Brain health, and specifically dementia, is a major public health issue. Dementia refers to a range of conditions that cause a major loss of brain abilities, such as memory, language or reasoning. Some causes of dementia are progressive, meaning the disease continues to worsen over time.
The rate of dementia is staggering, with more than one in nine (11 percent) Americans over the age of 65 suffering from the disease. Age is a powerful risk factor for dementia, and the percentage of people with dementia increases with age, with dementia affecting 35 percent of people over the age of 85.
The most common form of dementia is Alzheimer’s disease, which accounts for nearly 60 to 80 percent of cases. While mortality rates from heart disease, the leading cause of death, have fallen by as much as seven percent over the last several years, deaths due to Alzheimer’s disease more than doubled. Over the coming decade, the aging of the Baby Boomer generation will cause the percentage of the Americans over the age of 65 to grow substantially, and this will bring with it a large increase in the number of Americans with dementia. The healthcare costs of dementia are massive and may cost as much as $355 billion in 2021; this amount is projected to increase to more than $1 trillion as the population ages.
Unfortunately, once a progressive dementia such as Alzheimer’s disease sets in, there is no known way to stop its progression. While there is no cure for dementia, increasing research supports the idea that dementia may be preventable. Some research estimates as many as 40 percent of dementia cases could have been delayed or prevented.
Some factors that influence risk for dementia, such as age and genetics, cannot be changed. However, there are several important factors that are changeable, and these are referred to as modifiable risk factors for dementia.
Factors that increase risk for dementia:
The main factors that increase risk for dementia involve cardiovascular health. The brain has very high energy needs and requires a constant supply of oxygen and energy to function normally, which are delivered via the blood stream. Poor vascular health causes problems with the energy supply to the brain and over time this can damage the brain.
The following are risk factors for cardiovascular disease, and should be avoided/treated to prevent cognitive problems:
- Type 2 diabetes
- Midlife hypertension
- Midlife obesity
- Smoking
- Physical inactivity
Factors that decrease risk for dementia:
The best way to reduce risk for dementia is to make lifestyle changes that prevent or reduce the health problems that increase dementia risk. Some lifestyle changes that can decrease your risk include:
Regular cardiovascular exercise
- Exercise is a powerful protective factor for brain health. Cardiovascular exercise involves any vigorous activity that increases heart rate and breathing. Research indicates 30 minutes of daily cardiovascular exercise is optimal for brain health.
- Examples include brisk walking, jogging, bicycling, swimming, stair climbing and circuit training.
- If you have trouble getting motivated for exercise, try making it more exciting! Consider joining a walking group, sports team or martial arts gym. Try out exercise classes at your local gym. Find friends to exercise with and help to motivate each other.
Mediterranean diet
Research has consistently found a Mediterranean-style diet to be associated with protection against dementia, as well as reductions in all-cause mortality and risk for heart disease. This diet emphasizes minimally processed foods from plant-based sources. Eat vegetables, fruits, whole (i.e., unrefined) grains, beans, nuts, seeds and olive oil every day. Throughout the week, in moderation, eat fish, poultry and dairy products. Once or twice a month, in small portions, eat red meat and sweets.
Other tips for eating Mediterranean:
- Avoid processed foods. Stick to foods with less than five ingredients in a package.
- Choose healthy fats, such as from nuts, olive oil and fish. Avoid butter.
- Try to have several vegetarian meals per week.
- Avoid refined carbohydrates, like white bread and pasta.
Engage your brain
- Regularly engaging in mentally stimulating activities is important for brain health. It is theorized that this helps to maintain your cognitive “reserve,” because it encourages the cells in your brain to make connections with many other cells. This protects the brain against decline.
- Jobs that are mentally stimulating help to protect brain health. If you are retired or are not working, try to find activities and hobbies that challenge your brain and make you think.
- Examples of cognitively stimulating activities include reading, playing an instrument, puzzles, word games, woodworking, and playing cards or board games.
What to do if you are concerned about your memory:
It is not always possible to prevent dementia. If you or a loved one notice possible signs of memory loss, early detection is key. You should reach out to your family medicine physician to discuss your concerns. There are some causes of cognitive decline that are reversible, particularly in the mild stages, and early treatment can sometimes prevent progression to dementia. In other cases, early treatment may help to slow progression.
Another important consideration is that untreated memory problems have the potential to cause worsening brain and physical health; for instance, a person with memory problems might accidentally take too much or too little of a medication, which can have various health complications. Early detection can help to ensure that the right supports are in place to prevent costly errors. Early detection can also allow for more time to make improvements in health and to plan for the future.
For more information about brain health, please visit TMH.ORG/Memory.
References:
Barnes, D. E., & Yaffe, K. (2011). The projected effect of risk factor reduction on Alzheimer's disease prevalence. The Lancet Neurology, 10(9), 819-828.
Alzheimer's Association. (2021). 2021 Alzheimer's disease facts and figures. Facts and figures.
Norton, S., Matthews, F. E., Barnes, D. E., Yaffe, K., & Brayne, C. (2014). Potential for primary prevention of Alzheimer's disease: an analysis of population-based data. The Lancet Neurology, 13(8), 788-794.
Kivipelto, M., & Mangialasche, F. (2014). To what extent can Alzheimer disease be prevented? Nature Reviews Neurology, 10(10), 552-553.
