Modifiable Risk Factors & Lowering Risk - DementiaHub.SG

Modifiable Risk Factors & Lowering Risk

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Although factors such as genes, gender, race, and age are not within control, there are things that can be done to reduce the risk of developing dementia.

Individuals can make lifestyle changes to reduce their risks of developing dementia, and systemic societal changes can be made to reduce the incidence of dementia in a community.

There is growing research evidence that supports the link between 12 factors, which are written about later in this article, and the risk of developing dementia. Though these risk factors are not direct causes of dementia, addressing all of them may potentially prevent or delay up to 40% of potential cases of the development of dementia cases.

dementia

Many of these 12 risk factors are also linked to other health conditions, such as cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, some of which, such as cardiovascular diseases, are themselves risk factors for dementia. Modifying the relevant health behaviours that prevent these health conditions may thus reduce the risk of many health issues simultaneously, leading to both better overall wellbeing and a reduced risk of developing dementia.

12 Modifiable Risk Factors of Dementia

physiotherapist

Physical inactivity

smoking

Smoking

wine

Excessive alcohol consumption

air-pollution

Air pollution

man-in-hospital-with-injured-head-arm-an-leg

Head injury

social-networks

Infrequent social contact

presentation

Lower levels of educational attainment

fat

Mid-life obesity

arm

Hypertension (High blood pressure)

sugar-blood-level

Diabetes

depression

Depression, loneliness and social isolation

deaf

Hearing impairment

Physical Inactivity

Regular physical activity is one of the best ways to reduce the risk of dementia. It is good for the heart, blood circulation, weight management and overall mental wellbeing. It can also help to lower cholesterol levels and maintain blood pressure at a healthy level, decreasing the risk of developing vascular dementia.

A year-long study by researchers at the University of Pittsburgh, involving 120 people aged between 60 and 80, found that walking briskly for 30 to 40 minutes a day three times a week was sufficient for re-growing the structures of the brain linked with cognitive decline in later life. Scans later revealed that the parts of the brain that shrink with age actually grew in volume after moderate but regular exercise.1

It is recommended that adults aim for either 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity each week, in order to maintain an activity level that raises the heart rate. This means simply brisk-walking for 30 minutes a day, five times a week, or jogging for 25 minutes a day, three times a week.

Though these are prescribed levels of physical activity for the general population, it is best if people pay attention to their own physical condition, which they know best. In addition, what matters is that they simply start trying. Every small step counts!

Smoking

Smoking greatly increases the risk of developing dementia in addition to creating complications for the lungs and heart, while increasing the risk of other conditions, including type 2 diabetes, stroke, lung cancer, and other cancers.

The World Health Organization (WHO) and Alzheimer’s Disease International (ADI) found a correlation between smoking and the risk of dementia: smokers have a 45% higher risk of developing dementia than non-smokers.2 WHO’s recently released guidelines for dementia risk reduction in 2019 listed tobacco dependence as the leading cause of preventable death globally, and associated it with other disorders and age-related conditions such as frailty and work ability in order people.3

These pieces of research and guidelines made based on evidence highlight the importance of not smoking for lowering the risk of dementia and cognitive decline. It is also better late than never when it comes to stopping the smoking habit, as stopping later in life also reduces the risk of dementia.

Excessive Alcohol Consumption

An excessive consumption of alcohol of more than 21 units per week significantly increases the risk of developing dementia, in addition to it being a causal factor in more than 200 disease and injury conditions, a range of mental and behavioural disorders, and other noncommunicable diseases.

Consuming moderate amounts of alcohol is recommended for reducing the above risks, and for maintaining overall wellbeing.

Air Pollution

A growing amount of research evidence suggests that air pollution increases the risk of developing dementia. It is recommended for policymakers to expedite improvements in air quality, particularly in areas with high air pollution.

Head Injury

Head injuries increase the risk of developing dementia. They are most commonly caused by car, motorcycle, and bicycle accidents; military exposures; boxing, football, hockey and other sports; firearms and violent assaults; and falls. Policymakers could use public health and other policy measures to reduce head injuries. In addition, individuals can exercise a reasonable level of precaution when participating in activities, such as wearing helmets during some sports activities, and observing workplace safety measures.

Infrequent Social Contact

Of all the ways to reduce the risk of dementia, engaging in frequent social activity may be the most enjoyable. It is well established that social interaction may delay the onset of dementia.

Though the research literature on which specific types of social activity reduce dementia risk is still developing, some theories suggest that social engagement may benefit brain health via brain stimulation, staving off dementia and depression in the process.

A study published in the American Journal of Public Health showed that women with larger social networks were 26% less likely to develop dementia than those with smaller social networks. In addition, women who had daily contact with friends and family cut their risk of developing dementia by almost half.4

The potential benefits of social contact on cutting dementia risk adds more reason to common experience of how social activity enriches lives. Some ways of engaging in activity include: joining a club or neighbourhood social activity, meeting friends for a meal, or volunteering.

The potential benefits of social contact on cutting dementia risk adds more reason to common experience of how social activity enriches lives. Some ways of engaging in activity include: joining a club or neighbourhood social activity, meeting friends for a meal, or volunteering.

Lower Levels of Educational Attainment

A low level of educational attainment in early life is one of the most significant risk factors for dementia. It is recommended that policy prioritises childhood education for all.

Mid-Life Obesity

Obesity is associated with an increased risk of dementia, especially in mid-life. It is also associated with other non-communicable diseases, and can generally be addressed through lifestyle changes such as diet and exercise.

