Risk Factors For Dementia
Researchers have identified several risk factors that affect the likelihood of developing one or more kinds of dementia. Some of these factors are modifiable, while others are not.
Age. The risk of Alzheimer’s disease, vascular dementia, and several other dementias goes up significantly with advancing age.
Genetics/family history. Researchers have discovered a number of genes that increase the risk of developing Alzheimer’s disease. Although people with a family history of Alzheimer’s disease are generally considered to be at a heightened risk of developing the disease themselves, many people who have relatives with Alzheimer’s disease never develop the disease, and many without a family history of the disease do get it.
In most cases, it is impossible to predict a specific person’s risk of the disorder based on family history alone. Some families with Creutzfeldt-Jakob disease, Gerstmann-Sträussler-Scheinker syndrome, or fatal familial insomnia have mutations in the prion protein gene, although these disorders can also occur in people without the gene mutation. Individuals with these mutations are at significantly higher risk of developing these forms of dementia.
Abnormal genes are also clearly implicated as risk factors in Huntington’s disease, FTDP-17, and several other kinds of dementia.
Many people with Down’s syndrome show neurological and behavioral signs of Alzheimer’s disease by the time they reach middle age.
What Are Risk Factors
- Risk factors are aspects of your lifestyle, environment and genetic background that increase the likelihood of getting a disease.
- Risk factors on their own are not causes of a disease. Rather, risk factors represent an increased chance, but not a certainty, that dementia will develop.
- Similarly, having little or no exposure to risk factors does not necessarily protect a person from developing dementia.
There are some risk factors that can be changed, and some that cannot â read on to know which are which!
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.
Limitations Of The Review And Risk Of Bias Within And Across Studies
The broad search and systematic methodology of this review is likely to have identified all the available literature. Our exclusion of studies without dementia as their outcome resulted in the exclusion of high quality studies examining the association between environmental risk factors and, for example, cognition or brain structure . Such studies may shed some light on the pathogenesis of dementia since cognitive or brain changes are important features of dementia but they are not specific to this syndrome. We excluded papers measuring levels of a particular substance in brain areas or in serum since these physiological changes could not be directly linked to environmental exposure. Our other exclusion criteria are unlikely to have resulted in the exclusion of relevant papers or introduced bias. As mentioned above, we did exclude papers examining the effect of rurality or urbanicity since we have previously reviewed this literature and found in a meta-analysis an increased risk of dementia in rural areas, particularly living in rural areas early in life . One unavoidable bias is that, despite the projected increase in dementia rates occurring disproportionately in low-to-middle income countries , the majority of the research was conducted in high-income countries.
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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 .
What Can You Do
Although there is no effective treatment or proven prevention for Alzheimers and related dementias, in general, leading a healthy lifestyle may help address risk factors that have been associated with these diseases.
Researchers cannot say for certain whether making the above lifestyle changes will protect against dementia, but these changes are good for your health and are all part of making healthy choices as you age.
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Guidelines Assess Strength Of Evidence
These guidelines review existing evidence on the most significant lifestyle-related risk factors for dementia and take each of these factors into account when issuing recommendations for prevention.
The authors aimed the recommendations at healthcare providers worldwide, but they hope that the guidelines will present a reliable source of information for governmental organizations too, helping them draft better prevention and care policies.
In the next 30 years, the number of people with dementia is expected to triple, warns the WHO Director-General Dr. Tedros Adhanom Ghebreyesus.
We need to do everything we can to reduce our risk of dementia. The scientific evidence gathered for these guidelines confirm what we have suspected for some time, that what is good for our heart, is also good for our brain, Dr. Ghebreyesus adds.
In their new guidelines, the WHO evaluate 12 possible risk factors for dementia and offer advice on how to address each of them.
These possible factors are: low levels of physical activity, smoking, a poor diet, alcohol misuse, insufficient or impaired cognitive reserve , lack of social activity, unhealthy weight gain, hypertension, diabetes, dyslipidemia , depression, and hearing loss.
While the WHO used the guidelines primarily to issue recommendations on how to address each of these potential factors, they also considered whether there is sufficient, strong evidence that tackling these risk factors can help stave off dementia.
How Are People Diagnosed With Vascular Dementia
If you or someone you love has concerns that they may have any type of dementia or vascular dementia, make an appointment with the individuals general practitioner. An early diagnosis of dementia of any kind can be beneficial to the individual. A diagnosis can help clarify a persons symptoms, provide access to early treatment and support, and allow them to prepare for changes in the future. Lifestyle changes and treatment can slow down the progression of symptoms for some individuals who are diagnosed with vascular dementia.
The physician will review a patients medical history, including questions about high blood pressure, diabetes, and dementia or cardiovascular disease in family members. A physical exam will help determine if a persons symptoms are impeding their life. Labs can also help to assess blood glucose, cholesterol, and homocysteine levels, as well as testing blood pressure. And a test of mental abilities will help find subtle changes or struggles. A general practitioner may refer their patient to a specialist who can run a broader range of tests to assess their symptoms in more detail.
If a patient is suspected of having vascular dementia, a brain scan can find changes in the brain. A CT or MRI can rule out issues, such as a brain tumor or build-up of fluids. A brain scan can also show brain tissue damage due to a stroke or series of smaller strokes, which can help to diagnose vascular dementia.
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Risk Factors You Can Change
Changing some facets of your lifestyle may decrease your risk of developing dementia. The Mayo Clinic reviews these pieces, and some of the steps a person can take in order to decrease their risk.
