for the whole family to deal with, not just the patient themselves. After a diagnosis, its natural to search for an explanation for why this has happened, and whether theres anything that could have been done to prevent it. Its also natural to worry whether the rest of the family is now at risk.
As theres currently no cure for dementia, its important to be aware of the potential risk factors for dementia, so you have the knowledge you need to make any lifestyle changes you feel are necessary.
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Gender And Hormonal Effects
Even when controlling for differences in longevity, several studies have found that women are at increased risk for Alzheimer’s disease. This is complicated by the observation that men have a greater risk of developing vascular dementia, which may lessen the likelihood of developing pure Alzheimer’s disease. Gender-related differences in risk could be at least partly ascribed to hormonal factors, as several studies suggest that oestrogen replacement can prevent or delay the onset of Alzheimer’s disease. A 16-year follow-up of nearly 500 women found that hormone replacement therapy produced a 54% reduction in risk of Alzheimer’s disease . However, a recent trial exploring the value of therapeutic oestrogen in subjects with Alzheimer’s disease was unable to demonstrate any improvement in cognition or disease progression . Oestrogen may be implicated in Alzheimer’s disease in several ways, for example, via reduction in -amyloid deposition, improvement in cerebral blood flow, neuroprotection or suppression of ApoE.
How To Reduce The Risk Of Dementia
There are many studies that are ongoing into how people can reduce their risk of dementia, and its hoped that therell be increased understanding of how the condition develops in the near future.
People aged 40-74 who dont have any pre-existing conditions are entitled to a free NHS Health Check every five years to monitor factors such as your weight and blood pressure, which may help you to identify your risk factors for dementia.
And while its important to avoid known risk factors for dementia such as smoking and drinking too much alcohol, there are other lifestyle changes you can try to help manage your risk of dementia.
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Assessing Risk Factors In The Clinic
When assessing cognitively unimpaired users in BHSs, consideration of their modifiable lifestyle and clinical risk factors and their genetic profile can inform personalized and targeted dementia prevention interventions.
Assessing potentially modifiable risk factors
The potentially modifiable risk factors to be assessed in BHSs are shown in Table , along with examples of methods to assess these factors in a clinical setting.
Table 1 Assessment of potentially modifiable risk factors in Brain Health Services
Assessing genetic risk factors
Isnt Dementia Part Of Normal Aging
No, many older adults live their entire lives without developing dementia. Normal aging may include weakening muscles and bones, stiffening of arteries and vessels, and some age-related memory changes that may show as:
- Occasionally misplacing car keys
- Struggling to find a word but remembering it later
- Forgetting the name of an acquaintance
- Forgetting the most recent events
Normally, knowledge and experiences built over years, old memories, and language would stay intact.
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Modifiable Risk Factors That Could Reduce Dementia Globally By 40%
12 risk factors have been identified which, if mitigated, could reduce future cases of dementia by 40% globally. Some are more difficult than others to avoid but there are things that you can do to reduce your risk of dementia.
The 12 risk factors are:
- Early life:
- Less education higher and longer lasting education is proven in improve cognitive performance
In countries such as the United States, UK and France, cases of dementia in older people seem to be falling slightly in part due to better lifestyle in early age and better treatment of heart disease.
Here are some changes you can make:
- Aim to maintain systolic blood pressure of 130 mm Hg or less from the age of 40.
- Encourage use of hearing aids for hearing loss and reduce hearing loss by protecting ears from high noise levels.
- Reduce exposure to air pollution and second-hand tobacco smoke.
- Prevent head injury .
- Limit alcohol intake to no more than 21 units per week .
- Stop smoking and support others to stop smoking.
- Lead an active life into mid-life and possibly later life.
- Reduce obesity and the linked condition of diabetes.
What Can Care Workers Do
Care workers can play a positive role in helping to reduce the risk by encouraging the people they support to do a range of things.
Eat a healthy, balanced diet: You can suggest healthy options when supporting people in shopping or when preparing meals. Try to make food as appealing as possible and dont overload the plate. Variety and providing food on a little and often basis is usually better. Helping the person to have regular drinks is very important too soups, smoothies, jellies and other liquid foods are all good as well as standard drinks. For more on this, see the section on Eating well.
Give up smoking: This can be hard, particularly if the person has been smoking for a long time. As a care worker, you can encourage and support the person by providing leaflets and information and by checking whether there are any local support services to help people stop smoking.
Reduce alcohol consumption: Care workers can play a role in encouraging people to drink sensibly and avoid over-consumption of alcohol. Alcohol is a mind-altering substance that can affect peoples ability to carry out everyday tasks. Brain cells can be damaged by alcohol, making this a risk factor for dementia.
Exercise regularly: Care workers can encourage exercise in a number of ways, for example by taking a person out for walks, helping them in the garden or encouraging them to keep active in the house by carrying out regular household jobs.
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Working With First Nations Inuit And Mtis Communities
The impact of colonization on First Nations, Inuit and Métis in Canada has had a devastating impact on health and wellness. As a result, First Nations, Inuit and Métis in Canada face specific challenges and have unique experiences with the social determinants of health. Organizations led by First Nations, Inuit and Métis in Canada, and organizations with strong partnerships with First Nations, Inuit and Métis communities are encouraged to submit funding request proposals.
How To Reduce Your Risk Of Dementia Or Delay Its Impact
Unfortunately, there are some risk factors you cant change, these include:
Age: people diagnosed with dementia tend to be over the age of 65. Above this age, a persons risk of developing Alzheimers disease or vascular dementia doubles roughly every five years. Over the age of 80 there is a one in six chance of developing dementia.
