Not Eating Enough Fat
You may be on a fat-free diet or skimp out on fat because like many people, you believe it will cause you to gain weight. But eating the right types and amount of fat will not only keep you at a healthy weight, but it can protect your brain too. People who consumed more fat than carbohydrates were 42 percent less likely to develop cognitive impairment.
Risk Factors That Cannot Be Controlled
- age the incidence of Alzheimers disease increases with age, with one in 30 Australians aged 70 to 74 years estimated to have dementia, increasing to one in eight aged 80 to 84 years and one in three of those aged 90 to 94 years
- genetics the genetics of dementia is not fully understood, but there are inherited genes in some forms of dementia, including familial Alzheimers disease, Down syndrome and familial frontotemporal dementia.
Multidomain Measures And Risk Profiling
A number of dementia risk prediction models have been developed to determine dementia risk in middle-aged or older adults . The validity of most risk models is unknown, as is the degree to which they can be appropriately used in different populations. Prediction models which have been validated in multiple samples include the Cardiovascular Risk Factors, Aging and Dementia score , the Australian National University Alzheimers Disease Risk Index , and the Brief Dementia Screening Indicator . Basic characteristics of these models are shown in Table . The CAIDE score assesses long-term risk of dementia in middle-aged adults, whereas the ANU-ADRI and the BDSI predict medium-term AD and dementia risk respectively in older adults. The overall accuracy of these risk prediction models is moderate , indicating that, although they can be improved upon, they can also generate useful predictions. It is notable that 10 of the 12 modifiable risk factors for dementia included in the 2020 Report of the Lancet Commission are included in these models . The only modifiable risk factors identified in that report which are not currently included are hearing loss and air pollution.
Table 2 Comparison of selected dementia risk models
Heart Risk Factors That Can Be Controlled
- Blood pressure untreated high blood pressure is associated with an increased risk of developing dementia. Effective long-term treatment can reduce dementia risk
- Body weight obesity in midlife is associated with an increased risk of developing cognitive impairment and dementia
- Cholesterol A history of high cholesterol is associated with an increased risk of developing dementia
- Diabetes type 2 diabetes in midlife and later is associated with an increased risk of developing cognitive impairment and dementia
- Smoking smoking is a risk factor for dementia and some studies have shown that a history of passive smoking may also increase dementia risk.
What Are The Most Common Types Of Dementia
- Alzheimers disease. This is the most common cause of dementia, accounting for 60 to 80 percent of cases. It is caused by specific changes in the brain. The trademark symptom is trouble remembering recent events, such as a conversation that occurred minutes or hours ago, while difficulty remembering more distant memories occurs later in the disease. Other concerns like difficulty with walking or talking or personality changes also come later. Family history is the most important risk factor. Having a first-degree relative with Alzheimers disease increases the risk of developing it by 10 to 30 percent.
- Vascular dementia. About 10 percent of dementia cases are linked to strokes or other issues with blood flow to the brain. Diabetes, high blood pressure and high cholesterol are also risk factors. Symptoms vary depending on the area and size of the brain impacted. The disease progresses in a step-wise fashion, meaning symptoms will suddenly get worse as the individual gets more strokes or mini-strokes.
- Lewy body dementia. In addition to more typical symptoms like memory loss, people with this form of dementia may have movement or balance problems like stiffness or trembling. Many people also experience changes in alertness including daytime sleepiness, confusion or staring spells. They may also have trouble sleeping at night or may experience visual hallucinations .
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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.
Adjustment For Informative Attrition
Of the 1,701 participants in the longitudinal analyses, over 5 years, 278 participants died, and 122 dropped out because of illness a further 308 relocated or dropped out for other reasons .
In the post hoc joint models, adjusting for informative dropout, risk of dementia incidence was increased with borderline significance by smoking , APOE*4 genotype , ApoA1 , and ApoB . Among those with dementia onset at age 87 years or younger, smoking significantly increased risk of incident dementia. APOE*4 increased risk with borderline significance ApoA1 decreased risk with borderline significance. As in the previous models, no risk or protective factors were found among those with dementia onset age after 87. Thus, selective attrition does not explain why no risk factors could be found in the later-onset group.
Refitting the joint models excluding the 4 cases who progressed directly from CDR 0 to 1, smoking became a significant risk factor and ApoA1 became a significant protective factor , while HDL was a borderline significant protective factor.
