Dementia prevention

Dementia is serious and currently incurable. It is therefore worth trying to minimise the risk of getting a dementia disorder. Read more about known risk factors for dementia.

Here you can read about the risk factors scientists are aware of and what you can do to prevent dementia. This article contains information about:

• Prevention and delaying dementia
• Physical health
• Mental health
• Medicine
• Diet
• Lifestyle
• Environment

Prevention and delaying dementia

The prevention of dementia has two tracks. One is to reduce the risk of developing dementia, and the other is to delay when you become ill – if you become ill.

You cannot completely eliminate the risk of developing a dementia disorder. However, for the individual, delaying when the disorder appears can be very important, because they will have more good years of life.

More information: How long can you live with dementia?

Researchers have discovered that it is possible to reduce the risk of dementia for the population as a whole, if efforts are focused on these areas:

• Smoking
  Heavy smokers in particular have an increased risk of getting a dementia disorder.
• Hypertension
  Middle-aged people with high blood pressure are at great risk of getting a dementia disorder later in life.
• Diabetes
  The risk of getting a dementia disorder increases for people who have type 2 diabetes or poorly regulated type 1 diabetes.
• Education and brain activity
  The well-educated and those who keep their brains active and engaged have a lesser risk of developing dementia.

The research is carried out on large groups, so it is unfortunately not possible to conclude that you will not get dementia if you stop smoking or have never smoked. For the population as a whole, stopping smoking leads to fewer cases of dementia overall.

Physical health

What is good for the heart is good for the brain. Numerous scientific studies and population studies have demonstrated that there is a correlation between risk factors for cardiovascular disease and risk factors for vascular dementia and Alzheimer’s disease.

The studies suggest that:

• High blood pressure in middle age increases the risk of developing dementia, in particular vascular dementia.
• Diabetes late in life – and probably also in middle age – can be connected with an increased risk of developing different forms of dementia, in particular vascular dementia.
• Overweight and obesity in middle age increases the risk of dementia. On the other hand, overweight and obesity late in life may give some protection against dementia disorders.
• It is possible to delay the development of dementia – especially Alzheimer’s disease – by between 5 and 15 years by reducing blood pressure, cholesterol and BMI. BMI is a calculation that shows whether one’s weight in relation to one’s height is within the normal range.
• Low BMI late in life is associated with a higher risk of dementia.
• The metabolic syndrome may possibly increase the risk of vascular dementia, but not Alzheimer’s disease or dementia in general. The metabolic syndrome is a collection of factors that increase the risk of atherosclerosis: diabetes, fatness on the stomach, increased blood pressure and the level of dangerous cholesterol in the blood.
• Accidents and falls that cause brain damage increase the risk of men (but not women) developing a dementia disorder later in life.

Mental health

The more you use your brain, the stronger it becomes. Although being well-educated does not in itself offer a guarantee against getting a dementia disorder, dementia is slightly less common among people with an extensive educational background. For each year of additional education compared to the average in Denmark (12.7 school years for women and 12.4 years for men), you counteract the effect of approximately four years of aging.

When you retire, you lose some of your brain capacity if you do not maintain mental and social activity levels. Researchers estimate that you lose around 10% of your brainpower when you stop working. Fortunately, it is never too late to learn something new and keep the brain occupied. Social activities and being together with other people also help to stimulate the brain. Courses, new languages and volunteering – preferably in the company of others – help keep the brain strong.

Researchers have also investigated whether there is any correlation between psychiatric disorders and the risk of developing dementia. Research has focused on the disorders of depression, anxiety, stress and certain personality traits.

Depression

If you have had one or more depressions, you have an increased risk of developing Alzheimer’s disease later in life. Scientists do not yet know how depression and dementia are linked. Depression is possibly an early symptom or sign of dementia. However, depression can also be a risk factor that is not directly correlated with dementia, but which affects the brain which then subsequently develops dementia.

Anxiety

Research into the correlation between anxiety and dementia has yielded contradictory results so far. However, there is a single, very strong study that has found a clear correlation between anxiety symptoms and the risk of developing dementia.

Personality

People who are psychologically vulnerable are at greater risk of developing dementia. On the other hand, it appears that the personality traits of conscientiousness, openness and kindness lead to a lower risk of getting a dementia disorder.

