Dementia isn’t just part of old age. Nearly half of cases can be avoided

NOBODY wants to develop dementia and for good reason: it’s the most feared condition among people over 50, according to surveys. Yet most people assume there’s little they can do to protect themselves.

The update from the Lancet Commission comes as welcome proof to the contrary: you CAN, in many cases, stop dementia before it happens. These findings make it clear that each one of us can reduce our risk of dementia. And it’s never too early to start. Much of the experts’ analysis of the available evidence points to mid-life – between the ages of 45 and 64 – as the crucial time to get healthy. From this point onwards, the effects of a poor lifestyle build up. And, as we all know, prevention is usually a much better option than attempts to cure, particularly as there is precious little to offer dementia patients at present.

So, according to the world’s leading experts, what are the risk factors you need to know about? And, crucially, what does the evidence say you need to do about them?

GET TO KNOW YOUR BLOOD PRESSURE

A STUDY of people from 12 highincome countries published last year shows Ireland has one of the highest rates of high blood pressure.

The condition puts those sufferers at risk of a heart attack, stroke and, we now know, dementia.

High blood pressure, which causes few, if any, symptoms, gradually damages the tiny blood vessels which supply the brain. If it is already high in midlife, research shows your risk of dementia increases by 60%.

But studies show that reducing your readings by changing your lifestyle, or taking medication, slashes your risk by a third.

Get your blood pressure checked regularly or invest in your own inexpensive home monitoring kit.

PROTECT YOURSELF FROM TYPE 2 DIABETES

AN estimated 200,000 people have diabetes in Ireland. But type 2 diabetes, which commonly occurs after age 40 and is caused by excess body fat, is closely linked to dementia.

A major study that analysed research involving 2.3million people found having diabetes makes you 60% more likely to develop any form of the brain disease. And the longer you have type 2 diabetes – and the worse it gets – the higher your risk becomes.

Lose weight, however, and you can put your type 2 diabetes into remission. It’s unclear whether this can reverse your dementia risk, too, but the most sensible option is to stick to a healthy diet and avoid weight gain.

CARE FOR YOUR HEART TO SAVE YOUR BRAIN

ANY doctor will tell you that what’s good for your heart is also good for your brain. If the tiny vessels that supply blood to the brain are damaged by heart disease, it makes it harder for oxygen and nutrients to reach brain cells.

They stop being able to work properly, which leads to dementia. But protect your heart and you’ll be doing wonders for your dementia risk too.

This means eating a balanced diet, maintaining a healthy weight, taking regular exercise and keeping blood pressure, blood sugar and cholesterol low.

Research has found this not only keeps your heart healthy but will also protect your memory and thinking processes.

ENJOY A TIPPLE… BUT NOT TOO MANY

ONE of the new risk factors identified by the Lancet Commission was alcohol – but don’t pour that nice bottle of summer rosé down the sink just yet.

They discovered that regularly drinking above 21 units of alcohol a week – at least two bottles of wine – increases dementia risk by 17%.

However, the studies show that those who abstain totally have similar raised risk. Why this is the case isn’t totally clear, but teetotallers are also more likely to suffer from heart disease and diabetes – conditions that increase the risk of dementia.

I suspect they gave up drinking due to their health problems, and it’s those problems, rather than abstinence, that is increasing the risk. More research is needed, but the message seems to be that you can still enjoy a glass or two. Moderation is the key.

Over 65s who read and play games, reduce the risk of dementia by 30%

WHEN ON YOUR BIKE, WEAR A HELMET

AS THE lockdown eases, people who want to avoid using public transport are increasingly opting to cycle, if they can.

However, if you do get back on your bike, another persuasive argument for wearing a helmet is that a head injury – even of the mild type – puts you at greater risk of dementia in later life.

The effect builds up, so the more knocks you take, the worse your chances are.

Footballers who head the ball during training, for instance, are up to 80% more likely to get the disease – which is why young players are now banned from doing so.

Some injuries are, of course, from accidents and are clearly impossible to avoid.

But if you are riding your bike, motorcycle or horse, or taking part in contact sports such as boxing or rugby, it just makes sense to wear a helmet or other protective headgear.

AVOID TOXIC FUMES FROM BUSY ROADS

FROM traffic exhaust fumes to wood smoke, all forms of air pollution are linked to dementia.