- Alcohol Use: Moderating alcohol intake can decrease the chance of a dementia diagnosis. Any abuse of alcohol can increase this risk.
- Blood pressure: Any blood pressure deviation from the norm may put you at risk for developing dementia. Further, high blood pressure can lead to a stroke, which can lead to vascular dementia.
- Cholesterol: High levels of LDL, or âbad” cholesterol, have been linked with a significant increase in developing vascular dementia.
- Depression: Especially in senior men, depression has been shown as an indicator a person might develop Alzheimer’s disease.
- Diabetes: Individuals with type 2 diabetes are at an increased risk for developing both Alzheimer’s disease and vascular dementia.
- High Estrogen Levels: For women, high estrogen levels indicate a greater risk of being diagnosed with dementia.
- Homocysteine Blood Levels: A type of amino acid in the body, elevated levels of homocysteine may increase your likelihood of a dementia diagnosis.
- Smoking: Smoking increases the risk of vascular disease, putting you at greater risk of vascular dementia. Quitting smoking helps significantly decrease this risk over time.
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Aluminum In The Environment
Aluminum has a non-metallic form that makes up eight per cent of the earth’s surface. In small amounts, aluminum is referred to as “trace elements”, and occur naturally in the foods we eat, in our drinking water and are even added to the water treatment process in some municipalities.
Trace elements of aluminum may also be found in:
- Many processed foods
- Cosmetics and personal hygiene products, such as deodorants and nasal sprays
- Some drugs in order to make them more effective or less irritating
- The air we breathe from dry soil, cigarette smoke, pesticide sprays and aluminum-based paint.
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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.
Myth: My Loved Ones Behaviors Such As Wandering And Agitation Are Caused By The Disease
REALITY: Dementia changes how a person understands and responds to the world around them. However, a lot of behaviors common to dementia are triggered by something in the environment, such as body language, obstacles, light and shadows, and more. Like you, people with dementia respond to whats around them, but because of their dementia, their responses may not be what you expect.
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What Is Vascular Dementia
Vascular dementia is a form of dementia caused by damage from impaired blood flow to the braineither a partial or complete blockage from a blood clot. Vascular dementia often develops after a stroke blocks an artery to the brain or a series of minor, asymptomatic strokes. Vascular dementia can also occur after major surgery, like a heart bypass, or caused by damaged blood vessels and reduced circulationeven for a short timethat deprives the brain of much-needed oxygen and nutrients.
Symptoms are often described as memory loss, problem-solving issues, inability to plan, or poor judgment and reasoning. Symptoms and changes in behavior often depend on the size and location within the brain that is damaged. If a large area of the brain is affected, symptoms may occur suddenly. An individual can experience more significant gaps in memory or, in some cases, are unable to function normally. But for other individuals, vascular dementia may go unnoticed at first because symptoms may gradually appear over time.
Reducing Your Risk For Dementia
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As you age, you may have concerns about the increased risk of dementia. You may have questions, too. Are there steps I can take to prevent it? Is there anything I can do to reduce my risk? There are currently no approaches that have been proven to effectively treat or prevent Alzheimers disease and related dementias. However, as with many other diseases, there may be steps you can take to help reduce your risk.
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Whats Next With Dementia Prevention Research
More research is needed to find ways to help prevent Alzheimers and related dementias. Future research may determine that specific interventions are needed to prevent or delay the disease in some people, but others may need a combination of treatments based on their individual risk factors. Understanding risk factors and choices you can make now is important for both your present and future health. In addition to this website, consider the resources listed below to learn more.
You can also help researchers learn more about preventing dementia by participating in clinical trials and studies. Search the Alzheimers.gov Clinical Trials Finder to find studies that need volunteers.
Do: Get Some Exercise
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A systematic review of studies relating smoking and dementia found that when you remove those studies funded by the tobacco industry, smokers have a significantly greater risk of dementia.
This is probably because smoking is related to cardiovascular disease and high blood pressure, which could cause damage to blood vessels in your brain.
If you’re a smoker right now, I have good news: There’s some evidence that if you quit smoking your dementia risk will go back to that of a nonsmoker.
Verdict: Strong evidence that smokers are more likely to get dementia.
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Age And Immune Response In Ad
What seemed like a farfetched idea a few years ago is now a well established fact in AD: inflammatory and immune responses have a significant role in its development and progression. Several of the genetic loci associated with AD risk contain genes with known roles in inflammation, the complement system and the immune response in general . Pathway analyses of GWAS data have identified the immune response as important in AD, and an integrated network analysis of genome and transcriptome data identified the immune and microglia module as significant for AD and TYROBP as the driver gene for this module .
Microglial activation and monocyte/macrophage-mediated inflammatory responses are currently particularly interesting areas of research on AD. To evaluate the relationship between known AD risk loci, Chan et al. recently conducted a protein quantitative trait analysis in monocytes and showed that the NME8 risk allele influences protein tyrosine kinase 2 , the CD33 risk allele influences triggering receptor expressed on myeloid cells 2 and the TREM1 risk allele is associated with a decreased TREM1/TREM2 ratio. Interestingly, the authors also uncovered potential differences associated with age in the expression of genes in the TREM locus. TREM1 expression was found to increase with advancing age in younger but not in older individuals, and TREM1 variants were found to affect TREM2 expression in younger but not older people .
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 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.