Stress and PTSD

The results from several population studies suggest that there is a correlation between stress and an increased risk of dementia. Studies of American veterans have also shown it is probable that posttraumatic stress (PTSD) increases the risk of dementia. However, scientists do not yet know precisely how PTSD and the risk of dementia are linked.

Medicine

Certain types of medicine may increase the risk of developing a dementia disorder.
For example, long-term use of medications that block the effect of the neurotransmitter (acetylcholine) used by the nerve cells when communicating, may give a heightened risk of developing a dementia disorder.

Researchers have discovered that these drugs also give an increased risk of getting dementia:

• Prolonged treatment with anticholinergic drugs, for example a certain type of medicine against an overactive bladder
• Antihistamines with a dulling effect, for example, the type taken to alleviate the symptoms of allergy, hay fever and coughs
• Antihistamines against motion sickness and insomnia
• A certain type of antidepressant (tricyclic antidepressants)
• Long-term treatment with benzodiazepines
• Hormone therapy for older women (over 65) is associated with a slightly increased risk of dementia.

Researchers have also been able to clear a number of medicines. At present, it does not appear that these medicines and treatments increase the risk of developing dementia:

• Treatment with hormonal supplements around the menopause.
• Short-term treatment with benzodiazepines (up to three months).

There is a large group of medicines that scientists suspect increase the risk of dementia. These are:

• Cholesterol-lowering medicines (the so-called statins).
• Medicines to lower blood pressure.
• Anti-inflammatory drugs and painkillers (NSAIDs).

However, the results of the studies are contradictory, so it is not yet possible to say with certainty whether the three types of medicines have an effect on the risk of developing dementia.

Diet

Your diet also affects your risk of getting dementia. Following a so-called Mediterranean diet reduces the risk of getting a dementia disorder. A Mediterranean diet has a high content of vegetables, legumes, olive oil, fish and shellfish. Vitamins from green, leafy vegetables combined with the healthy fats from fish and olive oil and the like are good for the brain and heart.

Conversely, a diet that is rich in saturated fats and trans-fatty acids gives an increased risk of dementia. There are saturated fats or trans-fatty acids in foods such as butter, cheese, fatty meat and certain oils when heated. On the other hand, single and polyunsaturated fatty acids – including omega 3 fatty acids – may reduce the risk of getting a dementia disorder. Single and polyunsaturated fatty acids are found in, among other things, rapeseed oil, nuts and fish oil.

A lack of vitamin B and D is also associated with an increased risk of developing dementia. There is no reason to take vitamins if you get enough B- and D vitamin from your diet and sunlight. Vitamin pills do not provide better protection against dementia.

Ginkgo Biloba may have a good effect on people with dementia. Some studies have shown it is probable that you can live longer with milder symptoms if you take Ginkgo Biloba. However, it does not appear that Ginkgo Biloba has any preventative effect.

Lifestyle

Lifestyle has an enormous impact on your risk of developing dementia. The three lifestyle factors – smoking, alcohol and physical activity – are what affect your risk of developing dementia. Lifestyle is particularly interesting in terms of prevention, because you can do something about it. Unfortunately, you cannot be certain of avoiding a dementia disease, but you can reduce the risk.

The three risk factors affect the risk of getting dementia in this way:

• Smoking
  If you smoke, you have a 30% higher risk of developing dementia compared to non-smokers.
• Alcohol
  A limited consumption of alcohol gives a 46% reduced risk of developing dementia.
  On the other hand, a high level of alcohol consumption increases the risk because the alcohol harms the brain.
  A moderate consumption is a maximum of seven units per week for women and 14 units for men.

• Physical activity
  Researchers presume that physical activity influences the risk of developing dementia. It is known that exercise reduces the risk of cardiovascular disease and other diseases that may increase the risk of getting dementia. However, researchers have not yet been able to say anything with absolute certainty about the relationship between physical activity and the risk of developing dementia.

The three lifestyle factors are interconnected. Unfortunately, it is not possible to say that the risk from smoking can be cancelled out by being physically active.

Environment

Population studies have shown that air pollution increases the risk of developing dementia. The risk of developing dementia is also greater if you live close to high-voltage power lines, if there is a high level of aluminium in your drinking water, or if you are exposed to certain chemicals at your work.

Researchers have made several attempts to study how pesticides, metals and organic solvents affect the risk of developing dementia later in life. However, thus far with conflicting or unclear results. Although it is certain that using a mobile phone does not increase the risk of getting a dementia disease.