HEALTH: Risk factors for dementia

BY DR. JASON BAINS

 Fraser Health

 

Mom is forgetting everything these days. Sometimes it seems like she can’t remember my name. How did this happen?”

 

MEMORY loss in a patient with dementia can be unsettling and difficult to accept for the patient and their loved ones. As outlined in the first article in this series, dementia is not a normal part of the aging process, and it can lead to many issues with memory, mood, and daily function that are not expected to occur simply because of old age. Generally, dementia is caused by progressive changes in the brain. Fortunately, there are actions we can take to decrease our risk of these changes.

Although age is the biggest risk factor for Alzheimer’s disease, which is seen mainly in people over 65 years of age and in every third or fourth person over the age of 85 years old, researchers have found that the changes in the brain start about 20 to 25 years before symptoms appear. There are numerous risk factors which, if not carefully controlled in middle age (40s to 50s), make dementia more likely to occur in a person’s later years.

It is very important to understand these risk factors and limit them over your lifetime to help lower your risk of developing dementia. They are outlined below along with healthy goals to minimize your risk.

 

Diabetes

Uncontrolled Type 2 diabetes makes a patient twice as likely to develop dementia.

Goal: Keep blood sugar well controlled, with Hemoglobin A1c less than 7%.

In persons 75 or older, Hemoglobin A1c less than 8% is reasonable.

 

Blood Pressure

High blood pressure puts strain on the arteries and blood circulation to the brain. This increases the chance of developing dementia.

Goal: Aim for blood pressure less than 140/90, or if diabetic, less than 130/80. Low salt intake and regular exercise can help achieve this, along with medications as advised by your doctor.

 

Cholesterol

High cholesterol levels also affect the circulation to the brain.

Goal: Keep total cholesterol under 5.2 mmol/L. Keep HDL (“good cholesterol”) above 1 mmol/L, but ideally above 1.5 mmol/L. LDL (“bad cholesterol”) should be kept as low as possible, depending on the other conditions you may have. Ideal level of LDL would be below 2 mmol/L.

 

Obesity

Obesity, especially in middle age, increases risk of dementia.

Goal: Men should aim for a waist circumference below 102 cm, and women below 88 cm. Ask your doctor to measure your Body Mass Index (BMI). Keeping BMI under 25 is ideal.

 

Physical Inactivity

A sedentary lifestyle increases risk of many serious illnesses, including dementia.

Goal: Aim for at least 30 minutes of strenuous physical activity per day, at least four days per week. Brisk walking is adequate for older adults.

 

Alcohol

Excessive alcohol use harms brain cells and increases the risk of dementia.

Goal: Keep alcohol use to occasionally at most. Avoid daily consumption and binge drinking (more than two drinks on one occasion).

 

Smoking

Smoking increases the risk of several types of dementia.

Goal:  Quit smoking. It is never too late, as risk for many conditions will decrease with every smoke-free day after quitting, even if you have smoked for many years.

 

Depression and Social Isolation

Research shows a link between lack of socialization and depression, and developing dementia. Many patients with early dementia also have depression.

Goal: Speak to your doctor openly about changes in mood as early as possible and get treatment. Socialize with friends often.

 

Poor Hearing

New research shows that reduced hearing can actually lead to the brain becoming smaller. The brain thrives on continued input from all your senses.

Goal: See your doctor as early as possible if you notice any hearing difficulty.

 

Cognitive Inactivity / Low Levels of Education

Research has shown a link between more education and lower dementia risk. This suggests that keeping the brain active and stimulated is protective against dementia.

Goal: Treat the brain like a muscle that needs exercise. Read often, and continue to try to learn new things. Engage in active conversation and brain stimulating activities.

 

Head Injuries

Severe or repeated head injuries, such as those occurring in contact sports or high speed outdoor activities like skiing or biking, can lead to brain changes that may be linked with dementia.

Goal: Always wear a helmet for dangerous activities. Play safely.

 

Generally keeping happy, social and proactive about your health can help decrease your chances of suffering the challenging effects of dementia in your later years. HE

It is important to speak to your doctor if you suspect dementia in yourself or a loved one. To learn more, contact Baljeet Judge at the South Asian Dementia Helpline at 604-449-5003.

 

Please watch for future articles in this series that will explore other topics related to dementia.

SHARE