Worldwide, more than fifty-five million people are living with dementia. Alzheimer’s makes up 60% to 80% of those cases. Over 60% of those live in low to middle income countries, but it’s all too common even in higher income countries. In 2020, statistics showed dementia cases at 5.8 million in the U.S., 920,000 in the UK, 76,000 in Canada, and 16.3 million in China.
Dementia and Alzheimer’s represent the seventh leading cause of death worldwide. In fact, nearly 1 in 5 of the deaths recorded in Finland in 2020 were attributed to dementia and Alzheimer’s disease. And this problem is growing all the time. Between 2000 and 2019, the number of annual deaths from Alzheimer’s more than doubled. Current projections estimate that the number of cases will nearly triple by 2030.
As you may already know, I was a caregiver for a number of years for my mother with dementia. She suffered from vascular dementia that took her life in the end. I know in a very personal way how dementia changes everything. The risk of dementia is measurably increased decades after a traumatic brain injury. And if you’ve suffered multiple TBIs, the risk increases even more.
This is something we need to take seriously. There is currently no known cure for dementia or Alzheimer’s disease. The only tool we have is prevention. And while we don’t currently have a 100% effective way to prevent this malady, we can greatly reduce our risk with just a few simple lifestyle changes.
About Dementia and Alzheimer’s Disease
Alzheimer’s is a brain disease that causes damage to neurons (nerve cells) in the brain. It’s a progressive disease, meaning that it continues to get worse as time passes and ultimately causes death. The first signs of damage are typically in the area of the brain responsible for memory, language, and thinking. We may not even be aware of the presence of disease until there are more obvious indicators. The changes in our brain are believed to have started 20 years or more before symptoms finally become evident (1).
Dementia is an inclusive term. It includes Alzheimer’s disease, but also dementia from other causes or multiple causes. Between 60% to 80% of dementia cases are caused by Alzheimer’s. However, more than half of Alzheimer’s cases also show evidence of one or more of the other forms of dementia as well. As mentioned earlier, there is no cure, the only tool we have here is prevention. The good news is, there are some simple lifestyle changes that can reduce our risk significantly.
What Science is Showing Us
According to the 2017 Lancet Commission on dementia prevention, intervention, and care, there are nine potentially modifiable risk factors for dementia (2). Newer studies have added another three (3), here’s the complete list:
- Less education
Studies show that each year spent in education proffers an 11% reduction in dementia risk. Even the classes taken later in life can have a significant positive impact towards risk reduction. Studies show that learning a second language improves functional connectivity in our brain (4), promotes neuroplasticity, and delays cognitive decline (5). - Hypertension
High blood pressure in mid-life is a key risk factor for dementia. If you have high blood pressure, you can take steps to help reduce it. This can include diet, exercise, and if needed, medications. - Hearing loss
According an article on the Johns Hopkins Medicine website (6), mild hearing loss can double your chances of developing dementia. Moderate loss triples risk, and a severe impairment makes you five times more likely to develop dementia. - Smoking
Current smokers are 30% more likely to develop some type of dementia and 40% more likely to develop Alzheimer’s disease. - Obesity
Not only does obesity increase your risk of dementia, but some evidence also suggests that it may worsen the effects. - Depression
Both early- and late-life depression can increase your risk of dementia. If you experience depression, it’s important to discuss your options for treatment with a trusted professional. - Physical inactivity
This one is an indirect link. Physical inactivity can increase risk of heart disease, obesity, and type 2 diabetes. These are all linked to a higher risk of dementia. - Diabetes
Risk of dementia is increased among those with type 2 diabetes. Insulin resistance represents a potential mechanism contributing to Alzheimer’s disease. - Low social contact
The CDC reports that social isolation is associated with a 50% increase in risk of dementia. - Excessive alcohol consumption
Low to moderate alcohol consumption is associated with a lower risk of dementia. Higher levels of alcohol consumption increase risk significantly. - Traumatic brain injury
Research has linked moderate to severe TBIs to a greater risk of dementia. - Air pollution
Evidence is showing that greater exposure to airborne pollutants increases risk of dementia.
Looking at My Own Risk Factors
That’s quite the list. I found at least a few items that caught my attention. Looking at the positive side of this equation, I’m learning a second language, my blood pressure runs fairly low, I don’t smoke, and I don’t express any symptoms of depression. I’m physically active on a daily basis, my blood sugar is always at healthy levels, and I’m able to socialize regularly. Last, but not least, my alcohol consumption these days typically runs at about three servings per week or so. This is good, because I also have some risk points, with one that’s considered high-risk (TBI).