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When It Isnt Dementia After All
While dementia often goes unreported and undiagnosed, depriving people who need help from getting it, there are situations in which people who appear to have dementia actually dont.
The reason is that certain conditions such as depression, delirium, side effects from medications, thyroid problems, certain vitamin deficiencies, and excessive alcohol use can cause dementia-like symptoms.
One meta-analysis found that 9 percent of people who appeared to have dementia did not but were instead experiencing other potentially treatable or reversible conditions.
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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Modifiable Risk Factors To Reduce Dementia Risk
Excessive alcohol intake, head injury, and air pollution are among the newest dementia risk factors added to the Lancet Commission report.
Lon Schneider, MD
An update to the Lancet Commission report on dementia prevention, intervention, and care published by 28 world-leading dementia experts and presented at the 2020 Alzheimer’s Association International Conference annual meeting, July 2630, outlines 12 potentially modifiable risk factors to prevent or delay up to 40% of cases of dementia.1
Presented at AAIC 2020 by Lon Schneider, MD, co-director of the University of Southern California Alzheimer Disease Research Center, and professor of psychiatry and neurology at Keck School of Medicine, the authors found that 9 potentially modifiable risk factors for people in low income and middle income countries together are associated with 35% of the population attributable fraction of dementia worldwide. Among them are less education, high blood pressure, obesity, hearing loss, depression, diabetes, physical inactivity, smoking, and social isolation, assuming causation.
Mid-life hearing loss
Traumatic brain injury
Findings from a Danish cohort study showed an increased risk for dementia and Alzheimer disease in those who experienced TBI. Dementia risk was highest in the 6 months after TBI and increased with number of injuries in people with TBI .
What Increases The Risk For Dementia
- AgeThe strongest known risk factor for dementia is increasing age, with most cases affecting those of 65 years and older
- Family historyThose who have parents or siblings with dementia are more likely to develop dementia themselves.
- Race/ethnicityOlder African Americans are twice more likely to have dementia than whites. Hispanics 1.5 times more likely to have dementia than whites.
- Poor heart healthHigh blood pressure, high cholesterol, and smoking increase the risk of dementia if not treated properly.
- Traumatic brain injuryHead injuries can increase the risk of dementia, especially if they are severe or occur repeatedly.
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Exposure To Bdz Assessment In Included Studies
None of the included studies focused on a single class or category of BDZ. Patients were classified as being exposed to BDZ if they took any BDZ for a prespecified duration. However, the included studies performed ad-hoc analyses according to various categories of BDZ. The method of exposure assessment differed across the included studies. The use of BDZ was analyzed using medical records in five of the six case-control studies, and self-reported in the sixth study, while medical records were used in two of the four cohort studies, with self-reporting in the other two. Further information about the BDZ use and assessment is given in Table 1 and and22.
Study Setting And Participants
The participants were drawn from the Betula Prospective Cohort Study, a longitudinal population-based study in the Umeå municipality in Sweden. For a detailed description of the Betula projects procedure and design, see Nilsson et al. . In short, the Betula study began in 1988 and includes six samples and six test waves , approximately 5 years apart: 19881990 , 19931995 , 19982000 , S3, S4), 20032005 , 20082010 , and 20132014 . All participants in the Betula project were randomly selected from the population registry, stratified by age and gender.
The present study initially included 2,066 participants, aged 60 years, and over at study baseline. All the included participants belonged to samples S1 to S5. The baseline for this study was set to test Wave 3 , and test Wave 4 as a depression scale was introduced in the Betula project at that time, and we wanted to include depression as a covariate in our analyses, since it typically correlates with loneliness .
Excluded participants were those that had a follow-up time of less than 1 year from the study baseline , incomplete information on the questionnaire regarding loneliness , or unknown dementia status at follow-up, e.g., due to moving from the catchment area . This left a final sample for the present study comprising 1,905 participants.
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Skimping On Foods With Fat
Eating fat doesn’t necessarily make you fat it might protect your body and your brain. People who eat a higher-fat diet tend to eat less carbs, particularly processed carbs, which can cause inflammation that leads to dementia, says Perlmutter. In fact, people who consumed high levels of fatmore than a third of their total calorieswere 42% less likely to experience cognitive impairment than those whose diets contained less than a quarter of fat, according to a 2012 Mayo Clinic study.
