Preventing Dementia: Actions You Can Take Today for Brain Health

A few decades before my Grandfather was put into care for dementia, he would often entertain us with funny stories. One, in particular, jumps out at me of how he had punched someone in his dream and wound up throwing an actual punch that knocked him out of his bed. As kids, it was just another funny thing that my Pop used to do. Or was it? Years later, a study came out stating that one of the earliest indicators of developing Lewy body dementia is acting out your dreams. Every year, researchers discover more and more early indicators of dementia and, therefore, preventative measures to support brain health and reduce the risk of dementia.

Dementia isn’t just one disease. It’s a term for a group of symptoms that happen if someone has certain diseases like Alzheimer’s. These symptoms come from changes in the brain. They can make it hard to think clearly, do daily tasks, or live independently. Dementia also affects how people feel, behave, and interact with others.

Dementia affects not only those who have it but also their caregivers, families, and society, impacting them physically, emotionally, socially, and financially. Many people don’t understand dementia well, which leads to stigma and makes diagnosis and care harder. While cases of dementia can’t be prevented or cured yet, avoiding certain risk factors can help keep your brain healthy as you get older and reduce the risk of developing dementia.

One report claims that a whopping 45% of dementia cases could be prevented or delayed by focusing on 14 risk factors. While people are living longer and dementia cases are expected to increase everywhere, there’s a big chance to prevent and manage dementia better if we address these risk factors, even for those with a high genetic risk.

At what age does dementia usually start?

For the majority of individuals with Alzheimer’s, specifically the late-onset type, symptoms typically manifest in their mid-60s or later. However, if the disease emerges before age 65, it is classified as early-onset Alzheimer’s, which, though uncommon, can start as early as a person’s 30s.

Risk Factor: Not Completing Secondary Education 

Skipping high school raises the chances of getting dementia. Having less education can make people more prone to losing their brain health because they have less “cognitive reserve.” This reserve helps keep the brain working well even as it ages or if there are problems. On the other hand, learning throughout life is good for the brain, and being mentally active in middle or old age can delay memory and thinking issues. Even if someone has less education, having a mentally challenging job can reduce the risk of dementia.

What You Can Do: Keep your brain active! Read, study a new language, learn a musical instrument, do a short course. Find ways to keep your brain muscle active and those neurons firing throughout your life.

Risk Factor: Hearing loss 

Many studies suggest that there is a link between hearing loss and dementia. Research shows that for every 10-decibel drop in hearing, the risk of dementia increases by four to twenty-four percent. This might be because hearing loss helps cause dementia, or maybe dementia changes the brain and affects hearing, or both. Hearing loss can also lead to feeling lonely or depressed, which can increase the risk of dementia. The good news is that hearing loss can be improved with hearing aids. A recent study found that people with hearing loss who use hearing aids have a lower chance of cognitive decline and dementia.

What You Can Do: Have your ears checked regularly and consider medical intervention for any hearing loss. If you are younger, protect your hearing by wearing earplugs to loud concerts and venues. If you listen to music with headphones or earbuds, practice safe listening habits. According to the World Health Organization, more than one billion young adults are at risk of permanent hearing loss due to unsafe listening habits. By 2050, it’s predicted that one in ten people will suffer from significant hearing loss. To protect your hearing, set a maximum volume limit on your phone, and try not to listen for too long. If your earbuds have a noise-canceling feature, use it, especially in noisy environments. A useful guideline is the 60-60 rule: listen at no more than 60% of the maximum volume for no more than 60 minutes at a time.

Risk Factor: High LDL cholesterol

Back in 2020, when the Lancet Commission on dementia shared their findings, they weren’t sure if LDL cholesterol was linked to dementia. But now, studies show that having high LDL cholesterol in middle age might increase the risk of getting dementia. Extra cholesterol in the brain can lead to a higher chance of strokes and the buildup of harmful substances related to Alzheimer’s disease, like amyloid and tau. On the other hand, people who used drugs to lower cholesterol didn’t have a higher risk of dementia. This highlights the importance of managing high LDL cholesterol for both heart and brain health.

What You Can Do: Keep an eye on your cholesterol levels with blood tests. To lower LDL cholesterol, be sure to exercise regularly, eat plenty of fiber, and get plenty of omega-3 and extra virgin olive oil into your diet. Work with your healthcare provider if you need medications that control cholesterol levels. 

