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Who Is At Risk Of Developing Dementia

What Are The Causes Of Vascular Dementia

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After Alzheimers disease, vascular dementia is the most frequent cause of dementia, accounting for about 10 percent of all cases. Still, many experts believe that vascular dementia, like Alzheimers disease, is under-diagnosed.

Vascular dementia often coexists with other forms of dementia. Autopsy studies reveal that 50 percent of people with Alzheimers also had another form of dementia, most commonly vascular dementia. This is especially true of the oldest-old people who are 85 and above.

Vascular dementia is caused by impaired blood flow to the brain, which prevents brain cells from getting the oxygen and nutrients they need.

A stroke that blocks an artery in the brain has the potential to cause permanent damage and dementia. The severity of the stroke and its location in the brain determines its impact on thinking and reasoning.

Some strokes, called silent brain infarctions,” may not cause any obvious symptoms. However, the more strokes one has, the higher ones dementia risk.

Risk factors for vascular dementia overlap with those for heart disease and stroke. They include:

  • Age. Vascular dementia is rare before age 65 people in their 80s and 90s are most at risk.
  • History of heart attack, strokes, or mini strokes
  • Atherosclerosis . When cholesterol and other substances build up in the arteries, these plaques can narrow blood vessels, impeding blood flow to the brain.

What To Do If A Loved One Is Suspicious Of Having Dementia

  • Discuss with loved one. Talk about seeing a medical provider about the observed changes soon. Talk about the issue of driving and always carrying an ID.
  • Medical assessment. Be with a provider that you are comfortable with. Ask about the Medicare Annual Wellness exam.
  • Family Meeting. Start planning, and gather documents like the Health Care Directive, Durable Power of Attorney for Health Care, Estate Plan.

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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Improving The Quality Of Life Of People Living With Dementia And Caregivers

Research is underway at the University of British Columbia to learn how communities can reduce stigma and promote social inclusion of people living with dementia with support from CIHR. A team of academic researchers, people with dementia, and community partners are working together to develop practical guidelines to provide direction for communities to reduce stigma and promote social inclusion of people living with dementia.

Text box 4: Connecting the national dementia strategy to the dementia research effort

Dementia research in Canada and globally continues to inform activities being undertaken in support of implementing the national dementia strategy. These efforts include sharing research findings with the general population and at-risk populations, including through knowledge translation. A priority is placed on ensuring information is up to date and accurate, including on the Government of Canada dementia website, and presented in language that is accessible for the general population.

Federal departments and agencies, including PHAC and CIHR, maintain close collaboration to ensure that policy makers are informed of federally funded research activities. Members of the Ministerial Advisory Board on Dementiawho are researchers or who have a strong connection to dementia research also share information with PHAC on research developments.

What Are The Causes Of Lewy Body Dementia

How can I reduce my risks of developing dementia?

Lewy bodies are abnormal clumps of the protein alpha-synuclein that accumulate in neurons in the brain. Lewy body dementia can develop when these clumps impede normal brain function, affecting thinking, movement, behavior, and mood.

Researchers are still trying to understand what causes Lewy body dementia. Theyve begun to correlate the accumulation of alpha-synuclein with the loss of neurons that produce two important neurotransmitters: acetylcholine, which plays a key role in learning and memory, and dopamine, which is important for behavior, cognition, mood, movement, and more.

The brains of people with Lewy body dementia can also exhibit the beta-amyloid plaques and tangled tau strands found in the brains of people with Alzheimers.

Risk factors include:

  • Age. Most people who get this dementia are over 50.
  • Diseases and other health problems. People with Parkinsons disease or REM sleep behavior disorder are at higher risk.
  • Genetics. Lewy body dementia is not considered a genetic illness but having a relative with the disease seems to increase risk.

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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
  • Mid-life:
  • Diabetes
  • Air pollution
  • 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 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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    Risk Factors For Developing Dementia

    Dementia is one of the biggest challenges we face globally with around 55 million people living with the disease worldwide according to the World Health Organisation. This is expected to rise to 78 million in 2030 and 139 million in 2050.

    Additionally, studies show that dementia is now the most feared disease for the over 55 age group. Previously cancer took this title but advances in screening, surgery and drug therapies have changed the outlook for patients with cancer, leaving the outlook for dementia trailing behind.

    There are currently around 850,000 people with dementia in the UK. This is projected to rise to 1.6 million people in the UK living with dementia in 2040. However, due to the gradual nature of dementia, the mild early stage symptoms and the low diagnosis rate, this figure could be higher as it is difficult to know the exact number of people living with the condition.

    Although current therapies and drugs can only slow the progression of the disease and alleviate the symptoms, scientists are optimistic that new treatments will be developed within five years which will either halt or reverse dementia.

    Alzheimers disease is the most common form of dementia affecting more than 520,000 people in Britain.

    In 2021 more than 6 million Americans now have Alzheimers according to the Alzheimers Association. Almost two thirds of Americans with the disease are women.