Aim to keep your carb intake below 50% of your total calories, and focus on good-for-you, heart-healthy fats such as those found in olive oil, flaxseed, nuts, and fatty fish like salmon.
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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Your Brain Is Your Most Valuable Asset
Being brain healthy is relevant at any age, whether you are young, old or in between. However, it is particularly important once you reach middle age as this is when changes start to occur in the brain.
The risk factors for dementia are different in everybody.
Your potential for developing dementia may be influenced by:
Non-modifiable risk factors are risks that cannot be changed, such as:
- age as you age, your risk of developing dementia increases
- genetics there are a few very rare forms of dementia associated with specific genes
- family history a family history of dementia increases your risk of developing dementia but at this stage it is not clear why.
Modifiable risk factors are risks that can be changed through lifestyle choices. You can reduce your risk of dementia by looking after your:
Whilst we cannot change getting older, genetics or family history, scientific research suggests that changing certain health and lifestyle habits may make a big difference to reducing or delaying your risk of developing dementia.
Its never too early or too late to start.
Health Conditions And Diseases
There are a number of health conditions and diseases that can increase a person’s risk of dementia.
A cardiovascular disease is a disease that damages the heart or makes it harder for blood to circulate around the body. CVD can greatly increase a persons risk of developing dementia. This means that most risk factors for CVD are also risk factors for dementia.
The main CVD risk factors that are known to increase a persons risk ofgetting dementia are:
- rheumatoid arthritis
- kidney disease.
Downs syndrome and other learning disabilities greatly increase a persons risk of developing young-onset dementia, usually caused by Alzheimers disease.
Effects of air pollution
Certain forms of air pollution increase a persons risk of dementia. These include very small particles from traffic fumes and from burning wood in the house, for example in a fireplace. If a person breathes in these particles, the particles may cause damage to blood vessels in the persons brain, as well as a build-up of substances that can cause Alzheimers disease.
Unfortunately it is difficult for a person to reduce their exposure to polluted air. Governments need to develop better environmental policies to reduce air pollution, such as banning heating fuels that produce lots of smoke particles.
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Avoid Excess Alcohol Consumption
Drinking an excessive amount of alcohol can damage your brain and increase your risk of dementia. Long-term excessive alcohol consumption can cause brain damage and lead to a condition called alcohol-related dementia. It may also increase the risk of Alzheimers disease and other dementias.
National physical activity and sedentary behaviour guidelines for Australian adults
- are active every day in as many ways as you can
- think of movement as an opportunity, not an inconvenience
- incorporate movement and activity into your normal daily routine
- are active with a friend or family member
- choose activities you enjoy
- if you can, enjoy regular vigorous exercise for extra health and fitness.
Look After Your Heart
Research shows that people who have high blood pressure, high cholesterol, diabetes, or are obese, particularly around middle age, have a greater risk of developing dementia later in life. Leaving these conditions untreated can lead to damaged blood vessels in the brain, which in turn damages brain cells and leads to impaired thinking functions.
Although there are no guarantees that keeping your heart healthy will prevent dementia, you will give yourself the best chance of avoiding or delaying dementia.
Promisingly, studies have shown that the treatment of high blood pressure reduces that risk. Other studies indicate that treating high cholesterol and diabetes may also reduce the risk of developing dementia, although more research is needed in this area.
It is recommended you have regular check-ups to assess your:
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Dementia Increases The Risk And Severity Of Covid
People with dementia have a higher risk of getting COVID-19, are more likely to require hospitalization, and are more likely to have severe or fatal cases of this disease compared with people without dementia. This risk is even higher in Black patients with dementia, according to a new study funded in part by NIA and published in Alzheimers & Dementia.
A persons age and preexisting health conditions such as asthma, diabetes, heart disease, and obesity are significant risk factors for serious illness from COVID-19. Interestingly, these factors are also linked to dementia. However, scientists and doctors have little information about how COVID-19 affects people who have dementia. The new study, led by researchers at Case Western Reserve University, used information from the electronic health records of about 61.9 million U.S. adults from all 50 states to explore the link between dementia and COVID-19. The data was collected as part of the IBM Watson Health Explorys database. In this dataset, more than 1 million patients had dementia, 15,770 had COVID-19, and 810 had both.
This research was supported in part by NIA grants AG057557 and AG062272.