Risk Factor: Depression 

People with depression are more likely to get dementia than those without it. This link is seen at all adult ages but is strongest for depression in middle age. Depression could raise dementia risk by boosting stress hormones, lowering brain-friendly protein levels, and shrinking the hippocampus, which is important for memory. People treated for depression using medicine, therapy, or both are less likely to develop dementia than those who aren’t treated, showing why it’s important to address depression for brain health.

What You Can Do:  Build a support network for your mental health. If you are struggling with depression, work with a healthcare provider for the appropriate treatment, whether that be medication, therapy, or a combination.

Risk Factor: Traumatic brain injury

Traumatic brain injuries can happen from car, motorcycle, or bicycle accidents, military events, boxing, other contact sports, and falls. Research suggests these injuries might increase the risk of dementia and could cause it to start earlier by two to three years compared to people without such injuries. 

What You Can Do: To help prevent traumatic brain injuries, the Centers for Disease Control and Prevention suggest always wearing a seat belt in cars and wearing a helmet when engaging in activities that require it. Keeping your surroundings safe to avoid falls is also crucial.

Risk Factor: Physical Inactivity 

Staying active at any age helps keep your brain sharp and can lower the risk of dementia. Exercise benefits brain health in many ways: it reduces inflammation, boosts blood flow, helps release a protein important for brain cells, and improves heart and metabolic health. 

What You Can Do: The World Health Organization suggests adults do 150 to 300 minutes of moderate exercise (or 75 to 150 minutes of intense exercise) weekly, plus muscle-strengthening activities at least twice a week.

Risk Factor: Diabetes 

New research shows that getting type 2 diabetes in middle age is linked to a higher risk of dementia, but this isn’t true for those who get it later in life. Both type 2 diabetes and dementia have things in common, like problems with insulin, brain health and metabolism, blood vessels, inflammation, and stress in the body. 

What You Can Do: To manage diabetes, it’s important to eat healthy, exercise, and keep a healthy weight, and then use medications if needed.

Risk Factor: Smoking 

Cigarettes and their smoke have over 4,700 chemicals, and some are very toxic. Studies show that smokers are more likely to get dementia and have up to a 79% higher risk for Alzheimer’s disease. The good news is that quitting smoking can lower your risk of getting dementia, as some studies found no higher risk in people who used to smoke.

What You Can Do: At the risk of stating the obvious, stop smoking. Seems these addictive little things increase your risk of dementia and almost everything else! If you are having trouble quitting, chat with your doctor. Medications are available that can help, or you could even try something like hypnosis.

Risk Factor: Hypertension 

Research shows that having high blood pressure in middle age can raise the chance of getting dementia or Alzheimer’s disease. In older adults, the evidence is less clear because some people with dementia have lower blood pressure compared to those without it. Studies have found that people taking blood pressure medicine often have a lower chance of developing dementia and tend to think more clearly than those who take a placebo. 

What You Can Do: High blood pressure can be managed by eating a healthy diet, making lifestyle changes, and taking medication.

Risk Factor: Obesity 

People who are overweight in middle age have a higher chance of developing dementia compared to those with a healthy weight. A study that looked at over five million people found that having more belly fat, measured by waist size or waist-to-hip ratio, is linked to a greater risk of memory problems and dementia. Obesity is more common in people who don’t exercise much and is linked to a higher risk of diabetes and high blood pressure, which are also connected to a higher risk of dementia. Another study showed that people with mild memory issues who had a normal weight exercised more and ate healthier had fewer signs of Alzheimer’s disease, like plaques, in their brains.

What You Can Do: Maintain a healthy body fat percentage with regular exercise and a healthy diet.

Risk Factor: Excessive alcohol consumption

Drinking heavily can lead to problems with thinking, memory, and overall brain health, including dementia. Different studies define heavy drinking differently, but it usually means having more than 21 units of alcohol per week (one unit is about eight grams of pure alcohol; a glass of wine or beer can have up to three units). A large study in France with over 31 million people found that those with alcohol use disorders had a risk of dementia more than three times higher than others, especially for those who developed it before age 65. Another review of 28 studies showed that heavy drinking is linked to a higher chance of dementia and changes in the brain.

What You Can Do: Moderate your intake of alcohol to as little as possible. If you are having trouble moderating your alcohol intake, then look into getting yourself some support. There are plenty of resources available, but the SAMHSA website is a great one to get you started.

