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Key points
- Dementia affects over 55 million people globally, with women making up two-thirds of cases.
- Modifiable lifestyle factors may drive the majority of global dementia cases.
- Prevention is the most powerful strategy against dementia.
Dementia is a word that strikes fear in the hearts of many. The thought of losing cognitive function, of forgetting loved ones and cherished memories is simply terrifying. Dementia isn’t just a general health issue; it’s a deeply personal one. I’ve personally lost two family members to Alzheimer’s, and I can tell you firsthand that dementia affects not only those who suffer from it but also their families and communities.
Despite the widespread prevalence of dementia, many continue to believe there’s little we can do to prevent it. This belief is not only disheartening but also misleading. Recent research suggests that many cases of dementia, particularly Alzheimer’s disease, may be preventable. Here’s why dementia is such an issue, and six of the most powerful steps you can take to counter dementia today.
The Scale of the Dementia Problem
Dementia is not a single disease but rather an umbrella term encompassing various conditions characterized by a decline in cognitive function. The most powerful risk factor for dementia is age. If you live to age 85, you have a 1 in 3 chance of having dementia. Alzheimer’s disease is the most common form, affecting more than 55 million people globally, with two-thirds of these cases being women. Other forms include vascular dementia, Lewy body dementia, and frontotemporal dementia. Each type has its own distinct characteristics, but they all lead to a devastating decline in brain function.
In the United States alone, nearly 7 million people are living with Alzheimer’s disease, and this number is rapidly increasing. Globally, 10 million new cases of dementia are diagnosed each year. While some disease numbers have dramatically improved in the last century, especially those related to infectious diseases, the number of people dying from Alzheimer’s has skyrocketed by almost 150 percent in the past 20 years. Clearly, we are not winning the battle against dementia, and the narrative needs to change.
What Causes Dementia?
It’s true that there is a genetic component to many forms of dementia. For example, individuals carrying two copies of the APOE4 gene are at a substantially higher risk (10 to 15 times) of developing Alzheimer’s disease. However, genetics is only part of the story, and importantly, inheritance of genes that directly cause Alzheimer’s is deemed to be a very small contributor to total Alzheimer’s cases (only 1 to 5 percent). Conversely, research published by the Lancet Commission reports that 12 modifiable lifestyle factors account for 40 percent of total global dementia cases. Some research is even more pronounced, showing that people who ate healthy food, exercised regularly, had light to moderate alcohol intake, and didn’t smoke were 60 percent less likely to develop Alzheimer’s than those who didn’t. This data suggests that about half of our risk for developing dementia is within our control.
The biological underpinnings of dementia are varied and complex. Chronic inflammation, metabolic issues, and vascular dysfunction are all believed to be significant contributors. These processes may be driven by a wide range of factors. For example, sleep apnea, alterations in the gut microbiome, changes in the oral microbiome, infections like herpes simplex, poor diet, lack of exercise, low-quality sleep, stress, and air pollution seem to act on these pathways. Additionally, poor hearing and sight may increase risk for dementia, as may the use of certain medications.
At a molecular level, buildup of certain proteins is implicated in the development of dementia. Beta-amyloid proteins and tangles of tau proteins are found in Alzheimer’s, while Lewy body clusters are a buildup of alpha-synuclein protein seen in Lewy body dementia. These proteins (specifically amyloid) have been the target of new monoclonal antibody drugs like donanemab and lecanemab in hopes of improving dementia outcomes in Alzheimer’s disease.
Why Is Dementia So Often Ignored?
Despite its prevalence, dementia is often ignored until it’s too late. Many people live in denial, refusing to believe that they might develop dementia. This denial is partly due to fear—fear of losing independence, of becoming a burden to loved ones, and of the emotional and financial toll that dementia takes. Beyond this, it’s all too easy in our consumerism and quick-fix-driven world to be distracted at the expense of caring for brain health. Here’s what you absolutely need to know: If you’re worried about dementia, the most powerful strategy for dementia is prevention, and the time to start is now.
How Can We Prevent Dementia?
The good news is that we can significantly reduce our risk of dementia by making healthier lifestyle choices. Prevention is our most powerful tool, and it’s something we can all start working on today.
1. Diet: One of the most effective ways to protect your brain is through diet. The Mediterranean diet and the MIND diet, which is a combination of the Mediterranean and DASH diets, have been shown to lower the risk of dementia. These diets emphasize the consumption of whole, minimally processed foods, including a variety of fruits and vegetables, nuts, seeds, and healthy fats like olive oil. They also limit red meat, added sugars, unhealthy oils, and excessive alcohol. By choosing to eat a diet rich in nutrients and low in harmful substances, you’re giving your brain the fuel it needs to stay healthy.
2. Exercise: Regular physical activity is crucial for brain health. Exercise helps maintain blood flow to the brain, reduces inflammation, and may even reverse some of the brain changes associated with dementia. Whether it’s walking, swimming, lifting weights, or practicing yoga, any form of daily movement is beneficial. The key is consistency—making exercise a regular part of your routine can have profound effects on your cognitive health.
3. Sleep: Sleep is essential for brain function. Poor sleep quality or sleep disorders like sleep apnea can significantly increase the risk of dementia. Ensuring you get enough restful sleep each night is vital for maintaining brain health. A host of easy-to-implement techniques can quickly improve your sleep quality (for example, avoiding caffeine in the afternoon and minimizing blue light at night). If you’re having a lot of trouble sleeping, it may be worth undergoing a sleep study to identify any underlying issues.
4. Stress Reduction: Chronic stress is harmful to the brain. Finding ways to manage stress, whether through meditation, yoga, or simply spending time with loved ones, can help protect your cognitive health. It’s important to find stress-reduction techniques that work for you and to incorporate them into your daily life.
5. Avoid Harmful Substances and Head Trauma: Avoiding smoking, minimizing alcohol consumption, and reducing exposure to air pollution are all important steps in protecting your brain. Additionally, taking precautions to prevent head trauma, such as wearing helmets when cycling and using seat belts in cars, can reduce the risk of dementia.
6. Social Connection: Humans are social creatures, and our brains thrive on connection with others. Staying socially active and maintaining strong relationships can help keep your brain healthy. Whether it’s joining a local group, attending cultural events, or simply keeping in touch with friends and family, fostering social connections is crucial for cognitive health.
The Future of Dementia Research
While lifestyle changes are crucial, ongoing research and clinical trials are also playing a significant role in our understanding of dementia. Some of the most exciting work being done today involves interventional trials that aim to slow, stop, or even reverse cognitive decline in individuals with dementia.
One promising area of research involves multifactorial interventions—approaches that address multiple aspects of health simultaneously. For example, recent studies have shown that combining dietary changes, exercise, stress management, and medical interventions can lead to significant improvements in cognitive function in individuals with mild cognitive impairment or early-stage Alzheimer’s disease. These findings are incredibly encouraging and suggest that a comprehensive approach to brain health can make a real difference.
Beyond this, several recent studies have looked at the role of targeted antibodies for dementia. While the research has shown some promise, high rates of side effects and incredibly high prices remain a major challenge here.
Conclusion
Dementia is a complex and challenging condition, but it’s not an inevitable part of aging. By making informed lifestyle choices and staying proactive about our brain health, we can significantly reduce our risk of developing dementia. The best available treatment for dementia is prevention, and it’s something we can all start working on today.
At the end of the day, brain health matters because it’s how we connect with others, maintain our independence, and live fulfilling lives. The research is clear: We have the power to shape our brain’s future.
