Dear Dr. James,
My mother has dementia. My sister and I are in our 60s, and we want to do everything we can to avoid going down this road as we age. What steps can we take to prevent Alzheimer’s disease and dementia?
Becky Brown Mayhue
Rogers, Arkansas
Dr. James Prescribes
Let me start with some good news: The majority of people with a family history of Alzheimer’s won’t develop the disease.
Genetics play the strongest role in early-onset Alzheimer’s, which only affects 1% to 2% of the population, and that form of the disease generally appears before age 65. The greatest risk factor for the more common form of the disease, late-onset Alzheimer’s, is not family history; it’s aging.
In other words, the chances that you or your sister develop Alzheimer’s are probably only slightly higher than for the general population. Still, with roughly 1 in 3 adults 85 or older affected, it’s wise to think about prevention.
A comprehensive 2020 report by the Lancet Commission identified 12 risk factors that appear to increase a person’s odds of developing dementia. Many of these are things we maintain at least some control over even into the later years of our lives.
Controlling blood pressure, staying physically active and limiting alcohol consumption all appear to help lower dementia risk. So do maintaining a healthy weight, treating any hearing loss, and, if you are a smoker, quitting. Finally, studies have shown that maintaining social interaction and treating any depression or diabetes you might be experiencing may also be beneficial in preventing or delaying age-related cognitive decline.
A wide-ranging 2017 study from the National Academies of Medicine arrived at similar conclusions. It found “encouraging but inconclusive” evidence for three behavioral changes that may slow or prevent Alzheimer’s or other age-related dementia: physical activity, blood pressure control and cognitive training. More limited studies this year have also pointed to the potentially brain-protective effects of lowering stress in one’s life and eating a plant-based diet.
None of this is definitive. We still have miles to go before we fully understand what causes Alzheimer’s and other forms of age-related cognitive decline.
Nevertheless, if you follow the best clues we currently have, we’d all do well to embrace the common-sensical approaches scientists believe help limit our dementia risk. That means staying physically, intellectually and socially active, controlling our weight and blood pressure, and managing medical conditions like diabetes, depression and hearing loss. It also means not smoking and limiting the amount we drink.
At worst, these measures will simply contribute to a healthier existence, extending our lives and diminishing our chances of disability and myriad illnesses. At best, they’ll also protect our brains as we age.
Dr. Judith James, a physician-scientist, is OMRF’s executive vice president and chief medical officer. Submit your health questions at omrf.org/AskDrJames.
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