12 ways you can reduce risk of dementia

NEW Year’s Resolutions often aspire to improving health - I propose that this year we focus on cognitive health, and on dementia.

Most people have a very likely had a relative or friend who has developed this condition. While it is of course possible to optimise quality of life for those with dementia (initiatives like dementia-friendly communities, for example), we know dementia remains remorseless, irreversible, and ultimately unstoppable once it takes hold. There is research which shows it to be the greatest fear of older people.

It’s a condition very much linked to older age. As we live in an ageing world, this is an important point. From a policy perspective, it includes concerns about care provision, including costs. At the individual level, we know more people overall are likely to have dementia. But what of the rates of dementia; how likely is any one of us to succumb?

Predicting the future is a fraught business and often we are dealing with best guesses. But sometimes there is a consistent pattern in predictions. Until recently, this looked very positive - a good deal of research suggested that, over the past decades, the percentage of the population with dementia was decreasing - leading to a cautious optimism.

Wolters and colleagues in 2020 completed analysis of data over decades and reported that rates were dropping in the U.S and Europe.

Yuntao Chen and colleagues in 2023 soberingly suggested the opposite. Explaining that previous models failed to consider cases where people both developed dementia and died between survey times, and allowing for this, they found the rate of dementia decreased significantly between 2002 and 2008, but then increased between 2008 and 2016.

So what? Things may be less positive than many had hoped; at worst, if this upward trend continues, possibly far worse.

Previous studies had projected that England and Wales would have 1.2 million people with dementia by 2040. In the worst-case scenario, this would be 1.7 million; and if the rate remains stable from 2018, it would be 1.3 million. In short, we don’t know enough to be confident.

But playing the odds is a dangerous game at all times, especially when the stakes are so high. What can we ourselves do to protect ourselves as well as possible?

The research evidence points to 12 specific things, accounting for 40% of cases. According to Gill Livingston and colleagues, in 2020. these are:

1. Reduce rates of diabetes. We know Type 2 diabetes is related to obesity, so healthy eating and drinking are important.

2. Manage blood pressure. Try to live a healthy, active lifestyle. If blood pressure is a problem, adhere to medical advice. Get it down to healthy!

3. Take care to avoid head injury. As we all know, head injuries can lead to catastrophic change. But they can also leave weakness, which will emerge later, as the evidence suggests in boxers and footballers. Avoiding head trauma, always wearing a helmet when cycling for example, is important.

4. Don’t smoke. Smoking is good for pretty much nothing (except some people’s profits). Don’t do it, or stop doing it. It drives up blood pressure and makes clots in the brain more likely.

5. Reduce air pollution. We don’t often have direct control over this, but air quality can seriously affect our health. We can take our own small steps, but joining together to pressure the authorities could ultimately benefit us all.

6. Mind our weight. Not alone does obesity lead to a higher risk of diabetes, it also increases risk of damage to the blood vessels in the brain through its effect on blood pressure and on blood circulation.

7. Exercise. This is your general good. It keeps our bodies fit and healthy, and the health of our brain is intimately linked with that of the heart and lungs. Exercise keeps blood pressure down, improves heart function, and reduces obesity rates. It’s something we can all do, no equipment or training needed, and it is crucial.

8. Reduce risk of depression. If exercise is a general good, the opposite can be said of depression. It helps nothing. Add to that that there is evidence that depression, especially in later life, can predispose to dementia.

Depression affects many people, but there are things we can do to reduce the risk or to alleviate it. Exercise, engage with friends, work on what might be getting us down, and of course, seek professional help.

9. Maintain healthy levels of drinking. There is a strong toxic effect of alcohol on health, including brain health. It increases obesity and blood pressure, and is simply bad for the body in anything more than moderate amounts. It may not be easy, but it is within our grasp to exercise control here, and it’s really worth it. Again, there is no shame in seeking support or help in this.

10. Address hearing problems. A lot of research shows a link here. Consider that we engage with the world through our senses. If we can’t hear what’s said to us, what’s on the news, etc, we can’t engage. We lose our stimulation, and this physically impacts our brains.

11. Stay in touch socially. A great boost to well-being, this is also established as a means of maintaining cognitive health, possibly as engagement and communication keep us active and keep our brains stimulated.

12. Get educated! Again, all about developing our brain, or cognitive, reserve. Greater education is linked to reduced dementia risk, probably through its physical effects on the brain. Education is a lifelong thing - start as early as you can, and maintain it as much as you can.

Overall, any one of us can develop dementia. As we live longer, there may well be a greater chance that we will. We have an ability to influence this risk. Let’s use it. What better resolution for 2024?