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Understanding the risk factors for dementia, including lifestyle choices and health conditions, is crucial in preventing cognitive decline. Dr Emer MacSweeney, CEO, Medical Director and Consultant Neuroradiologist at Re:Cognition Health highlights how vision, cholesterol levels, education, hearing and other factors contribute to dementia risk and provides practical steps to enhance brain health and reduce the likelihood of developing dementia:
Being proactive is paramount in prevention. There are many things we can do every day to help reduce our risk of cognitive decline:
Vision
Diminished vision can hinder a person’s ability to engage with their surroundings and participate in stimulating activities, potentially leading to social isolation and reduced cognitive engagement—both significant dementia risk factors. When sight deteriorates, individuals might withdraw from social activities and hobbies that help keep their minds active, hastening cognitive decline.
Reduce the risk: Regular eye check-ups, wearing the appropriate corrective lenses, and safeguarding the eyes from injury are essential for maintaining visual health.
Cholesterol
High levels of low-density lipoprotein (LDL) cholesterol can lead to the build-up of plaques in arteries, a condition known as atherosclerosis. This can restrict blood flow to the brain, depriving it of essential nutrients and oxygen, which increases the risk for strokes and other forms of cerebrovascular disease. Reduced blood flow and damage to the brain’s blood vessels are linked to an increased risk of developing dementia.
Reduce the risk: Maintain a healthy diet, exercise regularly, ensure regular health check-ups and follow medical advice to manage cholesterol levels.
Lower Levels of Education
Lower educational attainment is associated with a lower cognitive reserve, which is the brain’s ability to compensate for damage. Studies suggest that individuals with higher levels of education develop a greater number of synaptic connections, providing more pathways for cognitive processes. This makes the brain more resilient to age-related changes and damage.
Reduce the risk: Engage in lifelong learning and mental stimulation through reading, puzzles and other cognitive activities.
Hearing Impairment
Hearing loss can result in social isolation, as people may shy away from interactions due to communication difficulties. This reduction in both social and cognitive activity can contribute to cognitive decline. Additionally, the brain must work harder to process sounds, potentially diverting resources from other cognitive tasks and accelerating the decline.
Reduce the risk: Regular hearing assessments, the use of hearing aids when necessary and staying socially engaged can help mitigate these risks.
High Blood Pressure
Hypertension, or high blood pressure, can damage the blood vessels in the brain, leading to conditions like vascular dementia. This damage may cause strokes and reduced brain blood flow, impairing cognitive function. Long-term high blood pressure is also linked with white matter lesions and brain microbleeds, further increasing dementia risk.
Reduce the risk: Regular monitoring, a healthy diet, exercise, and medication can help control blood pressure.
Smoking
Smoking introduces harmful toxins into the body, damaging blood vessels and reducing brain blood flow. Nicotine and other chemicals in cigarettes cause oxidative stress and inflammation, contributing to cognitive decline. Smoking is also associated with a higher risk of stroke, which can lead to significant brain damage and dementia.
Reduce the risk: Quitting smoking and avoiding passive smoke exposure are vital for protecting brain health and reducing dementia risk.
Obesity
Obesity is associated with several conditions that are risk factors for dementia, including diabetes, hypertension and cardiovascular disease. Excess body weight can lead to metabolic syndrome and insulin resistance, which have been linked to brain changes that contribute to dementia. Inflammatory processes associated with obesity can also harm brain health.
Reduce the risk: Maintain a balanced diet, exercise regularly and monitor weight, aiming for a healthy BMI. Consult with a healthcare professional for support in weight management
Depression
Depression is associated with chronic stress, leading to the release of cortisol, a stress hormone. Prolonged exposure to high cortisol levels can damage the hippocampus, a brain region essential for memory and learning. Depression may also cause social withdrawal and reduced engagement in mentally stimulating activities, increasing dementia risk.
Reduce the risk: If mood is affecting your quality of life, it’s important to consult with a medical professional. Therapy, medication and support systems are available to improve and manage symptoms.
Physical Inactivity
Lack of physical activity is associated with obesity, diabetes, and cardiovascular disease, all of which are risk factors for dementia. Exercise helps maintain healthy blood flow to the brain, supports the growth of new neurons, and reduces inflammation. Physical inactivity can also lead to a sedentary lifestyle, reducing opportunities for cognitive engagement and social interaction.
Reduce the risk: Aerobic activities, strength training and coordination exercises like yoga, tai chi or dance enhance brain health by improving blood flow, promoting neurogenesis and stimulating neural plasticity. Mind and body practices like meditation reduce stress and enhance attention, memory and may potentially lead to structural brain improvements.
Diabetes
Diabetes can cause damage to blood vessels and nerves due to high blood sugar levels, leading to both macrovascular and microvascular complications. These complications can affect the brain’s structure and function. Insulin resistance, a hallmark of type 2 diabetes, is also linked to Alzheimer’s disease and other forms of dementia through mechanisms involving inflammation and amyloid plaque formation.
Reduce the risk: Manage blood sugar levels through diet, exercise and medication adherence.
Excessive Alcohol Consumption
Chronic excessive alcohol consumption is toxic to the brain and can lead to brain damage, including shrinkage of brain tissue and deficiencies in essential nutrients like thiamine (vitamin B1). Alcohol abuse can cause conditions such as Wernicke-Korsakoff syndrome, which directly affects cognitive function. Alcohol’s neurotoxic effects can impair memory, judgment and other cognitive abilities.
Reduce the risk: Limit alcohol consumption to moderate levels as recommended by health guidelines (14 units per week, spread over 3 or more days).
Traumatic Brain Injury
Traumatic brain injuries (TBIs) can cause direct damage to brain cells, as well as secondary effects like inflammation and disrupted blood flow. Repeated TBIs are especially harmful and are associated with chronic traumatic encephalopathy (CTE), which leads to cognitive decline, memory loss and behavioural changes. Even a single moderate to severe TBI can increase the risk of developing dementia later in life.
Reduce the risk: Use safety gear during high-risk activities and take measures to prevent falls and accidents.
Air Pollution
Exposure to air pollutants like particulate matter and nitrogen dioxide can cause inflammation and oxidative stress in the brain. These pollutants can cross the blood-brain barrier and may contribute to neurodegenerative diseases. Long-term exposure to poor air quality is linked to faster cognitive decline and a higher risk of dementia.
Reduce the risk: Limit exposure by staying indoors on high pollution days, avoiding areas with heavy pollution, using air purifiers, and advocating for cleaner air initiatives.
Social Isolation
Social isolation reduces opportunities for cognitive stimulation and engagement, which are important for maintaining brain health. Loneliness and lack of social interaction can lead to depression and stress, further increasing the risk of cognitive decline. Social connections provide emotional support and cognitive challenges that help keep the brain active and resilient.
Reduce the risk: Maintain social connections through family, friends, colleagues, community activities, volunteering and social groups. Whilst it’s best to interact face to face, even a phone call or facetime contact will provide benefits.
What to do if you have symptoms of dementia?
Seeking an early diagnosis for the specific cause of your cognitive impairment, as soon as possible, and long before it progresses to the level where you have lost independence and therefore have reached the stage of dementia, is paramount. As we grow older the most common cause for cognitive decline, especially memory loss and problems with thinking ability, is Alzheimer’s Disease. Alzheimer’s disease is a pandemic. But today, there are novel sensitive diagnostic biomarker tests and new generation medications, in late phase clinical trials, which provide the opportunity to change your future. These new-generation medications are; designed to slow, or ideally halt disease progression.