Hypertension (High Blood Pressure)

Hypertension (high blood pressure) in mid-life increases a person’s risk of dementia, amongst other health problems. To reduce this risk, monitoring and keeping blood pressure at a healthy range is advised. This healthy blood pressure range can be worked towards and maintained through lifestyle changes, such as through exercise, a balanced diet, and stress management, and if necessary, medication for hypertension if prescribed by medical professionals.

Diabetes

Type 2 diabetes is a risk factor for the future development of dementia. Persons who have type 2 diabetes are advised to monitor their blood glucose level, and to manage it with dietary measures, regular exercise, other lifestyle measures, and medication, should this be prescribed by a doctor.

Depression, Loneliness and Social Isolation

Depression is associated with dementia incidence. It is currently not clear whether and to what extent dementia may be caused by depression or vice versa.

In any case, it is important to manage and treat depression because it is associated with increased disability, physical illnesses and other negative outcomes which themselves may complicate care for a person with dementia.

Hearing Impairment

People with hearing loss have a significantly increased risk of dementia, though using hearing aids seems to reduce this risk. As hearing loss is one of the risk factors which affects the most people, it may be a particularly strategic factor to address in reducing the incidence of dementia.

Watch and Learn the A, B, C, Ds to preventing Dementia today!

Source: Agency for Integrated Care

Additional Ways to Lower Dementia Risk

Mindful Mind Food

There is truth in the saying that you are what you eat, especially when it comes to reducing dementia risk. Maintaining a healthy and balanced diet not only makes one feel well, but also helps to reduce dementia risk, amongst other health issues like diabetes and heart disease. A diet rich in fruits, vegetables, unrefined cereals, grains, omega-3 fatty acids (commonly found in oily fish and nuts), and with less red meat may promote overall health and offset or delay the development of dementia. When in doubt, however, approach your doctor for more advice on making healthier dietary choices for a healthier brain.

lifestyle-beautiful-girl-during-yoga-exercise

Keep Your Mind Active – Brain Games

Just as exercise is highly beneficial for physical health, cognitive activities are also good for brain function and reduce the risk of developing dementia. According to Alzheimer’s Disease International (ADI), experiments conducted on both animals and humans showed that mentally stimulating activities are related to measurable improvements in brain vascular health, and in both brain structure and function.5 Another research report from the Rush Memory and Aging Project reports that cognitive stimulating activities (including reading and writing) in a group of 300 cognitively healthy men and women were associated with a slower cognitive decline in the six years prior to  death.6 The above evidence suggests that engaging in mentally stimulating activities, such as reading, playing bridge or chess, or doing puzzles (Sudoku, crosswords, etc.) may offset or delay the development of dementia.

pieces-white-jigsaw-wood

Heart Truths

There is evidence that a healthy heart benefits a healthy brain.

According to Meharvan Singh, Ph.D., Associate Professor of Pharmacology & Neuroscience, the brain receives approximately 15% of cardiac output, meaning that compromised cardiovascular function would reduce supply of blood (and thus oxygen) to the brain. Other research has shown that an increased risk of heart attacks and strokes can increase the chances of developing dementia.

A 2016 study by the University of Southern California found that statins, which are a kind of medication designed to help those with heart conditions, may play an additional role in protecting the brain from dementia.

teenager-woman-hand-with-cross-bible-praying-hands-folded-prayer_2379-1772

Adopting a healthy lifestyle by keeping active, eating a healthy and balanced diet, avoiding smoking and excessive alcohol consumption, and engaging in social activities, together promote good brain health, and can keep dementia as well as other diseases like stroke and heart attack at bay.

In light of the above, regular health checks, such as annual full-body check-ups which include cognitive screenings are encouraged. It is never too early to begin.

Some content is reproduced with permission from Alzheimer’s Disease International’s article on Risk Factors and Risk Reduction.

Downloadable Resources

The following resources contain bite-sized information on Modifiable Risk Factors & Lowering Risk that you may download and/ or print:

Click on the images below to download in English.

5 Ways to Reduce Your Risk of Dementia

Forget Us Not: Building a Dementia Friendly Community

understanding-dementia

Understanding Dementia

References

  1. Ahlskog, J. E., Geda, Y. E., Graff-Radford, N. R., & Petersen, R. C. (2011). Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clinic proceedings, 86(9), 876–884. https://doi.org/10.4065/mcp.2011.0252
  2. Alzheimer’s Disease International. (2014, July 9). Smoking increases risk of dementia. https://www.alzint.org/news/smoking-increases-risk-of-dementia/
  3. Geneva: World Health Organization. (2019). Risk reduction of cognitive decline and dementia: WHO guidelines. https://apps.who.int/iris/bitstream/handle/10665/312180/9789241550543-eng.pdf?ua=1
  4. Crooks, V. C., Lubben, J., Petitti, D. B., Little, D., & Chiu, V. (2008). Social network, cognitive function, and dementia incidence among elderly women. American journal of public health, 98(7), 1221–1227. https://doi.org/10.2105/AJPH.2007.115923
  5. Albanese, E., Guerchet, M., Prince, M., & Prina, M. (2014). World Alzheimer report 2014: Dementia and risk reduction: An analysis of protective and modifiable factors. Alzheimer’s Disease International. https://www.alzint.org/u/WorldAlzheimerReport2014.pdf
  6. Bennett, D. A., Schneider, J. A., Buchman, A. S., Barnes, L. L., Boyle, P. A., & Wilson, R. S. (2012). Overview and findings from the rush Memory and Aging Project. Current Alzheimer research, 9(6), 646–663. https://doi.org/10.2174/156720512801322663

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