Dementia - reducing your risk

Research shows that people who adopt a ‘brain-healthy’ lifestyle have a reduced risk of dementia in later life. This is particularly important once you reach middle age, because that is when changes in the brain start to occur. In fact, the changes that cause dementia may begin decades before symptoms appear.

This means it is important to look after your brain throughout your life. It is never too late, or too early, to live a brain-healthy lifestyle, as brain function can be improved at any age. Some risk factors cannot be controlled, so it is important to do what you can with the things you can, such as your lifestyle and habits. Understanding the risk factors can help you make decisions about strategies to reduce your risk.

Risk factors you cannot control#

• Age. The risk of dementia increases with age. As a rough guide, around one in 30 people aged 70 to 74 are estimated to have dementia, increasing to about one in eight of those aged 80 to 84, and around one in three of those aged 90 to 94.
• Genetics. The genetics of dementia is not fully understood, but some forms involve inherited genes, including familial Alzheimer’s disease and familial frontotemporal dementia.

Risk factors you can control#

Brain and social factors:

• Mental activity. Regularly challenging your brain with mentally stimulating activities — through education, occupation or leisure — is linked with a lower risk of decline in memory and thinking skills, and of dementia.
• Social activity. Taking part in social activities and staying connected with your community and friends is linked with a lower risk of dementia.

Body and heart factors:

• Physical activity. Regular exercise is associated with better brain function and a reduced risk of cognitive decline.
• Alcohol. Drinking too much can damage your brain and increase the risk of dementia.
• Body weight. Obesity in midlife is associated with an increased risk of cognitive impairment and dementia.
• Cholesterol. A history of high cholesterol is associated with an increased risk of dementia.
• Diabetes. Type 2 diabetes in midlife and later is associated with an increased risk of cognitive impairment and dementia.
• Smoking. Smoking is a risk factor for dementia, and some studies suggest a history of passive smoking may also increase the risk.

The good news is that effective long-term treatment of these conditions can help reduce dementia risk.

Exercise your brain#

Any activity that involves thinking and learning can improve your brain health and help protect against dementia. Evidence suggests greater benefit comes from more complex and challenging mental activities. The more brain activities you do, the more often you do them, and the more complex they are, the lower your risk is likely to be.

The best activities are those you enjoy — boredom and frustration are not good for your brain. Ideas include:

• hobbies such as painting, woodwork, sewing or writing
• doing a short course
• jigsaw, crossword, number or word puzzles
• learning to dance, play an instrument or speak a new language
• going to the theater, movies, a museum, gallery or a concert

Stay socially engaged#

Regular, enjoyable interactions with friends, family and others may help reduce your risk of dementia. Some suggestions:

• volunteering with a local group or favorite charity
• walking with friends or family
• joining a group such as a book club or walking group
• organizing games nights with friends
• taking dancing or singing lessons (dancing is also good exercise and helps your brain and body learn new moves)
• traveling with others, which often involves plenty of walking and activity
• catching up with friends and talking to your neighbors

Avoid excess alcohol#

Long-term excessive alcohol consumption can cause brain damage and lead to a condition called alcohol-related dementia. It may also increase the risk of Alzheimer’s disease and other dementias. If you drink, do so in moderation and stay within recommended limits — every drink above a low-risk level increases your lifetime risk of a number of conditions, including dementia.

Some evidence suggests that drinking in moderation might lower the risk of dementia slightly more than not drinking at all, but more research is needed. Alcohol can also increase health risks for people with certain conditions or who take certain medications. Your doctor can advise how much alcohol is safe for you, help you cut down if you are drinking too much, and refer you to specialist help if needed.

Enjoy a brain-healthy diet#

Research suggests that foods that are good for your heart and body may also be good for brain health and help protect against dementia. Based on current evidence, nutritionists generally recommend that you:

• eat a variety of foods, including fruits and vegetables, to ensure adequate nutrient intake
• reduce saturated fats by choosing fish, lean red meat, skinless chicken and reduced-fat dairy products
• limit butter, deep-fried foods, pastries, cakes and biscuits
• choose unsaturated fats such as olive, canola, sunflower and safflower oils
• include foods rich in omega-3 fats, such as soy, canola and flaxseed oils, and fish

Stay physically active#

People who are physically active have a lower risk of heart disease and stroke, both of which are associated with an increased risk of dementia. Research suggests that even small amounts of exercise — including simple activity like walking — are good for brain health.

Any physical activity you can build into your daily routine will help. A common recommendation is at least 30 minutes of moderate-intensity activity on most, preferably all, days of the week. For general fitness, the most useful types of activity are aerobic training, resistance or weight training, and flexibility exercises. Examples include brisk walking, cycling, dancing, aerobics, yoga, swimming, rowing, golf, gardening or even washing the car.

The type and amount of exercise you can do depends on your age, physical capability, fitness and any medical conditions, so get advice from your doctor on the best program for you. If you have been inactive, start slowly and build up gradually as you get fitter. Try to make movement an opportunity rather than an inconvenience, be active with a friend or family member, and choose activities you enjoy.

Look after your heart#

People with high blood pressure, high cholesterol or diabetes, or who are obese — particularly around middle age — have a greater risk of developing dementia later in life. Left untreated, these conditions can damage blood vessels in the brain, which in turn damages brain cells and impairs thinking.

There are no guarantees that keeping your heart healthy will prevent dementia, but it gives you the best chance of avoiding or delaying it. Studies show that treating high blood pressure reduces the risk, and other research suggests treating high cholesterol and diabetes may also help, though more research is needed.

It is recommended that you have regular check-ups to monitor:

• Blood pressure — effective long-term treatment can reduce dementia risk, so all adults, especially from middle age, should have it checked regularly.
• Body weight — aim to maintain a healthy weight, as obesity in midlife raises the risk.
• Cholesterol — even mildly elevated cholesterol is linked with increased risk, so keep it within a healthy range.
• Blood sugar — high blood sugar can indicate type 2 diabetes, which increases dementia risk.
• Smoking — if you smoke, try to quit, and avoid other people’s smoke.

Protect your head#

Head injury, particularly severe injury that causes unconsciousness for an extended time, is a risk factor for Alzheimer’s disease. Reduce your risk by taking care as a pedestrian, wearing seat belts in cars, and using protective headgear when cycling or doing other high-risk activities.

Key Points#

• People who adopt a brain-healthy lifestyle have a reduced risk of dementia in later life.
• Changes in the brain that cause dementia may start decades before symptoms appear.
• It is important to look after your brain throughout your life.
• Do what you can with the things you can control, such as lifestyle and habits.
• Risk factors fall into those you cannot control (age, genetics) and those you can (mental and social activity, alcohol, diet, exercise and heart health).

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).