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Elissa Burton

Dementia – Can we prevent it?



According to the World Health Organisation over 55 million people are living with dementia around the world. You may know of someone, a friend or relative who had dementia or is currently living with dementia. The most common type of dementia is Alzheimer’s Disease, but there are also other types such as vascular dementia, Lewy Body disease, frontotemporal dementia, and chronic traumatic encephalopathy (CTE). The big question though is can we do anything to prevent or lower our risk of getting dementia?


The answer is yes, and it is never too late to start doing something about it. Professor Gill Livingston from the University College London and her colleagues wrote a Lancet Commissioned paper in 2020 which outlined what we can do to try and reduce our risk of being diagnosed with dementia. The paper is freely available, but is also 34 pages long and full of academic jargon so I thought it easier to give you the low down here and you can decide what you are doing already and whether you would like to make some changes to your lifestyle now, which may benefit you in the future!

 

There are 12 risk factors, which, if modified (i.e. you do something about them), might prevent or delay up to 40% of dementias.(1) So this isn’t completely full proof, but it certainly helps to increase the odds in your favour, which is always a good thing!



 

So, those at most risk have:

  1. less education, particularly in early life;

  2. hypertension or commonly known as high blood pressure. The aim should be to keep your systolic blood pressure at 130 mmHg or less from age 40 years and above, and medications for high blood pressure are an effective way to stabilise blood pressure and help prevent dementia;

  3. hearing impairment, if you are in middle or older age and struggling to hear, especially in crowds, please go and see a reputable hearing specialist and get yourself checked, it could be a difference maker in so many ways (e.g. better social life, less feeling of isolation, potentially prevent dementia);

  4. smoking, this really is a no brainer (pardon the pun!). Australians have had decades of public health messaging about how bad smoking is for your health (e.g. cancer, emphysema, eye disease, the list goes on) and you can now add it will increase your risk of getting dementia. If you have never smoked great, if you smoked but have now quit, good on you that is such an achievement, if you are still smoking have a serious think about why and whether it really is worth it;

  5. obesity, like smoking being obese can have adverse effects on many parts of our health, both physical and mental, but it also increases your likelihood of dementia;

  6. physical inactivity, like smoking and obesity we know how important being physically active is but many of us don’t prioritise it. Get outdoors, do something you enjoy and try and move as much as you can every day, there are so many benefits for your body and mind from just being active;

  7. alcohol, excessive alcohol consumption impairs cognition, changes the brain and increases our chances of getting dementia. It is recommended people drink fewer than 21 standard alcohol drinks per week. However, like the many other lifestyle factors described here excessive alcohol consumption also increases our risk of high blood pressure, heart disease, stroke and many cancers, as well as weakening our immune system. Is it really worth it;

  8. depression, many people who are diagnosed with dementia have also been diagnosed with depression or another mental health condition, such as anxiety. Depression can often mask the symptoms of dementia and make diagnosis more difficult. It is always good to check in with a health professional if you are feeling really low to see what help is out there, and being physically active has been shown to help those living with depression, so it’s a double win if you do start being more active;

  9. diabetes, in particular type 2 diabetes which again happens due to certain lifestyle factors already mentioned above (e.g. poor diet, obesity and insufficient physical activity). If you can prevent type 2 diabetes through improving your lifestyle, I would highly recommend this;

  10. social isolation, if you are an energiser bunny and love seeing and connecting with people then you don’t need to worry about this at all. However, some people are a little more introverted and see fewer people across their week and may feel socially isolated. It is now well known that social contact is accepted as being a protective factor for dementia and it helps to enhance cognitive reserve. Enjoy your time with family and friends, they are helping to keep you healthy;

  11. air pollution, this is one of the newer risk factors and less is known about the effect of pollutants on our brain. We do know though that pollutions from traffic exhausts and residual wood burning are associated with an increase in the number of people diagnosed with dementia, tobacco smoke should also be avoided as much as possible;  

  12. traumatic brain injury, it is important in early life to minimise or prevent head injuries as much as you can.


So, there they are! How many of these risk factors do you think you are avoiding?

 


If you are doing some of these things to avoid these risk factors, for example, you are physically active, don’t smoke, alcohol consumption is much lower than suggested, then just keep that going.

 

If you’ve been concerned about a few of these factors, then try to make a plan. For example, if you’re worried about your hearing see if there is a high-quality hearing centre near you and go and get tested. You never know, your hearing might be ok or they may suggest hearing aids that make life and socialising so much more enjoyable. The good hearing centres will give you options and not try and sell you the most expensive products up front.

 

Make sure you see your GP at least once a year. If you only see them once a year, they should take your blood pressure and get blood screening as a minimum. If they don’t, then ask for it, if they won’t, find a GP that will. It is hard to prevent health issues when you don’t know where your baseline is.

 

Consider spending time at the beach, in nature or in the country, the air is amazing and if you go with friends, it’s a double win.

 

Live the good life!

 

Reference:

1.            Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet. 2020;396:413-446. doi:10.1016/ S0140-6736(20)30367-6. Access at https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930367-6



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