Experts recommend that walking along major roads is to be studiously avoided, and that making a detour just a street or two back from them could make a huge difference.

Some cyclists and motorbike riders rely on anti-pollution masks. But unless they’re tightfitting, they won’t have a protective effect.

GET UP OFF THE SOFA AND BREAK A SWEAT

KEEPING fit is not just good for your heart, it can also protect you against dementia. And you’ll get the biggest benefits if you keep active in mid-life and beyond.

Studies show that moderate exercise just once a week – whether it’s a jog, exercise class or strenuous gardening – reduces the risk of dementia by 20%.

Even if you start a fitness regime later in life, you’ll still benefit.

HEAD DOWN FOR A GOOD NIGHT’S SLEEP

POOR sleep can stop the body clearing out the damaging proteins which lead to Alzheimer’s, according to research. Even disturbed sleep can lead to inflammation in the brain, which may ramp up production of the proteins. You should aim for more than five hours. But more than nine might carry its own health and fitness risks.

DUMP THE DOUGHNUTS AND LOSE SOME WEIGHT

NEARLY a quarter of Irish people are clinically obese, which means their body mass index (BMI) is over 30. And new evidence points to obesity being linked to a 30% increased risk of dementia.

While the research found that being overweight – with a BMI of between 25 and 29 – didn’t significantly affect dementia risk, some studies do find that losing weight could still have a benefit.

One major piece of research showed that, even at age 50, losing 2kg or more can improve attention span and memory.

CUT OUT CIGARETTES ONCE AND FOR ALL

I WAS delighted to see the news last month that millions of people all over the world have quit smoking during the pandemic. We know smoking is catastrophic for health, but it also creates a huge dementia risk – responsible for five% of all cases.

And it’s never too late to stop, studies show.

If you can quit for at least four years – even if you do it after the age of 60 – you substantially slash your risk of dementia over the next eight years.

If you’re not doing it for your own health, then do it for your family. Second-hand smoke, or passive smoking, is also associated with worsening memory.

DON’T IGNORE THE SIGNS OF DEPRESSION

BEING depressed is linked to dementia – sometimes up to 25 years later, studies show. But it’s not yet clear whether it’s an early symptom of dementia or that it directly affects the brain. Either way, taking antidepressants may protect you.

Some studies have found that they can reduce the build-up of toxic plaques that lead to Alzheimer’s disease, while others found that they could help delay the onset of dementia.

STAY IN TOUCH WITH FRIENDS... OR ENEMIES

HAVING a more active social life at the age of 60 reduces your risk of dementia, studies show. Being married also helps, as lifelong singletons, and those who are widowed, saw their risk increase.

Oddly, research has found it doesn’t seem to matter if you particularly like who you’re with, or whether the interaction was positive – just being around other humans protects your brain.

EAT WELL… WITH PLENTY OF FRESH VEG

EAT a healthy, balanced diet and it’s only going to do you good – it’ll also help you lose weight.

The World Health Organisation recommends a diet rich in fruit and vegetables, nuts, wholegrains, beans and olive oil to protect against dementia, while keeping meat and saturated fat to a minimum. Green leafy veg might be even more beneficial.

A study found those who ate the most had fewer problems with thinking and memory.

NEED A HEARING AID? GET ONE AND WEAR IT!

HEARING declines naturally with age, but those who suffer the worst hearing loss are far more likely to get dementia. In fact, significant hearing loss increases an individuals’ risk of developing the disease by 90%.

According to studies, parts of the brain associated with memory shrink if we can’t hear. But those who wear hearing aids are less likely to develop the condition, or suffer age-related memory loss.

Even people with dementia who wear aids deteriorate less rapidly, too – further proof it’s never too late to take action.

KEEP THE BRAIN ACTIVE – USE IT OR LOSE IT

EDUCATION when young, while the brain is still developing, is crucial to reduce dementia risk. But in adulthood, the old saying ‘use it or lose it’ rings to an even greater extent.

Studies have shown later retirement and working in jobs which are more mentally demanding are linked with fewer cases of dementia. One found those over 65 who read and played games frequently reduced their risk by 30%.

Activities such as travelling, learning an instrument like the piano, exercising and speaking a second language are also linked to maintaining brain function for longer as they help to open up neural pathways in the brain.