Ethnicity: certain ethnic communities appear to be at higher risk of dementia than others. For example, South Asian and African or African-Caribbean people seem to develop dementia more often than white Europeans. Specific risk factors associated with these communities such as stroke, diabetes, hypertension and cardiovascular disease, as well as differences in diet, smoking, exercise and genes, are thought to explain this.
Gender: more women are affected by dementia than men. Worldwide, women with dementia outnumber men two to one. Twice as many women over the age of 65 are diagnosed with Alzheimers than men whereas vascular dementia is diagnosed in slightly more men than women.
Genetics: in rare cases, Alzheimers disease can be passed from one generation to another. This type of dementia usually affects people under the age of 65.
However, although getting older is undeniably the biggest risk factor for dementia, research suggests up to one in three cases of dementia are preventable. Modifiable risk factors include:
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What Do We Know About Reducing Risk For Dementia
The number of older Americans is rising, so the number of people with dementia is predicted to increase. However, some studies have shown that incidence rates of dementia meaning new cases in a population over a certain period of time have decreased in some locations, including in the United States. Based on observational studies, factors such as healthy lifestyle behaviors and higher levels of education may be contributing to such a decline. But the cause and effect is uncertain, and such factors need to be tested in a clinical trial to prove whether they can prevent dementia.
A review of published research evaluated the evidence from clinical trials on behavior and lifestyle changes to prevent or delay Alzheimers or age-related cognitive decline. The review found encouraging but inconclusive evidence for three types of behavioral changes : physical activity, blood pressure control, and cognitive training. The findings mean that interventions in these areas are promising enough that researchers should keep studying them to learn more. Researchers continue to explore these and other interventions to determine whether and in what amounts or forms they might prevent dementia.
Watch a video below that highlights conclusions and recommendations from the research review.
More Useful Links And Resources
Risk factors.Alzheimer Society of Canada, 2021. Read about risk factors for dementia in our downloadable, print-friendly infosheet. This sheet also contains strategies and lifestyle changes that can help you reduce your risk of developing dementia.
Understanding genetics and Alzheimer’s disease.Alzheimer Society of Canada, 2018.In our downloadable, print-friendly infosheet, learn more about the role that genetics plays as a risk factor for dementia, and find out whether you should pursue genetic testing.
Risk factors and prevention. Alzheimer’s Society UK. This comprehensive webpage from the Alzheimer’s Society UK has some helpful nuggets of research and advice related to reducing your risk of dementia.
Tobacco use and dementia. World Health Organization , 2014. This report from the WHO details the evidence behind smoking tobacco as a risk factor for dementia.
Women and Dementia: Understanding sex/gender differences in the brain. brainXchange, 2018. This webinar discusses understandings of sex and gender, sex differences in Alzheimerâs disease, how the higher number of women with Alzheimer’s may be due to both, and a discussion of the role of estrogen in the health of brain regions associated with Alzheimerâs disease. In partnership with the Alzheimer Society of Canada and the Canadian Consortium of Neurodegeneration in Aging .
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Risk Factors For Vascular Dementia
Research into dementia has concentrated on Alzheimer’s disease, and much progress has been made in revealing possible genetic and neuropathological mechanisms. However, over the past few years there has been renewed interest in vascular dementia, the only preventable type of dementia. This highlights the importance of identifying potential modifiable risk factors. Unlike Alzheimer’s disease, which is primarily a cortical dementia, and progressive supranuclear palsy, Parkinson’s disease and Huntington’s disease, which are all subcortical, vascular dementia can be cortical , subcortical or both cortical and subcortical.
The prevalence of dementia would appear to be constant worldwide, but the type of dementia varies from country to country. Alzheimer’s disease is generally accepted as the most common type of dementia in the Western world, whereas vascular dementia is more common in Asian countries .
Vascular dementia accounts for 2448% of dementing illnesses in older people, with an incidence of 610 in 10 000 per year in those aged over 70 years. Prevalence varies from 1.2% to 4.2% of those aged 65 years or above, increasing with age. There would appear to be a slight male preponderance. The average duration of the illness is 5 years and survival is less than that for Alzheimer’s disease .
Clinical diagnosis requires the presence of: dementia cerebrovascular disease and a temporal relation between vascular disease and dementia.
Oxidative And Inflammatory Stress
Increased levels of oxidative stress are a biochemical feature of Alzheimer’s disease. Trials of the antioxidants vitamin E and selegiline showed a delay in nursing home placement compared with patients receiving placebo. However, there was no effect on cognition . Oxidative changes may constitute a response rather than a cause. The same may apply to the described inflammatory changes within the Alzheimer brain. It is hypothesised that -amyloid excites an immune response via microglial cell activation. Anti-inflammatory drugs may inhibit this response and delay nerve cell damage. Several studies have reported that intake of non-steroidal anti-inflammatory drugs is negatively associated with the risk of developing Alzheimer’s disease . As with all casecontrol studies, confounding bias may weaken interpretations. Alzheimer’s disease patients may be less likely to receive NSAIDs because they are less able to complain of pain. In the central nervous system, cyclooxygenase-2 is present both in neurons and in reactive microglial cells. Therefore, COX-2 inhibition may favourably affect neuronal function as well as inflammation. Clinical trials involving selective COX-2 inhibitors in Alzheimer’s disease are underway.
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