Risk Factor: Social isolation 

Being alone a lot can increase the chances of getting dementia, high blood pressure, heart disease, and depression. Having fewer friends and feeling lonely can raise the risk of dementia. Not being around people might make your brain less active, speeding up memory loss and making you feel down. Spending time with others could help lower the chance of dementia by keeping your brain healthy, reducing stress, and encouraging good habits.

What You Can Do: Nurture your healthy social circles throughout your lifetime. Chat with people, join social activities, and build communities where you live. 

Risk Factor: Air Pollution

Many studies show air pollution, particularly the particles measured as PM2.5 (tiny particles smaller than 2.5 microns) and PM10 (particles smaller than 10 microns), is a risk factor for dementia and cognitive problems. Some studies show that tiny air pollution particles can get into the brain, but more research is needed to understand how air pollution affects brain health.

It’s believed that air pollution can affect the heart and blood vessels, which might reduce blood flow to the brain and lead to a type of dementia called vascular dementia. However, there’s no strong evidence yet that tiny pollution particles entering the brain directly cause dementia.

What You Can Do: While we can’t completely avoid air pollution, we can reduce our exposure by checking air pollution levels online or using apps and staying indoors when pollution is high. To avoid car exhaust, close vents and windows when in heavy traffic.

Risk Factor: Untreated Vision Loss

Back in 2020, the Lancet Commission on dementia didn’t count vision loss as a dementia risk factor. However, new studies have shown that vision problems might increase the chances of dementia and cognitive issues. This connection might be because of health problems like diabetes, which can cause both vision loss and dementia. A study in the US found that people with cataracts who got them removed had a much lower chance of developing dementia compared to those who didn’t, so it is worth doing what you can to protect your vision throughout your lifetime.

What You Can Do: Keep your eyes healthy by having regular vision checkups, and use glasses if they have been recommended for you. If you have a specific eye condition, be sure to keep it regularly monitored and treated by your healthcare practitioner. 

Why Lowering the Risk of Dementia is Important 

Lowering the risk of dementia not only adds more healthy years to life but also reduces the time people with dementia spend in poor health. This has huge benefits for people’s quality of life while also putting less strain on the economy.

We need more action worldwide to lower the risk of dementia. As the global population ages quickly, the number of people with dementia is expected to nearly triple by 2050, from 57 million in 2019 to 153 million. Longer life expectancy is also leading to more dementia cases in poorer countries. The global health and social costs of dementia are over $1 trillion every year.

In countries like the U.S. and the UK, fewer older people are developing dementia, especially in wealthier areas. This might be because they face fewer barriers and are much more able to avoid the 14 risk factors discussed, thanks to better healthcare and lifestyle changes. This shows how important it is to start prevention efforts as soon as possible for people of all socioeconomic statuses. However, many national dementia plans don’t give specific advice on how to consider diversity, fairness, or inclusion for people from underrepresented cultures and ethnic groups who face higher dementia risks.

Treatments for Dementia

Though a cure for the degenerative disease hasn’t been discovered, certain medications are already in use to either delay its onset or reduce its impact. These include:

• Namenda, containing memantine, which partially inhibits glutamate activity. Excessive glutamate is linked to Alzheimer’s symptoms and progression.
• Aricept, with the active ingredient donepezil, treats mild to moderate dementia by preventing the breakdown of acetylcholine, a chemical crucial for memory, thinking, and reasoning. Dementia patients often have reduced levels of this chemical.
• Exelon, with rivastigmine as its active ingredient, functions similarly to Aricept, helping maintain acetylcholine levels.
• Razadyne from Italy, containing galantamine Hbr, increases acetylcholine levels by slowing its breakdown and enhancing its activity.
• Reminyl, with galantamine Hbr, operates in the same manner as Razadyne.

Who is prone to dementia?

Aging is the primary risk factor for dementia. Although it can affect individuals under 65, the likelihood of developing dementia doubles approximately every 5 to 6 years for those over 65.

How does your body tell you dementia is coming?

While early signs can differ, common initial symptoms of dementia include memory issues, especially with recent events, growing confusion, and decreased concentration.

What symptom is most prominent in early dementia?

Early symptoms of dementia often include memory loss, difficulty concentrating, and confusion when performing familiar tasks, like handling change while shopping. Individuals may struggle to follow conversations, find the right words, feel disoriented about time and place, and experience mood changes.