Reading the part about hearing loss was a wakeup call for me. My wife wears hearing aids, and she loves them. Because my own loss is fairly mild, I haven’t bothered to go in and get a hearing test recently. But now that I know even a mild loss increases my risk, I think I’ll have to address that.
The obesity one is another item I need to pay attention to. I’m overweight by about thirty pounds, I don’t feel obese, but the BMI scale says otherwise. If this increases my risk, then I need to address the problem.
And then we come to the elephant in this room, my severe TBI. This isn’t something I can go back and change, it’s already happened. The best I can do is try not to get another one. I will be adamant about wearing a helmet if I’m in a situation where one is advised.
So, of my three key risk factors, I can only influence two. To me that suggests that I need to be as effective as I can about reducing those risk factors that I can influence.
Looking at the positive side of this equation, I’m doing many of the things that help reduce my risk of dementia and Alzheimer’s disease. I plan to continue and increase, where necessary, these activities.
In Closing
Each of us needs to review this list to identify our primary risk factors. We need to determine which ones we can change and do what we can to reduce our risk. Remember, it’s always advisable to talk to a medical professional before making significant lifestyle changes.
References
- Yakeel T. Quiroz, Henrik Zetterberg, Eric M. Reiman, Yinghua Chen, Yi Su, Joshua T. Fox-Fuller, Gloria Garcia, Andres Villegas, Diego Sepulveda-Falla, Marina Villada, Joseph F. Arboleda-Velasquez, Edmarie Guzmán-Vélez, Clara Vila-Castelar, Brian A. Gordon, Stephanie A. Schultz, Hillary D. Protas, Valentina Ghisays, Margarita Giraldo, Victoria Tirado, Ana Baena, Claudia Munoz, Silvia Rios-Romenets, Pierre N. Tariot, Kaj Blennow, Francisco Lopera, (2020), Plasma Neurofilament Light Chain in the Presenilin 1 E280A Autosomal Dominant Alzheimer’s Disease Kindred: A Cross-Sectional And Longitudinal Cohort Study
- Prof Gill Livingston, MD, Andrew Sommerlad, MSc, Vasiliki Orgeta, PhD, Sergi G Costafreda, PhD, Jonathan Huntley, PhD, Prof David Ames, MD, Prof Clive Ballard, MD, Prof Sube Banerjee, MD, Prof Alistair Burns, MD, Prof Jiska Cohen-Mansfield, PhD, Claudia Cooper, PhD, Prof Nick Fox, MD, Laura N Gitlin, PhD, Prof Robert Howard, MD, Prof Helen C Kales, MD, Prof Eric B Larson, MD, Prof Karen Ritchie, PhD, Prof Kenneth Rockwood, MD, Elizabeth L Sampson, MD, Quincy Samus, PhD, Prof Lon S Schneider, MD, Prof Geir Selbæk, PhD, Prof Linda Teri, PhD, Naaheed Mukadam, MSc, (2017), Dementia Prevention, Intervention, and Care
- Gill Livingston, Prof, MD, Jonathan Huntley, PhD, Andrew Sommerlad, PhD, David Ames, Prof, MD, Clive Ballard, Prof, MD, Sube Banerjee, Prof, MD, Carol Brayne, Prof, MD, Alistair Burns, Prof, MD, Jiska Cohen-Mansfield, Prof, PhD, Claudia Cooper, Prof, PhD, Sergi G Costafreda, PhD, Amit Dias, MD, Nick Fox, Prof, MD, Laura N Gitlin, Prof, PhD, Robert Howard, Prof, MD, Helen C Kales, Prof, MD, Mika Kivimäki, Prof, MedSci, Eric B Larson, Prof, MD, Adesola Ogunniyi, Prof, MBChB, Vasiliki Orgeta, PhD, Karen Ritchie, Prof, PhD, Kenneth Rockwood, Prof, MD, Elizabeth L Sampson, Prof, MD, Quincy Samus, PhD, Lon S Schneider, Prof, MD, Geir Selbæk, Prof, MD, Linda Teri, Prof, PhD, and Naaheed Mukadam, PhD, (2020), Dementia prevention, intervention, and care: 2020 report of the Lancet Commission
- Giovanna Bubbico, Piero Chiacchiaretta, Matteo Parenti, Marcin di Marco, Valentina Panara, Gianna Sepede, Antonio Ferretti, and Mauro Gianni Perrucci, (2019), Effects of Second Language Learning on the Plastic Aging Brain: Functional Connectivity, Cognitive Decline, and Reorganization
- Blanka Klimova, (2018), Learning a Foreign Language: A Review on Recent Findings About Its Effect on the Enhancement of Cognitive Functions Among Healthy Older Individuals
- The Hidden Risks of Hearing Loss
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