    Can You Prevent Lewy Body Dementia

    40 y/o and below individuals with high blood pressure at a higher risk of dementia

    If you have a family history of Lewy body dementia or Parkinson’s disease, it’s understandable to be concerned about developing Lewy body dementia. Like other types of dementia, there’s not a guaranteed way to completely prevent Lewy body dementia. However, understanding the factors that increase the risk helps us identify opposing strategies that can decrease this likelihood, and these strategies are generally connected with better physical health, as well.

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    Treatment And Management Implications

    Currently, there are 35.6 million individuals with dementia worldwide and the associated costs in 2010 were more than 600 billion dollars. Dementia is projected to increase to 65.7 million by 2030 with associated costs expected to rise 85%. Thus, delaying dementia onset could prevent millions of cases and save billions of dollars.

    An alternative strategy to improving the course of cognitive decline with depression-interventions is an integrated treatment approach. A recent pilot study in this area has shown promising results, where addition of a cholinesterase inhibitor following antidepressant medication treatment in elderly depressed, cognitively impaired patients showed significant improvement in memory. Another approach may be to combine antidepressants with behavioral interventions that may protect against cognitive decline . A combined treatment approach of antidepressants, cholinesterase inhibitors, vitamins, and diet, lifestyle and exercise modifications has been found to protract cognitive decline over 24 months and improve memory and frontal lobe functions. Although testing the efficacy and effectiveness of such interventions is in its infancy, these integrated strategies hold great promise. Thus, future studies should continue to examine the implication for depression modification in clinical trials, focusing on whether simultaneous or subsequent interventions have additive or multiplicative effects on cognition.

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    Those that drank the risky level of eight units a week had a greater decline in short-term memory over the study period.

    This is likely to progress to dementia, said Dr Tony Rao, who led the study at King’s College London.

    Risky drinkers tended to be male, white British, married, be higher educated, to have depression and have a history of smoking.

    Dr Tony Rao, who led the study at King’s College London, said the findings were the most groundbreaking in 20 years of research looking into the link between alcohol and dementia.

    The consultant psychiatrist warned its not just people who appear to be binge drinkers that are at harm.

    He told the Daily Mail: Scoring above the cut-off point for risky drinking does not just apply to heavy or binge drinkers.

    For example, it is possible even if someone is drinking two units of alcohol the equivalent of a pint of beer or small glass of wine four times a week.

    This may seem surprising and dispels the myth that alcohol is somehow good for the brain.

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    World Health Organization Guidelines

    These WHO Guidelines, published in May 2019, provide the knowledge base for health-care providers to advise people on what they can do to reduce their risk of cognitive decline and dementia.

    The reduction of risk factors for dementia is one of several areas of action included in WHOs Global action plan for the public health response to dementia.

    What Do We Know About Reducing Risk For Dementia

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    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.

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    Annual Spotlight: Highlights Of Canadas Dementia Research

    Canadian researchers have been at the forefront of efforts to find effective ways to prevent and treat dementia and to improve the quality of life of people living with dementia and caregivers. Through the Canadian Institutes of Health Research , the federal government has invested over $200M over the last 5 years to support dementia research in Canada, some of which is described below. CIHR collaborates with partners across the country who are helping to put Canada at the forefront of dementia research. Many of these partners are also supporting research projects outside of what is highlighted here.

    In June 2019, the Canadian Consortium on Neurodegeneration in Aging entered Phase II of its work with a renewed investment over five years. A major strategic initiative of the Canadian Institutes of Health Research since 2014, this pan-Canadian research network brings together more than 300 researchers and clinicians to advance an ambitious program of research that aligns with the national dementia strategys objectives of prevention, treatment, and quality of life. Through its research activities, the CCNA has made a commitment to meaningfully engage people living with dementia, support research on dementia care for Indigenous people, and conduct work in priority areas such as women and dementia. CCNA researchers continue to work on research ideas across each objective of the national dementia strategy such as those highlighted below.

    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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    Depression And Risk Of Dementia

    Most previous studies have examined late-life depression or depressive symptoms and risk of dementia, while a few studies have considered earlier-life depression. Given the variable nature of depression onset, the high occurrence of depression in young adulthood and middle age, and the long preclinical period of dementia, studying earlier-life depression may offer an opportunity to determine if depression is a risk factor of dementia, years before the syndrome starts. On the other hand, a significant relationship of late-life depression and dementia may allow for better study of depression as part of the prodromal stage of dementia. As such, studies focusing on both earlier- and late-life depression may provide complementary evidence.

    What Are Risk Factors

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    • 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!

    Risk factors

    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.

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    Dementia Prevention: Reduce Your Risk Starting Now

    Dementia is defined by loss of memory, problems with thinking and reasoning, and an inability to carry on with work and life activities independently. There are several kinds of dementia. Alzheimers disease is the most common, but for up to a third of people with dementia, even some of those diagnosed with Alzheimers, vascular disease is a major cause.

    The good news is you can lower your risk of dementia. A Johns Hopkins neurologist, explains how.

    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:

    • diabetes

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